Stroke; a journal of cerebral circulation
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To date, no validated, comprehensive, and practicable model exists to predict functional recovery within the first hours of cerebral ischemic symptoms. The purpose of this study was to externally validate 2 prognostic models predicting functional outcome and survival at 100 days within the first 6 hours after onset of acute cerebral ischemia. ⋯ The resulting prognostic models are useful to correctly stratify treatment groups in clinical trials and should guide inclusion criteria in clinical trials, which in turn increases the power to detect clinically relevant differences.
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Transcranial Doppler (TCD) monitoring for asymptomatic cerebral emboli is currently limited to short recordings by equipment size, restricting its clinical usefulness. We have developed a first ambulatory TCD system, evaluated it in at-risk patient groups, and used it to study the pattern of embolization in patients with symptomatic carotid stenosis. ⋯ We have developed the first ambulatory TCD system. Good-quality recordings of > or =5 hours can be obtained. In view of the demonstrated temporal variability in embolization, this technique is likely to improve the predictive value of recording for asymptomatic embolic signals and may be particularly useful in patients in whom embolic signals are relatively infrequent, such as those with asymptomatic carotid stenosis and atrial fibrillation.
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Multicenter Study Clinical Trial
Improving the predictive accuracy of recanalization on stroke outcome in patients treated with tissue plasminogen activator.
Although early recanalization is a powerful predictor of stroke outcome after thrombolysis, some stroke patients remain disabled despite tissue plasminogen activator (tPA)-induced recanalization. Therefore, we sought to investigate whether the predictive accuracy of early recanalization on stroke outcome is improved when combined with clinical and radiological information. ⋯ The combination of clinical, radiological, and hemodynamic information predicts with a high accuracy long-term stroke outcome during or shortly after intravenous tPA administration.
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Clinical Trial
Detection of reversed basilar flow with power-motion Doppler after acute occlusion predicts favorable outcome.
Power-motion transcranial Doppler PMD-TCD is a new method for simultaneous display of flow at multiple depths. We aimed to determine clinical significance of PMD-TCD demonstration of reversed basilar flow in patients with basilar artery (BA) occlusion. ⋯ Detection of reversed flow in the distal BA with PMD-TCD is associated with lower stroke severity and better outcome after acute basilar artery occlusion.