Stroke; a journal of cerebral circulation
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Leukoaraiosis (LA) predominantly affects the subcortical white matter, but mounting evidence suggests an association with cortical microvascular dysfunction and potentially decreased cortical ischemic tolerance. Thus, we sought to assess whether preexisting LA is predictive of the cortical infarct volume after middle cerebral artery branch occlusion and whether it relates to a worse outcome. ⋯ The presence of severe, subcortical LA contributes to larger cortical infarct volumes and worse functional outcomes adding to the notion that the brain is negatively affected beyond LA's macroscopic boundaries.
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Patients with stroke are more likely to have impaired autonomic nervous function and abnormal circadian blood pressure (BP) patterns. It remains unclear whether circadian BP patterns in patients with transient ischemic attack or minor stroke (National Institutes of Health Stroke Scale ≤3) differ from those in the normal population. ⋯ In contrast to previous findings among patients with acute stroke, patients with transient ischemic attack or minor stroke had similar BP patterns and autonomic nervous system function, when compared with controls.
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Randomized Controlled Trial
Mild hypothermia after intravenous thrombolysis in patients with acute stroke: a randomized controlled trial.
Hypothermia improves outcome in resuscitated patients and newborns with hypoxic brain injury. We studied the safety and feasibility of mild hypothermia in awake patients with stroke after intravenous thrombolysis. ⋯ http://www.clinicaltrials.gov. Unique identifier: NCT00987922.
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Review Meta Analysis
Detection of atrial fibrillation after ischemic stroke or transient ischemic attack: a systematic review and meta-analysis.
Atrial fibrillation (AF) confers a high risk of recurrent stroke, although detection methods and definitions of paroxysmal AF during screening vary. We therefore undertook a systematic review and meta-analysis to determine the frequency of newly detected AF using noninvasive or invasive cardiac monitoring after ischemic stroke or transient ischemic attack. ⋯ Detection of AF was highly variable, and the review was limited by small sample sizes and marked heterogeneity. Further studies are required to inform patient selection, optimal timing, methods, and duration of monitoring for detection of AF/paroxysmal AF.
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Randomized Controlled Trial
Alberta Stroke Program early computed tomography score to select patients for endovascular treatment: Interventional Management of Stroke (IMS)-III Trial.
The Interventional Management of Stroke (IMS)-III trial randomized patients with acute ischemic stroke to intravenous tissue-type plasminogen activator (tPA) plus endovascular therapy versus intravenous tPA therapy alone within 3 hours from symptom onset. A predefined secondary hypothesis was that subjects with significant early ischemic change on the baseline scan would not respond to endovascular therapy. ⋯ http://www.clinicaltrials.gov. Unique identifier: NCT00359424.