Stroke; a journal of cerebral circulation
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Apolipoprotein E genotype (APOE) is associated with cholesterol metabolism, ischemic heart disease, and cerebral amyloid angiopathy, and so may affect risk of both ischemic and hemorrhagic stroke. ⋯ Publication and selection biases make existing studies of APOE and stroke unreliable. Further, very large, methodologically rigorous studies are needed.
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Randomized Controlled Trial
A randomized controlled trial of supervised versus unsupervised exercise programs for ambulatory stroke survivors.
Little is known about the relative efficacy of supervised versus unsupervised community exercise programs for stroke survivors. This study compared the effectiveness of a 10-week supervised strengthening and conditioning program (supervised) with a 1-week supervised instruction program followed by a 9-week unsupervised home program (unsupervised) and evaluated retention of changes at 6 months and 1 year after program completion. ⋯ Supervised exercise programs and unsupervised programs after initial supervised instruction were both associated with physical benefits that were retained for 1 year, although supervised programs showed trends to greater improvements in self-reported gains. Gender differences require further research.
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Delayed cerebral ischemia (DCI) is an important cause of death and disability after subarachnoid hemorrhage. We studied the additional prognostic value of brain perfusion to 3 established predictors (age, clinical condition on admission, and amount of subarachnoid blood) for the development of DCI. ⋯ The CBF ratio is an independent predictor for the development of DCI and can contribute to a better identification of patients at high risk for DCI.
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Patients with a history of subarachnoid hemorrhage (SAH) or familial intracranial aneurysms (FIA) are at increased risk for aneurysm formation and rupture. Small aneurysms detected at screening may be left untreated and followed over time. The yield of follow-up CT/MR angiography (CTA/MRA) 1 or 2 years after detection to evaluate growth of these aneurysms is unknown. ⋯ The yield of early follow-up of small aneurysms in patients with a history of SAH or FIA is small and does not eliminate the risk of rupture. Whether follow-up at intervals >1 year is useful requires further study.