Cerebrovascular diseases
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Cerebrovascular diseases · Jan 2010
Site of ruptured intracranial saccular aneurysms in patients in Izumo City, Japan.
A community-based study was conducted to estimate the site distribution of ruptured intracranial aneurysms and to evaluate clinical features related to aneurysm site. ⋯ The roughly estimated proportions of the sites of aneurysm rupture were 40% for the ACA, including ACoA and distal ACA, 25% for the ICA, 25% for the MCA, and 10% for the VBA. The clinical features showed significant differences according to aneurysm site.
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Cerebrovascular diseases · Jan 2010
EEG power spectrum to predict prognosis after hemicraniectomy for space-occupying middle cerebral artery infarction.
Early prediction of outcome after decompressive surgery for space-occupying middle cerebral artery (MCA) infarction is needed to guide further therapy. Here we applied spectral EEG analysis to determine the prognosis early after hemicraniectomy, while the patient is still treated in the intensive care unit. ⋯ Spectral analysis in the subacute phase following hemicraniectomy may represent a parameter to predict early regain of consciousness and thus the capability and potential for further rehabilitation and favorable outcome.
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Cerebrovascular diseases · Jan 2010
Review Comparative StudyRisk of aneurysm rupture at intracranial arterial bifurcations.
Aneurysms on the posterior circulation, most commonly located at the basilar top, have a higher risk of rupture than aneurysms on the anterior circulation. If hemodynamic shear stress, which has its maximum impact at the distal carina of bifurcations, explains the higher rupture rate of basilar top aneurysms, aneurysms at the top of the carotid artery should have similar rupture rates given their geometrical similarities. ⋯ Aneurysms are less frequently located on the carotid than on the basilar artery bifurcation. The proportion of ruptured carotid aneurysms is smaller than that of unruptured carotid aneurysms, suggesting a lower rupture risk for aneurysms at the carotid artery bifurcation. The anatomical geometry of the bifurcations and concomitant hemodynamic stress are considered an unlikely explanation for the higher risk of posterior circulation aneurysms.
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Cerebrovascular diseases · Jan 2010
The modified Rankin Scale in acute stroke has good inter-rater-reliability but questionable validity.
The modified Rankin Scale (mRS), designed as a measure of disability in the community, has increasingly been administered in the acute stroke setting but has been poorly studied within the hospital environment. We prospectively studied the interrater reliability of the mRS in acutely hospitalised stroke patients and examined the effect of prior experience with the scale and use of a decision tool on the interrater agreement of trained raters. ⋯ Trained raters were found to have good interrater agreement overall when the mRS was scored in acute stroke patients but obvious problems with the interpretation and relevancy of the scale in this setting raise concerns about validity. The use of the mRS to rate disability in the acute hospital environment should be questioned.
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Cerebrovascular diseases · Jan 2010
Comparative StudyDetection of paroxysmal atrial fibrillation in acute stroke patients.
Atrial fibrillation (AF) is a frequent cause of stroke, but detecting paroxysmal AF (pAF) poses a challenge. We investigated whether continuous bedside ECG monitoring in a stroke unit detects pAF more sensitively than 24-hour Holter ECG, and tested whether examining RR interval dynamics on short-term ECG recordings using an automated screening algorithm (ASA) for pAF detection is a useful tool to predict the risk of pAF outside periods of manifest AF. ⋯ Continuous bedside ECG monitoring is more sensitive than 24-hour Holter ECG for pAF detection in acute stroke/TIA patients. Screening patients for pAF outside AF episodes using ASA requires further development.