Cerebrovascular diseases
-
Cerebrovascular diseases · Jan 2011
Comparative StudyChanges in cerebral perfusion around the time of delayed cerebral ischemia in subarachnoid hemorrhage patients.
Because the pathogenesis of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) is unclear, we studied cerebral perfusion at different time points around the occurrence of DCI. ⋯ Our findings suggest that DCI patients already have diffusely worse perfusion (absolute values) than no-DCI patients before focal worsening (increased asymmetry) occurs and becomes symptomatic. The partial recovery in the measured areas suggests that DCI can be partly reversible.
-
Cerebrovascular diseases · Jan 2011
Ischemic stroke survivors' opinion regarding research utilizing exception from informed consent.
'Exception from informed consent for research' (EFIC) is a rigorous procedure regulated by the FDA that requires community assent but allows enrollment without patient or family consent. Recently, several acute stroke trials have explored the use of EFIC to improve enrollment. We obtained ischemic stroke survivors' opinions regarding hypothetical enrollment into a clinical trial at the time of their stroke without personal or proxy consent. ⋯ We found that the majority of interviewed ischemic stroke patients were agreeable to being enrolled in acute stroke research with exception from informed consent, although the rates of agreement were lower than we expected among a cohort of patients who had already agreed to research. Older subjects, black race, and women were less likely to agree to blood draws or treatment strategies.
-
Cerebrovascular diseases · Jan 2011
Comparative StudyConventional enhancement CT: a valuable tool for evaluating pial collateral flow in acute ischemic stroke.
To establish an easy and rapid method for evaluating pial collateral flow, we compared the Alberta Stroke Program Early CT Score (ASPECTS) on nonenhanced CT (NECT), conventional contrast-enhanced CT (CECT), and CT angiography source images (CTA-SI) in patients with acute ischemic stroke. ⋯ ASPECTS on CECT is a feasible method for predicting pial collateral flow and overall outcomes in acute ischemic stroke.
-
Cerebrovascular diseases · Jan 2011
Post-thrombolytic hyperglycemia and 3-month outcome in acute ischemic stroke.
Treating hyperglycemia in acute ischemic stroke may be beneficial, but knowledge on its prognostic value and optimal target glucose levels is scarce. We investigated the dynamics of glucose levels and the association of hyperglycemia with outcomes on admission and within 48 h after thrombolysis. ⋯ Hyperglycemia (≥8.0 mmol/l) during 48 h after intravenous thrombolysis of ischemic stroke is strongly associated with unfavorable outcome, sICH, and death.
-
Cerebrovascular diseases · Jan 2011
Score for the targeting of atrial fibrillation: a new approach to diagnosing paroxysmal atrial fibrillation.
Detecting paroxysmal atrial fibrillation (PAF) after ischaemic stroke is challenging. There are several methods to increase the detection rate of PAF, but it is first necessary to identify subgroups of patients at risk. In a previous study, we established a clinicoradiologic score that predicts atrial fibrillation (AF) in stroke patients. The purpose of the present study is to validate this score specifically for PAF patients. ⋯ Due to its reproducibility and predictive value, the STAF can be used by neurologists as part of a novel diagnostic strategy for occult AF.