Cerebrovascular diseases
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Cerebrovascular diseases · Jan 2009
High resolution wall and lumen MRI of the middle cerebral arteries at 3 tesla.
Although black-blood MRI (BB-MRI) can identify plaques in the cervical carotid arteries, this modality has not been applied in intracranial arteries. We imaged the lumina and walls of stenotic middle cerebral arteries (MCAs) in symptomatic and asymptomatic patients using high-resolution BB-MRI, in order to characterize vulnerable plaques and to determine the diagnostic accuracy of BB-MRI in MCA stenosis. ⋯ High-resolution, multicontrast-weighted BB-MRI has the potential to characterize atherosclerotic plaques in the MCA and may be a useful modality for evaluating the degree of stenosis.
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Cerebrovascular diseases · Jan 2009
Poststroke depression: prevalence and determinants in Brazilian stroke patients.
Poststroke depression (PSD) is one of the most important long-term adverse psychosocial consequences in stroke survivors. Our objective was to assess the prevalence of PSD in Brazilian stroke patients and identify significant associated factors. ⋯ PSD was highly prevalent in the chronic phase of stroke. Early detection and recognition of associated risk factors is important to treat and prevent PSD in a rehabilitation setting.
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Cerebrovascular diseases · Jan 2009
Validation of the National Institutes of Health Stroke Scale, modified Rankin Scale and Barthel Index in Brazil: the role of cultural adaptation and structured interviewing.
We aimed to validate three widely used scales in stroke research in a multiethnic Brazilian population. ⋯ The NIHSS, BI and mRS show good validity when translated and culturally adapted. Using a structured interview for the mRS improves interobserver concordance rates.
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Cerebrovascular diseases · Jan 2009
Fiberoptic endoscopic Dysphagia severity scale predicts outcome after acute stroke.
Fiberoptic endoscopic evaluation of swallowing (FEES) is a suitable method for dysphagia assessment after acute stroke. Recently, we developed the fiberoptic endoscopic dysphagia severity scale (FEDSS) for acute stroke patients, grading dysphagia into 6 severity codes (1 to 6; 1 being best). The purpose of this study was to investigate the impact of the FEDSS as a predictor of outcomes at 3 months and intermediate complications during acute treatment. ⋯ The FEDSS strongly and independently predicts outcome and intercurrent complications after acute stroke. Thus, a baseline FEES examination provides valuable prognostic information for the treatment of acute stroke patients.
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Cerebrovascular diseases · Jan 2009
Relevance of stroke code, stroke unit and stroke networks in organization of acute stroke care--the Madrid acute stroke care program.
Stroke is a neurological emergency. The early administration of specific treatment improves the prognosis of the patients. Emergency care systems with early warning for the hospital regarding patients who are candidates for this treatment (stroke code) increases the number of patients treated. ⋯ The neurologist has the function of coordinating the protocols of intrahospital care. These organizational plans should also take into account the process beyond the acute phase, to ensure the appropriate application of measures of secondary prevention, rehabilitation, and chronic care of the patients that remain in a dependent state. We describe here the stroke care program in the Community of Madrid (Spain).