Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Oct 2013
Safety and effectiveness of endovascular treatment after 6 hours of symptom onset in patients with anterior circulation ischemic stroke: a matched case control study.
Endovascular treatment within 6 hours of symptom onset appears to be beneficial in carefully selected patients with ischemic stroke. It is unclear whether endovascular treatment beyond 6 hours of symptom onset is safe and efficacious. ⋯ We did not observe any evidence of benefit in halting neurologic worsening or improving outcomes among patients undergoing endovascular treatment for treatment of an anterior circulation ischemic stroke after 6 hours of symptom onset. Strong evidence of both the safety and efficacy of emergent endovascular treatment when administered to patients with stroke in the anterior circulation is needed.
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J Stroke Cerebrovasc Dis · Oct 2013
Cerebral hemodynamic changes at basilar artery in obstructive sleep apnea syndrome after continuous positive airway pressure treatment.
Cerebral vasoreactivity in obstructive sleep apnea syndrome is altered. Continuous positive airway pressure is effective in the reduction of the occurrence of apneas. We studied whether this treatment also improves cerebral vasoreactivity. ⋯ Cerebral vasoreactivity as measured by the apnea test improves after 2 years of continuous positive airway pressure. This improvement depends of the body mass index of the patient.
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J Stroke Cerebrovasc Dis · Oct 2013
Association of physical activity with the visuospatial/executive functions of the montreal cognitive assessment in patients with vascular cognitive impairment.
The Montreal Cognitive Assessment (MoCA) is more suitable than the Mini-Mental State Examination (MMSE) for the detection of vascular cognitive impairment. In this study, we performed a correlation analysis of MoCA/MMSE scores with daily physical activity in patients with subcortical ischemic white matter changes. ⋯ These results suggest that MoCA is useful to detect a biologically determined specific relationship between physical activity and executive function. In addition, physical exercise, such as walking, may help enhance cognitive function in patients with vascular cognitive impairment of subcortical origin.
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J Stroke Cerebrovasc Dis · Oct 2013
Melatonin receptor agonists for treating delirium in elderly patients with acute stroke.
Delirium is considered to worsen life prognosis in elderly patients with stroke. We examined the effects of the melatonin receptor agonist ramelteon for treating delirium in elderly stroke patients with insomnia in comparison to the other drugs. ⋯ Melatonin receptor agonists may be effective for the treatment of delirium in elderly patients with acute stroke.
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J Stroke Cerebrovasc Dis · Oct 2013
Comparative StudyAccuracy of computed tomographic angiography compared to digital subtraction angiography in the diagnosis of intracranial stenosis and its impact on clinical decision-making.
Few studies to date have examined the accuracy of computed tomographic angiography (CTA) compared to digital subtraction angiography (DSA) in diagnosing intracranial stenosis. The purpose of this study was to compare CTA to DSA in diagnosing intracranial stenosis and to explore the impact of the addition of DSA on the management of stroke patients. ⋯ CTA has a high sensitivity and specificity compared to DSA to diagnose intracranial stenosis. The addition of DSA to CTA may not affect clinical management in most patients with suspected stenosis.