Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Nov 2013
Multicenter StudyInterobserver reproducibility of signal intensity ratio on magnetic resonance angiography for hemodynamic impact of intracranial atherosclerosis.
Changes of signal intensities (SIs) across intracranial atherosclerosis (ICAS) on magnetic resonance angiography (MRA) may reflect hemodynamic impact of the lesion. We evaluated the interobserver reproducibility of an index termed signal intensity ratio (SIR), developed in a previous study to represent the changes of SIs across ICAS on MRA. ⋯ SIR was demonstrated to be highly reproducible between observers in the present study. Future studies are warranted to further explore the role of this index in comprehensive evaluation and risk stratification of symptomatic ICAS.
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J Stroke Cerebrovasc Dis · Nov 2013
Review Case ReportsRecurrent embolic strokes associated with vertical atlantoaxial subluxation in a patient with rheumatoid arthritis: a case report and review of literature.
We report a 78-year-old woman with rheumatoid arthritis who developed recurrent embolic cerebellar strokes associated with vertical atlantoaxial subluxation (AAS). On contrast angiography, the bilateral vertebral arteries (VAs) were occluded between the C1 and C2 levels, and the distal parts of bilateral VA were supplied by the collateral circulations. Dynamic cerebral angiography and carotid duplex ultrasonography showed that blood flow was substantially decreased in the left VA and left posterior inferior cerebellar artery on cervical anteflexion. It is suggested that vertical AAS reduced the blood flow of collateral circulation in the left VA with cervical anteflexion and might be a cause of recurrent ischemic stroke.
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Hypothyroidism is associated with increased ischemic stroke risk but paradoxically results in more favorable outcomes once a stroke occurs. Whether a similar pattern emerges in patients with primary intracerebral hemorrhage (ICH) is unknown. ⋯ This study suggests that the history of hypothyroidism does not affect clinical severity or outcome after ICH.
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J Stroke Cerebrovasc Dis · Nov 2013
Comparative StudyTrends in antihypertensive drug prescription patterns among ambulatory stroke patients in the United States, 2000-2009.
Although the ambulatory setting is recognized as the best arena for optimizing antihypertensive drug treatment after a stroke, little is known about recent office-based antihypertensive drug treatment patterns in the United States. We assessed national trends in antihypertensive treatment for stroke patients in office-based medical practice. ⋯ Over the last decade, there was a significant rise in the use of antihypertensive drugs and combination of agent classes for patients aged 40 years or older seen in an ambulatory setting with a diagnosis of stroke. PCPs were more likely than neurologists to prescribe these agents.
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J Stroke Cerebrovasc Dis · Nov 2013
Risk factors for poor outcome and mortality at 3 months after the ischemic stroke in patients with atrial fibrillation.
It has been shown that patients with atrial fibrillation have a poor prognosis in the early recovery phase after ischemic stroke (IS) or transient ischemic attack (TIA). The purpose of this study was to identify the risk factors associated with poor outcome, including mortality, 3 months after the onset of IS in patients with atrial fibrillation. ⋯ Age, gender, and NIHSS score were independently associated with poor outcome for IS or TIA patients with nonvalvular atrial fibrillation in the early recovery stage.