Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Jun 2019
Case ReportsTranscranial Optical Monitoring of Cerebral Hemodynamics in Acute Stroke Patients during Mechanical Thrombectomy.
Mechanical thrombectomy is revolutionizing treatment of acute stroke due to large vessel occlusion (LVO). Unfortunately, use of the modified Thrombolysis in Cerebral Infarction score (mTICI) to characterize recanalization of the cerebral vasculature does not address microvascular perfusion of the distal parenchyma, nor provide more than a vascular "snapshot." Thus, little is known about tissue-level hemodynamic consequences of LVO recanalization. Diffuse correlation spectroscopy (DCS) and diffuse optical spectroscopy (DOS) are promising methods for continuous, noninvasive, contrast-free transcranial monitoring of cerebral microvasculature. ⋯ The monitoring instrument identified a recanalization-induced increase in ipsilateral cerebral blood flow (CBF) with little or no concurrent change in contralateral CBF and extracerebral blood flow. The results suggest that diffuse optical monitoring is sensitive to intracerebral hemodynamics in patients with ICA occlusion and can measure microvascular responses to mechanical thrombectomy.
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J Stroke Cerebrovasc Dis · May 2019
Multicenter Study Comparative Study Observational StudyOutcomes for Patients With In-Hospital Stroke: A Multicenter Study From the Australian Stroke Clinical Registry (AuSCR).
The quality of care and outcomes for people who experience stroke whilst in hospital for another condition has not been previously studied in Australia. ⋯ The benefits of SU care may extend to patients experiencing in-hospital stroke. Validation, including accounting for potential residual confounding factors, is required.
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J Stroke Cerebrovasc Dis · May 2019
Randomized Controlled TrialProgressive Respiratory Muscle Training for Improving Trunk Stability in Chronic Stroke Survivors: A Pilot Randomized Controlled Trial.
Stroke weakens the respiratory muscles, which in turn may influence the trunk stability; it is unclear whether the progressive respiratory muscle training (RMT) is effective in improving the trunk stability. The aim of this study was to investigate the effects of progressive RMT with trunk stabilization exercise (TSE) on respiratory muscles thickness, respiratory muscle functions, and trunk stability in chronic stroke survivors. ⋯ RMT combined with TSE can be suggested as an effective method to improve the respiratory muscle thickness, respiratory muscle functions, and trunk stability in chronic stroke survivors as opposed to TSE only.
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J Stroke Cerebrovasc Dis · May 2019
Self-Reported Body Weight Changes, Perceptions, and Weight Loss Techniques among Stroke Survivors.
Little is known about the body weight goals and trends of stroke survivors, despite evidence that overweight and obesity can negatively influence poststroke rehabilitation outcomes. Thus, the purpose of this study was to identify self-reported body weight trends over time in stroke survivors and nonstroke controls (>50 years old) and describe the methods used to attempt to achieve body weight goals. ⋯ Future research is needed to identify optimal body weight and ways to incorporate preferred methods of lifestyle modification, including diet and exercise, to promote weight management in stroke survivors.
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J Stroke Cerebrovasc Dis · Apr 2019
Comparative StudyA Clinical Paradigm for Classifying Neurologic Symptoms to Screen for Emergent Large Vessel Occlusions.
With newly-extended treatment windows for endovascular therapy in emergent large vessel occlusions, it is increasingly important to identify thrombectomy-eligible patients without overwhelming resources dedicated to acute stroke care. We devised a simple paradigm to classify patient's presenting neurologic symptoms to screen for large vessel occlusions. ⋯ Patients who presented as stroke alerts without focal neurologic symptoms were unlikely to have large vessel occlusions. With high sensitivity, classifying patients' neurologic exams into focal objective versus subjective or nonfocal categories may serve as a useful tool to screen for large vessel occlusions and prevent unnecessary emergent workup in patients unlikely to be endovascular candidates.