Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Jan 2017
Case ReportsAcute Cerebral Artery Occlusion by a Calcified Embolus with False Patency Sign on Computed Tomographic Angiography.
Computed tomographic angiography (CTA) is a quick and accurate method in triage to determine recanalization therapies for acute ischemic stroke. To minimize delay in the start of recanalization therapies, performance of CTA immediately after unenhanced brain computed tomography (CT) is recommended as the minimum standard. However, there are some pitfalls related to image interpretation of CTA in acute stroke, such as false patency sign. ⋯ We misinterpreted the CTA image as a patent MCA, and unnecessary brain magnetic resonance imaging caused delay in the start of endovascular thrombectomy. Our findings suggest that calcified cerebral emboli can present with false patency sign on CTA. To avoid misinterpretation of the CTA image and start recanalization therapy as soon as possible, physicians should be aware of false patency sign, especially when unenhanced CT shows hyperdense emboli and CTA findings do not correspond with patients' symptoms in acute ischemic stroke.
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J Stroke Cerebrovasc Dis · Jan 2017
Predictive Value of Modifications of the Prehospital Rapid Arterial Occlusion Evaluation Scale for Large Vessel Occlusion in Patients with Acute Stroke.
Prehospital clinical scales to identify patients with acute stroke with a large vessel occlusion (LVO) and direct them to an endovascular-capable stroke center are needed. We evaluated whether simplification of the Rapid Arterial oCclusion Evaluation (RACE) scale, a 5-item scale previously validated in the field, could maintain its high performance to identify patients with LVO. ⋯ We recommend the original RACE scale for prehospital assessment of patients with suspected stroke for its ease of use and its high performance to predict the presence of a LVO. The use of simplified versions would reduce its predictive value.
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J Stroke Cerebrovasc Dis · Jan 2017
Observational StudyUnattended Hospital and Home Sleep Apnea Testing Following Cerebrovascular Events.
Home sleep apnea testing (HSAT) is an alternative to polysomnography for the detection of obstructive sleep apnea (OSA). We assessed the feasibility of HSAT as an unattended screening tool for patients with a stroke or transient ischemic attack (TIA). ⋯ Unattended HSAT can be feasibly implemented after stroke or TIA. This method facilitates rapid diagnosis and management of OSA in both the outpatient and inpatient settings.
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J Stroke Cerebrovasc Dis · Dec 2016
Randomized Controlled Trial Comparative StudyContralesional Cathodal versus Dual Transcranial Direct Current Stimulation for Decreasing Upper Limb Spasticity in Chronic Stroke Individuals: A Clinical and Neurophysiological Study.
Different transcranial direct current stimulation (tDCS) paradigms have been implemented to treat poststroke spasticity, but discordant results have been reported. ⋯ Cathodal tDCS is slightly more effective than dual tDCS in reducing distal UL spasticity in chronic poststroke subjects. A modulation of spinal inhibitory mechanisms, demonstrated by H-reflex modifications, supports this finding.
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J Stroke Cerebrovasc Dis · Dec 2016
Association of Rare Nonsynonymous Variants in PKD1 and PKD2 with Familial Intracranial Aneurysms in a Japanese Population.
Autosomal dominant polycystic kidney disease (ADPKD) caused by deleterious mutations in PKD1 (16p13.3) and PKD2 (4q21) often coexists with intracranial aneurysms (IAs). In this study, we investigated whether IAs without obvious renal diseases were also associated with these ADPKD genes. ⋯ ADPKD genes are susceptibility genes for IA even in patients without ADPKD.