Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Dec 2016
Comparative StudyEmbolic Stroke of Undetermined Source and Detection of Atrial Fibrillation on Follow-Up: How Much Causality Is There?
There is increasing debate whether atrial fibrillation (AF) episodes during follow-up in patients with embolic stroke of undetermined source (ESUS) are causally associated with the event. AF-related strokes are more severe than strokes of other etiologies. In this context, we aimed to compare stroke severity between ESUS patients diagnosed with AF during follow-up and those who were not. We hypothesized that, if AF episodes detected during follow-up are indeed causally associated with the index event, stroke severity in the AF group should be higher than the non-AF group. ⋯ Stroke severity is similar between ESUS patients who were diagnosed with AF during follow-up and those who were not. Given that AF-related strokes are more severe than strokes of other etiologies, this finding challenges the assumption that the association between ESUS and AF detected during follow-up is as frequently causal as regarded.
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J Stroke Cerebrovasc Dis · Dec 2016
Intracerebral Hemorrhage Outcomes in Patients with Systemic Cancer.
Single-center studies suggest that patients with cancer have similar outcomes after intracerebral hemorrhage (ICH) compared to patients without cancer. However, these studies were limited by small sample sizes and high rates of intratumoral hemorrhage. Our hypothesis was that systemic cancer patients without brain involvement fare worse after ICH than patients without cancer. ⋯ Patients with systemic cancer have higher mortality and less favorable discharge outcomes after ICH than patients without cancer. Cancer subtype may influence outcomes after ICH.
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J Stroke Cerebrovasc Dis · Nov 2016
Predictors of Occult Atrial Fibrillation in One Hundred Seventy-One Patients with Cryptogenic Transient Ischemic Attack and Minor Stroke.
Recent randomized studies have shown the potential of prolonged cardiac rhythm monitoring to detect silent paroxysmal atrial fibrillation (PAF) in patients with cryptogenic stroke. Our aim was to identify clinical and magnetic resonance imaging (MRI) factors that predict the detection of PAF during long-duration rhythm cardiac Holter (LDRCH) monitoring. ⋯ LDRCH is a noninvasive and inexpensive test with a high rate of AF detection in patients with cryptogenic stroke or transient ischemic attack. Occult PAF was more commonly diagnosed in older patients with premature atrial complex on the baseline electrocardiogram, left ventricular hypertrophy on echocardiography, and with previous white matter lesions on brain MRI.
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J Stroke Cerebrovasc Dis · Nov 2016
Comparative StudyFocal Neurological Deficit at Onset of Aneurysmal Subarachnoid Hemorrhage: Frequency and Causes.
Focal neurological deficit (FND) is a recognized presenting symptom of aneurysmal subarachnoid hemorrhage (SAH). However, little is known on how often aneurysmal SAH patients present with FND and what the responsible mechanisms are. The aim of this study was to examine the frequency and causes of FND at onset in aneurysmal SAH. ⋯ One in every 10 aneurysmal SAH patients presents with FND. FND at presentation has diverse mechanisms, is not associated with a specific aneurysm location, and is independently associated with poor outcome.
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J Stroke Cerebrovasc Dis · Oct 2016
Intravenous Thrombolysis and Passes of Thrombectomy as Predictors for Endovascular Revascularization in Ischemic Stroke.
Patient selection for endovascular revascularization treatment (ERT) in acute ischemic stroke depends on the expected benefit-risk ratio. As rapid revascularization is a major determinant of good functional outcome, we aimed to identify its predictors after ERT. ⋯ ivT and lower passes of thrombectomy are associated with recanalization after ERT for ischemic stroke with proximal vessel occlusions.