Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Jul 2015
Blood Pressure Variability and Clinical Outcome in Patients with Acute Intracerebral Hemorrhage.
The aim of this study was to evaluate whether fluctuations of blood pressure (BP) levels occurring in the acute stage of spontaneous intracerebral hemorrhage (ICH) affect the 3-month clinical outcome. ⋯ In patients with acute ICH, BPV was a strong predictor of the 3-month clinical outcome and may represent a still neglected potential therapeutic target.
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J Stroke Cerebrovasc Dis · Jul 2015
Systemic Inflammatory Response Syndrome Predicts Severity of Stroke and Outcome.
This study was undertaken to evaluate the frequency of systemic inflammatory response syndrome (SIRS) at admission and its correlation with clinical and radiological severity of stroke and outcome. ⋯ SIRS at presentation is a useful marker for clinicoradiological severity of stroke but not an independent marker of death and disability.
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J Stroke Cerebrovasc Dis · Jul 2015
Outcome of Intensive Care Unit-Dependent, Tracheotomized Patients with Cerebrovascular Diseases.
Outcome studies in intensive care unit -dependent, tracheotomized, and mechanical ventilated patients with cerebrovascular disease (CVD) are scarce. ⋯ This study shows that even severely affected, tracheotomized patients with CVD benefit from early in-patient rehabilitation, irrespective of the etiology of vascular brain injury. Mortality rates of early rehabilitation in CVD are low. Until no validated outcome predictors are available, all efforts should be undertaken to enable in-patient rehabilitation, even in severe cases of CVD to improve outcome and to prevent accommodation in long-time-care facilities.
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J Stroke Cerebrovasc Dis · Jun 2015
Circulatory and Respiratory Parameters during Acute Endovascular Stroke Therapy in Conscious Sedation or General Anesthesia.
Whether patients suffering from acute ischemic stroke and undergoing endovascular recanalization should be treated under general anesthesia (GA) or conscious sedation (CS) is a matter of debate. According to retrospective studies, GA appears to be associated with a worse outcome than CS. The underlying mechanisms are unknown, but hypotension and hypocapnia during GA have been suggested. There are no prospective data on this question. ⋯ In this small prospective study, patients under CS required less vasopressor medication and had a higher mean blood pressure than those under GA, but they also showed signs of hyperventilation. The impact of these physiological differences on outcome needs to be studied in randomized trials.
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J Stroke Cerebrovasc Dis · Jun 2015
Inter-rater Reliability and Misclassification of the ABCD(2) Score after Transient Ischemic Attack.
The ABCD(2) score was initially developed as a simple tool to help first-line clinicians identify patients at highest short-term risk for stroke after transient ischemic attack (TIA). The score is increasingly used for risk stratification of TIA patients, but little is known about its inter-rater reliability. The aim of the present study was to prospectively assess the inter-rater reliability of the ABCD(2) score in patients with TIA, including a comparison among raters of different specialties. ⋯ The inter-rater reliability of the ABCD(2) score is only fair, with rater disagreement of ABCD(2) risk category in nearly one third of patients.