Journal of the neurological sciences
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To date, pre-treatment with anti-platelet agents does not constitute a contraindication for thrombolysis in acute ischemic stroke. We tested the hypothesis that combined pre-treatment with aspirin and clopidogrel is a risk factor for thrombolysis-related symptomatic intracerebral hemorrhage (sICH). ⋯ In our retrospective study, only pre-treatment with aspirin and clopidogrel was associated with thrombolysis-related intracerebral hemorrhage. This finding should be further validated in large prospective databases like the SITS-MOST registry.
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To identify the main determinants of health-related quality of life (HRQoL) in Brazilian stroke survivors. ⋯ Post-stroke depression and disability are consistent determinants of HRQoL in Brazilian stroke patients.
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Perihematomal edema and secondary brain injury may influence the clinical course after intracerebral hemorrhage (ICH). The role of blood pressure (BP) in edema formation in ICH has not been studied sufficiently. We hypothesize that impaired blood pressure regulation (as measured by baroreflex sensitivity) leading to excessive BP fluctuations may enhance perilesional edema. The aims of our study were therefore to explore the effects of impaired baroreflex on edema in acute ICH and to evaluate the effects of perihematomal edema on early neurologic deterioration. ⋯ We found an independent association between decreased baroreflex sensitivity with increased blood pressure fluctuations and relative perihematomal edema in ICH. Moreover, independent effects of relative edema on early neurologic deterioration have been observed.
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Acetazolamide vasoreactive test measures the increment of cerebral blood flow caused by compensatory vasodilatation ability of cerebral vessels which can be detected by transcranial Doppler ultrasound (TCD). This study aimed to compare the vascular reactivity in patients with vascular dementia (VaD) and Alzheimer's disease (AD). ⋯ Acetazolamide vasoreactive test using TCD may be the additional criterion to differentiate VaD from AD. Further study with more number of subjects for the study or higher dose of acetazolamide may be needed to reveal the significant difference of vasoreactive response between VaD and AD patients.
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Non-linguistic cognitive impairments may limit rehabilitation efficacy in patients with aphasia. The aim of this study was to determine whether post-stroke aphasia was associated with impairments of visuo-spatial working memory and abstract thinking and whether these deficits adversely affected language recovery. ⋯ Even though the patients' non-linguistic cognitive abilities were impaired in general, the patients were heterogeneous with regard to their deficits. Linguistic and non-linguistic deficits appeared to be distinct, although they could be concurrent. Visuo-spatial working memory was associated with the degree of improvement in two functions crucial to language communication: naming and comprehension. No relationship was found between language therapy outcome and abstract thinking ability.