Результаты поиска

The decline of stroke.

Stroke mortality in the United States has declined since 1900. The mortality rates from stroke in Rochester, Minnesota, have declined 76% since 1950, and the primary cause for the declines is a decrease in the incidence of new cases of cerebral infarction and cerebral hemorrhage. There are no data on the incidence of stroke prior to 1945 to confirm the US mortality trend. The decline in incidence was noted in women 10-15 years before it was seen in men. Hypertension is the most important risk factor for stroke. Hypertension surveys have shown an increasing effectiveness of antihypertensive med…

The pupil in stroke.

Pupil sizes were assessed in 100 patients admitted to an intensive care stroke unit over a 1-year period to determine if differences existed and if anisocoria might help in diagnosis. From life-size photographs the pupil diameters were measured accurately, and clinical information compiled by the neurology staff was studied. Of the 19 patients with anisocoria 13 had a final diagnosis of stroke. This incidence of anisocoria, 16%, is similar to that in a normal population (20%). The side of the mydriasis was unrelated to the site of the lesions except when the stroke was due to a brainstem infar…

Stroke in neonates.

Five neonates with large cerebral infarctions of arterial origin are presented. Four had severe focal seizures on the first day of life. The fifth, a premature infant, was asymptomatic. The diagnoses were made by computed tomography (CT) scans between 5 and 12 days of life; CT scans obtained in the first few days of life were normal. In the fifth infant, the infarct was hemorrhagic and was also noted by cranial ultrasound. Three of the infants had a history of trauma to the head or neck during labor and birth. Only one was severely asphyxiated at birth. Two apparently are doing well at 1 year

Lacunar strokes.

Arterial hypertension causes the formation of small lacunes, or ischemic brain infarcts, which may result in transient ischemic attacks, hemiparesis, sensory loss, ataxic hemiparesis, or dysarthria. Usually these effects are reversible with physical therapy, but multiple lesions may lead to dementia. Prevention of lacunar disease is possible with vigorous control of hypertension.

Strokes in children.

Nine cases have been presented in detail to illustrate some of the varied causes of sudden neurological deficit in childhood: arteriovenous … agnosed first as multiple sclerosis then as a thalamic tumor. The many possible causes of childhood strokes has been thoroughly cataloged in the Report of the Joint Committee for Stroke Facilities in 1973 (11). Children may be more susceptible to strokes because of congenital abnormalities such as congenital heart disease, hemophilia, and sickle cell ane …

The neuropathology of stroke.

Vascular-circulatory derangements affecting the function of the central nervous system may result in parenchymal lesions that are hemorrhagic, ischemic, or mixed. Most nontraumatic intraparenchymal brain hemorrhages are found in asssociation with cerebral arteriolar sclerosis and other stigmata of hypertensive disease, such as hypertrophy of the left cardiac ventricle and granular kidneys. Global temporary ischemia, the type that exists during severe and transient hypotension, results in a wide variety of parenchymal lesions that may be bilateral, hypotension, results in a wide variety of pare

Variability in Stroke Journeys: A Qualitative Study of Experiences of Persons With Stroke.

BACKGROUND: Stroke recovery is highly individual and often involves multiple transitions across healthcare settings. While standardised stroke pathways aim to improve quality of care, less is known about how persons with stroke experience person-centred practice throughout their stroke journeys. AIM: To explore how persons with stroke experience person-centred practice throughout their stroke journeys. METHODS: A qualitative study was conducted with persons who had experienced stroke in Norway. Data were collected through twelve semi-structured interviews and one written response. Reflexive …

Exosomes in stroke management: A promising paradigm shift in stroke therapy.

Effective treatment methods for stroke, a common cerebrovascular disease with a high mortality rate, are still being sought. Exosome therapy, a form of acellular therapy, has demonstrated promising efficacy in various diseases in animal models; however, there is currently insufficient evidence to guide the clinical application of exosome in patients with stroke. This article reviews the progress of exosome applications in stroke treatment. It aims to elucidate the significant potential value of exosomes in stroke therapy and provide a reference for their clinical translation. At present, many …

Prevalence and Determinants of Prehospital Impression of Stroke in Ischemic Stroke Patients.

BACKGROUND: Emergency Medical Services (EMS) clinicians are front-line in evaluating patients with stroke in the community. Their ability to correctly identify stroke influences downstream management decisions. We sought to use a large national database of prehospital clinical data to determine risk factors associated with missed EMS stroke identification. METHODS: Retrospective study examining EMS evaluation of adults with Emergency Department (ED) stroke diagnosis. We leveraged the ESO Data Collaborative research dataset containing EHR data from 2019-2022 that has a subset of encounters wit…

A Stroke of Luck: Central Diabetes Insipidus Unmasked by a Heat Stroke.

Diabetes insipidus is a rarely encountered cause of hypernatremia, often presenting a diagnostic and therapeutic dilemma for the encountering physician. Patients are often asymptomatic for a number of years due to compensation of their polyuria with polydipsia, but may have dramatic presentations in situations where they lose access to hydration. Our case is of a 62-year-old woman who was found unconscious with signs and symptoms of a heat stroke, and later was found to have resistant hypernatremia that persisted despite extensive free water supplementation. She had dilute polyuria throughout …

Treatment of post-stroke aphasia: A narrative review for stroke neurologists.

This review is intended to help physicians guide patients to optimal management of post-stroke aphasia. We review literature on post-stroke aphasia treatment, focusing on: (1) when and for whom language therapy is most effective, (2) the variety of approaches that can be effective for different individuals, and (3) the extent to which behavioral therapy might be augmented by non-invasive brain stimulation and/or medications.

Инфекция как фактор риска и детерминант результата после разрушения.

Понимание взаимосвязи между инфекцией и инсультом приобрело новую актуальность в эпоху пандемии коронавируса 2019 года (COVID-19). Эта ассоциация не является новой концепцией, поскольку уже давно признано, что несколько инфекций способствуют опасности инсульта. Связь между инфекцией и инсультом также носит двунаправленный характер. Хотя инфекция может привести к инсульту, инсульт также вызывает иммунное подавление, что повышает риск инфицирования. Помимо их краткосрочных последствий, появляющиеся данные свидетельствуют о том, что посттрактные иммунные изменения могут также негативно сказыватьс

Совпадение в аннотации оригинала
Understanding the relationship between infection and stroke has taken on new urgency in the era of the coronavirus disease 2019 (COVID-19) pandemic. This association is not a new concept, as several infections have long been recognized to contribute to stroke risk. The association of infection and stroke is also bidirectional. Although infection can lead to …

Copeptin Levels in Patients With Acute Ischemic Stroke and Stroke Mimics.

BACKGROUND AND PURPOSE: Copeptin levels are increased in patients diagnosed with stroke and other vascular diseases. Copeptin elevation is associated with adverse outcome, predicts re-events in patients with transient ischemic attack and is used in ruling-out acute myocardial infarction. We evaluated whether copeptin can also be used as a diagnostic marker in the prehospital stroke setting. METHODS: We prospectively examined patients with suspected stroke on the Stroke Emergency Mobile-an ambulance that is equipped with computed tomography and point-of-care laboratory. A blood sample was take…

Trends in the treatment of risk factors for stroke in a Czech stroke unit.

The goal of this study is to evaluate therapeutic trends for several diseases that represent risk factors for stroke. The relative frequency of therapy with compounds that influence the risk factors for stroke was monitored in a group of 3,290 patients who were hospitalised in the Stroke Unit at the University Hospital in Hradec Kralove between 2005 and 2012. For most drugs monitored, the reasons for the significant decrease or increase in use were causes other than the reduction of stroke risk. Despite this finding, the majority of statistically significant changes had, according to review of…

Insulin resistance and the risk of stroke and stroke subtypes in the nondiabetic elderly.

Insulin resistance, which plays a key role in the development of diabetes mellitus, is a putative modifiable risk factor for stroke. The aim of this study was to investigate if markers of insulin resistance were associated with risk of stroke in the general elderly population. This study was part of the large population-based Rotterdam Study and included 5,234 participants who were aged 55 years or older and stroke free and diabetes free at baseline (1997-2001). Fasting insulin levels and homeostasis model assessment for insulin resistance were used as markers for insulin resistance. Cox regre…

Stroke location and brain function in an embolic rabbit stroke model.

PURPOSE: Current rabbit stroke models often depend on symptoms as endpoints for embolization and produce wide variation in location, size, and severity of strokes. In a further refinement of an angiographic embolic stroke model, localized infarctions were correlated to neurologic deficits with the goal to create a rabbit model for long-term studies of therapies after stroke. MATERIALS AND METHODS: New Zealand White rabbits (4-5 kg; N = 71) had selective internal carotid artery (ICA) angiography and a single clot was injected. At 24 hours, neurologic assessment score (NAS) was measured on an 1…

Raloxifene and risk for stroke based on the framingham stroke risk score.

PURPOSE: Raloxifene reduces vertebral fracture and invasive breast cancer risks, but increases fatal strokes in postmenopausal women at increased coronary risk. We assessed whether this risk is concentrated in postmenopausal women already at high stroke risk. METHODS: Raloxifene Use for The Heart (RUTH) enrolled 10,101 postmenopausal women (mean age 67 years) with or at increased coronary heart disease risk; Multiple Outcomes of Raloxifene Evaluation (MORE) enrolled 7705 osteoporotic postmenopausal women (mean age 66 years). A Framingham Stroke Risk Score (FSRS) was calculated for all women w…