Percent Change on the National Institutes of Health Stroke Scale: A Useful Acute Stroke Outcome Measure

Abstract Background Many therapeutic interventions are performed by physiotherapists to improve upper extremity function and/or activities of daily living (ADL) in stroke patients. Mirror therapy (MT) is a simple technique that can be self-administered by the patients with intact cognition following patient education by a skilled physiotherapist. However, the effectiveness of self-administered MT in post-stroke patients in upper extremity function remains unclear. Therefore, the objective of this study is to examine the effectiveness of MT in improving upper extremity function and recovery in acute stroke patients. Methods This study is a single-center, prospective, randomized, open-label, controlled trial with blinded outcome evaluation (PROBE design), in which a total of 36 eligible acute stroke patients will be randomly assigned to control (n=18) and experimental group (n=18). Participants in the control group will receive regular rehabilitation interventions whereas participants in the experimental group will receive MT education in addition to their regular interventions for 4 weeks. Study outcome The primary outcome measure will be upper extremity function that will be measured using the Fugl-Meyer Assessment scale and the Wolf Motor Function Test. The secondary outcome measure will be behaviors related to ADL as estimated using the Modified Barthel Index. Outcome measures will be assessed at baseline and at 4 weeks post-rehabilitation intervention/MT. Results A two-way repeated analysis of variance (ANOVA) with time and group effects will be used to analyze between-group differences. The level of significance will be set at P < 0.05. Conclusion The results of the study will provide critical information to include self-administered MT as an adjuvant to regular interventions and may facilitate recovery of the upper extremity function of stroke patients. Trial registration ClinicalTrials.gov NCT04542772. Registered on 9 September 2020. Protocol version: Final 1.0.

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Utility of CT perfusion scanning in patient selection for acute stroke intervention: experience at University at Buffalo Neurosurgery–Millard Fillmore Gates Circle Hospital

Neurosurgical FOCUS ◽

10.3171/2011.2.focus1130 ◽

2011 ◽

Vol 30 (6) ◽

pp. E4 ◽

Cited By ~ 6

Author(s):

Peter T. Kan ◽

Kenneth V. Snyder ◽

Parham Yashar ◽

Adnan H. Siddiqui ◽

L. Nelson Hopkins ◽

...

Keyword(s):

Acute Stroke ◽

Patient Selection ◽

Ct Perfusion ◽

Brain Parenchyma ◽

National Institutes Of Health ◽

Time Interval ◽

Case Examples ◽

Flow Parameters ◽

Selection For ◽

The Brain

Computed tomography perfusion scanning generates physiological flow parameters of the brain parenchyma, allowing differentiation of ischemic penumbra and core infarct. Perfusion maps, along with the National Institutes of Health Stroke Scale score, are used as the bases for endovascular stroke intervention at the authors' institute, regardless of the time interval from stroke onset. With case examples, the authors illustrate their perfusion-based imaging guidelines in patient selection for endovascular treatment in the setting of acute stroke.

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Procedural Complications During Early Versus Late Endovascular Treatment in Acute Stroke

Stroke ◽

10.1161/strokeaha.120.031349 ◽

2021 ◽

Author(s):

Errikos Maslias ◽

Stefania Nannoni ◽

Federico Ricciardi ◽

Bruno Bartolini ◽

Davide Strambo ◽

...

Keyword(s):

Endovascular Treatment ◽

Acute Stroke ◽

Time Window ◽

National Institutes Of Health ◽

Late Time ◽

Short Term ◽

Term Outcome ◽

Stroke Registry ◽

Short Term Outcome ◽

Procedural Complications

Background and Purpose: Endovascular treatment (EVT) in acute ischemic stroke is effective in the late time window in selected patients. However, the frequency and clinical impact of procedural complications in the early versus late time window has received little attention. Methods: We retrospectively studied all acute ischemic strokes from 2015 to 2019 receiving EVT in the Acute Stroke Registry and Analysis of Lausanne. We compared the procedural EVT complications in the early (<6 hours) versus late (6–24 hours) window and correlated them with short-term clinical outcome. Results: Among 695 acute ischemic strokes receiving EVT (of which 202 were in the late window), 113 (16.3%) had at least one procedural complication. The frequency of each single, and for overall procedural complications was similar for early versus late EVT (16.2% versus 16.3%, P adj =0.90). Procedural complications lead to a significantly less favorable short-term outcome, reflected by the absence of National Institutes of Health Stroke Scale improvement in late EVT (delta-National Institutes of Health Stroke Scale-24 hours, −2.5 versus 2, P adj =0.01). Conclusions: In this retrospective analysis of consecutive EVT, the frequency of procedural complications was similar for early and late EVT patients but very short-term outcome seemed less favorable in late EVT patients with complications.

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Serum uric acid and acute stroke outcome in Nigerian Africans

Annals of Nigerian Medicine ◽

10.4103/0331-3131.108125 ◽

2012 ◽

Vol 6 (2) ◽

pp. 75

Author(s):

FrankAiwansoba Imarhiagbe ◽

JosephOsagie Idemudia

Keyword(s):

Uric Acid ◽

Acute Stroke ◽

Serum Uric Acid ◽

Stroke Outcome

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Abstract TP64: Negative-FLAIR Vascular Hyperintensities Serves as a Marker of Chronic Major Arterial Occlusion in Acute Stroke

Stroke ◽

10.1161/str.47.suppl_1.tp64 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Junya Aoki ◽

Kentaro Suzuki ◽

Yuki Sakamoto ◽

Arata Abe ◽

Satoshi Suda ◽

...

Keyword(s):

Acute Stroke ◽

Arterial Occlusion ◽

Intravenous Thrombolysis ◽

Multivariate Regression Analysis ◽

Artery Occlusion ◽

Carotid Artery Occlusion ◽

National Institutes Of Health ◽

Chronic Occlusion ◽

Fluid Attenuated Inversion Recovery

Introduction: Because acute fluid-attenuated inversion recovery vascular hyperintensities (FVH) represent disordered blood flow, FVH has been considered as a marker of major arterial occlusions. Contrary, the role of absence of FVH (negative-FVH) is unknown. Hypothesis: We hypothesized that negative-FVH may indicate chronic occlusion. Thus, we investigated the clinical characteristics and neuroimaging findings in patients with negative-FVH and major arterial occlusion. Methods: Consecutive acute stroke patients within 24 hours of onset and major arterial occlusion on magnetic resonance angiography (MRA) were studied. All patients were examined using serial angiography to evaluate the presence of recanalization. Patients were classified into two groups (NF: group without FVH, F: group with FVH). Results: Seventy-two patients (49 [68%] males, 76 [66-83] years) were enrolled. Thirty-six (50%) patients were treated with acute recanalization therapy, including the intravenous thrombolysis or endovascular therapy. On admission, 10 patients were NF group and 62 were F group. Initial National Institutes of Health Stroke Scale (NIHSS) score was 4 (2-8) in NF group and 10 (4-21) in F group (p=0.012). The rate of internal carotid artery occlusion was similar between NF and F group (20% vs. 29%, p=0.716). Serial angiography studies revealed that recanalization was achieved in only 1 (10%) of the 10 patients with NF group and 49 (79%) of the 62 patients with F group during hospitalization (p<0.001). When all patients divided into 2 groups based on the presence or absence of recanalization, patients with recanalization were younger (p=0.023), had higher NIHSS (p=0.008), earlier admission (p=0.014), higher prevalence of atrial fibrillation (p=0.010), and frequently treated with acute recanalization therapy (p=0.040). When multivariate regression analysis was conducted, that Negative-FVH (odds ratio 0.061, 95% CI 0.06-0.620, p=0.018) was a negative independent factor associated with recanalization during hospitalization. Conclusions: Negative-FVH was independently associated with no recanalization during hospitalization. Negative-FLAIR may present not acute occlusion but chronic occlusion.

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