scholarly journals Predicting stroke severity with a 3-min recording from the Muse portable EEG system for rapid diagnosis of stroke

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Cassandra M. Wilkinson ◽  
Jennifer I. Burrell ◽  
Jonathan W. P. Kuziek ◽  
Sibi Thirunavukkarasu ◽  
Brian H. Buck ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Low Cost ◽  
Minor Stroke ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Low Frequencies ◽  
Severe Stroke ◽  
High Frequencies ◽  
Detection Tool ◽  
Record Data

Abstract In this study, we demonstrated the use of low-cost portable electroencephalography (EEG) as a method for prehospital stroke diagnosis. We used a portable EEG system to record data from 25 participants, 16 had acute ischemic stroke events, and compared the results to age-matched controls that included stroke mimics. Delta/alpha ratio (DAR), (delta + theta)/(alpha + beta) ratio (DBATR) and pairwise-derived Brain Symmetry Index (pdBSI) were investigated, as well as head movement using the on-board accelerometer and gyroscope. We then used machine learning to distinguish between different subgroups. DAR and DBATR increased in ischemic stroke patients with increasing stroke severity (p = 0.0021, partial η2 = 0.293; p = 0.01, partial η2 = 0.234). Also, pdBSI decreased in low frequencies and increased in high frequencies in patients who had a stroke (p = 0.036, partial η2 = 0.177). Using classification trees, we were able to distinguish moderate to severe stroke patients and from minor stroke and controls, with a 63% sensitivity, 86% specificity and accuracy of 76%. There are significant differences in DAR, DBATR, and pdBSI between patients with ischemic stroke when compared to controls, and these effects scale with severity. We have shown the utility of a low-cost portable EEG system to aid in patient triage and diagnosis as an early detection tool.

scholarly journals Application of the Muse portable EEG system to aid in rapid diagnosis of stroke

2020 ◽  
Author(s):  
Cassandra M. Wilkinson ◽  
Jennifer I. Burrell ◽  
Jonathan W. P. Kuziek ◽  
Sibi Thirunavukkarasu ◽  
Brian H. Buck ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Classification Trees ◽  
Quantitative Eeg ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Low Frequencies ◽  
High Frequencies ◽  
Stroke Mimics ◽  
Detection Tool ◽  
Record Data

AbstractObjectiveIn this pilot study, we investigated using portable electroencephalography (EEG) as a potential prehospital stroke diagnostic method.MethodsWe used a portable EEG system to record data from 25 participants, 16 had acute ischemic stroke events, and compared the results of age-matched controls that included stroke mimics. Delta/alpha ratio (DAR), (delta+theta)/(alpha+beta) ratio (DBATR) and pairwise-derived Brain Symmetry Index (pdBSI) were investigated, as well as accelerometer and gyroscope trends. We then made classification trees using TreeBagger to distinguish between different subgroups.ResultsDAR and DBATR showed an increase in ischemic stroke patients that correlates with stroke severity (p<0.01, partial η2 = 0.293; p<0.01, partial η2 = 0.234). pdBSI decreased in low frequencies and increased in high frequencies in patients who had a stroke (p<0.05, partial η2 = 0. 177). All quantitative EEG measures were significant between stroke patients and controls. Using classification trees, we were able to distinguish between subgroups of stroke patients and controls.ConclusionsThere are significant differences in DAR, DBATR, and pdBSI between patients with ischemic stroke when compared to controls; results relate to severity.SignificanceWith significant differences between patients with strokes and controls, we have shown the feasibility and utility for the Muse™ EEG system to aid in patient triage and diagnosis as an early detection tool.

scholarly journals Trends in the seeking of emergency service for ischemic stroke and its risk factors during the COVID-19 pandemic, a study from Taiwan

2021 ◽  
Vol 26 (3) ◽  
pp. 441-447
Author(s):  
Yi Te Tsai ◽  
Yachung Jeng ◽  
Hsiu-Hsi Chen ◽  
Kai-Chieh Chang
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Emergency Services ◽  
Stroke Care ◽  
University Hospital ◽  
Minor Stroke ◽  
Stroke Severity ◽  
Health Seeking ◽  
Stroke Patients ◽  
Ich Score

Background & Objectives: COVID-19 may influence the health seeking behavior of acute ischemic stroke patients. This study aimed to determine the characteristics of the patients who visited the emergency room in a centre designated for stroke care in Taiwan. Methods: This was a retrospective database-based study comparing the severity of ischemic stroke, intracerebral hemorrhage (ICH), and risk factors of patients seen between 2019 and 2020 in the National Taiwan University Hospital Yunlin Branch. Patients with or without thrombolysis therapy were analysed. Results: The median NIHSS of ischemic stroke patients were lower in 2019 than in 2020 (p = 0.015). The difference was seen in non-thrombolysis patients (2019: 3[1-6] vs. 4 [2-7.5], p = 0.012) but not in thrombolysis patients. The frequency of minor stroke was higher in 2019 (45.1%) than in 2020 (37.9%, p = 0.038). The discharge mRS was lower overall (p = 0.004) and in non-thrombolysis patients (0.003), but not in thrombolysis patients in 2019. As for the ICH patients, the severity of ICH score (p = 0.021) and discharge mRS (p = 0.001) were also lower in 2019. The frequencies of risk factors of stroke were higher in 2019 than in 2020, including smoking (24% vs. 18.2%, p = 0.046), alcohol (11.9% vs. 7.5%, p = 0.039), hypertension (72.9% vs. 66.2%, p = 0.039), history of stroke (16.5% vs. 11.6%, p = 0.047), and atrial fibrillation (11.9% vs. 7.5%, p = 0.039). Conclusions: This study in Taiwan revealed a decline in the willingness to seek emergency services under the influence of COVID-19 among patients with lower stroke severity, especially those with more risk factors.

scholarly journals HUBUNGAN ANTARA RIWAYAT PENYAKIT JANTUNG DENGAN TINGKAT KEPARAHAN STROKE ISKEMIK AKUT PERTAMA KALI

2019 ◽  
Vol 37 (1) ◽  
Author(s):  
Ignatius Ivan ◽  
Budi Riyanto Wreksoatmodjo ◽  
Octavianus Darmawan
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
National Institutes Of Health ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Severe Stroke ◽  
History Of

ASSOCIATION BETWEEN HISTORY OF HEART DISEASE AND SEVERITY OF ACUTE FIRST-EVER ISCHEMIC STROKEABSTRACTIntroduction: History of heart disease such as atrial  fibrillation, angina pectoris, myocardial infarction, heart failure has a role on ischemic stroke severity.Aim: This research aims to find the association between history of heart disease and stroke severity using NIHSS score on acute ischemic stroke patients in Atma Jaya hospital during 2014-2018.Method: This research used cross-sectional method with two-sided fisher’s exact test. With total sampling, samples retrieved from secondary sources in Atma Jaya hospital during 2014-2018 resulting 236 subjects. Stroke severity measured by NIHSS score during admission, categorized with severe stroke (15-42) and non-severe stroke (0-14).Result: There is a significant association between history of AF (p=0.046) on first-ever ischemic stroke severity. Acute first-ever ischemic stroke patients who are  >18 years old with history of AF has a tendency of 5,2 times to have severe stroke compared with patients without AF. Other history of heart disease has no significant association towards stroke severity.Discussion: In accordance with previous research, our findings suggest a significant association between history of atrial fibrillation and acute first-ever ischemic stroke severity in which there is a tendency of more severe stroke compared wth patients without AF. Unlike previous findings, this research shows no significant association between history of heart failure and stroke severity due to limited data characteristic  of ejection fraction preventing us to include patient with ejection fraction below 30%. This limitation may also allow history of angina pectoris and myocardial infarction to be insignificant.Keywords:  Atrial  fibrillation,  heart  failure,  ischemic  stroke,  myocardial  infarction,  National  Institutes  of Health Stroke ScaleABSTRAKPendahuluan: Riwayat penyakit jantung seperti atrial fibrilasi, angina pektoris, infark miokardium, gagal jantung memiliki peran terhadap keparahan stroke iskemik.Tujuan: Mengetahui hubungan riwayat penyakit jantung dengan tingkat keparahan stroke berdasarkan skor NIHSS pada pasien stroke iskemik akut di RS Atma Jaya pada tahun 2014-2018.Metode: Penelitian potong lintang terhadap data sekunder pasien stroke iskemik pertama kali yang dirawat di RS Atma Jaya pada tahun 2014-2018. Keparahan stroke diukur berdasarkan National Institutes of Health Stroke Scale (NIHSS) masuk dengan kategori severe stroke (skor 15-42) dan non-severe stroke (0-14). Dilakukan uji Fisher dua sisi untuk menilai hubungan.Hasil: Terdapat 236 subjek dengan mayoritas hubungan riwayat AF (p=0,046) terhadap tingkat keparahan stroke. Pasien berumur >18 tahun yang mengalami stroke iskemik akut pertama kali dengan riwayat AF akan berpeluang 5,2 kali lebih tinggi untuk mengalami severe stroke dibandingkan jika tanpa riwayat AF. Riwayat penyakit jantung lain tidak memiliki hubungan signifikan terhadap tingkat keparahan stroke.Diskusi: Terdapat hubungan yang signifikan antara riwayat AF terhadap tingkat keparahan stroke, terutama pada subjek dengan severe stroke jika dibandingkan pasien tanpa riwayat AF. Tidak ditemukan hubungan signifikan antara penyakit jantung yang lain dikarenakan keterbatasan data penelitian.Kata kunci: Atrial fibrilasi, gagal jantung, infark miokardium, National Institutes of Health Stroke Scale, stroke iskemik

Abstract P532: Hypertension and Gender Differences in Acute Ischemic Stroke Patients Treated With Rtpa

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Thomas I Nathaniel ◽  
Jordan Gainey ◽  
Leah Wormack ◽  
Chibueze Ubah ◽  
Leanne Brechtel ◽  
...  
Keyword(s):  
Gender Differences ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Severe Stroke ◽  
Hypertensive Patients ◽  
Ischemic Cerebrovascular Disease ◽  
And Gender ◽  
Similar Incidence

Background: Women and men have a similar incidence for ischemic cerebrovascular disease but women are more frequently hit by stroke later in life than men. It has been shown that women presented with severe stroke symptoms during admission, a poorer prognosis, are likely to have an overall poorer outcome after ischemic stroke when compared with men. However, some studies indicate similarities in outcome for men and women after stroke. Moreover, there is evidence that women treated with tPA benefit at least as much as men. Since a higher diastolic blood pressure increases the risk for a worse prospective functional status in men, but less significance in women, it is not clear whether hypertensive patients with acute ischemic stroke treated will reveal similarity or difference in functional outcome. We investigated this issue in the current study. Method: We performed a retrospective analysis of 4500 acute ischemic stroke patients who presented to a health care system between January 2010 and June 2016 and received rt-PA. We develop a new tool to determine the possibility of erasing any gender difference, and identify the most important factor for the poorer outcomes in women or men and whether thrombolysis may counteract this effect. Results: Our results reveal that poorer outcomes after stroke and the observed gender differences is due to age, at stroke onset, and that thrombolysis may neutralize this effect. Conclusion: The important factor for the poorer outcome and gender differences in hypertensive patients with acute ischemic stroke is mainly due to stroke severity and thrombolysis may play a major role in neutralizing this effect.

scholarly journals Serum Creatine Kinase Concentration & Its Association with Severity in Acute Ischemic Stroke Patients: A Cross-Sectional Analytical Study

2016 ◽  
Vol 32 (2) ◽  
pp. 52-55
Author(s):  
- Md Arifuzzaman ◽  
Md Rafiqul Islam ◽  
Sheikh Mahabub Alam ◽  
Abdul Kader Sheikh ◽  
Md Shafiqus Saleheen ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Creatine Kinase Level ◽  
Serum Creatine Kinase ◽  
Minor Stroke ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Severe Stroke ◽  
Serum Creatine Kinase Level

Background: The diagnosis of ischemic stroke remains a clinical one, with confirmatory evidence obtained through neuroimaging. Analogous to the role that the creatine kinase (CK), a biochemical test may be useful in diagnosis as well as detect severity which ultimately helps in the management of acute ischemic stroke. Objective: To evaluate serum creatine kinase level and its association with severity in acute ischemic stroke patients. Methods: This cross-sectional analytic study was carried out in the Department of Neurology, BSMMU, Dhaka from January 2014 to December 2014.In this study 50 acute ischemic stroke patients were enrolled as cases. Result: In this study, 42.0% patients were female and 58% were male and their mean age was 55.96±10.93 years. According to classification by NIH Stroke score, 32% patients was found in minor stroke, 28% in moderate stroke, 26% in moderate to severe stroke and 14% in severe stroke. 80.0% patients had increased level of serum creatine kinase. In this study there is a positive correlation between NIH Stroke Score and Serum creatine kinase level (r= 0.869, p < 0.0001). Conclusion: Increase severity of acute ischaemic stroke causes increased level of serum creatine kinase. Bangladesh Journal of Neuroscience 2016; Vol. 32 (2): 52-55

Prestroke statin use enhances collateralization in acute ischemic stroke patients

2020 ◽  
Vol 38 (4) ◽  
pp. 311-321
Author(s):  
Jiaying Zhu ◽  
Mengmeng Ma ◽  
Jinghuan Fang ◽  
Jiajia Bao ◽  
Shuju Dong ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Middle Cerebral Artery ◽  
Acute Ischemic Stroke ◽  
Statin Therapy ◽  
Cerebral Artery ◽  
Functional Outcomes ◽  
Collateral Circulation ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Statin Use

Background: Statin therapy has been shown to be effective in the prevention of ischemic stroke. In addition, recent studies have suggested that prior statin therapy could lower the initial stroke severity and improve stroke functional outcomes in the event of stroke. It was speculated that prestroke statin use may enhance collateral circulation and result in favorable functional outcomes. Objective: The aim of the study was to investigate the association of prestroke statin use with leptomeningeal collaterals and to determine the association of prestroke statin use with stroke severity and functional outcome in acute ischemic stroke patients. Methods: We prospectively and consecutively enrolled 239 acute ischemic stroke patients with acute infarction due to occlusion of the middle cerebral artery within 24 h in the neurology department of West China Hospital from May 2011 to April 2017. Computed tomographic angiography (CTA) imaging was performed for all patients to detect middle cerebral artery thrombus; regional leptomeningeal collateral score (rLMCS) was used to assess the degree of collateral circulation; the National Institutes of Health Stroke Scale (NIHSS) was used to measure stroke severity at admission; the modified Rankin scale (mRS) was used to measure outcome at 90 days; and premorbid medications were recorded. Univariate and multivariate analyses were performed. Results: Overall, 239 patients met the inclusion criteria. Fifty-four patients used statins, and 185 did not use statins before stroke onset. Prestroke statin use was independently associated with good collateral circulation (rLMCS > 10) (odds ratio [OR], 4.786; 95% confidence interval [CI], 1.195–19.171; P = 0.027). Prestroke statin use was not independently associated with lower stroke severity (NIHSS score≤14) (OR, 1.955; 95% CI, 0.657–5.816; p = 0.228), but prestroke statin use was independently associated with favorable outcome (mRS score≤2) (OR, 3.868; 95% CI, 1.325–11.289; P = 0.013). Conclusions: Our findings suggest that prestroke statin use was associated with good leptomeningeal collaterals and clinical outcomes in acute ischemic stroke (AIS) patients presenting with occlusion of the middle cerebral artery. However, clinical studies should be conducted to verify this claim.

scholarly journals Association of Anemia with Stroke Severity in Acute Ischemic Stroke Patients

Cureus ◽  
2018 ◽  
Author(s):  
Muhammad F Khan ◽  
Ibrahim Shamael ◽  
Qamar Zaman ◽  
Asad Mahmood ◽  
Maimoona Siddiqui
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Severity ◽  
Stroke Patients

scholarly journals CD163 as a Potential Biomarker of Monocyte Activation in Ischemic Stroke Patients

2021 ◽  
Vol 22 (13) ◽  
pp. 6712
Author(s):  
Rosaria Greco ◽  
Chiara Demartini ◽  
Anna Maria Zanaboni ◽  
Elena Tumelero ◽  
Alessandra Persico ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Stroke Severity ◽  
Mrna Levels ◽  
Monocyte Count ◽  
Stroke Patients ◽  
Inflammatory Status ◽  
Specific Distribution ◽  
Cd163 Expression ◽  
Potential Biomarker ◽  
Complex Correlation

In ischemic stroke patients, a higher monocyte count is associated with disease severity and worse prognosis. The complex correlation between subset phenotypes and functions underscores the importance of clarifying the role of monocyte subpopulations. We examined the subtype-specific distribution of the CD163+ and CD80+ circulating monocytes and evaluated their association with the inflammatory status in 26 ischemic stroke patients and 16 healthy controls. An increased percentage of CD163+/CD16+ and CD163+/CD14++ events occurred 24 and 48 h after a stroke compared to the controls. CD163+ expression was more pronounced in CD16+ non-classical and intermediate monocytes, as compared to CD14+ classical subtype, 24 h after stroke. Conversely, the percentage of CD80+/CD16+ events was unaffected in patients; meanwhile, the percentage of CD80+/CD14+ events significantly increased only 24 h after stroke. Interleukin (IL)-1beta, TNF-alpha, and IL-4 mRNA levels were higher, while IL-10 mRNA levels were reduced in total monocytes from patients versus controls, at either 24 h or 48 h after stroke. The percentage of CD163+/CD16+ events 24 h after stroke was positively associated with NIHSS score and mRS at admission, suggesting that stroke severity and disability are relevant triggers for CD163+ expression in circulating CD16+ monocytes.

scholarly journals Predictors of the functional outcome after thrombolysis in an Egyptian patients’ sample

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
H. M. Eldeeb ◽  
D. H. Elsalamawy ◽  
A. M. Elabd ◽  
H. S. Abdelraheem
Keyword(s):  
Ischemic Stroke ◽  
Hospital Stay ◽  
Functional Outcome ◽  
Arterial Occlusion ◽  
University Hospital ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Predicting Factors ◽  
Egyptian Patients ◽  
Cerebrovascular Stroke

Abstract Background About 6.2 million individuals worldwide and approximately 200 Egyptians/100,000 citizens have cerebrovascular stroke annually, and only less than 1% of stroke patients received intravenous (IV) thrombolysis in 2014. Outcome of the ischemic stroke after IV thrombolysis varies, and there is lack of data about the predicting factors that contributes to the outcome of ischemic strokes after IV thrombolysis in Egypt. Objective The aim of this work is to study the predictors of the functional outcome of ischemic cerebrovascular stroke after IV thrombolysis in Egyptian patients. Patients and methods This is a prospective study that includes acute ischemic stroke patients who received IV thrombolysis at the Alexandria University Hospital during the year from February 2017 to February 2018, and they were evaluated initially by Rapid Arterial Occlusion Evaluation (RACE) scale and followed-up serially for 6 months after thrombolysis using the National Institutes of Health Stroke Scale (NIHSS) and modified ranking score (mRS). Results Forty-five patients are included; 56% had favorable functional outcome (mRS 0–2) after 6 months, 68% had ≥ 4 points improvement in NIHSS after 6 months, and 13% had hemorrhagic conversion with 18% mortality rate. High initial RACE scale and long hospital stay are associated with poor functional outcome 6 months after thrombolysis. Conclusion Stroke severity demonstrated by high initial RACE and the duration of hospital stay are the two most significant predictors with an impact on the functional outcome of ischemic cerebrovascular stroke after thrombolysis.

scholarly journals The Difference of Barthel Index Score Based on Stroke Severity, Weakness Side, and Onset of Physiotherapy in Ischemic Stroke Patients at Atma Jaya Hospital

2017 ◽  
Vol 6 (02) ◽  
pp. 15
Author(s):  
Agustina Novita Putri Soegiarto ◽  
Linda Suryakusuma ◽  
Jane Pelealu
Keyword(s):  
Ischemic Stroke ◽  
Barthel Index ◽  
Daily Living ◽  
Index Score ◽  
Stroke Severity ◽  
Activity Of Daily Living ◽  
Stroke Patients ◽  
Barthel Index Score ◽  
Cross Sectional ◽  
Stroke Registry

Background: Stroke is the third cause of disability that can affect the Activity of Daily Living (ADL). Ischemicstroke had higher incidence compared to hemorrhagic strokes. Rehabilitation in the form of physiotherapy canreduce the level of ADL dependencies, that is be measured by Barthel Index Score. Stroke severity, weaknessside, and physiotherapy onset can be factors that influence the success of physiotherapy to reducing the levelof ADL dependencies.Methods:A descriptive analytic study with a cross-sectional design in ischemic stroke patients using secondarydata from the Stroke Registry and medical records at Atma Jaya Hospital for the period of January 2016 toDecember 2017. The data were analyzed using Chi-Square.Results: Study on 110 subjects, consisted of 62 men(56.4%), aged divided by under of 58 years, and above of 58years were 52(47.3%) and 58 (52.7%). While subjects divided by stroke severity, i.e. minor, moderate, moderateto severe, and severe; 44 (40%), 58 (52.7%), 5 (4.5%), and 3 (2.7%) respectively. There were 77 participants(70%) had right side weakness and 33 participants (30%) were left side weakness. The changes of Barthel Indexof ADL score, were 73 (66.4%) improvement, 6 (5.5%) deterioration, and 31 (28.2%) remained. The study hasshown relationship between severity of stroke (p=0.008), weakness side (p=0.000), and physiotherapy onset(p=0.039) with the changes of Barthel Indexscore after treatment.Conclusion: There was a relationship between stroke severity, the weakness side of stroke, and physiotherapyonset with the better result of Barthel Index of ADL score after the physiotherapy.Keywords: Activity of Daily Living (ADL), Barthel Index, ischemic stroke, physiotherapy onset, stroke severity,Weakness side

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