Factors Associated With Non-enrollment of Center-Based Cardiovascular Rehabilitation Program Among Transient Ischemic Attack or Mild Stroke Patients

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Guangxia Meng ◽  
Hammad Qazi ◽  
Helen Chen
Keyword(s):  
Transient Ischemic Attack ◽  
Rehabilitation Program ◽  
Stroke Patients ◽  
Factors Associated ◽  
Cardiovascular Rehabilitation ◽  
Mild Stroke ◽  
Ischemic Attack

scholarly journals Rancang bangun alat monitoring fisioterapi pasien pasca stroke menggunakan sensor MPU6050 melalui media transmisi bluetooth

JURNAL ELTEK ◽  
2021 ◽  
Vol 19 (2) ◽  
pp. 39
Author(s):  
Lis Diana Mustafa ◽  
Azam Muzakhim Imamuddin ◽  
Yoyok Heru Prasetio
Keyword(s):  
Transient Ischemic Attack ◽  
Knee Flexion ◽  
The Body ◽  
Stroke Patients ◽  
Post Stroke ◽  
Elbow Movement ◽  
Mild Stroke ◽  
Ischemic Attack ◽  
The Brain ◽  
Average Angle

Stroke Transient Ischemic Attack (TIA ) adalah kondisi stroke ringan. Stroke ringan diakibatkan oleh berkurangnya suplai darah menuju otak. Kelumpuhan disebabkan oleh kurangnya aliran darah ke otak, sehingga sisi tubuh akan mengalami kelumpuhan terutama pada siku dan lutut. Fisioterapi pada pasien pasca stroke ringan dilakukan dengan metode terapi gerakan antara lain seperti penggunaan alat bantu fisioterapi pasien pasca stroke menggunakan sensor MPU6050 melalui media transmisi Bluetooth. Sistem rancangan ini membantu latihan pada pasien berbentuk sensor MPU6050 yang digunakan untuk  mendeteksi sudut serta banyaknya gerakan rehabilitasi pasien pasca stroke. Sensor gyroscope menghasilkan deteksi sudut pada siku sebesar 150  dan sudut pada  lutut sebesar 135 . Data yang didapatkan diproses oleh arduino nano menggunakan metode I2C. Penelitian ini bertujuan untuk merancang alat bantu fisioterapi pasien pasca stroke berbasis mikrokontroler guna memperoleh hasil yang maksimal karena bentuk alat ini yang portable. Stroke Transient Ischemic Attack (TIA) is a mild stroke condition that can be caused by reduced blood supply to the brain due to blocked blood vessels. Lack of blood flow to the brain can cause paralysis, usually only on one side of the body such as the elbows and knees. Physiotherapy in post-stroke patients is carried out using movement therapy methods, including elbow and knee flexion. Currently, patients come to the therapist or vice versa to perform therapeutic movements, so a telemonitoring system for post-stroke patient physiotherapy tools is made using the MPU6050 sensor which is connected to ESP 232 and the internet network and can be monitored by therapists and clinic admins where the therapy is done. This system helps monitor elbow and knew flexion exercises using the MPU6050 sensor which is used to detect the angle and number of rehabilitation movements of post-stroke patients. . From the results of testing the accuracy of this sensor is able to detect the angle of elbow movement from 00-1500 and knee flexion angle of 00-1350 by 99%.The telemonitoring application for physiotherapy tools for post-stroke patients based on Android is equipped with a therapist menu so that the number of movements and the average angle of movement of the knees and elbows can be monitored by the therapist, this tool can also be used anywhere and anytime due to the portable form of this tool.

scholarly journals Stroke admission rates before, during and after the first phase of the COVID-19 pandemic

2021 ◽  
Vol 42 (3) ◽  
pp. 791-798
Author(s):  
Espen Saxhaug Kristoffersen ◽  
Silje Holt Jahr ◽  
Kashif Waqar Faiz ◽  
Bente Thommessen ◽  
Ole Morten Rønning
Keyword(s):  
Transient Ischemic Attack ◽  
Chart Review ◽  
University Hospital ◽  
Medical Attention ◽  
Stroke Patients ◽  
Temporary Reduction ◽  
Admission Rates ◽  
States Of Emergency ◽  
Mild Stroke ◽  
Ischemic Attack

Abstract Background There was a significant decrease in stroke admissions during the first phase of the COVID-19 pandemic. There are concerns that stroke patients have not sought medical attention and in the months after the lockdown suffer recurrent severe strokes. The aims of this study were to investigate how stroke admission rates and distributions of severity varied before, during and after the lockdown in a representative Norwegian hospital population. Methods All patients discharged from Akershus University Hospital with a diagnosis of transient ischemic attack (TIA) or acute stroke from January to September 2020 were identified by hospital chart review. Results We observed a transient decrease in weekly stroke admissions during lockdown from an average of 21.4 (SD 4.7) before to 15.0 (SD 4.2) during and 17.2 (SD 3.3) after (p < 0.011). The proportion of mild ischemic and haemorrhagic strokes was also lower during lockdown with 66% before, 57% during and 68% after (p = 0.011). Conclusion The period of COVID-19 lockdown was associated with a temporary reduction in total admissions of strokes. In particular, there were fewer with TIA and mild stroke. Given the need to prevent the worsening of symptoms and risk of recurrence, it is necessary to emphasise the importance to seek medical care even in states of emergency.

Abstract 41: Prognostic Value of Perfusion MRI in Patients with Transient Ischemic Attack or Minor Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Joon Hwa Lee ◽  
Hyunjin Jo ◽  
Jihoon Cha ◽  
Woo-Keun Seo ◽  
Oh Young Bang ◽  
...  
Keyword(s):  
Cardiovascular Event ◽  
Transient Ischemic Attack ◽  
Recurrent Stroke ◽  
Perfusion Mri ◽  
Minor Stroke ◽  
Secondary Outcome ◽  
Stroke Recurrence ◽  
Composite Outcome ◽  
Stroke Patients ◽  
Ischemic Attack

Background and purpose: We aimed to investigate the role of perfusion MRI parameters (TTP: time to peak, CBF: cerebral blood flow, CBV: cerebral blood volume) as a prognostic factor for the risk of stroke recurrence or cardiovascular outcome in patients with transient ischemic attack (TIA) or minor stroke. Methods: We retrospectively reviewed TIA or minor stroke patients who underwent our stroke MRI protocol (DWI, perfusion MRI, and MRA) in a consecutively collected stroke registry. Primary outcome was nonfatal stroke recurrence and secondary outcome was cardiovascular composite outcome. Multivariate analysis was used to examine the association of perfusion MRI parameters and angiographic findings with the risk of stroke recurrence and cardiovascular event. Results: Of the 326 patients who met inclusion criteria, we identified 15(4.6%) nonfatal strokes and 25(7.7%) cardiovascular composite events during the first 1 year after the index TIA or minor stroke. The presence of regional delayed perfusion on TTP maps (p=0.002) and regional hyperperfusion on CBV maps (p<0.001) were associated with recurrent stroke. In MRA images, concomitant stenosis of the intracranial arteries and/or extracranial carotid arteries was associated with cardiovascular events (p=0.009). Using multivariate cox proportional hazard analysis, presence of regional hyperperfusion on CBV remained an independent predictor of recurrent stroke (HR 10.82, 95% CI 4.19-38.67, p<0.001) and cardiovascular event (HR 6.30, 95% CI 2.67-18.25, p<0.001). The AUC of the CBV maps was also greater than other parameters for the prediction of stroke recurrence (AUC=0.701, 95% CI 0.54-0.86) and cardiovascular composite outcome (AUC=0.628, 95% CI 0.50-0.76). Conclusions: Increased CBV on perfusion MRI, representing the hemodynamic status of postischemic hyperperfusion, could be more useful than other perfusion parameters in predicting poor prognosis of TIA or minor stroke patients.

scholarly journals Coronary Artery Disease in Patients Presenting With Acute Ischemic Stroke or Transient Ischemic Attack and Elevated Troponin Levels

2022 ◽  
Vol 12 ◽  
Author(s):  
Mathieu Kruska ◽  
Anna Kolb ◽  
Christian Fastner ◽  
Iris Mildenberger ◽  
Svetlana Hetjens ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Ischemic Stroke ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Transient Ischemic Attack ◽  
Large Artery ◽  
Elevated Troponin ◽  
Stroke Patients ◽  
Artery Disease ◽  
Ischemic Attack

Background: There is little information concerning the invasive coronary angiography (ICA) findings of patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA) with elevated troponin levels and suspected myocardial infarction (MI). This study analyzed patient characteristics associated with ICA outcomes.Methods: A total of 8,322 patients with AIS or TIA, treated between March 2010 and May 2020, were retrospectively screened for elevated serum troponin I at hospital admission. Patients in whom ICA was performed, due to suspected type 1 MI based on symptoms, echocardiography, and ECG, were categorized according to ICA results (non-obstructive coronary artery disease (CAD): ≥1 stenosis ≥50% but no stenosis ≥80%; obstructive CAD: any stenosis ≥80% or hemodynamically relevant stenosis assessed by FFR/iwFR).Results: Elevated troponin levels were detected in 2,205 (22.5%) patients, of whom 123 (5.6%) underwent ICA (mean age 71 ± 12 years; 67% male). CAD was present in 98 (80%) patients, of whom 51 (41%) were diagnosed with obstructive CAD. Thus, ICA findings of obstructive CAD accounted for 2.3% of patients with troponin elevation and 0.6% of all stroke patients. The clinical hallmarks of myocardial ischemia, including angina pectoris (31 vs. 15%, p &lt; 0.05) and regional wall motion abnormalities (49 vs. 32%, p = 0.07), and increased cardiovascular risk indicated obstructive CAD. While there was no association between lesion site or stroke severity and ICA findings, causal large-artery atherosclerosis was significantly more common in patients with obstructive coronary disease (p &lt; 0.05).Conclusion: The rate of obstructive CAD in patients with stroke or TIA and elevated troponin levels with suspected concomitant type I MI is low. The cumulation of several cardiovascular risk factors and clinical signs of MI were predictive. AIS patients with large-artery atherosclerosis and elevated troponin may represent an especially vulnerable subgroup of stroke patients with risk for obstructive CAD.

scholarly journals Comparison of Carotid Atherosclerotic Plaque Characteristics between Symptomatic Patients with Transient Ischemic Attack and Stroke using High-Resolution Magnetic Resonance Imaging

2021 ◽  
Author(s):  
Mingming Lu ◽  
Lichen Zhang ◽  
Fei Yuan ◽  
Peng Peng ◽  
Hongtao Zhang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Transient Ischemic Attack ◽  
Carotid Arteries ◽  
Plaque Burden ◽  
Plaque Morphology ◽  
Stroke Patients ◽  
Carotid Plaques ◽  
Ischemic Attack ◽  
Ischemic Events

Abstract Background:This study aimed to compare the characteristics of carotid plaques between patients with transient ischemic attack (TIA) and ischemic stroke using magnetic resonance (MR) imaging.Methods：Patients with a recent ischemic stroke or TIA who exhibited atherosclerotic plaques of carotid arteries in the symptomatic sides determined by MR vessel wall imaging were recruited. The plaque morphology and compositions including intraplaque hemorrhage (IPH), lipid-rich necrotic-core (LRNC) and calcification were compared between TIA and stroke patients. Logistic regression was performed to relate the plaque characteristics to the types of ischemic events.Results:A total of 270 patients with TIA or ischemic stroke were recruited. Stroke patients had significantly higher prevalence of diabetes (42.2% vs. 28.2%, p=0.021), greater mean wall area (35.1 ± 10.1 mm2 vs. 32.0 ± 7.7 mm2, p = 0.004), mean wall thickness (1.3 ± 0.2 mm vs. 1.2 ± 0.2 mm, p=0.001), maximum normalized wall index (NWI)(63.9% ± 6.0% vs. 62.2% ± 5.9%, p=0.023) and %volume of LRNC (9.7%± 8.2% vs. 7.4% ±7.9%, p=0.025) in carotid arteries compared to those with TIA. After adjusted for clinical factors, above characteristics of carotid arteries were significantly associated with the type of ischemic events. After further adjusted for maximum NWI, this association remained statistically significant (OR, 1.41; CI, 1.01-1.96; p=0.041).Conclusions:Ischemic stroke patients had larger plaque burden and greater proportion of LRNC in carotid plaques compared to those with TIA. This study suggests that ischemic stroke patients had more vulnerable plaques compared to those with TIA.

Diagnosis and management of carotid free-floating thrombus: A systematic literature review

2019 ◽  
Vol 14 (3) ◽  
pp. 247-256 ◽  
Author(s):  
Sebastian Fridman ◽  
Stephen P Lownie ◽  
Jennifer Mandzia
Keyword(s):  
Transient Ischemic Attack ◽  
Large Scale ◽  
Cox Regression ◽  
Case Reports ◽  
Case Series ◽  
Duplex Ultrasound ◽  
Stroke Patients ◽  
Ischemic Attack ◽  
Associated Risk Factors

Background There is no consensus regarding the management of carotid free-floating thrombi in patients with acute ischemic stroke and transient ischemic attack. Aims This systematic review aims to (1) describe the current imaging methods for diagnosis of carotid free-floating thrombi and its associated risk factors, (2) estimate the proportion of carotid free-floating thrombi diagnosed in stroke patients, (3) estimate the proportion of carotid free-floating thrombi patients treated medically and surgically, and (4) evaluate 30-day outcomes. Methods We searched MEDLINE, EMBASE, and manually for references reporting carotid free-floating thrombi from 1960 until June 2017. We estimated the frequency of carotid free-floating thrombi and evaluated 30-day outcomes using Cox regression. We defined the timing of surgical intervention as early (less than 72 h) and delayed (more or equal to 72 h). Summary of review We retrieved 525 carotid free-floating thrombi cases from 58 case series and 83 case reports. Carotid free-floating thrombi were present in 1.53% of stroke patients. Carotid free-floating thrombi diagnosis was made by digital subtraction angiography (38.1%), carotid duplex ultrasound (29.5%), and computed tomography angiography (29.5%). The 30-day risk of transient ischemic attack, silent brain ischemia, any stroke or death was 17.1%. In multivariate analyses, there were no differences in outcome for any anticoagulation regime or timing of revascularization procedure. Conclusions The diagnosis of carotid free-floating thrombi is more common due to the increased use of early noninvasive vascular imaging in transient ischemic attack and stroke. It poses a high short-term risk of stroke and death, but there is as yet no established treatment. The low quality of evidence in the carotid free-floating thrombi literature limits the interpretation of our results and warrants a large-scale prospective cohort study in carotid free-floating thrombi.

Abstract TP299: Association Between Rates of Dysphagia Screening Failure and Short-Term Outcomes in Patients With Mild Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Syed F Ali ◽  
Lee H Schwamm ◽  
Sanjeeva Onteddu ◽  
Krishna Nalleballe ◽  
Kelly-Ann Patrice ◽  
...  
Keyword(s):  
Limited Data ◽  
Stroke Patients ◽  
Entire Cohort ◽  
Stroke Registry ◽  
Factors Associated ◽  
Stroke Risk Factors ◽  
Improved Outcomes ◽  
Multivariable Regression ◽  
Mild Stroke ◽  
Screen Failure

Intro: Guidelines advocate screening all acute stroke patients for dysphagia. However, limited data are available regarding how many patients with mild presentation fail initial screening. We sought to evaluate the rates and predictors of dysphagia screening failure in mild acute ischemic stroke patients (NIHSS < 5). Methods: Using GWTG stroke registry data from three large comprehensive stroke centers in the Northeast, South and West, we analyzed 8,687 stroke admissions from 06/2008 - 12/2018. Patients with mild stroke (NIHSS<5) were identified and dysphagia failure rate was evaluated. Using univariate and multivariable regression (MV) analysis (using factors with p<0.1, in bold), we evaluated factors associated with dysphagia screen failure in mild stroke patients. Results: Of the 8,687 patients, 3,614 (41%) had NIHSS < 5. Dysphagia screening failure was seen in 30.2% in the entire cohort while only 10.3% (373/3,614) in patients with NIHSS < 5. Mild stroke patients who failed dysphagia screening were older, more often had stroke risk factors of hypertension, hyperlipidemia, CAD/MI. They had higher median NIHSS and more often had language disturbance on presentation. Patients who failed dysphagia screening were less likely to be discharged home. On MV analysis, age (1.01, 95% 1.00, 1.02), hypertension (1.45, 95% 1.10, 1.91), NIHSS (1.62 95% 1.48, 1.77) and language disturbance at presentation (1.89 95% 1.13, 2.32) were significantly associated with initial dysphagia. Conclusion: Dysphagia screen failure rates are significantly less frequent in patients with mild symptoms and even lower for those with NIHSS of 0-1 at presentation. Factors associated with failure - older age, higher NIHSS and language disturbance at presentation may help focus efforts to avoid complications in these patients who might otherwise do well. This focused approach of screening patients all patients but targeting mild patients with dysphagia may hold potential for improved outcomes.

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