Multicenter trial of hemodilution in acute ischemic stroke. Results of subgroup analyses. Scandinavian Stroke Study Group.

Study Objective: To demonstrate the potential use of peripheral sulcus occipitotemporalis involvement as a first neuroimaging biomarker of visual object agnosia in acute ischemic stroke. Study Design: Retrospective study. Materials and Methods. We have examined 76 patients (52 males, 24 females) in peracute or acute hemisphetic (supratentorial) ischemic stroke. The age of participants was 66.5 ± 6.7 years. The examination involved neurological, neuropsychologic, neuroimaging and eye checks. Any disturbances of the visual object gnosis were diagnosed with the Object Decision test from the Birmingham Object Recognition Battery. According to brain CT and MRI results, all patients underwent assessment of their sulcus occipitotemporalis involvement. Study Results. Stroke-related visual object agnosia was diagnosed in 7 (9.2%) patients. Statistically significant correlation between foci localisation in the sulcus occipitotemporalis and visual object agnosia development (χ2 = 64.2; р < 0.001) has been demonstrated. The sensitivity of sulcus occipitotemporalis involvement as a biomarker of visual object agnosia in acute ischemic stroke was 85.7%, while the specificity was 100%. Conclusion. Sulcus occipitotemporalis involvement in acute ischemic stroke can be used as a neuroimaging biomarker of visual object agnosia. Keywords: visual agnosia, object agnosia, ischemic stroke, neuroimaging, sulcus occipitotemporalis.

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Intra-Arterial Bone Marrow Mononuclear Cells (BM-MNCS) Transplantation in Acute Ischemic Stroke (IBiS Trial): Protocol of a Phase II, Randomized, Dose-Finding, Controlled Multicenter Trial

International Journal of Stroke ◽

10.1111/ijs.12520 ◽

2015 ◽

Vol 10 (7) ◽

pp. 1149-1152 ◽

Cited By ~ 27

Author(s):

Francisco Moniche ◽

Irene Escudero ◽

Elena Zapata-Arriaza ◽

María Usero-Ruiz ◽

María Prieto-León ◽

...

Keyword(s):

Bone Marrow ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Phase Ii ◽

Mononuclear Cells ◽

Multicenter Trial ◽

Dose Finding ◽

Bone Marrow Mononuclear Cells ◽

Trial Protocol

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Abstract TMP25: Effects of Age and Ethnicity on the Benefits and Risks of Low- versus Standard-dose Alteplase in Acute Ischemic Stroke Patients: The Enchanted Trial

Stroke ◽

10.1161/str.48.suppl_1.tmp25 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Xia Wang ◽

Thompson Robinson ◽

Hisatomi. Arima ◽

Joseph Broderick ◽

Andrew Demchuk ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Treatment Effects ◽

Low Dose ◽

Standard Dose ◽

Intravenous Thrombolysis ◽

Open Label ◽

Poor Outcome ◽

Symptomatic Intracerebral Hemorrhage ◽

Stroke Study

Background and Purpose: As lower doses of alteplase reduce the risk of symptomatic intracerebral hemorrhage (sICH), older and Asian people may benefit more from low-dose alteplase than other patients with acute ischemic stroke (AIS). Methods: Data from the ENhanced Control of Hypertension ANd Thrombolysis strokE study (ENCHANTED), an international, multi-center, prospective, randomized, open-label, blinded-endpoint trial, were analyzed to assess effects of low- (0.6mg/kg body weight) vs. standard-dose (0.9mg/kg) alteplase in AIS patients, by age and ethnicity (Asian vs. non-Asian), pre-specified subgroup analyses, on key efficacy and safety outcomes. Results: 3297 patients (1248 female), mean age 67 years were included. After adjusting for baseline characteristics and management variables over the first seven days, increasing age was associated with poor outcome, defined by ordinal analysis of the modified Rankin score (mRS) (shift to a less favorable outcome, P trend <0.0001). In the comparison between low- and standard-dose alteplase, no significant differences were observed for 90-day poor outcome by age deciles and ethnicity. Less sICH was observed with low-dose alteplase, and this was consistent for age and ethnicity. There was no ethnic difference in the treatment effects by age, severity, and time to treatment. Conclusions: Increasing age predicts poor outcome in thrombolysis-treated AIS patients. There was no heterogeneity in the treatment effects of low- vs. standard-dose alteplase. Decisions about intravenous thrombolysis should be based on variables other than age and ethnicity.

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