scholarly journals Short-Term Outcome and In-Hospital Complications After Acute Cerebral Infarcts in Multiple Arterial Territories

Stroke ◽  
2019 ◽  
Vol 50 (12) ◽  
pp. 3625-3627 ◽  
Author(s):  
Vojtech Novotny ◽  
Andrej N. Khanevski ◽  
Anna T. Bjerkreim ◽  
Christopher E. Kvistad ◽  
Annette Fromm ◽  
...  
Keyword(s):  
Cerebral Infarct ◽  
National Institutes Of Health ◽  
Modified Rankin Scale ◽  
Cerebral Infarcts ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Stroke Population ◽  
Cerebral Ischemic ◽  
Acute Cerebral Infarct

Background and Purpose— Patients with acute cerebral infarcts in multiple arterial territories (MACI) represent a substantial portion of the stroke population. There are no data on short-term outcome and in-hospital complications in patients with MACI. We compared patients with MACI with patients having acute cerebral infarct(s) in a single arterial territory. Methods— We analyzed 3343 patients with diffusion-weighted imaging-confirmed acute cerebral infarcts. MACI was defined as at least 2 acute cerebral ischemic lesions in at least 2 arterial cerebral territories. Patients with MACI were compared with patients with acute cerebral infarct(s) in a single arterial territory for relevant in-hospital complications and short-term outcome, namely National Institutes of Health Stroke Scale and modified Rankin Scale at day 7 after admission or at discharge when earlier. Results— A total of 311 patients (9.3%) met the definition of MACI. Both median National Institutes of Health Stroke Scale (2 [1–7] versus 1 [0–4]) and modified Rankin Scale (3 [1–4] versus 2 [1–3]) were higher in patients with MACI. MACI was independently associated with higher National Institutes of Health Stroke Scale and modified Rankin Scale. Deep venous thrombosis, myocardial infarction, and any complications were more frequent in patients with MACI. Conclusions— In-hospital complications were more frequent in patients with MACI, which may adversely affect short-term clinical and functional outcome. Closer follow-up of patients with MACI during hospitalization may prevent such events and negative progression.

Procedural Complications During Early Versus Late Endovascular Treatment in Acute Stroke

Stroke ◽  
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.

scholarly journals Modified Rankin Scale and Short-Term Outcome in Cranial Neurosurgery: A Prospective and Unselected Cohort Study

2016 ◽  
Vol 91 ◽  
pp. 567-573.e7 ◽  
Author(s):  
Elina Reponen ◽  
Hanna Tuominen ◽  
Juha Hernesniemi ◽  
Miikka Korja
Keyword(s):  
Cohort Study ◽  
Modified Rankin Scale ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Unselected Cohort

Thrombomodulin-Dependent Protein C Activator Treatment Improves the Short-Term Outcome of Experimental Ischemic Stroke in Mice.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 895-895
Author(s):  
Andras Gruber ◽  
Patricia D. Hurn ◽  
Sawan Hurst ◽  
Leslie Bush ◽  
Ulla M. Marzec ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Infarct Size ◽  
Protein C ◽  
Brain Volume ◽  
Cerebral Infarct ◽  
Enzyme Treatment ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Dependent Protein

Abstract High dose human or mouse activated protein C (APC) treatment is neuroprotective in the transient intraluminal middle cerebral artery occlusion (MCAO) and reperfusion model of ischemic stroke, in mice. However, the therapeutic potential of systemic APC treatment in stroke might be limited because it can disable hemostasis. Low dose thrombomodulin-dependent protein C activator (PCA) enzyme treatment can generate antithrombotic APC on the intraluminal surface without profound systemic anticoagulation and antihemostatic effects in primates. We thus explored whether PCA treatment could produce short term outcome benefits in comparison to fibrinolysis with tPA in the mouse stroke model. Stroke was induced by MCAO between 0 and 60 min using an intraluminal filament that causes progressive and occlusive secondary thrombosis in the MCA region. Cortical perfusion as a measure of thrombotic occlusion was monitored from start until 75 min, i.e., following removal of the intraluminal filament. Cerebral infarct size (% brain volume, TTC stain), edema (% brain volume; calculated), and neurological damage scores (scale 0 – 5) were assessed in survivors at sacrifice next day. All animals (N=12 to 16 in each treatment group) were evaluated for macroscopic hemorrhage (intracerebral or other sites) on autopsy after death. Treatments with vehicle (saline bolus), recombinant PCA thrombin analog W215A/E217A (0.025 mg/kg IV bolus) or plasminogen activator (2.5 mg/kg Bolus, [tPA-B], or 10 mg/kg Infusion for 45 min, [tPA-I]) were started 15 min after initiation of MCAO. One day mortality rates were similar: 29% in the PCA, 38% in the tPA-B, and 23% in the tPA-I treatment groups vs. 23% in vehicle controls (P&gt;0.05 each). Cerebral infarct size was reduced by 62%, 43%, and 73% in the PCA bolus, tPA-B, and tPA-I treated groups, respectively (p&lt;0.05 for each). Macroscopic hemorrhage (intracranial and/or other sites) was found in 15% (2/13), 14% (2/14), 44% (7/16), and 31% (4/13) in the vehicle, PCA, tPA-B, and tPA-I-treated groups, respectively. One day neurological scores averaged 1.5 in PCA-treated (p&lt;0.05), 3.2 in tPA-B (NS), and 2.2 in tPA-I treated (p&lt;0.05) versus 3.9 in saline vehicle-treated animals. All enzyme treatments significantly reduced secondary (thrombotic) vascular occlusions, as evidenced by 62% (PCA), 66% (tPA-B), and 72% (tPA-I) improvement of early cortical reperfusion vs. vehicle-treated controls (p&lt;0.05 each). The means and SEM are illustrated in the figure below. The apparent efficacy and safety of intermediate dose PCA in this model suggests that PCA treatment might have therapeutic utility in acute ischemic stroke, e.g. when reperfusion of the MCA is achieved by tPA treatment or other modalities. Figure Figure

Short-term outcome of patients with cardiac- and thrombo-embolic cerebral infarcts

2008 ◽  
Vol 110 (6) ◽  
pp. 566-569 ◽  
Author(s):  
Jacques De Reuck ◽  
Veerle Vervaet ◽  
Georges Van Maele ◽  
Liesbeth De Groote
Keyword(s):  
Cerebral Infarcts ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome

scholarly journals Association of neuroimaging markers of cerebral small vessel disease with short-term outcomes in patients with minor cerebrovascular events

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xuemei Chen ◽  
Lin Wang ◽  
Junying Jiang ◽  
Yuanyuan Gao ◽  
Rui Zhang ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Small Vessel Disease ◽  
National Institutes Of Health ◽  
Stroke Recurrence ◽  
Short Term ◽  
Poor Functional Outcome ◽  
Term Outcome ◽  
Vessel Disease ◽  
Short Term Outcome ◽  
Cerebrovascular Events

Abstract Background Increasing evidences have showed that neuroimaging markers of SVD can predict the short-term outcome of acute ischemic stroke (AIS). It is unclear that whether neuroimaging markers of SVD are also associated with short-term outcomes of minor cerebrovascular events. In the present study, we investigate neuroimaging markers of SVD in order to explore their roles in prediction of short-term outcome in patients with minor cerebrovascular events. Methods Consecutive first-ever stroke patients (n = 546) from the Affiliated Jiangning Hospital of Nanjing Medical University were enrolled. A total of 388 patients were enrolled according to minor cerebrovascular events definition (National Institutes of Health Stroke Scale Score ≤ 3) and exclusion criteria. MRI scans were performed within 7 days of stroke onset, and then neuroimaging markers of SVD including WMH, lacunes, cerebral microbleeds (CMB), and perivascular spaces (PVS), SVD burden scores were assessed. We completed baseline characteristics and evaluated the relationships of short-term outcomes to SVD neuroimaging markers and SVD scores. The 90-day modified Rankin Scale (mRS) was thought as primary outcome and was dichotomized as good functional outcome (mRS 0–1) and poor outcome (mRS 2–6). Secondary outcomes were stroke progression and stroke recurrence. Results Higher age, National Institutes of Health Stroke Scale (NIHSS) upon admission, lipoprotein-associated phospholipase A2 (LP-PLA2) and lacunes, Fazekas score were correlated with poor functional outcome (P < 0.05), But after adjusting for confounding variables, among the neuroimaging markers of cerebral small vessel disease, only Fazekas score (OR, 1.343; 95% confidence interval, 1.020–1.770; P = 0.036) was found to be associated with poor outcome at 90 days. Higher Fazekas and SVD scores were not associated with stroke progression or stroke recurrence. Conclusion WMH can predict the poor functional outcome of minor cerebrovascular events. Adding other neuroimaging markers of SVD and total SVD burden score, however, does not improve the prediction, which indicated WMH can as neuroimaging markers for guiding the treatment of minor cerebrovascular events.

scholarly journals Association of Neuroimaging Markers of Cerebral Small Vessel Disease With Short-Term Outcomes in Patients With Minor Cerebrovascular Events

2020 ◽  
Author(s):  
Xuemei Chen ◽  
Lin Wang ◽  
Junying Jiang ◽  
Yuanyuan Gao ◽  
Rui Zhang ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Small Vessel Disease ◽  
National Institutes Of Health ◽  
Stroke Recurrence ◽  
Short Term ◽  
Poor Functional Outcome ◽  
Term Outcome ◽  
Vessel Disease ◽  
Short Term Outcome ◽  
Cerebrovascular Events

Abstract Background: Increasing evidences have showed that neuroimaging markers of SVD can predict the short-term outcome of acute ischemic stroke (AIS).It is unclear that whether neuroimaging markers of SVD are also associated with short-term outcomes of minor cerebrovascular events. In the present study, we investigate neuroimaging markers of SVD in order to explore their roles in prediction of short-term outcome in patients with minor cerebrovascular events. Methods: Consecutive first-ever stroke patients (n=546) from the Affiliated Jiangning Hospital of Nanjing Medical University were enrolled. A total of 388 patients were enrolled according to minor cerebrovascular events definition（National Institutes of Health Stroke Scale Score≤3）and exclusion criteria. MRI scans were performed within seven days of stroke onset, and then neuroimaging markers of SVD including WMH, lacunes, cerebral microbleeds (CMB), and perivascular spaces (PVS) , SVD burden scores were assessed. We completed baseline characteristics and evaluated the relationships of short-term outcomes to SVD neuroimaging markers and SVD scores. The 90-day modified Rankin Scale (mRS) was thought as primary outcome and was dichotomized as good functional outcome (mRS 0-1) and poor outcome (mRS 2-6). Secondary outcomes were stroke progression and stroke recurrence. Results: Higher age, National Institutes of Health Stroke Scale (NIHSS) upon admission, lipoprotein-associated phospholipase A2 (LP-PLA2) and lacunes, Fazekas score were correlated with poor functional outcome (P<0.05), But after adjusting for confounding variables, among the neuroimaging markers of cerebral small vessel disease, only Fazekas score (OR, 1.343; 95% confidence interval, 1.020-1.770; P=0.036) was found to be associated with poor outcome at 90 days. Higher Fazekas and SVD scores were not associated with stroke progression or stroke recurrence. Conclusion: WMH can predict the poor functional outcome of minor cerebrovascular events. Adding other neuroimaging markers of SVD and total SVD burden score, however, does not improve the prediction, which indicated WMH can as neuroimaging markers for guiding the treatment of minor cerebrovascular events.

scholarly journals Evaluation of Short Term Outcome of Acute Ischemic Stroke by Modified Rankin Scale

2020 ◽  
Vol 8 (11) ◽  
pp. 2556-2561
Author(s):  
Dr. Priobrata Karmakar ◽  
Dr. Sukumar Majumder ◽  
Dr. Monika Roy ◽  
Dr. Sushanta Kumar Barman ◽  
Dr. Asm Shafiujjaman ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Modified Rankin Scale ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome

scholarly journals Association of Neuroimaging Markers of Cerebral Small Vessel Disease With Short-Term Outcomes in Patients With Minor Cerebrovascular Events

2021 ◽  
Author(s):  
Xuemei Chen ◽  
Lin Wang ◽  
Junying Jiang ◽  
Yuanyuan Gao ◽  
Rui Zhang ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Small Vessel Disease ◽  
National Institutes Of Health ◽  
Stroke Recurrence ◽  
Short Term ◽  
Poor Functional Outcome ◽  
Term Outcome ◽  
Vessel Disease ◽  
Short Term Outcome ◽  
Cerebrovascular Events

Abstract Background: Increasing evidences have showed that neuroimaging markers of SVD can predict the short-term outcome of acute ischemic stroke (AIS).It is unclear that whether neuroimaging markers of SVD are also associated with short-term outcomes of minor cerebrovascular events. In the present study, we investigate neuroimaging markers of SVD in order to explore their roles in prediction of short-term outcome in patients with minor cerebrovascular events. Methods: Consecutive first-ever stroke patients (n=546) from the Affiliated Jiangning Hospital of Nanjing Medical University were enrolled. A total of 388 patients were enrolled according to minor cerebrovascular events definition（National Institutes of Health Stroke Scale Score≤3）and exclusion criteria. MRI scans were performed within seven days of stroke onset, and then neuroimaging markers of SVD including WMH, lacunes, cerebral microbleeds (CMB), and perivascular spaces (PVS) , SVD burden scores were assessed. We completed baseline characteristics and evaluated the relationships of short-term outcomes to SVD neuroimaging markers and SVD scores. The 90-day modified Rankin Scale (mRS) was thought as primary outcome and was dichotomized as good functional outcome (mRS 0-1) and poor outcome (mRS 2-6). Secondary outcomes were stroke progression and stroke recurrence. Results: Higher age, National Institutes of Health Stroke Scale (NIHSS) upon admission, lipoprotein-associated phospholipase A2 (LP-PLA2) and lacunes, Fazekas score were correlated with poor functional outcome (P<0.05), But after adjusting for confounding variables, among the neuroimaging markers of cerebral small vessel disease, only Fazekas score (OR, 1.343; 95% confidence interval, 1.020-1.770; P=0.036) was found to be associated with poor outcome at 90 days. Higher Fazekas and SVD scores were not associated with stroke progression or stroke recurrence. Conclusion: WMH can predict the poor functional outcome of minor cerebrovascular events. Adding other neuroimaging markers of SVD and total SVD burden score, however, does not improve the prediction, which indicated WMH can as neuroimaging markers for guiding the treatment of minor cerebrovascular events.

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