scholarly journals The Role of Serum Osteoprotegerin and S-100 Protein Levels in Patients with Acute Ischaemic Stroke: Determination of Stroke Subtype, Severity and Mortality

2011 ◽  
Vol 39 (3) ◽  
pp. 780-789 ◽  
Author(s):  
M Üstündağ ◽  
M Orak ◽  
C Güloğlu ◽  
Y Tamam ◽  
MB Sayhan ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Stroke Subtype ◽  
Protein Levels ◽  
S 100

scholarly journals Cerebral Haemodynamics following Acute Ischaemic Stroke: Effects of Stroke Severity and Stroke Subtype

2018 ◽  
Vol 8 (2) ◽  
pp. 80-89 ◽  
Author(s):  
Osian Llwyd ◽  
Angela S.M. Salinet ◽  
Ronney B. Panerai ◽  
Man Y. Lam ◽  
Nazia P. Saeed ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Cerebral Blood Flow Velocity ◽  
Cerebral Arteries ◽  
Correlation Coefficients ◽  
Stroke Severity ◽  
Stroke Subtype ◽  
Cerebral Haemodynamics ◽  
Anterior Circulation ◽  
Mean Values

Background: Acute ischaemic stroke (AIS) patients often show impaired cerebral autoregulation (CA). We tested the hypothesis that CA impairment and other alterations in cerebral haemodynamics are associated with stroke subtype and severity. Methods: AIS patients (n = 143) were amalgamated from similar studies. Data from baseline (< 48 h stroke onset) physiological recordings (beat-to-beat blood pressure [BP], cerebral blood flow velocity (CBFV) from bilateral insonation of the middle cerebral arteries) were calculated for mean values and autoregulation index (ARI). Differences were assessed between stroke subtype (Oxfordshire Community Stroke Project [OCSP] classification) and severity (National Institutes of Health Stroke Scale [NIHSS] score < 5 and 5–25). Correlation coefficients assessed associations between NIHSS and physiological measurements. Results: Thirty-two percent of AIS patients had impaired CA (ARI < 4) in affected hemisphere (AH) that was similar between stroke subtypes and severity. CBFV in AH was comparable between stroke subtype and severity. In unaffected hemisphere (UH), differences existed in mean CBFV between lacunar and total anterior circulation OCSP subtypes (42 vs. 56 cm•s–1, p < 0.01), and mild and moderate-to-severe stroke severity (45 vs. 51 cm•s–1, p = 0.04). NIHSS was associated with peripheral (diastolic and mean arterial BP) and cerebral haemodynamic parameters (CBFV and ARI) in the UH. Conclusions: AIS patients with different OCSP subtypes and severity have homogeneity in CA capability. Cerebral haemodynamic measurements in the UH were distinguishable between stroke subtype and severity, including the association between deteriorating ARI in UH with stroke severity. More studies are needed to determine their clinical significance and to understand the determinants of CA impairment in AIS patients.

Stress hyperglycaemia is associated with poor functional outcomes in patients with acute ischaemic stroke after intravenous thrombolysis

QJM ◽  
2020 ◽  
Author(s):  
J N Ngiam ◽  
C W S Cheong ◽  
A S T Leow ◽  
Y -T Wei ◽  
J K X Thet ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Functional Outcomes ◽  
Mechanical Thrombectomy ◽  
Venous Blood ◽  
Intravenous Thrombolysis ◽  
Glycated Haemoglobin ◽  
Stress Hyperglycaemia ◽  
As Stress

Summary Background Transient hyperglycaemia in the context of illness with or without known diabetes has been termed as ‘stress hyperglycaemia’. Stress hyperglycaemia can result in poor functional outcomes in patients with acute ischaemic stroke (AIS) who underwent mechanical thrombectomy. We investigated the association between stress hyperglycaemia and clinical outcomes in AIS patients undergoing intravenous thrombolysis (IVT). Methods We examined 666 consecutive patients with AIS who underwent IVT from 2006 to 2018. All patients had a glycated haemoglobin level (HbA1c) and fasting venous blood glucose measured within 24 h of admission. Stress hyperglycaemia ratio (SHR) was defined as the ratio of the fasting glucose to the HbA1c. Univariate and multivariate analyses were employed to identify predictors of poor functional outcomes (modified Rankin Scale 3–6 at 3 months) after IVT. Results Three-hundred and sixty-one patients (54.2%) had good functional outcomes. These patients tended to be younger (60.7 ± 12.7 vs. 70 ± 14.4 years, P &lt; 0.001), male (70.7% vs. 51.5%, P &lt; 0.001), had lower prevalence of atrial fibrillation (13.0% vs. 20.7%, P = 0.008) and lower SHR (0.88 ± 0.20 vs. 0.99 ± 26, P &lt; 0.001). Patients with high SHR (≥0.97) were slightly older than those with low SHR (&lt;0.97) and were more likely to have diabetes mellitus. On multivariate analysis, higher SHR was independently associated with poor functional outcomes (adjusted odds ratio 3.85, 95% confidence interval 1.59–9.09, P = 0.003). Conclusion SHR appears to be an important predictor of functional outcomes in patients with AIS undergoing IVT. This may have important implications on the role of glycaemic control in the acute management of ischaemic stroke.

Critical care management of the patient with an acute ischaemic stroke

2021 ◽  
Vol 82 (1) ◽  
pp. 1-9
Author(s):  
Randeep K Mullhi ◽  
Naginder Singh ◽  
Tonny Veenith
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Care Management ◽  
Stroke Units ◽  
Medical Progress ◽  
Critical Care Management ◽  
The Uk

Acute ischaemic stroke is a leading cause of morbidity and mortality worldwide. In the UK alone, there are more than 100 000 strokes per year, causing 38 000 deaths. While the incidence remains high, there has been significant medical progress in reducing mortality following a stroke. Admission of patients to specialised stroke units has led to an improvement in clinical outcomes, but the role of intensive care is less well defined. This article reviews the current critical care management and neuro-therapeutic options after an acute ischaemic stroke.

Stroke basics

2010 ◽  
pp. 524-534
Author(s):  
George Samandouras
Keyword(s):  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Cerebral Veins ◽  
Dural Sinuses ◽  
Basic Concepts

Chapter 9.3 covers stroke basics, including basic concepts, management, imaging, specific ischaemic syndromes, treatment, the role of surgery in acute ischaemic stroke, and thrombosis of dural sinuses (DST) and cerebral veins.

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