scholarly journals Diagnostic Criteria For Acute Headache Attributed To Ischemic Stroke And For Sentinel Headache Before Ischemic Stroke.

2021 ◽  
Author(s):  
Elena R Lebedeva ◽  
Anton V. Ushenin ◽  
Natalia M. Gurary ◽  
Denis V. Gilev ◽  
Jes Olesen
Keyword(s):  
Ischemic Stroke ◽  
Emergency Room ◽  
Diagnostic Criteria ◽  
High Sensitivity ◽  
Structured Interview ◽  
Case Control ◽  
Neurological Deficits ◽  
Case Control Studies ◽  
Face To Face ◽  
Acute Headache

Abstract Background: Defining the relationship between a headache and stroke is essential. The current diagnostic criteria of the ICHD-3 for acute headache attributed to ischemic stroke are based primarily on the opinion of experts rather than on published clinical evidence based on extensive case-control studies in patients with first-ever stroke. Diagnostic criteria for sentinel headache before ischemic stroke do not exist. The present study aimed to develop explicit diagnostic criteria for headache attributed to ischemic stroke and for sentinel headache.Methods: This prospective case-control study included 550 patients (mean age 63,1, 54% males) with first-ever ischemic stroke and 192 control patients (mean age 58.7, 36% males) admitted to the emergency room without any acute neurological deficits or severe disorders. Standardized semi-structured interview forms were used to evaluate past and present headaches during face-to-face interviews by a neurologist on admission to the emergency room in both groups of patients. All headaches were diagnosed according to the ICHD-3. We tabulated the onset of different headaches before a first-ever ischemic stroke and at the time of onset of stroke. We divided them into three groups: a new type of headache, the previous headache with altered characteristics and previous unaltered headaches. The same was done for headaches in control patients within one week before admission to the hospital and at the time of entry. These data were used to create and test diagnostic criteria for acute headache attributed to stroke and sentinel headache. Results: Our previous studies showed that headache at onset of ischemic stroke was present in 82 (14.9%) of 550 patients, and 81 (14.7%) patients had sentinel headache within the last week before a stroke. Only 60% of the headaches at stroke onset fulfilled the diagnostic criteria of ICHD-3. Therefore, we proposed alternative criteria with a sensitivity of 100% and specificity of 97%. Besides, we developed diagnostic criteria for sentinel headache for the first time with a specificity of 98% and a sensitivity of 100%. Conclusion: We suggest alternative criteria for acute headache attributed to ischemic stroke and new diagnostic criteria for sentinel headache with high sensitivity and specificity.

scholarly journals Risk Factors for Hemorrhagic and Ischemic Stroke in Sub-Saharan Africa

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Gertrude Namale ◽  
Onesmus Kamacooko ◽  
Alison Kinengyere ◽  
Laetitia Yperzeele ◽  
Patrick Cras ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Case Series ◽  
Pooled Analysis ◽  
Case Control ◽  
Sub Saharan Africa ◽  
Cochrane Central Register ◽  
Case Control Studies ◽  
Pooled Prevalence ◽  
Sub Saharan

Introduction. In sub-Saharan Africa (SSA), there is a significant burden of ischemic stroke (IS) and hemorrhagic stroke (HS), although data on risk factors for each type are sparse. In this systematic review we attempt to characterize the risk factors. Methods. We systematically reviewed (PubMed, EMBASE, WHOLIS, Google Scholar, Wiley online, and the Cochrane Central Register of Controlled Trials (CENTRAL)) case-control studies and case series from 1980 to 2016 that reported risk factors for IS and/or HS in SSA. For each risk factor we calculated random-effects pooled odds ratios (ORs) for case-control studies and pooled prevalence estimates for case series. Results. We identified 12 studies, including 4,387 stroke patients. Pooled analysis showed that patients who had diabetes (OR = 2.39; 95% CI: 1.14–5.03) and HIV (OR = 2.46 (95% CI: 1.59–3.81) were at a significantly greater risk of suffering from all stroke types. There were insufficient data to examine these factors by stroke type. Among case series, the pooled prevalence of hypertension was higher for HS than for IS (73.5% versus 62.8%), while diabetes mellitus (DM) and atrial fibrillation (AF) were more prevalent among IS compared to HS (15.9% versus 10.6% and 9.6% versus 2.3%, respectively). Conclusions. There remain too few data from SSA to reliably estimate the effect of various factors on the risk of IS and HS. Furthermore, the vast majority of cases were identified in hospital and so are unlikely to be representative of the totality of stroke cases in the community.

Association between rs1801133 polymorphism and risk of adult ischemic stroke: Meta-analysis based on case–control studies

2016 ◽  
Vol 137 ◽  
pp. 17-25 ◽  
Author(s):  
Min Chen ◽  
Ben Yu Mao ◽  
Dan Wang ◽  
Xianglin Cheng ◽  
Chuan Xin Xu
Keyword(s):  
Ischemic Stroke ◽  
Meta Analysis ◽  
Case Control ◽  
Case Control Studies

Plasma Levels of Protein Z in Ischemic Stroke: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 120 (05) ◽  
pp. 815-822
Author(s):  
Artur Słomka ◽  
Mariusz Kowalewski ◽  
Ewa Żekanowska ◽  
Piotr Suwalski ◽  
Roberto Lorusso ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Phase ◽  
Meta Analysis ◽  
The United States ◽  
Case Control ◽  
Cochrane Library ◽  
Blood Levels ◽  
Case Control Studies ◽  
Protein Z ◽  
Convalescent Phase

AbstractThe association between blood levels of protein Z (PZ) and risk of ischemic stroke remains poorly understood. We aimed to assess this potential relationship through a meta-analysis of case–control studies. PubMed, Scopus, Web of Science Core Collection, and the Cochrane Library were searched from April 1984 to April 2019. We selected case–control studies comparing PZ levels in adult patients with ischemic stroke and controls without ischemic stroke. Six case–control studies, with a total of 1,011 ischemic stroke patients and 1,128 controls, were included. Patients in the acute phase of ischemic stroke showed significantly higher levels of PZ compared with patients in the convalescent phase (standardized mean difference [SMD]: 0.289 mg/L; 95% confidence interval [CI]: 0.010, 0.569; p = 0.043). No significant differences in PZ levels were found between patients and controls in the acute phase (SMD: −0.059 mg/L; 95% CI: −0.570, 0.452; p = 0.821) or in the convalescent phase of ischemic stroke (SMD: −0.341 mg/L; 95% CI: −0.736, 0.055; p = 0.091). Subgroup analysis indicated that older patients (≥ 50 years old) had lower PZ levels than similarly aged controls. In contrast, when the study groups came from the United States and Australia or Europe no significant differences in PZ levels existed between patients and controls. No association between PZ and ischemic stroke was identified in this meta-analysis. The acute phase of ischemic stroke was associated with higher levels of PZ.

scholarly journals The effect of misclassification error on risk estimation in case-control studies

2015 ◽  
Vol 18 (2) ◽  
pp. 341-356 ◽  
Author(s):  
Armando Baena ◽  
Isabel Cristina Garcés-Palacio ◽  
Hugo Grisales
Keyword(s):  
Linear Models ◽  
Risk Estimation ◽  
High Sensitivity ◽  
High Specificity ◽  
Epidemiological Studies ◽  
Case Control ◽  
Misclassification Error ◽  
Case Control Studies ◽  
Differential Misclassification ◽  
Study Bias

INTRODUCTION: In epidemiological studies, misclassification error, especially differential misclassification, has serious implications. OBJECTIVE: To illustrate how differential misclassification error (DME) and non-differential misclassification error (NDME) occur in a case-control design and to describe the trends in DME and NDME. METHODS: Different sensitivity levels, specificity levels, prevalence rates and odds ratios were simulated. Interaction graphics were constructed to study bias in the different settings, and the effect of the different factors on bias was described using linear models. RESULTS: One hundred per cent of the biases caused by NDME were negative. DME biased the association positively more often than it did negatively (70 versus 30%), increasing or decreasing the OR estimate towards the null hypothesis. CONCLUSIONS: The effect of the sensitivity and specificity in classifying exposure, the prevalence of exposure in controls and true OR differed between positive and negative biases. The use of valid exposure classification instruments with high sensitivity and high specificity is recommended to mitigate this type of bias.

scholarly journals Genetic Variant on Chromosome 12p13 Does Not Show Association to Ischemic Stroke in 3 Swedish Case-Control Studies

Stroke ◽  
2011 ◽  
Vol 42 (1) ◽  
pp. 214-216 ◽  
Author(s):  
Sandra Olsson ◽  
Olle Melander ◽  
Katarina Jood ◽  
J. Gustav Smith ◽  
Håkan Lövkvist ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Genetic Variant ◽  
Case Control ◽  
Case Control Studies
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