Vascular dementia: Clinical and neuroradiological correlation

All stroke patients admitted to Banjaluka Clinical Centre during one year were evaluated by the standard protocol during the hospitalization and three months after the stroke. It included clinical, functional and neuropsychological examination and neuroimaging. Dementia was diagnosed according to the criteria of National Institute of Neurological Disorders and Stroke-Association Internationale pour la Recherche et l?Enseignement en Neurosciences. Demographic and clinical variables were examined. After the exclusion of the patients who died (n=139) and those who refused to be interviewed during the 3-month follow up (n=52) and those with pre-stroke dementia (n=22), a total of 273 (58.8%) patients underwent neuropsychological examination 3 months after the stroke. Fortynine (19.52%) of them met the criteria for vascular dementia. The predictors of vascular dementia were age, atrial fibrillation, cognitive and functional impairment on admission and functional outcome, subcortical lacunar infarctions, leukoaraiosis, multiple and bilateral brain lesions. Dementia is frequent after stroke and it cannot be determined by a single factor. A combination of several factors increases the critical threshold for cognitive decline.

Download Full-text

Abstract 51: Access to Primary Stroke Centers for Older Adults and Implications for Travel Times, and Mortality

Stroke ◽

10.1161/str.46.suppl_1.51 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Kimon Bekelis ◽

Kendrew Wong ◽

Nancy Marth ◽

Weiping Zhou ◽

Jonathan Skinner

Keyword(s):

Regional Variation ◽

Fee For Service ◽

Travel Times ◽

Stroke Patients ◽

Multivariable Regression ◽

Potential Impact ◽

One Year ◽

Multivariable Regression Models ◽

Regionalization Of Care

Background: Regionalization of care to primary stroke centers (PSC) may improve outcomes for stroke patients. We evaluated the current access of Medicare stroke patients to PSC, and its potential impact on mortality. Methods: We performed a retrospective cohort study of a 100% sample of Medicare fee-for-service claims data for patients admitted with stroke in 2008-2009, with one-year follow-up through 2010. Population weighted centroids were created, helicopter pad locations were identified, and driving distances were calculated based on real road network data. Driving and flying speeds, dispatch, scene, and pre-hospital times were estimated using validated models, adjusted for population density. The association of 30-day mortality with travel times, and treatment at a PSC was investigated using multivariable regression models. Results: During the study period, 510,822 patients (mean age 79.6 years, 59.7% females) had a stroke. There was significant regional variation in our cohort, (Figure) with 8.6% of stroke patients having ground access to a PSC within 30 minutes, 14.9% from 30 to 45 minutes, 11.1% from 45 to 60 minutes, 43.9% from 1 to 4.5 hours, and 21.5% over 4.5 hours. The latter group could be limited to 0.1% of stroke patients, if existing helicopter services were used optimally. 164,485 (32.2%) patients received treatment in a PSC, and had modestly decreased mortality (OR, 0.97; 95% CI, 0.95-0.99). For this group, actual travel time to the PSC was not associated with mortality for patients within one hour of the PSC. On the contrary, travel times from 1 to 4.5 hours (OR, 1.15; 95% CI, 1.08-1.22), and over 4.5 hours (OR, 1.41; 95% CI, 1.29-1.54) were associated with increased mortality. Conclusions: There is significant regional variation in access to PSC for elderly stroke patients, with a potential impact on outcomes. Optimal use of helicopter services may address these disparities. Funding: NIH (P01-AG19783, and U01-AG046830-01).

Download Full-text

The effect of an intensive exercise programme on leg function in chronic stroke patients: a pilot study with one-year follow-up

Clinical Rehabilitation ◽

10.1177/0269215509335291 ◽

2009 ◽

Vol 23 (9) ◽

pp. 790-799 ◽

Cited By ~ 10

Author(s):

Roland Stock ◽

Paul Jarle Mork

Keyword(s):

Pilot Study ◽

Exercise Programme ◽

Chronic Stroke ◽

Stroke Patients ◽

Intensive Exercise ◽

One Year

Download Full-text

One-Year Follow-Up in Stroke Patients Discharged from Rehabilitation Hospital

Cerebrovascular Diseases ◽

10.1159/000016021 ◽

2000 ◽

Vol 10 (1) ◽

pp. 25-32 ◽

Cited By ~ 32

Author(s):

Stefano Paolucci ◽

Maria Grazia Grasso ◽

Gabriella Antonucci ◽

Elio Troisi ◽

Daniela Morelli ◽

...

Keyword(s):

Stroke Patients ◽

Rehabilitation Hospital ◽

One Year

Download Full-text

Recurrence of Febrile Convulsions

Paediatrica Indonesiana ◽

10.14238/pi35.5-6.1995.118-23 ◽

2018 ◽

Vol 35 (5-6) ◽

pp. 118-23

Author(s):

Taslim S Soetomenggolo

Keyword(s):

Child Health ◽

Neurological Disorders ◽

Febrile Convulsion ◽

Febrile Convulsions ◽

Pediatric Neurology ◽

Neurology Clinic ◽

History Of ◽

History Of Epilepsy ◽

One Year

During two years, 92 patients who experienced first febrile convulsion were followed-up in the Pediatric Neurology Clinic, Department of Child Health, Cipto Mangunkusumo Hospital, Jakarta for at least one year. Of the 92 patients 58 (63%) were males and 34 (37%) females. Most of the patients were less than 4 years, and only 6 patients (6,5%) aged more than 4 years. Eight (8, 7%) of the 92 patients suffered from recurrence of febrile convulsions, and in 5 of them the recurrence occurred within the first 6 months of follow-up. The recurrences of febrile convulsions occurred mostly in patients less than one year of age, those with tonic seizures, those with neurological disorders, and those who had history of epilepsy in their family. In this study the occurrence of recurrent febrile convulsions in patients with normal EEG was higher than that in patients with abnormal EEG.

Download Full-text

A one-year follow-up after modified constraint-induced movement therapy for chronic stroke patients with paretic arm: a prospective case series study

Topics in Stroke Rehabilitation ◽

10.1179/1074935714z.0000000028 ◽

2015 ◽

Vol 22 (1) ◽

pp. 18-25 ◽

Cited By ~ 8

Author(s):

Takashi Takebayashi ◽

Satoru Amano ◽

Keisuke Hanada ◽

Atsushi Umeji ◽

Kayoko Takahashi ◽

...

Keyword(s):

Case Series ◽

Movement Therapy ◽

Chronic Stroke ◽

Stroke Patients ◽

Constraint Induced Movement Therapy ◽

Case Series Study ◽

Prospective Case Series ◽

One Year ◽

Series Study

Download Full-text

The Sensitivity and Specificity of the Center for Epidemiologic Studies Depression Scale in Screening for Post-Stroke Depression

The International Journal of Psychiatry in Medicine ◽

10.2190/bh75-euya-4fm1-j7qa ◽

1989 ◽

Vol 18 (2) ◽

pp. 169-181 ◽

Cited By ~ 95

Author(s):

Rajesh M. Parikh ◽

Dianne T. Eden ◽

Thomas R. Price ◽

Robert G. Robinson

Keyword(s):

Sensitivity And Specificity ◽

Depression Scale ◽

Screening Instrument ◽

Epidemiologic Studies ◽

Stroke Patients ◽

Post Stroke ◽

Standardized Interview ◽

Post Stroke Depression ◽

One Year

The present study examines the sensitivity and specificity of the Center for Epidemiologic Studies Depression Scale (CES-D) as a screening instrument for post-stroke depression. Eighty stroke patients were evaluated by a research nurse over a two-year period using the CES-D and also by a trained psychiatrist using a standardized interview for affective, cognitive, physical and social functioning. CES-D scores correlated significantly with DSM-III diagnoses of depression in-hospital and at three months, six months, and one year follow-up but not at two years follow-up, reflecting the natural course of these depressions, as well as the predictive validity of the CES-D. Furthermore, at a cut-off point of 16, the CES-D was found to have a specificity of 90 percent, a sensitivity of 86 percent and a positive predictive value of 80 percent and thus may be a potentially useful screening instrument for post-stroke depression.

Download Full-text

Impact of White Matter Lesions on Cognition in Stroke Patients Free from Pre-Stroke Cognitive Impairment: A One-Year Follow-Up Study

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000336817 ◽

2012 ◽

Vol 2 (1) ◽

pp. 38-47 ◽

Cited By ~ 15

Author(s):

Hege Ihle-Hansen ◽

Bente Thommessen ◽

Morten Wang Fagerland ◽

Torgeir Bruun Wyller ◽

Knut Engedal ◽

...

Keyword(s):

Cognitive Impairment ◽

White Matter ◽

White Matter Lesions ◽

Stroke Patients ◽

Follow Up Study ◽

One Year

Download Full-text

Evolution of short cognitive test performance in stroke patients with vascular cognitive impairment and vascular dementia: Baseline evaluation and follow-up

Dementia & Neuropsychologia ◽

10.1590/1980-57642016dn11-040007 ◽

2017 ◽

Vol 11 (4) ◽

pp. 381-388 ◽

Cited By ~ 3

Author(s):

Nilton Custodio ◽

Rosa Montesinos ◽

David Lira ◽

Eder Herrera-Perez ◽

Yadira Bardales ◽

...

Keyword(s):

Cognitive Impairment ◽

Vascular Dementia ◽

Cognitive Performance ◽

Vascular Cognitive Impairment ◽

Cognitive Test ◽

Stroke Patients ◽

Clinical Dementia Rating ◽

Baseline Evaluation ◽

Box Plot

ABSTRACT. There is limited evidence about the progression of cognitive performance during the post-stroke stage. Objective: To assess the evolution of cognitive performance in stroke patients without vascular cognitive impairment (VCI), patients with vascular mild cognitive impairment (MCI), and patients with vascular dementia (VD). Methods: A prospective cohort of stroke outpatients from two secondary medical centers in Lima, Peru was studied. We performed standardized evaluations at definitive diagnosis (baseline evaluation), and control follow-ups at 6 and 12 months, including a battery of short cognitive tests: Clinical Dementia Rating (CDR), Addenbrooke's Cognitive Examination (ACE), and INECO Frontal Screening (IFS). Results: 152 outpatients completed the follow-up, showing progressive increase in mean score on the CDR(0.34 to 0.46), contrary to the pattern observed on the ACE and IFS (78.18 to 76.48 and 23.63 to 22.24). The box plot for the CDR test showed that VCI patients had progressive worsening (0.79 to 0.16). Conversely, this trend was not observed in subjects without VCI. The box plot for the ACE and IFS showed that, for the majority of the differentiated stroke types, both non-VCI and VCI patients had progressive worsening. Conclusion: According to both ACE and IFS results during a 1-year follow-up, the cognitive performance of stroke patients worsened, a trend which was particularly consistent in infarction-type stroke patients.

Download Full-text