scholarly journals Anosognosia for Motor and Cognitive Deficit as a Clinical Manifestation of Ischemic Stroke: Review of Literature

Doctor Ru ◽  
2020 ◽  
Vol 19 (9) ◽  
pp. 33-38
Author(s):  
V.N. Grigorieva ◽  
◽  
T.A. Sorokina ◽  
◽  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Neurological Deficit ◽  
Cognitive Deficit ◽  
Negative Impact ◽  
Behavioral Therapy ◽  
Vestibular Stimulation ◽  
Medical Rehabilitation ◽  
Stroke Patients ◽  
Caloric Vestibular Stimulation

Objective of the Review: To present data from the latest research studies focusing on anosognosia for neurological deficit in patients with acute ischemic stroke. Key Points: Anosognosia for motor and cognitive deficit is a quite common disorder in acute ischemic stroke patients. This condition is of interest for neurologists because it manifests itself in an unusual way and has a negative impact on patients’ medical rehabilitation. The understanding of the pathophysiology of anosognosia and its neuroanatomical underpinnings is changing and improving. New information about approaches to the diagnosis and treatment of this condition is becoming available, making this review timely. Conclusion: Patients with acute ischemic stroke may have reduced perception of their neurological deficit and cognitive, emotional, and behavioral disorders. Hemispatial neglect is the most common cognitive disorder associated with anosognosia for paralysis. Medical rehabilitation of post-stroke patients with anosognosia is challenging and requires the participation of a multidisciplinary team and a differentiated approach, tailored to the type of anosognosia. At present, rehabilitation specialists have started discussing the possibility of therapeutic application of instrumental investigation techniques, such as caloric vestibular stimulation and transcranial brain stimulation, in addition to cognitive behavioral therapy. Keywords: reduced perception of disease, anosognosia, regulatory dysfunction, neglect, ischemic stroke.

Abstract 4013: The Hydration Influence on the Risk of Ischemic Stroke Outcome (THIRST-O) Study

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Mohammad Moussavi ◽  
Usama Siddique ◽  
Cecilia Carlowicz ◽  
Bahareh Hassanzadeh ◽  
Theja Channapragada ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Negative Impact ◽  
Randomized Study ◽  
Plasma Osmolality ◽  
Clinical Severity ◽  
Stroke Severity ◽  
Electrolyte Balance ◽  
Stroke Patients ◽  
Serum Osmolarity

Background: Alterations in electrolyte balance and other basic elements such as serum osmolarity have been claimed to play a role in the pathophysiology of ischemic cerebrovascular disease. However, the relationship between the serum osmolarity pattern, clinical severity and outcome after an acute ischemic stroke is not fully understood. Acute ischemic stroke may be due to heperviscosity that is commonly secondary to dehydration. Also, there is a decreased sensation of thirst and ability to swallow fluids in post stroke patients. It is unclear whether these changes contribute to cerebral ischemic events. This study may add to our understanding of previously published findings of THIRST study. Objective: The aim of the present study was to test whether the calculated serum osmolarity on admission and discharge have correlation with severity, as measured by National Institute of Health Stroke Scale(NIHSS); and outcome of ischemic stroke patients, as measured by Discharge Modified Rankin Scale (DCmRS). Methods: Consecutive patients presenting to a university affiliated community hospital within 24 hour of symptom onset, and a discharge diagnosis of acute ischemic stroke were identified. Their serum BUN level and calculated plasma Osmolality at the time of presentation and before discharge was compared. Correlation coefficient (Spearsman’s rho) and Mann Whitney test were performed. SPSS version 11 was utilized for data analysis. Results: A total of 540 patients met the study criteria. We divided the patients into two groups, Osmolarity more than 295 (group A= 217 patients) and less than 295 (group B=323 patients). The initial NIHSS (p=0.036) and DCmRS (p=0.19) were statistically different in both groups. We found a similar trend between day of discharge serum osmolarity and DCmRS. Conclusion: Our study suggests that high initial and discharge serum osmolarity has a negative impact on stroke severity and outcome especially in elderly patients. A future prospective randomized study is warranted.

scholarly journals Clinical Features, Risk Factors and Hospital Mortality of Acute Stroke Patients

2020 ◽  
pp. 9-14
Author(s):  
Mahfuj-Ul Anwar ◽  
Sajeda Afrin ◽  
ASM Rahenur Mondol ◽  
Mohammad Nurul Islam Khan ◽  
Narayan Chandra Sarkar ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Patient ◽  
Neurological Deficit ◽  
Hemorrhagic Stroke ◽  
Acute Onset ◽  
Stroke Patients ◽  
Focal Neurological Deficit ◽  
Alteration Of Consciousness ◽  
Acute Hemorrhagic Stroke

Background: Stroke is a leading cause of mortality and disability worldwide. To prevent complications and permanent defects, early diagnosis, distinguishing the type and risk factor of stroke is crucial. Methodology: It was a hospital based cross sectional study, purposive sampling method was used, and a total of 469 stroke patients admitted into Department of Medicine, Rangpur medical college hospital, Bangladesh were included in this study. Results: In this study we have studied of 469 acute stroke patients. Among them 81% (380) were ischemic stroke patients and 19% (89) were hemorrhagic stroke. Overall male were more than female 308 (65.7%) vs 161(34.4%). The mean age for the ischemic stroke group was 64.1 ± 10.9 years, which was significantly higher than that of the hemorrhagic group (59.8 ± 9.60years) (P<0.05). Acute hemorrhagic stroke patients presented with acute onset of focal neurological deficit 61.8%, headache 64%, vomiting 59.6%, alteration of consciousness 48.3% and convulsion 27%. On the other hand, acute ischemic stroke patient presented with alteration of consciousness 65.5%, acute onset of focal neurological deficit 39.5%, paralysis 41%, deficit after awakening 32.4% and aphasia 34.7%. Among the risk factors of stroke in acute ischemic stroke patients hypertension was 59.2%, diabetes mellitus 20%, history of previous stroke 16.1%, ischemic heart disease 14.5% and atrial fibrillation 10.3% were present, on the other hand in acute hemorrhagic stroke patients hypertension 76.4%, smoking 70.8% and diabetes mellitus 6.7% were present. 26.97% of the acute hemorrhagic stroke and 13.9% of the acute ischemic stroke patients died in hospital. Conclusion: Common presentation of stroke was acute onset of focal neurological deficit; headache and vomiting were more in hemorrhagic stroke patient; alteration of consciousness, paralysis was predominant in ischemic stroke patient.

scholarly journals Management of acute ischemic stroke in patients with COVID-19 infection: Report of an international panel

2020 ◽  
Vol 15 (5) ◽  
pp. 540-554 ◽  
Author(s):  
Adnan I Qureshi ◽  
Foad Abd-Allah ◽  
Fahmi Al-Senani ◽  
Emrah Aytac ◽  
Afshin Borhani-Haghighi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Current Knowledge ◽  
Intravenous Thrombolysis ◽  
Adult Patients ◽  
World Health ◽  
Stroke Patients ◽  
International Panel ◽  
Health Organization ◽  
Tract Infections

Background and purpose On 11 March 2020, World Health Organization (WHO) declared the COVID-19 infection a pandemic. The risk of ischemic stroke may be higher in patients with COVID-19 infection similar to those with other respiratory tract infections. We present a comprehensive set of practice implications in a single document for clinicians caring for adult patients with acute ischemic stroke with confirmed or suspected COVID-19 infection. Methods The practice implications were prepared after review of data to reach the consensus among stroke experts from 18 countries. The writers used systematic literature reviews, reference to previously published stroke guidelines, personal files, and expert opinion to summarize existing evidence, indicate gaps in current knowledge, and when appropriate, formulate practice implications. All members of the writing group had opportunities to comment in writing on the practice implications and approved the final version of this document. Results This document with consensus is divided into 18 sections. A total of 41 conclusions and practice implications have been developed. The document includes practice implications for evaluation of stroke patients with caution for stroke team members to avoid COVID-19 exposure, during clinical evaluation and performance of imaging and laboratory procedures with special considerations of intravenous thrombolysis and mechanical thrombectomy in stroke patients with suspected or confirmed COVID-19 infection. Conclusions These practice implications with consensus based on the currently available evidence aim to guide clinicians caring for adult patients with acute ischemic stroke who are suspected of, or confirmed, with COVID-19 infection. Under certain circumstances, however, only limited evidence is available to support these practice implications, suggesting an urgent need for establishing procedures for the management of stroke patients with suspected or confirmed COVID-19 infection.

Sign in / Sign up

Export Citation Format

Share Document