Frequency and Predictors of Early Seizures Following First Acute Stroke: Data from a University Hospital in South India

2021 ◽  
Vol 69 (4) ◽  
pp. 847
Author(s):  
SuryaP Turaga ◽  
RangineniL Chaithanya ◽  
AbhijeetK Kohat ◽  
Suvarna Alladi ◽  
Subhash Kaul
Keyword(s):  
Acute Stroke ◽  
South India ◽  
University Hospital ◽  
Early Seizures

scholarly journals Physiological parameters deterioration in acute stage after stroke: Rehabilitation versus conventional care

2019 ◽  
Vol 10 (3) ◽  
pp. 79
Author(s):  
Reham AbdElhamed AbdElmawla Elsaid ◽  
Amina Mohamed AbdElfatah Sliman
Keyword(s):  
Acute Stroke ◽  
Acute Phase ◽  
Stroke Rehabilitation ◽  
Recovery Period ◽  
Acute Stage ◽  
Conventional Care ◽  
Physiological Parameters ◽  
Stroke Recovery ◽  
University Hospital ◽  
Control Group

Objective: Stroke is considered the main health problem and the second leading cause of death worldwide. Stroke resulting in varied and unpredictable complications if not managed correctly in the acute stage with intensive rehabilitation therapy which may affect stroke prognosis, and resulting functional decline. Therefore, the aim of the study was to explore the consequences of rehabilitation versus conventional care on physiological parameters during the acute stroke recovery period.Methods: The quasi-experimental research design was used in the neurology department at Mansoura University Hospital. A convenient sample of sixty-four adult patients of both sex with stroke, who corresponded to inclusion criteria was assigned into two equal groups, study group (rehabilitation group) and control group (conventional care).Results: The results indicates, acute phase rehabilitation limit physiological parameters deterioration during acute stroke recovery period comparing to conventional care only.Conclusions: Acute phase stroke rehabilitation has a significant positive impact on physiological parameters.

scholarly journals Predictors for affected stroke territory and outcome of acute stroke treatments are different for posterior versus anterior circulation stroke

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
H. Handelsmann ◽  
L. Herzog ◽  
Z. Kulcsar ◽  
A. R. Luft ◽  
S. Wegener
Keyword(s):  
Acute Stroke ◽  
Functional Outcome ◽  
Patient Characteristics ◽  
Posterior Circulation ◽  
University Hospital ◽  
Outcome Predictors ◽  
Anterior Circulation ◽  
Stroke Treatment ◽  
The University ◽  
Median Admission

AbstractDistinct patient characteristics have been proposed for ischaemic stroke in the anterior versus posterior circulation. However, data on functional outcome according to stroke territory in patients with acute stroke treatment are conflicting and information on outcome predictors is scarce. In this retrospective study, we analysed functional outcome in 517 patients with stroke and thrombolysis and/or thrombectomy treated at the University Hospital Zurich. We compared clinical factors and performed multivariate logistic regression analyses investigating the effect of outcome predictors according to stroke territory. Of the 517 patients included, 80 (15.5%) suffered a posterior circulation stroke (PCS). PCS patients were less often female (32.5% vs. 45.5%, p = 0.031), received thrombectomy less often (28.7% vs. 48.3%, p = 0.001), and had lower median admission NIHSS scores (5 vs. 10, p < 0.001) as well as a better median three months functional outcome (mRS 1 vs. 2, p = 0.010). Predictors for functional outcome were admission NIHSS (OR 0.864, 95% CI 0.790–0.944, p = 0.001) in PCS and age (OR 0.952, 95% CI 0.935–0.970, p < 0.001), known symptom onset (OR 1.869, 95% CI 1.111–3.144, p = 0.018) and admission NIHSS (OR 0.840, 95% CI 0.806–0.876, p < 0.001) in ACS. Acutely treated PCS and ACS patients differed in their baseline and treatment characteristics. We identified specific functional outcome predictors of thrombolysis and/or thrombectomy success for each stroke territory.

scholarly journals Study on the risk profile of patients with acute stroke hospitalized in the Second Clinic of Neurology, St. Marina University Hospital

2019 ◽  
Vol 8 (1) ◽  
pp. 73
Author(s):  
Mihael Emilov Tsalta-Mladenov ◽  
Vladina Kirilova Dimitrova ◽  
Darina Georgieva ◽  
Silva Andonova
Keyword(s):  
Acute Stroke ◽  
Risk Profile ◽  
University Hospital

Abstract TP439: Occurrence (Incidence and Prevalence) Rate of Delirium and Risk Factors in Acute Stroke - Cross-sectional Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Terence J Quinn ◽  
Robert Shaw ◽  
Martin Taylor-Rowan
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Acute Stroke ◽  
Cognitive Assessment ◽  
University Hospital ◽  
Initial Assessment ◽  
Cognitive Assessments ◽  
Cross Sectional ◽  
Post Stroke ◽  
Cognitive Problems

Introduction: Guidelines recommend screening all stroke admissions for cognitive impairment. Delirium may be an important contributor to cognitive problems, but available data are limited by potential selection biases and imperfect delirium assessment. We aimed to describe robust estimates of delirium occurrence (incidence and prevalence) and risk factors in an acute stroke unit (ASU). Methods: We collected data from sequential admissions to our University Hospital ASU over a 20 week period (Feb-July 2016). The only exclusion was where the clinical team felt that any form of assessment was inappropriate. We aimed to perform cognitive assessments at 48 hours post stroke. Cognitive assessments were based on mini Montreal Cognitive Assessment (m-MoCA) and GP-Cog informant interview to assess for pre-stroke dementia. We assessed for delirium based on DSM-V criteria. We described univariable and multivariable associations with delirium occurrence. Results: Across the study period, 184 strokes were admitted; median age 71 years (IQR:61-79). Some form of cognitive assessment was available for 178 (97%). In total. 152 had evidence of cognitive impairment on m-MOCA, 55 (31%) met criteria for delirium and 25 (15%) had pre-stroke dementia. Significant univariable associations with delirium were:age and pre-existing cognitive decline. On logistic regression:age, history of drug or alcohol misuse and pre-stroke mRS were all independently associated with delirium. Discussion: In an unselected ASU population a substantial proportion will have cognitive impairment based on screening. Delirium is common and contributes to this cognitive problems seen in acute stroke. Independent associations with delirium occurrence were identified but were non-modifiable. Our results have implications for policy and practice. As post-stroke cognitive impairment is multifactorial, screening delirium and pre-existing cognitive issues should form part of the initial assessment.

scholarly journals 43Computed Tomography Angiography in Acute Stroke Patients in St. Vincent’s University Hospital- A Vessel for Change?

2018 ◽  
Vol 47 (suppl_5) ◽  
pp. v13-v60
Author(s):  
Michelle Brennan ◽  
Tim Cassidy ◽  
Imelda Noone ◽  
Mary Kate Meagher ◽  
Colin Cantwell
Keyword(s):  
Acute Stroke ◽  
University Hospital ◽  
Stroke Patients

scholarly journals Sex differences in risk factors, treatment, and prognosis in acute stroke

2020 ◽  
Vol 16 ◽  
pp. 174550652095203
Author(s):  
Solveig Dahl ◽  
Clara Hjalmarsson ◽  
Björn Andersson
Keyword(s):  
Risk Factors ◽  
Sex Differences ◽  
Acute Stroke ◽  
Functional Outcome ◽  
Independent Living ◽  
University Hospital ◽  
Stroke Severity ◽  
Stroke Registry ◽  
Study Population

Objectives: Stroke is a major cause of long-term disability and death worldwide. Several studies have shown that women in general have more severe symptoms at arrival to hospital and are less likely to return home and independent living. Our aim with the present study was to update previous results concerning sex differences in baseline characteristics, stroke management, and outcome in a population study from Sahlgrenska University Hospital, Gothenburg, Sweden. Methods: This study included patients with acute ischemic and hemorrhagic stroke in 2014 at Sahlgrenska University Hospital. All data were collected from The Swedish National Stroke Registry (Riksstroke). Results: The study population consisted of 1453 patients, with 46.7% females. Women were 5 years older than men. There was no sex difference in acute stroke severity. Frequency of revascularization was equal between men and women. The stroke mortality rate was the same between the sexes. At 3-months follow-up, women had a worse functional outcome and a higher frequency of depression and post-stroke fatigue. Conclusion: Our results show that there are no sex differences in management of acute stroke. However, the cause of worse functional outcome in women at 3-months follow-up, independent of other risk factors, is not clear and warrants further investigations.

Changes Related To Inpatient Mortality From Acute Stroke In The Stroke Unit Of The Klaipeda University Hospital In 2007-2015

2016 ◽  
Vol 26 (5) ◽  
pp. 74-78
Author(s):  
Henrikas Kazlauskas ◽  
Elena Bovina ◽  
Geriuldas Žiliukas
Keyword(s):  
Acute Stroke ◽  
Odds Ratio ◽  
Stroke Unit ◽  
Hemorrhagic Stroke ◽  
Age Groups ◽  
University Hospital ◽  
Inpatient Mortality ◽  
Significant Difference ◽  
Icd 10 ◽  
Stroke Type

The aim of the study was to analyse the changes in inpatient mortality from acute stroke in the stroke unit of the Klaipeda University Hospital in 2007- 2015. Medical history data of 265 patients who died from acute stroke in the stroke unit were analysed. Inpatient mortality rate was calculated among all patients diagnosed with acute stroke who were treated in the stroke unit during the entire study period. The number of deaths in different age groups (up until 65; 65 and older) and comorbidities in patients who died from acute stroke were analysed, depending on stroke type in different treatment periods (2007-2011 and 2012-2015). The International Classification of Diseases, Tenth Revision (ICD-10), Codes I60-I64 were used to diagnose different stroke types in 2007-2011, while ICD-10 AM, Codes I60-I64 were used in 2012- 2015. The statistical analysis was performed using SPSS 17.0 for Windows. Chi-squared (χ2) criterion and Fisher’s exact test were used for small samples to evaluate dependency and homogeneity of qualitative characteristics. The difference between them was considered as statistically significant at p <0.05. Data are presented as a percentage. Student’s t-test was applied for average age comparison. Odds ratio (OR), reflecting the mortality from acute stroke in different periods, was established. The comparison of the two study periods revealed the decrease in patients who died from acute stroke - from 7.0% (2007-2011) to 4,3 % (2012-2015), (p<0.001). Mortality from ischemic and hemorrhagic stroke was similar. The analysis showed significant age difference (p=0.007) among patients who died from acute stroke: in the later study period (2012-2015), the patients were older than those who died in the earlier period; however, no significant difference was observed when analysing them by age groups (up until 65; 65 and older). The odds of dying in 2007- 2011 were 1.69 times higher than in 2012-2015 (p<0.001), whereas the odds ratio for ischemic stroke in 2007-2011 was 1.75 times higher than in 2012- 2015 (p<0.0001). No significant difference between different study periods was established when analysing the changes in the number of comorbidities in patients who died from acute stroke. The assesment of differences in comorbidities depending on the stroke type revealed that significantly more patients who died from ischemic stroke had been diagnosed with coronary heart disease (CHD) (including angina pectoris (AP) and atrial fibrillation (AF)) than those who died from hemorrhagic stroke. It was concluded that, when comparing the two study periods, the number of patients who died from acute stroke decreased significantly - from 7.0% (2007- 2011) to 4.3% (2012-2015) (p<0.001). The odds ratio for dying from acute stroke in 2007-2011 was established to be significantly higher than in 2012- 2015 and patients who died from acute stroke in the later study period were significantly older.

Early Seizures After Acute Stroke: A Study of 1,640 Cases

Epilepsia ◽  
1994 ◽  
Vol 35 (5) ◽  
pp. 959-964 ◽  
Author(s):  
M. Giroud ◽  
P. Gras ◽  
H. Fayolle ◽  
N. Andre ◽  
P. Soichot ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Early Seizures

scholarly journals Clopidogrel resistance in stroke patients (The CRISP Trial)

2020 ◽  
Vol 11 (1) ◽  
pp. 1-5
Author(s):  
E Qazi, ◽  
Syed AH Zaidi ◽  
Olukolade O Owojori ◽  
LJ Bonnett ◽  
PR Fitzsimmons ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Acute Stroke ◽  
Acute Ischaemic Stroke ◽  
University Hospital ◽  
P Value ◽  
Clopidogrel Resistance ◽  
Appropriate Treatment ◽  
Unit Increase ◽  
Acute Stroke Unit

Objective: To investigate the incidence of clopidogrel resistance in patients with acute ischaemic stroke and to evaluate whether there is an association between clopidogrel resistance and the occurrence of a further cerebrovascular ischaemic event using the vasodilator-stimulated phosphoprotein (VASP) index as a marker of clopidogrel resistance. Methods: It is a prospective cohort study that recruited 120 patients from the acute stroke unit at the Royal Liverpool University Hospital. All patients with confirmed acute ischaemic stroke had clopidogrel 75mg/day at discharge or after 14 days of acute stroke if deemed by the direct clinical team to be the most appropriate treatment. After at least 7 days of clopidogrel 75mg/day, all those patients fulfilling inclusion/exclusion criteria had phosphorylation of vasodilator-stimulated phosphoprotein (VASP) measured. If VASP measured ≥50% after ≥7 days of clopidogrel maintenance, these patients were deemed as ‘clopidogrel resistant’, while those with VASP <50% were deemed as ‘clopidogrel responder’. Statistical analysis was by univariable analysis which considered the association of each variable – diagnosis, age, duration of clopidogrel, VASP, days to VASP, and number of comorbidities – with the outcome. Risk of second stroke after a first at 6, 12 and 24 months was estimated using logistic regression. Results: No variables were significantly associated with risk of stroke at 6 months with clopidogrel resistance having no significant effect on likelihood of a further stroke compared to the no clopiodgrel resistance cohort (p value= 0.39). Results were similar at 12 months follow up. However, at 24 months VASP index was significantly associated with risk of a further stroke; each one unit increase in VASP was associated with a 3% increase in risk of stroke at 24 months (p value = 0.05, CI Interval of 1.00- 1.06). Conclusion: No variables were significantly associated with risk of further stroke at 6 months and 12 months after a first stroke. However, VASP was significantly associated with risk of further stroke at 24 months with increasing VASP leading to a higher risk of further stroke.

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