دسترسی یکساله به بیش از ۵۰۰ ژورنال روز جهان موجود در سامانه
-
http://medilib.ir
- ﻣﺪﺕ ﺯﻣﺎﻥ : 365 ﺭﻭﺯ
قیمت : 3,800,000 تومان- قیمت ویژه : 1,900,000تومان
Early Apixaban Use Following Stroke in Patients With Atrial Fibrillation
Arthur J. Labovitz, David Z. Rose, Michael G. Fradley, John N. Meriwether, Swetha Renati, Ryan Martin, Thomas Kasprowicz, Ryan Murtagh, Kevin Kip, Theresa M. Beckie, Marcus Stoddard, Andrea C. Bozeman, Tara McTigue, Bonnie Kirby, Nhi Tran, W. Scott Burgin,
doi : 10.1161/STROKEAHA.120.030042
Stroke. 2021;52:1164–1171
It is unknown when to start anticoagulation after acute ischemic stroke (AIS) from atrial fibrillation (AF). Early anticoagulation may prevent recurrent infarctions but may provoke hemorrhagic transformation as AF strokes are typically larger and hemorrhagic transformation-prone. Later anticoagulation may prevent hemorrhagic transformation but increases risk of secondary stroke in this time frame. Our aim was to compare early anticoagulation with apixaban in AF patients with stroke or transient ischemic attack (TIA) versus warfarin administration at later intervals.
Reactive Oxygen Species Scavenger in Acute Intracerebral Hemorrhage Patients
Moinay Kim, Joonho Byun, Yeongu Chung, Si Un Lee, Ji Eun Park, Wonhyoung Park, Jung Cheol Park, Jae Sung Ahn, Seungjoo Lee
doi : 10.1161/STROKEAHA.120.032266
Stroke. 2021;52:1172–1181
Patients with intracerebral hemorrhage (ICH) have oxidative stress. Oxidative stress contributes to the development and progression of perihematomal edema (PHE) in brain hemorrhage patients. We hypothesized that reactive oxygen species (ROS) scavengers might have a neuroprotective role in the acute period of patients with ICH.
Combatting Secondary Injury From Intracerebral Hemorrhage With Supplemental Antioxidant Therapy
Ashkan Shoamanesh, Aristeidis H. Katsanos
doi : 10.1161/STROKEAHA.121.033849
Stroke. 2021;52:1182–1184
Quality of Life in Physical, Social, and Cognitive Domains Improves With Endovascular Therapy in the DEFUSE 3 Trial
Laura C. Polding, William J. Tate, Michael Mlynash, Michael P. Marks, Jeremy J. Heit, Soren Christensen, Stephanie Kemp, Gregory W. Albers, Maarten G. Lansberg and on behalf of the DEFUSE 3 Investigators
doi : 10.1161/STROKEAHA.120.031490
Stroke. 2021;52:1185–1191
The DEFUSE 3 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3) randomized clinical trial demonstrated the efficacy of endovascular therapy in treating ischemic stroke 6 to 16 hours after onset, resulting in better functional outcomes than standard medical therapy alone. The objective of this secondary analysis is to analyze the effect of late-window endovascular treatment of ischemic stroke on quality of life (QoL) outcomes.
Intra-Arterial Adjunctive Medications for Acute Ischemic Stroke During Mechanical Thrombectomy
Vanessa H.E. Chen, Grace K.H. Lee, Choon-Han Tan, Aloysius S.T. Leow, Ying-Kiat Tan, Claire Goh, Anil Gopinathan, Cunli Yang, Bernard P.L. Chan, Vijay K. Sharma, Benjamin Y.Q. Tan, Leonard L.L. Yeo
doi : 10.1161/STROKEAHA.120.031738
Stroke. 2021;52:1192–1202
In patients with acute ischemic stroke with large vessel occlusion, the role of intra-arterial adjunctive medications (IAMs), such as urokinase, tPA (tissue-type plasminogen activator), or glycoprotein IIb/IIIa inhibitors, during mechanical thrombectomy (MT) has not been clearly established. We aim to evaluate the efficacy and safety of concomitant or rescue IAM for acute ischemic stroke with large vessel occlusion patients undergoing MT.
Current Status of Endovascular Treatment for Acute Large Vessel Occlusion in China
Baixue Jia, Zeguang Ren, Maxim Mokin, W. Scott Burgin, Clayton T. Bauer, Jens Fiehler, Dapeng Mo, Ning Ma, Feng Gao, Xiaochuan Huo, Gang Luo, Anxin Wang, Yuesong Pan, Ligang Song, Xuan Sun, Xuelei Zhang, Liqiang Gui, Cunfeng Song, Ya Peng, Jin Wu, Shijun Zhao, Junfeng Zhao, Zhiming Zhou, Yongli Li, Ping Jing, Lei Yang, Yajie Liu, Qingshi Zhao, Yan Liu, Xiaoxiang Peng, Qingchun Gao, Zaiyu Guo, Wenhuo Chen, Weirong Li, Xiaojiang Cheng, Yun Xu, Yongqiang Zhang, Guilian Zhang, Yijiu Lu, Xinyu Lu, Dengxiang Wang, Yan Wang, Hao Li, Li Ling, Guangge Peng, Jingyu Zhang, Kai Zhang, Shuo Li, Zhongqi Qi, Haifeng Xu, Xu Tong, Gaoting Ma, Raynald Liu, Xu Guo, Yiming Deng, Xinyi Leng, Thomas W. Leung, David S. Liebeskind, Yilong Wang, Yongjun Wang, Zhongrong Miao,
doi : 10.1161/STROKEAHA.120.031869
Stroke. 2021;52:1203–1212
The benefit of endovascular treatment (EVT) for large vessel occlusion in clinical practice in developing countries like China needs to be confirmed. The aim of the study was to determine whether the benefit of EVT for acute ischemic stroke in randomized trials could be generalized to clinical practice in Chinese population.
Higher-Quality Data Collection Is Critical to Establish the Safety and Efficacy of Pediatric Mechanical Thrombectomy
Megan Barry, Dwight Barry, Akash P. Kansagra, Danial Hallam, Michael Abraham, Catherine Amlie-Lefond,
doi : 10.1161/STROKEAHA.120.032009
Stroke. 2021;52:1213–1221
Because children often have lifelong morbidity after stroke, there is considerable enthusiasm to pursue mechanical thrombectomy in childhood stroke based on literature reports. However, current published data may reflect inconsistent reporting and publication bias, which limit the ability to assess safety and efficacy of mechanical thrombectomy in childhood stroke.
Key Metrics Are Required to Refine Guidelines for Pediatric Mechanical Thrombectomy
Lauren A. Beslow, Warren D. Lo
doi : 10.1161/STROKEAHA.120.033561
Stroke. 2021;52:1222–1224
Comparative Effectiveness and Safety of Non–Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients
Wengen Zhu, Zi Ye, Shilan Chen, Dexi Wu, Jiangui He, Yugang Dong, Gregory Y.H. Lip, Chen Liu
doi : 10.1161/STROKEAHA.120.031007
Stroke. 2021;52:1225–1233
Several observational studies have compared the effect of the non–vitamin K antagonist oral anticoagulants to each other in patients with atrial fibrillation. However, confounding by indication is a major problem when comparing non–vitamin K antagonist oral anticoagulant treatments in some of these studies. This meta-analysis was conducted to compare the effectiveness and safety between non–vitamin K antagonist oral anticoagulant and non–vitamin K antagonist oral anticoagulant by only including the propensity score matching studies.
Blood Pressure Level and Variability During Long-Term Prasugrel or Clopidogrel Medication After Stroke
Kazunori Toyoda, Hiroshi Yamagami, Kazuo Kitagawa, Takanari Kitazono, Takehiko Nagao, Kazuo Minematsu, Shinichiro Uchiyama, Norio Tanahashi, Masayasu Matsumoto, Izumi Nagata, Masakatsu Nishikawa, Shinsuke Nanto, Toshiaki Shirai, Kenji Abe, Yasuo Ikeda, Akira Ogawa,
doi : 10.1161/STROKEAHA.120.032824
Stroke. 2021;52:1234–1243
High blood pressure increases bleeding risk during treatment with antithrombotic medication. The association between blood pressure levels and the risk of recurrent stroke during long-term secondary stroke prevention with thienopyridines (particularly prasugrel) has not been well studied.
Statins After Ischemic Stroke in the Oldest
Geert J. Lefeber, Wilma Knol, Patrick C. Souverein, Marcel L. Bouvy, Anthonius de Boer, Huiberdina L. Koek
doi : 10.1161/STROKEAHA.120.030755
Stroke. 2021;52:1244–1252
Statins are frequently initiated in patients aged 80 years and older after an ischemic stroke, even though evidence on prevention of recurrent cardiovascular disease is scarce. In this study, we seek evidence for statin prescription in the oldest old.
Clinical Characteristics and In-Hospital Outcomes of Varying Definitions of Minor Stroke
Yunyun Xiong, Hongqiu Gu, Xing-Quan Zhao, Xin Yang, Chunjuan Wang, Yi-Long Wang, Li-Ping Liu, Qi Zhou, Marc Fisher, Zixiao Li, Yongjun Wang
doi : 10.1161/STROKEAHA.120.031329
Stroke. 2021;52:1253–1258
A variety of definitions for minor stroke have been proposed. We aimed to compare the clinical characteristics and outcomes of minor stroke defined as the National Institutes of Health Stroke Scale (NIHSS) score ?5 versus ?3.
Modifiable Cardiovascular Risk Factors in Patients With Sporadic Cerebral Cavernous Malformations
Bixia Chen, Dino Saban, Steffen Rauscher, Annika Herten, Laurèl Rauschenbach, Alejandro Santos, Yan Li, Boerge Schmidt, Yuan Zhu, Ramazan Jabbarli, Karsten H. Wrede, Christoph Kleinschnitz, Ulrich Sure, Philipp Dammann
doi : 10.1161/STROKEAHA.120.031569
Stroke. 2021;52:1259–1264
This study aims to assess the influence of modifiable cardiovascular risk factors on hemorrhage risk of sporadic cerebral cavernous malformations (CCMs).
Tandem Lesions in Anterior Circulation Stroke
Katharina Feil, Moriz Herzberg, Franziska Dorn, Steffen Tiedt, Clemens Küpper, Dennis C. Thunstedt, Panagiotis Papanagiotou, Lukas Meyer, Andreas Kastrup, Konstantinos Dimitriadis, Thomas Liebig, Marianne Dieterich, Lars Kellert,
doi : 10.1161/STROKEAHA.120.031797
Stroke. 2021;52:1265–1275
Tandem lesions in the anterior circulation account for up to 30% of all large vessel occlusion strokes. The optimal periprocedural approach in these lesions is still a matter of debate.
Retinal Vasculature Fractal and Stroke Mortality
Gerald Liew, Bamini Gopinath, Andrew J. White, George Burlutsky, Tien Yin Wong, Paul Mitchell
doi : 10.1161/STROKEAHA.120.031886
Stroke. 2021;52:1276–1282
Fractal analysis is a method of quantifying the branching complexity and density of the retinal vessels. We hypothesized that reduced fractal dimension, signifying a sparser vascular network, is associated with long-term stroke mortality.
Accuracy of the Informant Questionnaire on Cognitive Decline in the Elderly for Detecting Preexisting Dementia in Transient Ischemic Attack and Stroke
Astrid C. van Nieuwkerk, Sarah T. Pendlebury, Peter M. Rothwell and for the Oxford Vascular Study
doi : 10.1161/STROKEAHA.120.031961
Stroke. 2021;52:1283–1290
Prestroke dementia prevalence is high and impacts outcome. Although the IQCODE (Informant Questionnaire on Cognitive Decline in the Elderly) is being used to assess prestroke cognition, data on its validity for prestroke dementia are lacking. We studied the accuracy of the short-form (16-item) IQCODE for pre-event dementia in a population-based study of all transient ischemic attack (TIA)/stroke.
Predictors for Failure of Early Neurological Improvement After Successful Thrombectomy in the Anterior Circulation
Charlotte S. Weyland, Yahia Mokli, Johannes A. Vey, Meinhard Kieser, Christian Herweh, Silvia Sch?nenberger, Martin Bendszuz, Markus A. M?hlenbruch, Peter A. Ringleb, Simon Nagel
doi : 10.1161/STROKEAHA.120.030519
Stroke. 2021;52:1291–1298
Failure of early neurological improvement (fENI) despite successful mechanical thrombectomy in the anterior circulation is a clinically frequent occurrence. Purpose of this analysis was to define independent clinical, radiological, laboratory, or procedural predictors for fENI.
Subclinical Atrial Fibrillation Burden and Adverse Clinical Outcomes in Patients With Permanent Pacemakers
Young Jun Park, June Soo Kim, Kyoung-Min Park, Young Keun On, Seung-Jung Park
doi : 10.1161/STROKEAHA.120.031822
Stroke. 2021;52:1299–1308
Unlike clinical atrial fibrillation (AF), the significance of subclinical AF (SCAF) burden in patients with permanent pacemakers has not been fully evaluated.
Swallowing, Oral Motor, Motor Speech, and Language Impairments Following Acute Pediatric Ischemic Stroke
Victoria Sherman, Rosemary Martino, Ishvinder Bhathal, Gabrielle DeVeber, Nomazulu Dlamini, Daune MacGregor, Elizabeth Pulcine, Deryk S. Beal, Kevin E. Thorpe, Mahendranath Moharir
doi : 10.1161/STROKEAHA.120.031893
Stroke. 2021;52:1309–1318
Following adult stroke, dysphagia, dysarthria, and aphasia are common sequelae. Little is known about these impairments in pediatric stroke. We assessed frequencies, co-occurrence and associations of dysphagia, oral motor, motor speech, language impairment, and caregiver burden in pediatric stroke.
Hard to Swallow
Lori C. Jordan, Lauren A. Beslow
doi : 10.1161/STROKEAHA.120.033524
Stroke. 2021;52:1319–1321
Impact of Delirium and Its Motor Subtypes on Stroke Outcomes
Iv? Taiuan Fialho Silva, Pedro Assis Lopes, Tiago Timotio Almeida, Saint Clair Ramos, Ana Teresa Caliman Fontes, Daniel Guimar?es Silva, Camila Martins Soares, Lays Oliveira Carneiro, Ian Felipe Barbosa Souza, Fernanda Ferreira Abreu, Gabriel Nascimento Silva, Let?cia Mascarenhas de Souza, Thiago Brito Pinheiro, Filipe Nolasco de Souza e Silva, Jo?o Pedro de Santana, Beatriz Kelly Silva, Danilo Almeida Souza, Silvana Silva Macedo, Leila Silva Almeida Ismael, Pedro Antonio Pereira de Jesus
doi : 10.1161/STROKEAHA.120.026425
Stroke. 2021;52:1322–1329
Delirium is an acute and fluctuating impairment of attention, cognition, and behavior. Although common in stroke, studies that associate the clinical subtypes of delirium with functional outcome and death are lacking. We aimed to evaluate the influence of delirium occurrence and its different motor subtypes over stroke patients’ prognosis.
Body Mass Index and Arterial Stiffness Are Associated With Greater Beat-to-Beat Blood Pressure Variability After Transient Ischemic Attack or Minor Stroke
Alastair J.S. Webb, Amy Lawson, Sara Mazzucco, Linxin Li, Peter M. Rothwell and for the Oxford Vascular Study Phenotyped Cohort
doi : 10.1161/STROKEAHA.120.031179
Stroke. 2021;52:1330–1338
Blood pressure variability (BPV) from beat to beat is associated with an increased risk of cardiovascular events and enables rapid assessment of BPV, but the underlying causes of elevated BPV are unclear.
Stroke Risk Factor Status and Use of Stroke Prevention Medications Among Hispanic/Latino Adults in HCHS/SOL
Fang Bai, Jingsong Chen, Dilip Pandey, Ramon Durazo-Arvizu, Gregory A. Talavera, Matthew A. Allison, Krista M. Perreira, Neil Schneiderman, Melanie W. Sutherland, Jianwen Cai, Martha L. Daviglus, Fernando D. Testai
doi : 10.1161/STROKEAHA.120.031216
Stroke. 2021;52:1339–1346
We investigated the prevalence, awareness, and control of vascular risk factors (VRFs) and the use of antithrombotic and statin agents in HCHS (Hispanic Community Health Study)/SOL (Study of Latinos) participants with self-reported history of stroke or transient ischemic attack.
Pregnancy Risk Factors as Predictors of Offspring Cerebrovascular Disease
Milja Kivel?, Ina Rissanen, Eero Kajantie, Hilkka Ij?s, Harri Rusanen, Jouko Miettunen, Markus Paananen
doi : 10.1161/STROKEAHA.120.031618
Stroke. 2021;52:1347–1354
For prevention of cerebrovascular diseases, it is important to understand the risk factors occurring early in life. The aim was to investigate the relationship of maternal and offspring anthropometrics and pregnancy complications with offspring’s risk of ischemic and hemorrhagic stroke and transient ischemic attack in adulthood.
Aging Immune System in Acute Ischemic Stroke
Gina P. Sykes, Joseph Kamtchum-Tatuene, Sarina Falcione, Sarah Zehnder, Danielle Munsterman, Boryana Stamova, Bradley P. Ander, Frank R. Sharp, Glen Jickling
doi : 10.1161/STROKEAHA.120.032040
Stroke. 2021;52:1355–1361
With advancing age, alterations occur to the immune system, including an increase in inflammation (inflammaging) and a reduced ability to respond to new immune challenges. The role of an aging immune system in patients with ischemic stroke remains unclear, although age is an important determinant of stroke risk and outcome. This study assessed the aging immune system in patients with acute ischemic stroke by differences in leukocyte gene expression in relationship to age.
Hospitalizations for Stroke in France During the COVID-19 Pandemic Before, During, and After the National Lockdown
Anne-Sophie Mariet, Maurice Giroud, Eric Benzenine, Jonathan Cottenet, Adrien Roussot, Ludwig Serge Aho-Glélé, Pascale Tubert-Bitter, Yannick Béjot, Catherine Quantin
doi : 10.1161/STROKEAHA.120.032312
Stroke. 2021;52:1362–1369
In France, the entire population was put under a total lockdown from March 17 to May 11, 2020 during the peak of the coronavirus disease 2019 (COVID-19) pandemic. Whether the lockdown had consequences on the management of medical emergencies such as stroke and transient ischemic attack (TIA) has yet to be fully evaluated. This article describes hospitalization rates for acute stroke in 2 French regions that experienced contrasting rates of COVID-19 infection, before, during, and after the nationwide lockdown (January to June 2020).
Dynamic Detection of Delayed Cerebral Ischemia
Murad Megjhani, Kalijah Terilli, Miriam Weiss, Jude Savarraj, Li Hui Chen, Ayham Alkhachroum, David J. Roh, Sachin Agarwal, E. Sander Connolly Jr, Angela Velazquez, Amelia Boehme, Jan Claassen, HuiMahn A. Choi, Gerrit A. Schubert, Soojin Park
doi : 10.1161/STROKEAHA.120.032546
Stroke. 2021;52:1370–1379
Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage negatively impacts long-term recovery but is often detected too late to prevent damage. We aim to develop hourly risk scores using routinely collected clinical data to detect DCI.
Automated Quantification of Reduced Sulcal Volume Identifies Early Brain Injury After Aneurysmal Subarachnoid Hemorrhage
Jane Y. Yuan, Yasheng Chen, Atul Kumar, Zach Zlepper, Keshav Jayaraman, Wint Y. Aung, Julian V. Clarke, Michelle Allen, Umeshkumar Athiraman, Joshua Osbun, Gregory J. Zipfel, Rajat Dhar
doi : 10.1161/STROKEAHA.120.032001
Stroke. 2021;52:1380–1389
Early brain injury may be a more significant contributor to poor outcome after aneurysmal subarachnoid hemorrhage (aSAH) than vasospasm and delayed cerebral ischemia. However, studying this process has been hampered by lack of a means of quantifying the spectrum of injury. Global cerebral edema (GCE) is the most widely accepted manifestation of early brain injury but is currently assessed only through subjective, qualitative or semi-quantitative means. Selective sulcal volume (SSV), the CSF volume above the lateral ventricles, has been proposed as a quantitative biomarker of GCE, but is time-consuming to measure manually. Here we implement an automated algorithm to extract SSV and evaluate the age-dependent relationship of reduced SSV on early outcomes after aSAH.
Economic Evaluation of Andexanet Versus Prothrombin Complex Concentrate for Reversal of Factor Xa-Associated Intracranial Hemorrhage
Andrew Micieli, Andrew M. Demchuk, Harindra C. Wijeysundera
doi : 10.1161/STROKEAHA.120.031108
Stroke. 2021;52:1390–1397
Andexanet was approved by the Food and Drug Administration in 2018 for reversal of life-threatening or uncontrolled bleeding associated with factor Xa anticoagulation; however, the cost-effectiveness of Andexanet compared with standard of care (ie, prothrombin complex concentrate, PCC) in patients with factor Xa–associated intracranial hemorrhage (ICrH) is unknown.
Regional Changes in Patterns of Stroke Presentation During the COVID-19 Pandemic
Mark R. Etherton, Kori S. Zachrison, Zhiyu Yan, Lukas Sveikata, Martin Bretzner, Juan Estrada, Anand Viswanathan, Aneesh B. Singhal, Lee H. Schwamm
doi : 10.1161/STROKEAHA.120.031300
Stroke. 2021;52:1398–1406
Patient care-seeking has likely changed during the coronavirus disease 2019 (COVID-19) pandemic. In stroke, delayed or avoided care may translate to substantial morbidity. We sought to determine the effect of the pandemic on patterns of stroke patient presentation and quality of care.
Qualitative Study of Chinese Stroke Caregivers’ Caregiving Experience During the COVID-19 Pandemic
Jung Jae Lee, Wing Nga Tsang, Sook Ching Yang, Jojo Yan Yan Kwok, Vivian W.Q. Lou, Kui Kai Lau
doi : 10.1161/STROKEAHA.120.032250
Stroke. 2021;52:1407–1414
The coronavirus disease 2019 (COVID-19) outbreak has led to disruptions in health care service delivery worldwide, inevitably affecting stroke survivors requiring ongoing rehabilitation and chronic illness management. To date, no published research has been found on stroke caregiving during the COVID-19 pandemic. This study aimed to explore Hong Kong stroke caregivers’ caregiving experiences in the midst of this difficult time.
Stroke Family Caregiving and the COVID-19 Pandemic
Tamilyn Bakas, Patricia Commiskey
doi : 10.1161/STROKEAHA.120.033525
Stroke. 2021;52:1415–1417
Propranolol Reduces the Development of Lesions and Rescues Barrier Function in Cerebral Cavernous Malformations
Joppe Oldenburg, Matteo Malinverno, Maria Ascencion Globisch, Claudio Maderna, Monica Corada, Fabrizio Orsenigo, Lei Liu Conze, Charlotte Rorsman, Veronica Sundell, Maximiliano Arce, Ross O. Smith, Anthony C.Y. Yau, Gry Hulsart Billstr?m, Caroline ?hman M?gi, Galina V. Beznoussenko, Alexander A. Mironov, Dinesh Fernando, Geoffrey Daniel, Davide Olivari, Francesca Fumagalli, Maria Grazia Lampugnani, Elisabetta Dejana, Peetra U. Magnusson
doi : 10.1161/STROKEAHA.120.029676
Stroke. 2021;52:1418–1427
Cerebral cavernous malformations (CCM) present as mulberry-like malformations of the microvasculature of the central nervous system. Current medical treatment of CCM lesions is limited to surgical removal of the vascular malformations. It is, therefore, important to identify therapeutic drug treatments for patients with CCM. Propranolol has shown great benefit in the treatment of infantile hemangioma. In addition, patients with CCM who receive propranolol have demonstrated a reduction of their lesions. Our investigation set out to provide preclinical data to support propranolol as a therapeutic treatment.
CCM2L (Cerebral Cavernous Malformation 2 Like) Deletion Aggravates Cerebral Cavernous Malformation Through Map3k3-KLF Signaling Pathway
Jaesung P. Choi, Xi Yang, Shuang He, Renhua Song, Zi-Ran Xu, Matthew Foley, Justin J.-L. Wong, Cheng-Ran Xu, Xiangjian Zheng
doi : 10.1161/STROKEAHA.120.031523
Stroke. 2021;52:1428–1436
Cerebral cavernous malformation (CCM) is a common cerebrovascular disease. CCMs are major causes of stroke, cerebral hemorrhage, and neurological deficits in young individuals. Loss-of-function mutations in CCM1, CCM2, and CCM3 have been identified to cause CCM in humans. Ccm2-like (Ccm2l) is a paralog of Ccm2 and is predominantly expressed in endothelial cells (ECs). CCM2L (CCM2-like) competes with CCM2 for binding to CCM1 and has been shown to have an antagonistic function to that of CCM2 during vascular development. The role of CCM2L in CCM pathogenesis is unknown.
Portable Neuromonitoring Device Detects Large Vessel Occlusion in Suspected Acute Ischemic Stroke
Paulina B. Sergot, Andrew J. Maza, Bruce J. Derrick, Lane M. Smith, Liam T. Berti, Madeleine R. Wilcox, Matthew R. Kesinger, W. Frank Peacock,
doi : 10.1161/STROKEAHA.120.031225
Stroke. 2021;52:1437–1440
Early detection of large vessel occlusion (LVO) stroke optimizes endovascular therapy and improves outcomes. Clinical stroke severity scales used for LVO identification have variable accuracy. We investigated a portable LVO-detection device (PLD), using electroencephalography and somatosensory-evoked potentials, to identify LVO stroke.
Prehospital Triage Accuracy in Patients With Stroke Symptoms Assessed Within 6 to 24 Hours or With an Unknown Time of Onset
Tove Almqvist, Annika Berglund, Christina Sj?strand, Einar Eriksson, Michael V. Mazya
doi : 10.1161/STROKEAHA.120.033676
Stroke. 2021;52:1441–1445
The Stockholm Stroke Triage System, implemented in 2017, identifies patients with high likelihood of large vessel occlusion (LVO) stroke. A previous report has shown Stockholm Stroke Triage System notably reduced time to endovascular thrombectomy (EVT). As the indication for EVT now includes patients up to 24 hours, we aimed to assess Stockholm Stroke Triage System triage accuracy for LVO stroke and EVT treatment for patients presenting late (within 6-24 hours or with an unknown onset), put in contrast to triage accuracy within 0 to 6 hours.
Two-State Kinetic Model of Rates of Stroke Recurrence in the POINT Study Population
James R. Brorson, Zachary B. Bulwa
doi : 10.1161/STROKEAHA.120.031447
Stroke. 2021;52:1446–1449
Following an acute ischemic stroke or transient ischemic attack, 2 rates of stroke recurrence are suggested by data from trials of acute secondary prevention treatments: a transient rapid rate followed by a persisting slower rate of stroke.
Risk Factors for Intracerebral Hemorrhage in Patients With Atrial Fibrillation on Non–Vitamin K Antagonist Oral Anticoagulants for Stroke Prevention
Maurizio Paciaroni, Giancarlo Agnelli, Michela Giustozzi, Valeria Caso, Elisabetta Toso, Filippo Angelini, Isabella Canavero, Giuseppe Micieli, Kateryna Antonenko, Alessandro Rocco, Marina Diomedi, Aristeidis H. Katsanos, Ashkan Shoamanesh, Sotirios Giannopoulos, Walter Ageno, Samuela Pegoraro, Jukka Putaala, Daniel Strbian, Hanne Sallinen, Brian C. Mac Grory, Karen L. Furie, Christoph Stretz, Michael E. Reznik, Andrea Alberti, Michele Venti, Maria Giulia Mosconi, Maria Cristina Vedovati, Laura Franco, Giorgia Zepponi, Michele Romoli, Andrea Zini, Laura Brancaleoni, Letizia Riva, Giorgio Silvestrelli, Alfonso Ciccone, Maria Luisa Zedde, Elisa Giorli, Maria Kosmidou, Evangelos Ntais, Lina Palaiodimou, Panagiotis Halvatsiotis, Tiziana Tassinari, Valentina Saia, Raffaele Ornello, Simona Sacco, Fabio Bandini, Michelangelo Mancuso, Giovanni Orlandi, Elena Ferrari, Alessandro Pezzini, Loris Poli, Manuel Cappellari, Stefano Forlivesi, Alberto Rigatelli, Shadi Yaghi, Erica Scher, Jennifer A. Frontera, Luca Masotti, Elisa Grifoni, Pietro Caliandro, Aurelia Zauli, Giuseppe Reale, Simona Marcheselli, Antonio Gasparro, Valeria Terruso, Valentina Arnao, Paolo Aridon, Azmil H. Abdul-Rahim, Jesse Dawson, Carlo Emanuele Saggese, Francesco Palmerini, Boris Doronin, Vera Volodina, Danilo Toni, Angela Risitano, Erika Schirinzi, Massimo Del Sette, Piergiorgio Lochner, Serena Monaco, Marina Mannino, Rossana Tassi, Francesca Guideri, Maurizio Acampa, Giuseppe Martini, Enrico Maria Lotti, Marina Padroni, Leonardo Pantoni, Silvia Rosa, Pierluigi Bertora, George Ntaios, Dimitrios Sagris, Antonio Baldi, Cataldo D’Amore, Nicola Mumoli, Cesare Porta, Licia Denti, Alberto Chiti, Francesco Corea, Monica Acciarresi, Yuriy Flomin, Nemanja Popovic, Georgios Tsivgoulis
doi : 10.1161/STROKEAHA.120.031827
Stroke. 2021;52:1450–1454
Clinical trials on stroke prevention in patients with atrial fibrillation have consistently shown clinical benefit from either warfarin or non–vitamin K antagonist oral anticoagulants (NOACs). NOAC-treated patients have consistently reported to be at lower risk for intracerebral hemorrhage (ICH) than warfarin-treated patients. The aims of this prospective, multicenter, multinational, unmatched, case-control study were (1) to investigate for risk factors that could predict ICH occurring in patients with atrial fibrillation during NOAC treatment and (2) to evaluate the role of CHA2DS2-VASc and HAS-BLED scores in the same setting.
Trends in Incidence of Intracranial and Spinal Arteriovenous Shunts
Satoshi Murai, Masafumi Hiramatsu, Etsuji Suzuki, Ryota Ishibashi, Hiroki Takai, Yuko Miyazaki, Yuji Takasugi, Yoko Yamaoka, Kazuhiko Nishi, Yu Takahashi, Jun Haruma, Tomohito Hishikawa, Takao Yasuhara, Masaki Chin, Shunji Matsubara, Masaaki Uno, Koji Tokunaga, Kenji Sugiu, Isao Date and on behalf of the Okayama Cranial and Spinal A-V Shunts (OCSS) Study Group
doi : 10.1161/STROKEAHA.120.032052
Stroke. 2021;52:1455–1459
To date, the incidence of intracranial and spinal arteriovenous shunts has not been thoroughly investigated. We aimed to clarify recent trends in the rates of intracranial and spinal arteriovenous shunts in Japan.
Association Between Stroke and Subsequent Risk of Suicide
Manav V. Vyas, Jeffrey Z. Wang, Meah M. Gao, Daniel G. Hackam
doi : 10.1161/STROKEAHA.120.032692
Stroke. 2021;52:1460–1464
Poor mental health and depression are well-recognized sequelae of stroke; however, the association between stroke and subsequent risk of suicide is unknown.
Concentration of Lp(a) (Lipoprotein[a]) in Aneurysm Sac Is Associated With Wall Enhancement of Unruptured Intracranial Aneurysm
Daizo Ishii, Mario Zanaty, Jorge A. Roa, Luyuan Li, Yongjun Lu, Ryan Sabotin, Lauren Allan, Edgar A Samaniego, David M. Hasan
doi : 10.1161/STROKEAHA.120.032304
Stroke. 2021;52:1465–1468
Atherosclerotic remodeling of the aneurysm wall, which could be detected as aneurysm wall enhancement (AWE) by magnetic resonance–vessel wall imaging, is a part of degenerative change of unruptured intracranial aneurysms (UIAs). The purpose of this study was to determine whether the luminal concentrations of atherosclerotic proteins in the aneurysm sac were associated with increased wall enhancement of UIAs in vessel wall imaging.
Increased Ipsilateral Posterior Cerebral Artery P2-Segment Flow Velocity Predicts Hemodynamic Impairment
Christiaan H.B. van Niftrik, Martina Seb?k, Susanne Wegener, Giuseppe Esposito, Matthias Halter, Aimee Hiller, Christoph Stippich, Andreas R. Luft, Luca Regli, Jorn Fierstra
doi : 10.1161/STROKEAHA.120.032848
Stroke. 2021;52:1469–1472
Increased Transcranial Doppler flow velocity in the ipsilateral P2-segment of the posterior cerebral artery (PCA-P2: cm/second) is associated with recurrent cerebrovascular events in patients with unilateral internal carotid artery occlusion. However, its predictive value and correlation with hemodynamic impairment in an overall stroke patient cohort remains to be determined.
Intraluminal Thrombus and Outcomes of Patients With Acute Large Vessel Occlusive Stroke Undergoing Endovascular Treatment
Yarong Ding, Xinyi Leng, Ximing Nie, Yuesong Pan, JieJie Li, Dacheng Liu, Hongyi Yan, Yuehua Pu, Yufei Wei, Yuan Cai, Qixuan Lu, Zhe Zhang, Wanying Duan, Weibin Gu, Xinyi Hou, Zhonghua Yang, Miao Wen, Ning Ma, Zhongrong Miao, Yongjun Wang, Liping Liu and on behalf of the RESCUE-RE Study Group
doi : 10.1161/STROKEAHA.120.032876
Stroke. 2021;52:1473–1477
Intraluminal thrombus (ILT) is an emerging imaging marker in acute ischemic stroke. We aimed to investigate the association of ILT with outcomes of acute large vessel occlusion (LVO) patients receiving endovascular treatment.
Brain Glucose Metabolism in Cerebral Amyloid Angiopathy
Sébastien Bergeret, Mathieu Queneau, Mathieu Rodallec, Brigitte Landeau, Gaël Chetelat, Young T. Hong, Julien Dumurgier, Jacques Hugon, Claire Paquet, Karim Farid, Jean-Claude Baron
doi : 10.1161/STROKEAHA.120.032905
Stroke. 2021;52:1478–1482
The in vivo diagnosis of cerebral amyloid angiopathy (CAA) is currently based on the Boston criteria, which largely rely on hemorrhagic features on brain magnetic resonance imaging. Adding to these criteria 18F-fluoro-deoxy-D-glucose (FDG) positron emission tomography, a widely available imaging modality, might improve their accuracy. Here we tested the hypothesis that FDG uptake is reduced in posterior cortical areas, particularly the primary occipital cortex, which pathologically bear the brunt of vascular A? deposition.
Nursing Scientific Statements Advancing Stroke Care
Janice L. Hinkle, Elaine T. Miller
doi : 10.1161/STROKEAHA.121.033559
Stroke. 2021;52:1483–1485
no abstract
Imaging Advances
David S. Liebeskind, Joanna M. Wardlaw
doi : 10.1161/STROKEAHA.121.033449
Stroke. 2021;52:1486–1489
no abstract
New Avenues for Optimal Treatment of Atrial Fibrillation and Stroke Prevention
Gian Marco De Marchis, Luciano A. Sposato, Michael Kühne, Tolga D. Dittrich, Leo H. Bonati, Urs Fischer, Seemant Chaturvedi
doi : 10.1161/STROKEAHA.120.032060
Stroke. 2021;52:1490–1499
One in 3 individuals free of atrial fibrillation (AF) at index age 55 years is estimated to develop AF later in life. AF increases not only the risk of ischemic stroke but also of dementia, even in stroke-free patients. In this review, we address recent advances in the heart-brain interaction with focus on AF. Issues discussed are (1) the timing of direct oral anticoagulants start following an ischemic stroke; (2) the comparison of direct oral anticoagulants versus vitamin K antagonists in early secondary stroke prevention; (3) harms of bridging with heparin before direct oral anticoagulants; (4) importance of appropriate direct oral anticoagulants dosing; (5) screening for AF in high-risk populations, including the role of wearables; (6) left atrial appendage occlusion as an alternative to oral anticoagulation; (7) the role of early rhythm-control therapy; (8) effect of lifestyle interventions on AF; (9) AF as a risk factor for dementia. An interdisciplinary approach seems appropriate to address the complex challenges posed by AF.
Decompressive Hemicraniectomy for Large Hemispheric Strokes
Jessica Lin, Jennifer A. Frontera
doi : 10.1161/STROKEAHA.120.032359
Stroke. 2021;52:1500–1510
Large hemispheric infarcts occur in up to 10% of all ischemic strokes and can cause devastating disability. Significant research and clinical efforts have been made in hopes of mitigating the morbidity and mortality of this disease. Areas of interest include identifying predictors of malignant edema, optimizing medical and surgical techniques, selecting the patient population that would benefit most from decompressive hemicraniectomy, and studying the impact on quality of life of those who survive. Decompressive surgery can be a life-saving measure, and here we discuss the most up-to-date literature and provide a review on the surgical management of large hemispheric ischemic strokes.
Pediatric Thrombectomy
David C. Lauzier, Maria M. Galardi, Kristin P. Guilliams, Manu S. Goyal, Catherine Amlie-Lefond, Danial K. Hallam, Akash P. Kansagra
doi : 10.1161/STROKEAHA.120.032268
Stroke. 2021;52:1511–1519
Endovascular thrombectomy has played a major role in advancing adult stroke care and may serve a similar role in pediatric stroke care. However, there is a need to develop better evidence and infrastructure for pediatric stroke care. In this work, we review 2 experienced pediatric endovascular thrombectomy programs and examine key design features in both care environments, including a formalized protocol and workflow, integration with an adult endovascular thrombectomy workflow, simplification and automation of workflow steps, pediatric adaptations of stroke imaging, advocacy of pediatric stroke care, and collaboration between providers, among others. These essential features transcend any single hospital environment and may provide an important foundation for other pediatric centers that aim to enhance the care of children with stroke.
Recommendations for Research Assessing Outcomes for Patients With Anticoagulant-Related Intracerebral Bleeds
Mauricio Concha, Alexander T. Cohen
doi : 10.1161/STROKEAHA.120.031730
Stroke. 2021;52:1520–1526
Intracerebral bleeds related to anticoagulant use have a poor prognosis and substantial risk of disability and death. Recent publications evaluating replacement or reversal therapies for anticoagulants lack consistency in controlling for key factors that significantly influence outcomes. In an effort to guide future research by providing a framework to improve consistency and reduce the potential for confounding in this dynamic and highly time-dependent brain insult, we provide here a brief overview of variables we consider critical in studies evaluating the risk and the reversal of anticoagulant therapies in anticoagulant-related intracerebral bleeds. Hematoma expansion stands out as one of the few potentially modifiable risk factors and its early control could mitigate secondary brain injury, and it, therefore, requires careful categorization. In addition to the baseline demographic, clinical, and radiological predictors of hematoma expansion, we specifically highlight time-dependent factors such as the time from the last dose, time from symptom onset and time to treatment, the computed tomography angiography spot sign, and the limitation of early care as especially critical predictors of outcomes in anticoagulant-related intracerebral bleeds. Intracerebral hemorrhage is a condition that requires fast diagnosis and treatment, especially when associated with anticoagulants. The advent of therapies with rapid reversal of anticoagulation open the opportunity to assess the scale to which faster reversal of anticoagulation modifies hematoma expansion and clinical outcomes. Thus, comprehensive assessment and reporting of these important potential confounding factors, particularly the critical time variables, is crucial to improving research and treatment of intracerebral hemorrhages.
Rethinking Consent for Stroke Trials in Time-Sensitive Situations
Mayank Goyal, Johanna Maria Ospel, Aravind Ganesh, Martha Marko, Marc Fisher
doi : 10.1161/STROKEAHA.120.031976
Stroke. 2021;52:1527–1531
Informed consent is a key concept to ensure patient autonomy in clinical trials and routine care. The coronavirus disease 2019 (COVID-19) pandemic has complicated informed consent processes, due to physical distancing precautions and increased physician workload. As such, obtaining timely and adequate patient consent has become a bottleneck for many clinical trials. However, this challenging situation might also present an opportunity to rethink and reappraise our approach to consent in clinical trials. This viewpoint discusses the challenges related to informed consent during the COVID-19 pandemic, whether it could be acceptable to alter current consent processes under these circumstances, and outlines a possible framework with predefined criteria and a system of checks and balances that could allow for alterations of existing consent processes to maximize patient benefit under exceptional circumstances such as the COVID-19 pandemic without undermining patient autonomy.
How to Set Up a Successfully Running Mobile Stroke Unit Program
Erik Freitag, Maximilian Kaffes, Joachim E. Weber, Heinrich J. Audebert
doi : 10.1161/STROKEAHA.120.033576
Stroke. 2021;52:e107–e110
Cardioembolic Stroke Secondary to an Aortic Valve Fibroelastoma
Laura Esteban-Luc?a, Soraya De la Fuente Batista, Andrea Mar?a Kallmeyer Mayor, Marcelino Cortés Garc?a
doi : 10.1161/STROKEAHA.120.029361
Stroke. 2021;52:e111–e114
Correction to: Stroke Fellow Redeployed: My Fellowship in COVID in the Epicenter of a Pandemic
doi : 10.1161/STR.0000000000000370
Stroke. 2021;52:e115
Correction to: Good Clinical Outcome Decreases With Number of Retrieval Attempts in Stroke Thrombectomy: Beyond the First-Pass Effect
doi : 10.1161/STR.0000000000000371
Stroke. 2021;52:e116
