دسترسی یکساله به بیش از ۵۰۰ ژورنال روز جهان موجود در سامانه
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May 2021 Stroke Highlights
José Rafael Romero
doi : 10.1161/STROKEAHA.121.035163
Stroke. 2021;52:1533
New Class of Radially Adjustable Stentrievers for Acute Ischemic Stroke
Rishi Gupta, Jeffrey L. Saver, Elad Levy, Osama O. Zaidat, Dileep Yavagal, David S. Liebeskind, Ahmad Khaldi, Bradley Gross, Michael Lang, Sandra Narayanan, Brian Jankowitz, Kenneth Snyder, Adnan Siddiqui, Jason Davies, Eugene Lin, Ameer Hassan, Ricardo Hanel, Amin Aghaebrahim, Ritesh Kaushal, Ali Malek, Nils Mueller-Kronast, Robert Starke, Hormozd Bozorgchami, Gary Nesbit, Masahiro Horikawa, Ryan Priest, Jesse Liu, Ronald F. Budzik, Peter Pema, Nirav Vora, M. Asif Taqi, Edgar Samaniego, Qingliang Tony Wang, Erez Nossek, Guilherme Dabus, Italo Linfante, Ajit Puri, Eitan Abergel, Sidney Starkman, Satoshi Tateshima, Ashutosh P. Jadhav, and for the TIGER Trial Investigators See fewer authors
doi : 10.1161/STROKEAHA.121.034436
Stroke. 2021;52:1534–1544
The Tigertriever is a novel, radially adjustable, fully visible, stentriever that permits the operator to align radial expansion with target vessel diameters. This multicenter trial compared the Tigertriever’s effectiveness and safety compared with established stent retrievers.
Effect of SGLT2 Inhibitors on Stroke and Atrial Fibrillation in Diabetic Kidney Disease
Zien Zhou, Meg J. Jardine, Qiang Li, Brendon L. Neuen, Christopher P. Cannon, Dick de Zeeuw, Robert Edwards, Adeera Levin, Kenneth W. Mahaffey, Vlado Perkovic, Bruce Neal, Richard I. Lindley,
doi : 10.1161/STROKEAHA.120.031623
Stroke. 2021;52:1545–1556
Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus.
Treating Diabetes to Prevent Stroke
Walter N. Kernan, Silvio E. Inzucchi
doi : 10.1161/STROKEAHA.120.032725
Stroke. 2021;52:1557–1560
Outcomes of Large Vessel Occlusion Stroke in Patients Aged ?90 Years
Kyohei Fujita, Kanta Tanaka, Hiroshi Yamagami, Takeshi Yoshimoto, Kazutaka Uchida, Takeshi Morimoto, Hirotoshi Imamura, Nobuyuki Sakai, Nobuyuki Ohara, Yasushi Matsumoto, Masataka Takeuchi, Keigo Shigeta, Kazunori Toyoda, Shinichi Yoshimura
doi : 10.1161/STROKEAHA.120.031386
Stroke. 2021;52:1561–1569
Outcomes in patients ?90 years of age with stroke due to large vessel occlusion were compared between endovascular therapy (EVT) and medical management.
Early Thrombectomy Protects the Internal Capsule in Patients With Proximal Middle Cerebral Artery Occlusion
Johannes Kaesmacher, Mirjam Kaesmacher, Maria Berndt, Christian Maegerlein, Sebastian M?nch, Silke Wunderlich, Thomas R. Meinel, Urs Fischer, Claus Zimmer, Tobias Boeckh-Behrens, Justus F. Kleine See fewer authors
doi : 10.1161/STROKEAHA.120.031977
Stroke. 2021;52:1570–1579
Proximal middle cerebral artery (MCA) occlusions impede blood flow to the noncollateralized lenticulostriate artery territory. Previous work has shown that this almost inevitably leads to infarction of the dependent gray matter territories in the striate even if perfusion is restored by mechanical thrombectomy. Purpose of this analysis was to evaluate potential sparing of neighboring fiber tracts, ie, the internal capsule.
Number of Retrieval Attempts Rather Than Procedure Time Is Associated With Risk of Symptomatic Intracranial Hemorrhage
M?té El?d Maros, Caspar Brekenfeld, Gabriel Broocks, Hannes Leischner, Rosalie McDonough, Milani Deb-Chatterji, Anna Alegiani, G?tz Thomalla, Jens Fiehler, Fabian Flottmann,
doi : 10.1161/STROKEAHA.120.031242
Stroke. 2021;52:1580–1588
Endovascular therapy is the standard of care in the treatment of acute ischemic stroke due to large-vessel occlusion. A direct association between the number of device passes and the occurrence of symptomatic intracranial hemorrhage (SICH) has been suggested. This study represents an in-depth investigation of the hypothesis that >3 retrieval attempts is associated with an increased rate of SICH in a large multicenter patient cohort.
Thrombectomy Versus Combined Thrombolysis and Thrombectomy in Patients With Acute Stroke
Xu Tong, Yilong Wang, Jens Fiehler, Clayton T. Bauer, Baixue Jia, Xuelei Zhang, Xiaochuan Huo, Gang Luo, Anxin Wang, Yuesong Pan, Ning Ma, Feng Gao, Dapeng Mo, Ligang Song, Xuan Sun, Lian Liu, Yiming Deng, Xiaoqing Li, Bo Wang, Gaoting Ma, Yongjun Wang, Zeguang Ren, Zhongrong Miao, See fewer authors
doi : 10.1161/STROKEAHA.120.031599
Stroke. 2021;52:1589–1600
A recent randomized controlled trial DIRECT-MT (Direct Intra-Arterial Thrombectomy to Revascularize AIS Patients With Large Vessel Occlusion Efficiently in Chinese Tertiary Hospitals) compared the safety and efficacy of mechanical thrombectomy (MT) versus combined intravenous thrombolysis (IVT) and MT for acute large vessel occlusion. The current study utilized a prospective, nationwide registry to validate the results of the DIRECT-MT trial in a real-world practice setting.
Intravenous Tirofiban Infusion After Angioplasty and Stenting in Intracranial Atherosclerotic Stenosis-Related Stroke
Byung Hyun Baek, Woong Yoon, Yun Young Lee, Seul Kee Kim, Joon-Tae Kim, Man Seok Park
doi : 10.1161/STROKEAHA.120.033551
Stroke. 2021;52:1601–1608
This study aimed to investigate the effectiveness and safety of intravenous infusion of tirofiban after emergent angioplasty with or without stenting in patients with intracranial atherosclerotic stenosis-related large-vessel occlusion stroke.
Social Cognitive Dysfunction Following Pediatric Arterial Ischemic Stroke
Nicholas P. Ryan, Mardee Greenham, Anne L. Gordon, Michael Ditchfield, Lee Coleman, Anna Cooper, Louise Crowe, Rod W. Hunt, Paul Monagle, Mark T. Mackay, Vicki Anderson
doi : 10.1161/STROKEAHA.120.032955
Stroke. 2021;52:1609–1617
Childhood and adolescence coincide with rapid maturation of distributed brain networks supporting social cognition; however, little is known about the impact of early ischemic brain insult on the acquisition of these skills. This study aimed to examine the influence of arterial ischemic stroke (AIS) on facial emotion recognition and theory of mind (ToM) abilities of children and adolescents initially recruited to a single-center, prospective longitudinal study of recovery following AIS.
Quantitative Assessment of Motor Neglect
Monica N. Toba, Chiara Pagliari, Marco Rabuffetti, Norbert Nighoghossian, Gilles Rode, François Cotton, Lucia Spinazzola, Francesca Baglio, Raffaella Migliaccio, Paolo Bartolomeo
doi : 10.1161/STROKEAHA.120.031949
Stroke. 2021;52:1618–1627
We used differential actigraphy as a novel, objective method to quantify motor neglect (a clinical condition whereby patients mimic hemiplegia even in the absence of sensorimotor deficits), whose diagnosis is at present highly subjective, based on the clinical observation of patients’ spontaneous motor behavior.
Spontaneous Cervical Artery Dissection in Vascular Ehlers-Danlos Syndrome
Salma Adham, Clarisse Billon, Anne Legrand, Valérie Domigo, Nicolas Denarié, Etienne Charpentier, Xavier Jeunemaitre, Michael Frank
doi : 10.1161/STROKEAHA.120.032106
Stroke. 2021;52:1628–1635
Vascular Ehlers-Danlos syndrome is a rare inherited connective tissue disorder because of pathogenic variants in the COL3A1 gene. Arterial complications can affect all anatomic areas and about 25% involve supra-aortic trunks (SATs) but no systematic assessment of cervical artery lesions has been made. The primary objective was to determine an accurate prevalence of spontaneous SAT lesions in a large series of patients with vascular Ehlers-Danlos syndrome at diagnosis and during follow-up. Secondary objectives were to study their neurological consequences (transient ischemic attack or stroke) and the possible relationships with sex, genotype, ascertainment status.
Health-Related Quality of Life Among Patients With Acute Ischemic Stroke and Large Vessel Occlusion in the ESCAPE Trial
Raed A. Joundi, Alexander D. Rebchuk, Thalia S. Field, Eric E. Smith, Mayank Goyal, Andrew M. Demchuk, Dar Dowlatshahi, Alexandre Y. Poppe, David J. Williams, Jennifer L. Mandzia, Brian H. Buck, Ashutosh P. Jadhav, Aleksandra Pikula, Bijoy K. Menon, Michael D. Hill
doi : 10.1161/STROKEAHA.120.033872
Stroke. 2021;52:1636–1642
Endovascular thrombectomy (EVT) reduces 90-day disability in patients following acute ischemic stroke due to large vessel occlusion. Patient-reported outcome measures after EVT, such as health-related quality of life and specific functional domains, are less well described.
Embolic Stroke of Undetermined Source and Patent Foramen Ovale
Davide Strambo, Gaia Sirimarco, Stefania Nannoni, Kalliopi Perlepe, George Ntaios, Kostantinos Vemmos, Patrik Michel
doi : 10.1161/STROKEAHA.120.032453
Stroke. 2021;52:1643–1652
The Risk of Paradoxical Embolism (RoPE) score stratifies patients with stroke according to the probability of having a patent foramen ovale (PFO), which (through Bayes theorem and simple assumptions) can be used to estimate the probability that a PFO is pathogenic in a given subgroup of patients with specific features (ie, a given RoPE score value): a higher PFO prevalence corresponds to a higher probability that a PFO is pathogenic. Among alternative mechanisms in embolic stroke of undetermined source (ESUS), the actual stroke cause may be covert atrial fibrillation. We aimed to validate the RoPE score in a large ESUS population and investigate the rate of stroke recurrence and new incident atrial fibrillation during follow-up according to PFO status and RoPE score.
Atrial Fibrillation Following Patent Foramen Ovale Closure
Jessie Ze-Jun Chen, Vincent N. Thijs
doi : 10.1161/STROKEAHA.120.030293
Stroke. 2021;52:1653–1661
Multiple studies evaluated whether patent foramen ovale (PFO) closure reduces the risk of ischemic stroke. One commonly reported complication of PFO closure is the development of atrial fibrillation (AF), which is itself a powerful stroke risk factor that requires specific management. This study aims to evaluate the frequency of AF in patients post-percutaneous closure of PFO and the clinical factors that predict AF detection.
Atherosclerotic Burden and Vascular Risk in Stroke Patients With Atrial Fibrillation
Jong-Ho Park, Jong-Won Chung, Oh Young Bang, Gyeong-Moon Kim, Kang-Ho Choi, Man-Seok Park, Joon-Tae Kim, Yang-Ha Hwang, Tae-Jin Song, Yong-Jae Kim, Bum Joon Kim, Sung Hyuk Heo, Jin-Man Jung, Kyungmi Oh, Chi Kyung Kim, Sungwook Yu, Kwang Yeol Park, Jeong-Min Kim, Jay Chol Choi, Woo-Keun Seo
doi : 10.1161/STROKEAHA.120.032232
Stroke. 2021;52:1662–1672
Data on the effect on vascular outcomes of concomitant atherosclerotic vascular disease (ASVD) with atrial fibrillation (AF) after stroke are limited. This study evaluated the effect of ASVD with AF versus AF only on the risk of vascular events.
Intracerebral Hemorrhage Incidence, Mortality, and Association With Oral Anticoagulation Use
Shannon M. Fernando, Danial Qureshi, Robert Talarico, Peter Tanuseputro, Dar Dowlatshahi, Manish M. Sood, Eric E. Smith, Michael D. Hill, Victoria A. McCredie, Damon C. Scales, Shane W. English, Bram Rochwerg, Kwadwo Kyeremanteng
doi : 10.1161/STROKEAHA.120.032550
Stroke. 2021;52:1673–1681
Spontaneous intracerebral hemorrhage (ICH) is a devastating form of stroke associated with significant morbidity and mortality. Recent epidemiological data on incidence, mortality, and association with oral anticoagulation are needed.
Epidemiological Surveillance of the Impact of the COVID-19 Pandemic on Stroke Care Using Artificial Intelligence
Raul G. Nogueira, Jason M. Davies, Rishi Gupta, Ameer E. Hassan, Thomas Devlin, Diogo C. Haussen, Mahmoud H. Mohammaden, Christopher P. Kellner, Adam Arthur, Lucas Elijovich, Kumiko Owada, Dina Begun, Mukund Narayan, Nadia Mordenfeld, Wondwossen G. Tekle, Fadi Nahab, Tudor G. Jovin, Don Frei, Adnan H. Siddiqui, Michael R. Frankel, J Mocco
doi : 10.1161/STROKEAHA.120.031960
Stroke. 2021;52:1682–1690
The degree to which the coronavirus disease 2019 (COVID-19) pandemic has affected systems of care, in particular, those for time-sensitive conditions such as stroke, remains poorly quantified. We sought to evaluate the impact of COVID-19 in the overall screening for acute stroke utilizing a commercial clinical artificial intelligence platform.
COVID-19 Impact as an Illustration of Big Data Monitoring of Clinical Practice
Bruce C.V. Campbell
doi : 10.1161/STROKEAHA.120.033628
Stroke. 2021;52:1691–1692
SARS-CoV-2 and Stroke Characteristics
Shima Shahjouei, Georgios Tsivgoulis, Ghasem Farahmand, Eric Koza, Ashkan Mowla, Alireza Vafaei Sadr, Arash Kia, Alaleh Vaghefi Far, Stefania Mondello, Achille Cernigliaro, Annemarei Ranta, Martin Punter, Faezeh Khodadadi, Soheil Naderi, Mirna Sabra, Mahtab Ramezani, Ali Amini Harandi, Oluwaseyi Olulana, Durgesh Chaudhary, Aicha Lyoubi, Bruce C.V. Campbell, Juan F. Arenillas, Daniel Bock, Joan Montaner, Saeideh Aghayari Sheikh Neshin, Diana Aguiar de Sousa, Matthew S. Tenser, Ana Aires, Mercedes de Lera Alfonso, Orkhan Alizada, Elsa Azevedo, Nitin Goyal, Zabihollah Babaeepour, Gelareh Banihashemi, Leo H. Bonati, Carlo W. Cereda, Jason J. Chang, Miljenko Crnjakovic, Gian Marco De Marchis, Massimo Del Sette, Seyed Amir Ebrahimzadeh, Mehdi Farhoudi, Ilaria Gandoglia, Bruno Gonçalves, Christoph J. Griessenauer, Mehmet Murat Hanci, Aristeidis H. Katsanos, Christos Krogias, Ronen R. Leker, Lev Lotman, Jeffrey Mai, Shailesh Male, Konark Malhotra, Branko Malojcic, Teresa Mesquita, Asadollah Mir Ghasemi, Hany Mohamed Aref, Zeinab Mohseni Afshar, Jusun Moon, Mika Niemel?, Behnam Rezai Jahromi, Lawrence Nolan, Abhi Pandhi, Jong-Ho Park, Jo?o Pedro Marto, Francisco Purroy, Sakineh Ranji-Burachaloo, Nuno Reis Carreira, Manuel Requena, Marta Rubiera, Seyed Aidin Sajedi, Jo?o Sargento-Freitas, Vijay K. Sharma, Thorsten Steiner, Kristi Tempro, Guillaume Turc, Yasaman Ahmadzadeh, Mostafa Almasi-Dooghaee, Farhad Assarzadegan, Arefeh Babazadeh, Humain Baharvahdat, Fabricio Buchadid Cardoso, Apoorva Dev, Mohammad Ghorbani, Ava Hamidi, Zeynab Sadat Hasheminejad, Sahar Hojjat-Anasri Komachali, Fariborz Khorvash, Firas Kobeissy, Hamidreza Mirkarimi, Elahe Mohammadi-Vosough, Debdipto Misra, Ali Reza Noorian, Peyman Nowrouzi-Sohrabi, Sepideh Paybast, Leila Poorsaadat, Mehrdad Roozbeh, Behnam Sabayan, Saeideh Salehizadeh, Alia Saberi, Mercedeh Sepehrnia, Fahimeh Vahabizad, Thomas Aleandre Yasuda, Mojdeh Ghabaee, Nasrin Rahimian, Mohammad Hossein Harirchian, Afshin Borhani-Haghighi, Mahmoud Reza Azarpazhooh, Rohan Arora, Saeed Ansari, Vekatesh Avula, Jiang Li, Vida Abedi, Ramin Zand See fewer authors
doi : 10.1161/STROKEAHA.120.032927
Stroke. 2021;52:e117–e130
Stroke is reported as a consequence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in several reports. However, data are sparse regarding the details of these patients in a multinational and large scale.
Maintenance of Acute Stroke Care Service During the COVID-19 Pandemic Lockdown
Valerian L. Altersberger, Lotte J. Stolze, Mirjam R. Heldner, Hilde Henon, Nicolas Martinez-Majander, Christian Hametner, Annika Nordanstig, Andrea Zini, Stefania Nannoni, Bruno Gonçalves, Christian H. Nolte, Philipp Baumgartner, Andreas Kastrup, Panagiotis Papanagiotou, Georg K?gi, Ronen R. Leker, Marialuisa Zedde, Alessandro Padovani, Alessandro Pezzini, Visnja Padjen, Carlo W. Cereda, Georges Ntaios, Leo H. Bonati, Leon A. Rinkel, Urs Fischer, Jan F. Scheitz, Susanne Wegener, Guillaume Turc, Patrik Michel, Mauro Gentile, Alexandros Rentzos, Peter A. Ringleb, Sami Curtze, Charlotte Cordonnier, Marcel Arnold, Paul J. Nederkoorn, Stefan T. Engelter, Henrik Gensicke, and on behalf of the TRISP Collaborators
doi : 10.1161/STROKEAHA.120.032176
Stroke. 2021;52:1693–1701
Timely reperfusion is an important goal in treatment of eligible patients with acute ischemic stroke. However, during the coronavirus disease 2019 (COVID-19) pandemic, prehospital and in-hospital emergency procedures faced unprecedented challenges, which might have caused a decline in the number of acute reperfusion therapy applied and led to a worsening of key quality measures for this treatment during lockdown.
Temporal Trends in Stroke-Related Memory Change
Chloe W. Eng, Elizabeth R. Mayeda, Paola Gilsanz, Rachel A. Whitmer, Anthony S. Kim, M. Maria Glymour
doi : 10.1161/STROKEAHA.120.031063
Stroke. 2021;52:1702–1711
Findings from the Framingham Heart Study suggest that declines in dementia incidence rates over recent decades are partially due to decreases in stroke incidence and mortality; however, whether trends of declining dementia rates extend to survivors of incident stroke remains unclear. We investigated evidence for temporal trends in memory change related to incident stroke in a nationally representative cohort.
Herpes Zoster Vaccine Live and Risk of Stroke Among Medicare Beneficiaries
Quanhe Yang, Anping Chang, Xin Tong, Robert Merritt
doi : 10.1161/STROKEAHA.120.032788
Stroke. 2021;52:1712–1721
Herpes zoster (HZ) is associated with increased risk of stroke, and zoster vaccine live (ZVL, Zostavax) reduces the risk of HZ. No study has examined the association between ZVL (Zostavax) and risk of stroke. Present study examined association between receipt of ZVL (Zostavax) and risk of stroke among older US population.
Vaccination Against Herpes Zoster and the Potential to Reduce to the Global Burden of Stroke
Lachlan L. Dalli, Joosup Kim, Monique F. Kilkenny
doi : 10.1161/STROKEAHA.121.034671
Stroke. 2021;52:1722–1723
Time to Thrombolysis and Long-Term Outcomes in Patients With Acute Ischemic Stroke
Adelina Yafasova, Emil Loldrup Fosb?l, S?ren Paaske Johnsen, Christina Kruuse, Jeppe Kofoed Petersen, Amna Alhakak, Naja Emborg Vinding, Christian Torp-Pedersen, Gunnar Hilmar Gislason, Lars K?ber, Jawad Haider Butt See fewer authors
doi : 10.1161/STROKEAHA.120.032837
Stroke. 2021;52:1724–1732
It is well-established that increasing treatment delay reduces the benefits of thrombolysis in patients with acute ischemic stroke. However, most studies focus on short-term outcomes. This study examined long-term outcomes according to time to thrombolysis in patients with first-time ischemic stroke.
Association of Serum IL-6 (Interleukin 6) With Functional Outcome After Intracerebral Hemorrhage
Audrey C. Leasure, Lindsey R. Kuohn, Kevin N. Vanent, Matthew B. Bevers, W. Taylor Kimberly, Thorsten Steiner, Stephan A. Mayer, Charles C. Matouk, Lauren H. Sansing, Guido J. Falcone, Kevin N. Sheth
doi : 10.1161/STROKEAHA.120.032888
Stroke. 2021;52:1733–1740
IL-6 (interleukin 6) is a proinflammatory cytokine and an established biomarker in acute brain injury. We sought to determine whether admission IL-6 levels are associated with severity and functional outcome after spontaneous intracerebral hemorrhage (ICH).
Distinct Hippocampal Subfields Atrophy in Older People With Vascular Brain Injuries
Grégoire Pin, Pierrick Coupé, Louis Nadal, Jose V. Manjon, Catherine Helmer, Hélène Amieva, Bernard Mazoyer, Jean-François Dartigues, Gwénaëlle Catheline, Vincent Planche
doi : 10.1161/STROKEAHA.120.031743
Stroke. 2021;52:1741–1750
Many neurological or psychiatric diseases affect the hippocampus during aging. The study of hippocampal regional vulnerability may provide important insights into the pathophysiological mechanisms underlying these processes; however, little is known about the specific impact of vascular brain damage on hippocampal subfields atrophy.
Ischemic Core Overestimation on Computed Tomography Perfusion
?lvaro Garc?a-Tornel, Daniel Campos, Marta Rubiera, Sandra Boned, Marta Olivé-Gadea, Manuel Requena, Ludovico Ciolli, Marian Muchada, Jorge Pagola, David Rodriguez-Luna, Matias Deck, Jesus Juega, Noelia Rodr?guez-Villatoro, Estela Sanjuan, Alejandro Tomasello, Carlos Pi?ana, David Hern?ndez, José ?lvarez-Sabin, Carlos A. Molina, Marc Rib? See fewer authors
doi : 10.1161/STROKEAHA.120.031800
Stroke. 2021;52:1751–1760
Different studies have pointed that CT perfusion (CTP) could overestimate ischemic core in early time window. We aim to evaluate the influence of time and collateral status on ischemic core overestimation.
Favorable Venous Outflow Profiles Correlate With Favorable Tissue-Level Collaterals and Clinical Outcome
Tobias D. Faizy, Reza Kabiri, Soren Christensen, Michael Mlynash, Gabriella M. Kuraitis, Gabriel Broocks, Fabian Flottmann, Michael P. Marks, Maarten G. Lansberg, Gregory W. Albers, Jens Fiehler, Max Wintermark, Jeremy J. Heit
doi : 10.1161/STROKEAHA.120.032242
Stroke. 2021;52:1761–1767
Patients with acute ischemic stroke due to large vessel occlusion and favorable tissue-level collaterals (TLCs) likely have robust cortical venous outflow (VO). We hypothesized that favorable VO predicts robust TLC and good clinical outcomes.
Predictors of Daily Steps at 1-Year Poststroke
Reed Handlery, Elizabeth W. Regan, Jill C. Stewart, Christine Pellegrini, Courtney Monroe, Garrett Hainline, Kaci Handlery, Stacy L. Fritz
doi : 10.1161/STROKEAHA.121.034249
Stroke. 2021;52:1768–1777
Walking has the potential to improve endurance and community participation after stroke. Obtaining ?6000 daily steps can decrease subsequent stroke risk. Early identification of those prone to low daily steps could facilitate interventions that lead to increased walking and improved health. The purpose of this study was to (1) determine which factors at 2 months poststroke can predict daily step counts at 1 year and (2) determine what step count at 2 months corresponds to obtaining ?6000 daily steps at 1-year poststroke.
Predictors of Poststroke Aphasia Recovery
The REhabilitation and recovery of peopLE with Aphasia after StrokE (RELEASE) Collaborators
doi : 10.1161/STROKEAHA.120.031162
Stroke. 2021;52:1778–1787
The factors associated with recovery of language domains after stroke remain uncertain. We described recovery of overall-language-ability, auditory comprehension, naming, and functional-communication across participants’ age, sex, and aphasia chronicity in a large, multilingual, international aphasia dataset.
Intracerebral Injection of Heme Induces Lipid Peroxidation, Neuroinflammation, and Sensorimotor Deficits
Luiz Ricardo C. Vasconcellos, Let?cia Martimiano, Danillo Pereira Dantas, Filipe Mota Fonseca, Hilton Mata-Santos, Leonardo Travassos, Rosalia Mendez-Otero, Marcelo Torres Bozza, Pedro Moreno Pimentel-Coelho
doi : 10.1161/STROKEAHA.120.031911
Stroke. 2021;52:1788–1797
Heme is a red blood cell component released in the brain parenchyma following intracerebral hemorrhage. However, the study of the pathophysiological mechanisms triggered by heme in the brain is hampered by the lack of well-established in vivo models of intracerebral heme injection. This study aims to optimize and characterize a protocol of intrastriatal heme injection in mice, with a focus on the induction of lipid peroxidation, neuroinflammation and, ultimately, sensorimotor deficits. We also evaluated the involvement of NLRP3 (NOD-, LRR-, and pyrin domain-containing protein 3), an inflammasome sensor, in the behavior deficits induced by heme in this model.
Divergent Functions of Tissue-Resident and Blood-Derived Macrophages in the Hemorrhagic Brain
Che-Feng Chang, Brittany A. Goods, Michael H. Askenase, Hannah E. Beatty, Artem Osherov, Jonathan H. DeLong, Matthew D. Hammond, Jordan Massey, Margaret Landreneau, J. Christopher Love, Lauren H. Sansing
doi : 10.1161/STROKEAHA.120.032196
Stroke. 2021;52:1798–1808
Brain tissue-resident microglia and monocyte-derived macrophages (MDMs) are innate immune cells that contribute to the inflammatory response, phagocytosis of debris, and tissue repair after injury. We have previously reported that both microglia and MDMs transition from proinflammatory to reparative phenotypes over days after an intracerebral hemorrhage (ICH). However, their individual functional properties in the brain remain largely unknown. Here we characterized the differences between microglia and MDMs and further elucidate their distinct activation states and functional contributions to the pathophysiology and recovery after ICH.
CAPN1 (Calpain1)-Mediated Impairment of Autophagic Flux Contributes to Cerebral Ischemia-Induced Neuronal Damage
Yueyang Liu, Xiaohang Che, Haotian Zhang, Xiaoxiao Fu, Yang Yao, Jun Luo, Yu Yang, Ruiping Cai, Xiangnan Yu, Jingyu Yang, Ming-Sheng Zhou
doi : 10.1161/STROKEAHA.120.032749
Stroke. 2021;52:1809–1821
CAPN1 (calpain1)—an intracellular Ca2+-regulated cysteine protease—can be activated under cerebral ischemia. However, the mechanisms by which CAPN1 activation promotes cerebral ischemic injury are not defined.
Exploring the Collateral Damage of the COVID-19 Pandemic on Stroke Care
Clotilde Balucani, J. Ricardo Carhuapoma, Joseph K. Canner, Roland Faigle, Brenda Johnson, Anna Aycock, Michael S. Phipps, Chad Schrier, Karen Yarbrough, Linda Toral, Susan Groman, Erin Lawrence, Eric Aldrich, Adrian Goldszmidt, Elizabeth Marsh, Victor C. Urrutia
doi : 10.1161/STROKEAHA.121.034150
Stroke. 2021;52:1822–1825
During the coronavirus disease 2019 (COVID-19) pandemic, the various emergency measures implemented to contain the spread of the virus and to overcome the volume of affected patients presenting to hospitals may have had unintended consequences. Several studies reported a decrease in the number of stroke admissions. There are no data on the impact of the COVID-19 pandemic on stroke admissions and stroke care in Maryland.
Acute Ischemic Stroke in Patients With COVID-19
Pratyaksh K. Srivastava, Shuaiqi Zhang, Ying Xian, Hanzhang Xu, Christine Rutan, Heather M. Alger, Jason Walchok, Joseph Williams, James A. de Lemos, Marquita R. Decker-Palmer, Brooke Alhanti, Mitchell S.V. Elkind, Steve R. Messé, Eric E. Smith, Lee H. Schwamm, Gregg C. Fonarow
doi : 10.1161/STROKEAHA.121.034301
Stroke. 2021;52:1826–1829
Studies suggest an increased risk of adverse outcomes among patients with acute ischemic stroke (AIS) and coronavirus disease 2019 (COVID-19).
Cerebral Hemodynamics and Executive Function in Sickle Cell Anemia
Kemar V. Prussien, Bruce E. Compas, Rachel E. Siciliano, Abagail E. Ciriegio, Chelsea A. Lee, Adetola A. Kassim, Michael R. DeBaun, Manus J. Donahue, Lori C. Jordan
doi : 10.1161/STROKEAHA.120.032741
Stroke. 2021;52:1830–1834
Individuals with sickle cell anemia experience cognitive deficits, even in the absence of cerebral infarcts or strokes. This study tested the hypothesis that elevated cerebral blood flow and oxygen extraction fraction are associated with lower executive function in individuals with sickle cell anemia.
Obstructive Sleep Apnea as a Risk Factor for Intracerebral Hemorrhage
Jacqueline H. Geer, Guido J. Falcone, Kevin N. Vanent, Audrey C. Leasure, Daniel Woo, Jennifer R. Molano, Lauren H. Sansing, Carl D. Langefeld, Margaret A. Pisani, Henry K. Yaggi, Kevin N. Sheth
doi : 10.1161/STROKEAHA.120.033342
Stroke. 2021;52:1835–1838
To determine whether obstructive sleep apnea (OSA) is associated with intracerebral hemorrhage (ICH) risk, we assessed premorbid OSA exposure of patients with nontraumatic ICH and matched controls.
Susceptibility Vessel Sign in Relation With Time From Onset to Magnetic Resonance Imaging
Sebastien Soize, Pierre-François Manceau, Maxime Gauberti, Thibault Herbin, Mathieu Zuber, Laurent Pierot, Emmanuel Touzé
doi : 10.1161/STROKEAHA.120.032198
Stroke. 2021;52:1839–1842
In acute ischemic stroke, the susceptibility vessel sign (SVS) on T2* MR-sequence witnesses the red blood cell content of the clot. Although clot composition strongly depends on its age in vitro, the relationship between SVS and time has not been studied. In this study, we evaluated whether the presence of SVS was related to the time from symptom onset.
Improved Detectability of Brain Stem Ischemia by Combining Axial and Coronal Diffusion-Weighted Imaging
Paul Steffen, Lara-Sophie Beyer, Rosalie McDonough, Christian Thaler, Tobias Faizy, Jens Fiehler, Joystone Gbadamosi, Christian R. Habermann, Michael H. Sch?nfeld
doi : 10.1161/STROKEAHA.120.032457
Stroke. 2021;52:1843–1846
To evaluate the benefit of a coronal diffusion-weighted imaging (DWI) in addition to standard axial DWI for the detection of brain stem infarctions.
Which Acute Ischemic Stroke Patients Are Fast Progressors?
Johanna M. Ospel, Michael D. Hill, Manon Kappelhof, Andrew M. Demchuk, Bijoy K. Menon, Arnuv Mayank, Dar Dowlatshahi, Don Frei, Jeremy L. Rempel, Blaise Baxter, Mayank Goyal
doi : 10.1161/STROKEAHA.120.032950
Stroke. 2021;52:1847–1850
Fast infarct progression in acute ischemic stroke has a severe impact on patient prognosis and benefit of endovascular thrombectomy. In this post hoc analysis of the ESCAPE trial (Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke), we identified acute ischemic stroke patients with rapid infarct growth and investigated their baseline clinical and imaging characteristics.
Occipital Cortical Calcifications in Cerebral Amyloid Angiopathy
Ingeborg Rasing, Sabine Voigt, Emma A. Koemans, Erik van Zwet, Paul C. de Kruijff, Thijs W. van Harten, Ellis S. van Etten, Sanneke van Rooden, Louise van der Weerd, Mark A. van Buchem, Matthias J.P. van Osch, Steven M. Greenberg, Marianne A.A. van Walderveen, Gisela M. Terwindt, Marieke J.H. Wermer
doi : 10.1161/STROKEAHA.120.033286
Stroke. 2021;52:1851–1855
Cortical calcifications have been reported in patients with cerebral amyloid angiopathy (CAA), although their prevalence and pathophysiology are unknown. We investigated the frequency of calcifications on computed tomography, their association with intracerebral hemorrhage (ICH) and their coexistence with a striped pattern of the occipital cortex reflecting microcalcifications on ultra-high-field 7T-magnetic resonance imaging in Dutch-type hereditary CAA (D-CAA) and sporadic CAA.
Observation of Collagen-Containing Lesions After Hematoma Resolution in Intracerebral Hemorrhage
Christopher J. Love, Daniel Kirschenbaum, Magdy Selim, Eng H. Lo, Elisabeth Rushing, Myron Spector, Adriano Aguzzi
doi : 10.1161/STROKEAHA.120.030240
Stroke. 2021;52:1856–1860
The classic presentation of chronic (stage III) hemorrhagic stroke lesions is a fluid-filled cavity. In one of the most commonly used animal models of intracerebral hemorrhage (ICH), we noticed additional solid material within the chronic lesion. We examined the composition of those chronic ICH lesions and compared them with human autopsy cases.
Mature Adult Mice With Exercise-Preconditioning Show Better Recovery After Intracerebral Hemorrhage
Keita Kinoshita, Gen Hamanaka, Ryo Ohtomo, Hajime Takase, Kelly K. Chung, Josephine Lok, Eng H. Lo, Hiroshi Katsuki, Ken Arai
doi : 10.1161/STROKEAHA.120.032201
Stroke. 2021;52:1861–1865
Physical exercise offers therapeutic potentials for several central nervous system disorders, including stroke and cardiovascular diseases. However, it is still mostly unknown whether and how exercise preconditioning affects the prognosis of intracerebral hemorrhage (ICH). In this study, we examined the effects of preconditioning on ICH pathology in mature adult mice using treadmill exercise.
Endocannabinoid Response in Acute Ischemic Stroke
Marina Buciuc, Gian Marco Conte, Eugene L. Scharf
doi : 10.1161/STROKEAHA.121.034131
Stroke. 2021;52:e131–e132
Quality Improvement
Monique F. Kilkenny, Dawn M. Bravata
doi : 10.1161/STROKEAHA.121.033451
Stroke. 2021;52:1866–1870
Neurohospitalist
Eric E. Adelman, Michelle H. Leppert
doi : 10.1161/STROKEAHA.121.033557
Stroke. 2021;52:1871–1873
Thrombophilia Testing After Ischemic Stroke
Setareh Salehi Omran, Adam Hartman, Neil A. Zakai, Babak B. Navi
doi : 10.1161/STROKEAHA.120.032360
Stroke. 2021;52:1874–1884
Thrombophilia testing is frequently performed after an ischemic stroke, particularly when cryptogenic. However, there is minimal evidence supporting a significant association between most conditions assessed through thrombophilia testing and ischemic stroke, and the rationale for thrombophilia testing in many clinical situations remains uncertain. In this topical review, we review and contextualize the existing data on the risks, predictors, and outcomes of thrombophilic conditions in patients with ischemic stroke. We report that inherited thrombophilias have an uncertain relationship with ischemic stroke. Conversely, antiphospholipid syndrome, an acquired immune-mediated thrombophilia, seems to be a strong risk factor for arterial thromboembolic events, including ischemic stroke, and especially among young patients. Our findings suggest that certain circumstances may warrant targeted thrombophilia testing, such as stroke in the young, cryptogenic stroke, and high estrogen states. Future prospective studies should investigate the utility and cost effectiveness of thrombophilia testing in various stroke settings, including among patients with patent foramen ovale; as well as the optimal secondary stroke prevention regimen in patients with confirmed thrombophilia, particularly if no other potential stroke mechanism is identified.
Acute Viral Illnesses and Ischemic Stroke
Mona N. Bahouth, Arun Venkatesan
doi : 10.1161/STROKEAHA.120.030630
Stroke. 2021;52:1885–1894
The severe acute respiratory syndrome coronavirus 2 or coronavirus disease 2019 (COVID-19) pandemic has raised concerns about the correlation with this viral illness and increased risk of stroke. Although it is too early in the pandemic to know the strength of the association between COVID-19 and stroke, it is an opportune time to review the relationship between acute viral illnesses and stroke. Here, we summarize pathophysiological principles and available literature to guide understanding of how viruses may contribute to ischemic stroke. After a review of inflammatory mechanisms, we summarize relevant pathophysiological principles of vasculopathy, hypercoagulability, and hemodynamic instability. We will end by discussing mechanisms by which several well-known viruses may cause stroke in an effort to inform our understanding of the relationship between COVID-19 and stroke.
Endothelial Dysfunction in the Brain
Maithili Sashindranath, Harshal H. Nandurkar
doi : 10.1161/STROKEAHA.120.032711
Stroke. 2021;52:1895–1904
The Coronavirus disease 2019 (COVID)-19 pandemic has already affected millions worldwide, with a current mortality rate of 2.2%. While it is well-established that severe acute respiratory syndrome-coronavirus-2 causes upper and lower respiratory tract infections, a number of neurological sequelae have now been reported in a large proportion of cases. Additionally, the disease causes arterial and venous thromboses including pulmonary embolism, myocardial infarction, and a significant number of cerebrovascular complications. The increasing incidence of large vessel ischemic strokes as well as intracranial hemorrhages, frequently in younger individuals, and associated with increased morbidity and mortality, has raised questions as to why the brain is a major target of the disease. COVID-19 is characterized by hypercoagulability with alterations in hemostatic markers including high D-dimer levels, which are a prognosticator of poor outcome. Together with findings of fibrin-rich microthrombi, widespread extracellular fibrin deposition in affected various organs and hypercytokinemia, this suggests that COVID-19 is more than a pulmonary viral infection. Evidently, COVID-19 is a thrombo-inflammatory disease. Endothelial cells that constitute the lining of blood vessels are the primary targets of a thrombo-inflammatory response, and severe acute respiratory syndrome coronavirus 2 also directly infects endothelial cells through the ACE2 (angiotensin-converting enzyme 2) receptor. Being highly heterogeneous in their structure and function, differences in the endothelial cells may govern the susceptibility of organs to COVID-19. Here, we have explored how the unique characteristics of the cerebral endothelium may be the underlying reason for the increased rates of cerebrovascular pathology associated with COVID-19.
The Story of Intracerebral Hemorrhage
Joseph P. Broderick, James C. Grotta, Andrew M. Naidech, Thorsten Steiner, Nikola Sprigg, Kazunori Toyoda, Dar Dowlatshahi, Andrew M. Demchuk, Magdy Selim, J Mocco, Stephan Mayer
doi : 10.1161/STROKEAHA.121.033484
Stroke. 2021;52:1905–1914
This invited special report is based on an award presentation at the World Stroke Organization/European Stroke Organization Conference in November of 2020 outlining progress in the acute management of intracerebral hemorrhage (ICH) over the past 35 years. ICH is the second most common and the deadliest type of stroke for which there is no scientifically proven medical or surgical treatment. Prospective studies from the 1990s onward have demonstrated that most growth of spontaneous ICH occurs within the first 2 to 3 hours and that growth of ICH and resulting volumes of ICH and intraventricular hemorrhage are modifiable factors that can improve outcome. Trials focusing on early treatment of elevated blood pressure have suggested a target systolic blood pressure of 140 mm?Hg, but none of the trials were positive by their primary end point. Hemostatic agents to decrease bleeding in spontaneous ICH have included desmopressin, tranexamic acid, and rFVIIa (recombinant factor VIIa) without clear benefit, and platelet infusions which were associated with harm. Hemostatic agents delivered within the first several hours have the greatest impact on growth of ICH and potentially on outcome. No large Phase III surgical ICH trial has been positive by primary end point, but pooled analyses suggest that earlier ICH removal is more likely to be beneficial. Recent trials emphasize maximization of clot removal and minimizing brain injury from the surgical approach. The future of ICH therapy must focus on delivery of medical and surgical therapies as soon as possible if we are to improve outcomes.
Recommendations for Regional Stroke Destination Plans in Rural, Suburban, and Urban Communities From the Prehospital Stroke System of Care Consensus Conference: A Consensus Statement From the American Academy of Neurology, American Heart Association/American Stroke Association, American Society of Neuroradiology, National Association of EMS Physicians, National Association of State EMS Officials, Society of NeuroInterventional Surgery, and Society of Vascular and Interventional Neurology: Endorsed by the Neurocritical Care Society
Edward C. Jauch, Lee H. Schwamm, Peter D. Panagos, Jolene Barbazzeni, Robert Dickson, Robert Dunne, Jenevra Foley, Justin F. Fraser, Geoffrey Lassers, Christian Martin-Gill, Suzanne O’Brien, Mark Pinchalk, Shyam Prabhakaran, Christopher T. Richards, Peter Taillac, Albert W. Tsai, Anil Yallapragada, and on behalf of the Prehospital Stroke System of Care Consensus Conference See fewer authors
doi : 10.1161/STROKEAHA.120.033228
Stroke. 2021;52:e133–e152
no abstract
Inflated Estimates of Proportional Recovery From Stroke
Howard Bowman, Anna Bonkhoff, Tom Hope, Christian Grefkes, Cathy Price
doi : 10.1161/STROKEAHA.120.033031
Stroke. 2021;52:1915–1920
The proportional recovery rule states that most survivors recover a fixed proportion (?70%) of lost function after stroke. A strong (negative) correlation between the initial score and subsequent change (outcome minus initial; ie, recovery) is interpreted as empirical support for the proportional recovery rule. However, this rule has recently been critiqued, with a central observation being that the correlation of initial scores with change over time is confounded in the situations in which it is typically assessed. This critique has prompted reassessments of patients’ behavioral trajectory following stroke in 2 prominent papers. The first of these, by van der Vliet et al presented an impressive modeling of upper limb deficits following stroke, which avoided the confounded correlation of initial scores with change. The second by Kundert et al reassessed the value of the proportional recovery rule, as classically formulated as the correlation between initial scores and change. They argued that while effective prediction of recovery trajectories of individual patients is not supported by the available evidence, group-level inferences about the existence of proportional recovery are reliable. In this article, we respond to the van der Vliet and Kundert papers by distilling the essence of the argument for why the classic assessment of proportional recovery is confounded. In this respect, we reemphasize the role of mathematical coupling and compression to ceiling in the confounded nature of the correlation of initial scores with change. We further argue that this confound will be present for both individual-level and group-level inference. We then focus on the difficulties that can arise from ceiling effects, even when initial scores are not being correlated with change/recovery. We conclude by emphasizing the need for new techniques to analyze recovery after stroke that are not confounded in the ways highlighted here.
Challenges of Outcome Prediction for Acute Stroke Treatment Decisions
Mayank Goyal, Johanna Maria Ospel, Manon Kappelhof, Aravind Ganesh
doi : 10.1161/STROKEAHA.120.033785
Stroke. 2021;52:1921–1928
Physicians often base their decisions to offer acute stroke therapies to patients around the question of whether the patient will benefit from treatment. This has led to a plethora of attempts at accurate outcome prediction for acute ischemic stroke treatment, which have evolved in complexity over the years. In theory, physicians could eventually use such models to make a prediction about the treatment outcome for a given patient by plugging in a combination of demographic, clinical, laboratory, and imaging variables. In this article, we highlight the importance of considering the limits and nuances of outcome prediction models and their applicability in the clinical setting. From the clinical perspective of decision-making about acute treatment, we argue that it is important to consider 4 main questions about a given prediction model: (1) what outcome is being predicted, (2) what patients contributed to the model, (3) what variables are in the model (considering their quantifiability, knowability at the time of decision-making, and modifiability), and (4) what is the intended purpose of the model? We discuss relevant aspects of these questions, accompanied by clinically relevant examples. By acknowledging the limits of outcome prediction for acute stroke therapies, we can incorporate them into our decision-making more meaningfully, critically examining their contents, outcomes, and intentions before heeding their predictions. By rigorously identifying and optimizing modifiable variables in such models, we can be empowered rather than paralyzed by them.
Iatrogenic Diffusion-Weighted Imaging Lesions
Mayank Goyal, Aravind Ganesh, Michael Tymianski, Michael D. Hill, Johanna Maria Ospel
doi : 10.1161/STROKEAHA.120.033984
Stroke. 2021;52:1929–1936
Infarct volume in acute ischemic stroke is closely linked with clinical outcome, with larger infarct volumes being associated with a worse prognosis. Small iatrogenic infarcts, which can occur as a result of surgical or endovascular procedures, are often only seen on diffusion-weighted MR imaging. They often do not lead to any overtly appreciable clinical deficits, hence the term covert or silent infarcts. There is relative paucity of data on the clinical impact of periprocedural hyperintense diffusion-weighted MR imaging lesions, partly because they commonly remain undiagnosed. Clearly, a better understanding of iatrogenic periprocedural diffusion-weighted MR imaging lesions and their clinical significance is needed. In this article, we describe the current limitations of our understanding of the significance of iatrogenic diffusion-weighted MR imaging lesions using exemplary data from the ENACT trial (Safety and Efficacy of NA-1 in Patients With Iatrogenic Stroke After Endovascular Aneurysm Repair) and outline a framework for how to investigate their clinical impact.
Electromechanical-Assisted Training for Walking After Stroke
Jan Mehrholz, Marcus Pohl, Joachim Kugler, Bernhard Elsner
doi : 10.1161/STROKEAHA.120.033755
Stroke. 2021;52:e153–e154
Shattering the Carotids
Ankur Wadhwa, Simerpreet Bal, Oje Imoukhuede, Darshan Doshi
doi : 10.1161/STROKEAHA.120.032428
Stroke. 2021;52:e160–e163
Care of the Patient With Acute Ischemic Stroke (Prehospital and Acute Phase of Care): Update to the 2009 Comprehensive Nursing Care Scientific Statement: A Scientific Statement From the American Heart Association
Susan Ashcraft, Susan E. Wilson, Karin V. Nystr?m, Wendy Dusenbury, Charles R. Wira, Tamika M. Burrus, and on behalf of the American Heart Association Council on Cardiovascular and Stroke Nursing and the Stroke Council
doi : 10.1161/STR.0000000000000356
Stroke. 2021;52:e164–e178
The year 2020 was the year of the nurse, celebrating nurse scholarship, innovation, and leadership by promoting scientific nursing research, improving nursing practice, advancing nursing education, and providing leadership to influence health policy. As architects of stroke care, neuroscience nurses play a vital role in collaborating and coordinating care between multiple health professionals. Nurses improve accessibility and equity through telestroke, emergency medical services, and mobile stroke units and are integral to implementing education strategies by advocating and ensuring that patients and caregivers receive stroke education while safely transitioning through the health care system and to home. Stroke care is increasingly complex in the new reperfusion era, requiring nurses to participate in continuing education while attaining levels of competency in both the acute and recovery care process. Advanced practice nurses are taking the lead in many organizations, serving as prehospital providers on mobile stroke units, participating as members of the stroke response team, and directing stroke care protocols in the emergency department. This scientific statement is an update to the 2009 “Comprehensive Overview of Nursing and Interdisciplinary Care of the Acute Ischemic Stroke Patient.” The aim is to provide a comprehensive review of the scientific evidence on nursing care in the prehospital and hyperacute emergency hospital setting, arming nurses with the necessary tools to provide evidenced-based high-quality care.
Care of the Patient With Acute Ischemic Stroke (Posthyperacute and Prehospital Discharge): Update to 2009 Comprehensive Nursing Care Scientific Statement: A Scientific Statement From the American Heart Association
Theresa L. Green, Norma D. McNair, Janice L. Hinkle, Sandy Middleton, Elaine T. Miller, Stacy Perrin, Martha Power, Andrew M. Southerland, Debbie V. Summers, and on behalf of the American Heart Association Stroke Nursing Committee of the Council on Cardiovascular and Stroke Nursing and the Stroke Council
doi : 10.1161/STR.0000000000000357
Stroke. 2021;52:e179–e197
In 2009, the American Heart Association/American Stroke Association published a comprehensive scientific statement detailing the nursing care of the patient with an acute ischemic stroke through all phases of hospitalization. The purpose of this statement is to provide an update to the 2009 document by summarizing and incorporating current best practice evidence relevant to the provision of nursing and interprofessional care to patients with ischemic stroke and their families during the acute (posthyperacute phase) inpatient admission phase of recovery. Many of the nursing care elements are informed by nurse-led research to embed best practices in the provision and standard of care for patients with stroke. The writing group comprised members of the Stroke Nursing Committee of the Council on Cardiovascular and Stroke Nursing and the Stroke Council. A literature review was undertaken to examine the best practices in the care of the patient with acute ischemic stroke. The drafts were circulated and reviewed by all committee members. This statement provides a summary of best practices based on available evidence to guide nurses caring for adult patients with acute ischemic stroke in the hospital posthyperacute/intensive care unit. In many instances, however, knowledge gaps exist, demonstrating the need for continued nurse-led research on care of the patient with acute ischemic stroke.
Care of the Patient With Acute Ischemic Stroke (Endovascular/Intensive Care Unit-Postinterventional Therapy): Update to 2009 Comprehensive Nursing Care Scientific Statement: A Scientific Statement From the American Heart Association
Mary L. Rodgers, Elizabeth Fox, Tamer Abdelhak, Lauren M. Franker, Brenda Joyce Johnson, Christina Kirchner-Sullivan, Sarah L. Livesay, Franklin A. Marden, and on behalf of the American Heart Association Council on Cardiovascular and Stroke Nursing and the Stroke Council
doi : 10.1161/STR.0000000000000358
Stroke. 2021;52:e198–e210
Ischemic stroke remains the fifth leading cause of death in the United States. Nurses play a pivotal role in the care of patients throughout the continuum. With the advances in stroke care, including mechanical thrombectomy, the American Heart Association/American Stroke Association charged the writing panel to complement the 2009 clinical practice guideline, “Comprehensive Overview of Nursing and Interdisciplinary Care of the Acute Ischemic Stroke Patient,” with current evidence-based nursing care. This update is 1 of a 3-part series focusing on emergency medical services/emergency care, endovascular/intensive care unit care, and postacute care. The aim of this scientific statement is to review and present current evidence, complications, best practices, and clinical practice strategies to provide current comprehensive scientific information for nursing care in the neuroendovascular area and intensive care unit in conjunction with medical treatments, including intravenous thrombolysis and mechanical thrombectomy.
Correction to: Predictors for Failure of Early Neurological Improvement After Successful Thrombectomy in the Anterior Circulation
doi : 10.1161/STR.0000000000000372
Stroke. 2021;52:e211
Correction to: Care of the Patient With Acute Ischemic Stroke (Posthyperacute and Prehospital Discharge): Update to 2009 Comprehensive Nursing Care Scientific Statement: A Scientific Statement From the American Heart Association
doi : 10.1161/STR.0000000000000373
Stroke. 2021;52:e212
