دسترسی یکساله به بیش از ۵۰۰ ژورنال روز جهان موجود در سامانه
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July 2021 Stroke Highlights
José Rafael Romero
doi : 10.1161/STROKEAHA.121.035884
Stroke. 2021;52:2199
Launching a New Collaborative Journal
David S. Liebeskind, Mitchell S.V. Elkind, Ralph L. Sacco
doi : 10.1161/STROKEAHA.121.035500
Stroke. 2021;52:2200–2202
Dose Escalation and Safety of Capsaicin for Cerebral Perfusion Augmentation
Juan Manuel Marquez-Romero, Mar?a Raquel Huerta-Franco, Miguel Vargas-Luna, César Abraham Madrigal-Gutiérrez, José Mart?n Esparza-Hern?ndez, Mar?a Guadalupe Vel?zquez-Barcena
doi : 10.1161/STROKEAHA.120.032773
Stroke. 2021;52:2203–2209
Sphenopalatine ganglion (SPG) electrical stimulation has been studied in the setting of acute ischemic stroke to enhance collateral flow. Capsaicin poses an alternative to chemically stimulate the sphenopalatine ganglion. Therefore, the objective of this study was to determine the safety and effect of increasing doses of capsaicin upon serial transcranial Doppler markers of cerebral blood flow.
Delayed Neurological Improvement After Full Endovascular Reperfusion in Acute Anterior Circulation Ischemic Stroke
Blanca Talavera, Beatriz G?mez-Vicente, Mario Mart?nez-Gald?mez, Elena L?pez-Cancio, Carmen Garc?a-Cabo, Mar Castellanos, Alexia Roel, Herbert Tejada-Meza, Javier Marta-Moreno, Cristina Pérez-L?zaro, Mar?a Pilar Navarro-Pérez, Yolanda Bravo-Anguiano, M?nica B?rtulos-Iglesias, Javier Tejada-Garc?a, Gabriela Rodrigo-Stevens, Maite Mart?nez-Zabaleta, Patricia de la Riva, Juan José Timiraos-Fern?ndez, Mar?a del Mar Freijo, Alain Luna, Juan Manuel Garc?a-S?nchez, Mar?a del Carmen Gil-Alzueta, Enrique Jes?s Palacio-Portilla, Yésica Jiménez-L?pez, Luis L?pez-Mesonero, Laura Redondo-Robles, Agust?n Mayo-Iscar, Juan F. Arenillas, and on behalf of the NORDICTUS Investigators*
doi : 10.1161/STROKEAHA.120.032066
Stroke. 2021;52:2210–2217
We aimed to determine the prevalence and predictors of delayed neurological improvement (DNI) after complete endovascular reperfusion in anterior circulation acute ischemic stroke (AIS).
Delayed Neurological Improvement
William J. Meurer
doi : 10.1161/STROKEAHA.121.034342
Stroke. 2021;52:2218–2219
Impact of Age and Alberta Stroke Program Early Computed Tomography Score 0 to 5 on Mechanical Thrombectomy Outcomes: Analysis From the STRATIS Registry
Osama O. Zaidat, David S. Liebeskind, Ashutosh P. Jadhav, Santiago Ortega-Gutierrez, Thanh N. Nguyen, Diogo C. Haussen, Dileep R. Yavagal, Michael T. Froehler, Reza Jahan, Raul G. Nogueira, Tom L. Yao, Bader A. Alenzi, Saif Bushnaq, Nils H. Mueller-Kronast
doi : 10.1161/STROKEAHA.120.032430
Stroke. 2021;52:2220–2228
This study investigates clinical outcomes after mechanical thrombectomy in adult patients with baseline Alberta Stroke Program Early CT Score (ASPECTS) of 0 to 5.
Endovascular Therapy for Patients With Large Ischemic Strokes
Mikael Mazighi, G?tz Thomalla
doi : 10.1161/STROKEAHA.120.033884
Stroke. 2021;52:2229–2231
Fluid-Attenuated Inversion Recovery May Serve As a Tissue Clock in Patients Treated With Endovascular Thrombectomy
Junya Aoki, Yuki Sakamoto, Kentaro Suzuki, Yuji Nishi, Akihito Kutsuna, Yukako Takei, Kazutaka Sawada, Takuya Kanamaru, Arata Abe, Takehiro Katano, Yuho Takeshi, Toru Nakagami, Shinichiro Numao, Ryutaro Kimura, Satoshi Suda, Yasuhiro Nishiyama, Kazumi Kimura
doi : 10.1161/STROKEAHA.120.033374
Stroke. 2021;52:2232–2240
We investigated whether the signal change on fluid-attenuated inversion recovery (FLAIR) can serve as a tissue clock that predicts the clinical outcome after endovascular thrombectomy (EVT), independently of the onset-to-admission time.
Frequency, Determinants, and Outcomes of Emboli to Distal and New Territories Related to Mechanical Thrombectomy for Acute Ischemic Stroke
Gregory J. Wong, Bryan Yoo, David Liebeskind, Humain Baharvahdat, Jeffrey Gornbein, Reza Jahan, Viktor Szeder, Gary Duckwiler, Satoshi Tateshima, Geoffrey Colby, May Nour, Latisha Sharma, Neal Rao, Jason Hinman, Sidney Starkman, Jeffrey L. Saver,
doi : 10.1161/STROKEAHA.120.033377
Stroke. 2021;52:2241–2249
Clot fragmentation and distal embolization during endovascular thrombectomy for acute ischemic stroke may produce emboli downstream of the target occlusion or in previously uninvolved territories. Susceptibility-weighted magnetic resonance imaging can identify both emboli to distal territories (EDT) and new territories (ENT) as new susceptibility vessel signs (SVS). Diffusion-weighted imaging (DWI) can identify infarcts in new territories (INT).
P2Y12 Inhibitors Plus Aspirin Versus Aspirin Alone in Patients With Minor Stroke or High-Risk Transient Ischemic Attack
Zi-Xiao Li, Yunyun Xiong, Hong-Qiu Gu, Marc Fisher, Ying Xian, S. Claiborne Johnston, Yong-Jun Wang
doi : 10.1161/STROKEAHA.120.033040
Stroke. 2021;52:2250–2257
We performed a systemic review and meta-analysis to elucidate the effectiveness and safety of dual antiplatelet (DAPT) therapy with P2Y12 inhibitors (clopidogrel/ticagrelor) and aspirin versus aspirin monotherapy in patients with mild ischemic stroke or high-risk transient ischemic attack.
Focal Cerebral Arteriopathy of Childhood
Gabriela Oesch, Francisco A. Perez, Mark S. Wainwright, Dennis W.W. Shaw, Catherine Amlie-Lefond
doi : 10.1161/STROKEAHA.120.031880
Stroke. 2021;52:2258–2265
Focal cerebral arteriopathy (FCA) of childhood with unilateral stenosis of the anterior circulation is reported to account for up to one-quarter of childhood arterial ischemic stroke, with stroke recurrence in 25% of cases. Limited knowledge regarding pathophysiology and outcome results in inconsistent treatment of FCA.
Risk of Atrial Fibrillation and Stroke After Bariatric Surgery in Patients With Morbid Obesity With or Without Obstructive Sleep Apnea
Ahmed Dalmar, Maharaj Singh, Zoe Heis, Tabitha L. Cumpian, Cheryl Ceretto, M. Eyman Mortada, Atul Bhatia, Imran Niazi, Thomas Y. Chua, Jasbir Sra, Arshad Jahangir
doi : 10.1161/STROKEAHA.120.031920
Stroke. 2021;52:2266–2274
Weight loss in morbidly obese patients reduces atrial fibrillation (AF); however, it is unknown whether similar benefits are maintained in patients with obstructive sleep apnea (OSA). We sought to determine whether incident AF and stroke rates are affected by OSA after weight loss and to identify predictors of AF and stroke.
Blood-Based Cardiac Biomarkers and the Risk of Cognitive Decline, Cerebrovascular Disease, and Clinical Events
Bibek Gyanwali, Mitchell K.P. Lai, Benedict Lui, Oi Wah Liew, Narayanaswamy Venketasubramanian, Arthur Mark Richards, Christopher Chen, Saima Hilal
doi : 10.1161/STROKEAHA.120.032571
Stroke. 2021;52:2275–2283
Cardiac biomarkers, NT-proBNP (N-terminal probrain natriuretic peptide), hs-cTnT (high-sensitivity-cardiac troponin T), and GDF-15 (growth differentiation factor-15) have been proposed as important biomarkers of early vascular pathology. However, little is known of the longitudinal associations of these cardiac biomarkers with cerebrovascular disease and clinical events. We examine the association of blood-based cardiac biomarkers (NT-proBNP, hs-cTnT, and GDF-15) with cognitive decline, incident cerebrovascular disease, vascular events, and mortality.
Severe Dysphagia Predicts Poststroke Fever
Sebastian St?sser, Matthias Gotthardt, Beate Lindner-Pfleghar, Eric Jüttler, Rebecca Kassubek, Hermann Neugebauer
doi : 10.1161/STROKEAHA.120.033396
Stroke. 2021;52:2284–2291
Fever is a common observation after ischemic or hemorrhagic stroke and is associated with a worse clinical outcome. Infections, stroke severity, preexisting medical conditions, insertion of catheters, and dysphagia have been implicated in causing poststroke fever. Given that dysphagia has not been evaluated in detail yet, the aim of this study was to investigate if the severity of dysphagia assessed by a detailed swallowing assessment predicts poststroke fever.
d-dimer Level as a Predictor of Recurrent Stroke in Patients With Embolic Stroke of Undetermined Source
Kang-Ho Choi, Ja-Hae Kim, Jae-Myung Kim, Kyung-Wook Kang, Changho Lee, Joon-Tae Kim, Seong-Min Choi, Man-Seok Park, Ki-Hyun Cho
doi : 10.1161/STROKEAHA.120.033217
Stroke. 2021;52:2292–2301
This study aimed to investigate the value of d-dimer levels in predicting recurrent stroke in patients with embolic stroke of undetermined source. We also evaluated the underlying causes of recurrent stroke according to d-dimer levels.
Preoperative Risks of Cerebral Infarction in Pediatric Moyamoya Disease
Toshiaki Hayashi, Tomomi Kimiwada, Hiroshi Karibe, Reizo Shirane, Tatsuya Sasaki, Hirohito Metoki, Teiji Tominaga
doi : 10.1161/STROKEAHA.120.032699
Stroke. 2021;52:2302–2310
In pediatric moyamoya disease, there have been few reports of the risk factors for preoperative cerebral infarction, especially during the waiting period before surgery. The clinical and radiological findings of surgically treated pediatric moyamoya patients were evaluated to analyze the risk factors for cerebral infarction seen from onset to surgery.
Prevalence and Clinical Correlates of Intracranial Dolichoectasia in Individuals With Ischemic Stroke
Victor J. Del Brutto, Jose Gutierrez, Mohammed Z. Goryawala, Ralph L. Sacco, Tatjana Rundek, Jose G. Romano
doi : 10.1161/STROKEAHA.120.032225
Stroke. 2021;52:2311–2318
Acute ischemic stroke is a known complication of intracranial dolichoectasia (IDE). However, the frequency of IDE causing brain infarction is unknown. We aim to determine the prevalence and clinical correlates of IDE in acute ischemic stroke by employing an objective IDE definition for major intracranial arteries of the anterior and posterior circulation.
Characterizing Diaschisis-Related Thalamic Perfusion and Diffusion After Middle Cerebral Artery Infarction
Cong Xia, Jiaying Zhou, Chunqiang Lu, Yuancheng Wang, Tianyu Tang, Yu Cai, Shenghong Ju
doi : 10.1161/STROKEAHA.120.032464
Stroke. 2021;52:2319–2327
Ipsilateral thalamic diaschisis (ITD) initially describes functional depression of the thalamus ipsilateral to a supratentorial lesion, but accumulating evidence has shown morphological changes also occur. Therefore, we aimed to characterize thalamic perfusion and diffusion related to ITD over time and their inter-relationships after middle cerebral artery infarction.
Predicting Infarct Core From Computed Tomography Perfusion in Acute Ischemia With Machine Learning: Lessons From the ISLES Challenge
Arsany Hakim, S?ren Christensen, Stefan Winzeck, Maarten G. Lansberg, Mark W. Parsons, Christian Lucas, David Robben, Roland Wiest, Mauricio Reyes, Greg Zaharchuk
doi : 10.1161/STROKEAHA.120.030696
Stroke. 2021;52:2328–2337
The ISLES challenge (Ischemic Stroke Lesion Segmentation) enables globally diverse teams to compete to develop advanced tools for stroke lesion analysis with machine learning. Detection of irreversibly damaged tissue on computed tomography perfusion (CTP) is often necessary to determine eligibility for late-time-window thrombectomy. Therefore, the aim of ISLES-2018 was to segment infarcted tissue on CTP based on diffusion-weighted imaging as a reference standard.
Reversible Edema in the Penumbra Correlates With Severity of Hypoperfusion
Lauranne Scheldeman, Anke Wouters, Patrick Dupont, Soren Christensen, Florent Boutitie, Bastian Cheng, Martin Ebinger, Matthias Endres, Jochen B. Fiebach, Christian Gerloff, Keith W. Muir, Norbert Nighoghossian, Salvador Pedraza, Claus Z. Simonsen, Erich B. Ringelstein, Angel Chamorro, Martin Grond, Rico Laage, Armin Schneider, G?tz Thomalla, Vincent Thijs, Robin Lemmens
doi : 10.1161/STROKEAHA.120.033071
Stroke. 2021;52:2338–2346
We aimed to investigate fluid-attenuated inversion recovery changes in the penumbra.
Cerebral Microbleeds
Jonathan Graff-Radford, Timothy Lesnick, Alejandro A. Rabinstein, Jeffrey L. Gunter, Scott A. Przybelski, Peter A. Noseworthy, Gregory M. Preboske, Michelle M. Mielke, Val J. Lowe, David S. Knopman, Ronald C. Petersen, Walter K. Kremers, Clifford R. Jack Jr, Prashanthi Vemuri, Kejal Kantarci
doi : 10.1161/STROKEAHA.120.031515
Stroke. 2021;52:2347–2355
Cerebral microbleeds (CMBs) are represented by small areas of hemosiderin deposition, detected on brain magnetic resonance imaging (MRI), and found in ?23% of the cognitively normal population over age of 60 years. CMBs predict risk of hemorrhagic and ischemic stroke. They correlate with increased cardiovascular mortality. In this article, we sought to determine in a population-based study whether antithrombotic medications correlate with CMBs and, if present, whether the association was direct or mediated by another variable.
Centrum Semiovale Perivascular Space and Amyloid Deposition in Spontaneous Intracerebral Hemorrhage
Hsin-Hsi Tsai, Marco Pasi, Li-Kai Tsai, Chi-Ching Huang, Ya-Fang Chen, Bo-Ching Lee, Ruoh-Fang Yen, M. Edip Gurol, Jiann-Shing Jeng
doi : 10.1161/STROKEAHA.120.032139
Stroke. 2021;52:2356–2362
We explored whether high-degree magnetic resonance imaging–visible perivascular spaces in centrum semiovale (CSO) are more prevalent in cerebral amyloid angiopathy (CAA) than hypertensive small vessel disease and their relationship to brain amyloid retention in patients with primary intracerebral hemorrhage (ICH).
Can Children With Perinatal Stroke Use a Simple Brain Computer Interface?
Zeanna Jadavji, Jack Zhang, Brett Paffrath, Ephrem Zewdie, Adam Kirton
doi : 10.1161/STROKEAHA.120.030596
Stroke. 2021;52:2363–2370
Perinatal stroke is the leading cause of hemiparetic cerebral palsy resulting in lifelong disability for millions of people worldwide. Options for motor rehabilitation are limited, especially for the most severely affected children. Brain computer interfaces (BCIs) sample brain activity to allow users to control external devices. Functional electrical stimulation enhances motor recovery after stroke, and BCI-activated functional electrical stimulation was recently shown to improve upper extremity function in adult stroke. We aimed to determine the ability of children with perinatal stroke to operate a simple BCI.
Hospital Factors, Performance on Process Measures After Transient Ischemic Attack, and 90-Day Ischemic Stroke Incidence
Deborah A. Levine, Anthony J. Perkins, Jason J. Sico, Laura J. Myers, Michael S. Phipps, Ying Zhang, Dawn M. Bravata
doi : 10.1161/STROKEAHA.120.031721
Stroke. 2021;52:2371–2378
We determined the association between hospital factors, performance on transient ischemic attack (TIA) process measures, and 90-day ischemic stroke incidence.
Attacking Quality-of-Care Gaps in Transient Ischemic Attack
Adam G. Kelly
doi : 10.1161/STROKEAHA.121.034734
Stroke. 2021;52:2379–2380
Long Noncoding RNA Fos Downstream Transcript Is Developmentally Dispensable but Vital for Shaping the Poststroke Functional Outcome
Suresh L. Mehta, Anil K. Chokkalla, TaeHee Kim, Saivenkateshkomal Bathula, Bharath Chelluboina, Kahlilia C. Morris-Blanco, Aleah Holmes, Anik Banerjee, Anjali Chauhan, Juneyoung Lee, Venugopal R. Venna, Louise D. McCullough, Raghu Vemuganti
doi : 10.1161/STROKEAHA.120.033547
Stroke. 2021;52:2381–2392
Stroke induces the expression of several long noncoding RNAs in the brain. However, their functional significance in poststroke outcome is poorly understood. We recently observed that a brain-specific long noncoding RNA called Fos downstream transcript (FosDT) is induced rapidly in the rodent brain following focal ischemia. Using FosDT knockout rats, we presently evaluated the role of FosDT in poststroke brain damage.
FTO (Fat-Mass and Obesity-Associated Protein) Participates in Hemorrhage-Induced Thalamic Pain by Stabilizing Toll-Like Receptor 4 Expression in Thalamic Neurons
Ganglan Fu, Shibin Du, Tianfeng Huang, Minghui Cao, Xiaozhou Feng, Shaogen Wu, Sfian Albik, Alex Bekker, Yuan-Xiang Tao
doi : 10.1161/STROKEAHA.121.034173
Stroke. 2021;52:2393–2403
Hemorrhage-caused gene changes in the thalamus likely contribute to thalamic pain genesis. RNA N6-methyladenosine modification is an additional layer of gene regulation. Whether FTO (fat-mass and obesity-associated protein), an N6-methyladenosine demethylase, participates in hemorrhage-induced thalamic pain is unknown.
Activation of the Central Renin-Angiotensin System Causes Local Cerebrovascular Dysfunction
T. Michael De Silva, Mary L. Modrick, Justin L. Grobe, Frank M. Faraci
doi : 10.1161/STROKEAHA.121.034984
Stroke. 2021;52:2404–2413
Hypertension is a leading risk factor for cerebrovascular disease and loss of brain health. While the brain renin-angiotensin system (RAS) contributes to hypertension, its potential impact on the local vasculature is unclear. We tested the hypothesis that activation of the brain RAS would alter the local vasculature using a modified deoxycorticosterone acetate (DOCA) model.
Carotid Stenosis and Recurrent Ischemic Stroke
Shadi Yaghi, Adam de Havenon, Sara Rostanski, Alexandra Kvernland, Brian Mac Grory, Karen L. Furie, Anthony S. Kim, J. Donald Easton, S. Claiborne Johnston, Nils Henninger
doi : 10.1161/STROKEAHA.121.034089
Stroke. 2021;52:2414–2417
Randomized trials demonstrated the benefit of dual antiplatelet therapy in patients with minor ischemic stroke or high-risk transient ischemic attack. We sought to determine whether the presence of carotid stenosis was associated with increased risk of ischemic stroke and whether the addition of clopidogrel to aspirin was associated with more benefit in patients with versus without carotid stenosis.
Ischemic Stroke in Patients With Pulmonary Arteriovenous Fistulas
Karan K. Topiwala, Smit D. Patel, Mubashir Pervez, Claire L. Shovlin, Mark J. Alberts
doi : 10.1161/STROKEAHA.120.032073
Stroke. 2021;52:e311–e315
Pulmonary arteriovenous fistulas (PAVFs) are a treatable cause of acute ischemic stroke (AIS), not mentioned in current American Heart/Stroke Association guidelines. PAVFs are recognized as an important complication of hereditary hemorrhagic telangiectasia.
Causal Effect of MMP-1 (Matrix Metalloproteinase-1), MMP-8, and MMP-12 Levels on Ischemic Stroke
Jara C?rcel-M?rquez, Natalia Cullell, Elena Mui?o, Cristina Gallego-Fabrega, Miquel Lled?s, Laura Iba?ez, Jerzy Krupinski, Joan Montaner, Carlos Cruchaga, Jin-Moo Lee, Dipender Gill, Guillaume Paré, Marina Mola-Caminal, Jaume Roquer, Jordi Jimenez-Conde, Joan Mart?-Fàbregas, Israel Fernandez-Cadenas
doi : 10.1161/STROKEAHA.120.033041
Stroke. 2021;52:e316–e320
MMP (matrix metalloproteinase) levels have been widely associated with ischemic stroke risk and poststroke outcome. However, their role as a risk factor or as a subeffect because of ischemia is uncertain.
Additive Effect of Coexisting Aneurysms Increases Subarachnoid Hemorrhage Risk in Patients With Multiple Aneurysms
Xin Feng, Xin Tong, Fei Peng, Hao Niu, Peng Qi, Jun Lu, Yang Zhao, Weitao Jin, Zhongxue Wu, He Liu, Yuanli Zhao, Aihua Liu, Daming Wang
doi : 10.1161/STROKEAHA.120.032500
Stroke. 2021;52:2418–2421
It remains unclear whether the additive effect of coexisting intracranial aneurysms increases the risk of subarachnoid hemorrhage (SAH) in patients with multiple intracranial aneurysms. We have performed a tentative analysis for the additive effect of coexisting aneurysms.
Transcranial Doppler in Acute COVID-19 Infection
Wendy C. Ziai, Sung-Min Cho, Michelle C. Johansen, Bahattin Ergin, Mona N. Bahouth
doi : 10.1161/STROKEAHA.120.032150
Stroke. 2021;52:2422–2426
Stroke may complicate coronavirus disease 2019 (COVID-19) infection based on clinical hypercoagulability. We investigated whether transcranial Doppler ultrasound has utility for identifying microemboli and clinically relevant cerebral blood flow velocities (CBFVs) in COVID-19.
Disrupted Rest-Activity Rhythms and Cerebral Small Vessel Disease Pathology in Older Adults
Rosa Sommer, Lei Yu, Julie A. Schneider, David A. Bennett, Aron S. Buchman, Andrew S.P. Lim
doi : 10.1161/STROKEAHA.120.030870
Stroke. 2021;52:2427–2431
The pathogenesis of cerebral small vessel disease remains incompletely understood. The relationship between circadian rhythm disturbances and histopathologic measures of cerebral small vessel disease has not been studied. We hypothesized that disrupted circadian rest-activity rhythms would be associated with a higher burden of cerebral small vessel disease pathology.
Patient-Reported Experience Measures in Stroke Care
Cosette Cornelis, Sanne J. den Hartog, Carla M. Bastemeijer, Bob Roozenbeek, Paul J. Nederkoorn, Renske M. Van den Berg-Vos
doi : 10.1161/STROKEAHA.120.034028
Stroke. 2021;52:2432–2435
Patient-reported experience measures (PREMs) assess patients’ perception of health care. We aimed to identify all reported PREMs for stroke care and critically appraise psychometric properties of PREMs validated for patients with stroke.
Intracerebral Hemorrhage in Patients With COVID-19
Audrey C. Leasure, Yosef M. Khan, Raakhee Iyer, Mitchell S.V. Elkind, Lauren H. Sansing, Guido J. Falcone, Kevin N. Sheth
doi : 10.1161/STROKEAHA.121.034215
Stroke. 2021;52:e321–e323
Spontaneous intracerebral hemorrhage (ICH) is a devastating consequence of coronavirus disease 2019 (COVID-19) infection.1,2 Prior single-center studies have reported ICH in patients with COVID-19, but these findings have not been confirmed in a multicenter study.3,4
Angiotensin-Converting Enzyme 2 Activity Is Associated With Embolic Stroke of Undetermined Source
Jithin K. Sajeev, Helen Dewey, Jonathan M. Kalman, Bon Chou, Louise Roberts, Jennifer C. Cooke, Anoop N. Koshy, Sheila K. Patel, Merryn Gould, Jeremy Ngoh, Louise M. Burrell, Andrew W. Teh
doi : 10.1161/STROKEAHA.121.034135
Stroke. 2021;52:e324–e325
Deferral of Consent
Michel Shamy, Brian Dewar, Tess Fitzpatrick, David J. Gladstone, Bijoy K. Menon, Richard Swartz, Michael D. Hill, Dar Dowlatshahi
doi : 10.1161/STROKEAHA.121.034655
Stroke. 2021;52:e326–e327
Neurocritical Care Updates in Cerebrovascular Disease
Ruchira M. Jha, Kevin N. Sheth
doi : 10.1161/STROKEAHA.121.033291
Stroke. 2021;52:2436–2439
Vascular Biology
Nabil J. Alkayed, Marilyn J. Cipolla
doi : 10.1161/STROKEAHA.121.033556
Stroke. 2021;52:2440–2441
Direct to Thrombectomy
Kyriakos Lobotesis, Brian H. Buck
doi : 10.1161/STROKEAHA.121.034423
Stroke. 2021;52:2442–2444
Effect of Exercise Interventions on Health-Related Quality of Life After Stroke and Transient Ischemic Attack
Ali Ali, Dina Tabassum, Sheharyar S. Baig, Bethany Moyle, Jessica Redgrave, Simon Nichols, Gordon McGregor, Katherine Evans, Nikki Totton, Cindy Cooper, Arshad Majid
doi : 10.1161/STROKEAHA.120.032979
Stroke. 2021;52:2445–2455
Exercise interventions have been shown to help physical fitness, walking, and balance after stroke, but data are lacking on whether such interventions lead to improvements in health-related quality of life (HRQoL). In this systematic review and meta-analysis, 30 randomized controlled trials (n=1836 patients) were found from PubMed, OVID MEDLINE, Web of Science, CINAHL, SCOPUS, The Cochrane Library, and TRIP databases when searched from 1966 to February 2020 that examine the effects of exercise interventions on HRQoL after stroke or transient ischemic attack. Exercise interventions resulted in small to moderate beneficial effects on HRQoL at intervention end (standardized mean difference, ?0.23 [95% CI, ?0.40 to ?0.07]) that appeared to diminish at longer-term follow-up (standardized mean difference, ?0.11 [95% CI, ?0.26 to 0.04]). Exercise was associated with moderate improvements in physical health (standardized mean difference, ?0.33 [95% CI, ?0.61 to ?0.04]) and mental health (standardized mean difference, ?0.29 [95% CI, ?0.49 to ?0.09]) domains of HRQoL while effects on social or cognitive composites showed little difference. Interventions that were initiated within 6 months, lasted at least 12 weeks in duration, involved at least 150 minutes per week, and included resistance training appeared most effective. Exercise can lead to moderate beneficial effects on HRQoL and should be considered an integral part of stroke rehabilitation.
Central Nervous System Fibroblast-Like Cells in Stroke and Other Neurological Disorders
Lingling Xu, Yao Yao
doi : 10.1161/STROKEAHA.120.033431
Stroke. 2021;52:2456–2464
Fibroblasts are the most common cell type of connective tissues. In the central nervous system (CNS), fibroblast-like cells are mainly located in the meninges and perivascular Virchow-Robin space. The origins of these fibroblast-like cells and their functions in both CNS development and pathological conditions remain largely unknown. In this review, we first introduce the anatomic location and molecular markers of CNS fibroblast-like cells. Next, the functions of fibroblast-like cells in CNS development and neurological disorders, including stroke, CNS traumatic injuries, and other neurological diseases, are discussed. Third, current challenges and future directions in the field are summarized. We hope to provide a synthetic review that stimulates future research on CNS fibroblast-like cells.
Thomas Willis Lecture
Marilyn J. Cipolla
doi : 10.1161/STROKEAHA.121.034620
Stroke. 2021;52:2465–2477
Cerebral infarction or ischemic death of brain tissue, most notably neurons, is a primary response to vascular occlusion that if minimized leads to better stroke outcome. However, many cell types are affected in the brain during ischemia and reperfusion, including vascular cells of the cerebral circulation. Importantly, the structure and function of all brain vascular segments are major determinants of the depth of ischemia during the occlusion, the extent of collateral flow (and therefore amount of potentially salvageable tissue) and the degree of reperfusion. Thus, appropriate function of the cerebral circulation can influence stroke outcome. The brain vasculature is also directly involved in secondary injury to ischemia, including edema, hemorrhage, and infarct expansion, and provides a key delivery route for neuroprotective agents. Therefore, the cerebral circulation provides a therapeutic target for multiple aspects of stroke injury, including aiding neuroprotection. Understanding how ischemia and reperfusion affect the brain vasculature is key to this therapeutic potential, that is, vascular protection. This report is focused on regional differences in the cerebral circulation, how ischemia and reperfusion differentially affects these segments, and how the response of large versus small vessels in the brain to ischemia and reperfusion can influence stroke outcome. Last, how chronic hypertension, a common comorbidity in patients with stroke, affects the brain microvasculature to worsen stroke outcome will be described.
Diagnosis and Management of Cerebral Venous Sinus Thrombosis With Vaccine-Induced Immune Thrombotic Thrombocytopenia
Karen L. Furie, Mary Cushman, Mitchell S.V. Elkind, Patrick D. Lyden, Gustavo Saposnik, and on behalf of the American Heart Association/American Stroke Association Stroke Council Leadership
doi : 10.1161/STROKEAHA.121.035564
Stroke. 2021;52:2478–2482
Chronic Kidney Disease and Cerebrovascular Disease
Dearbhla M. Kelly, Zanfina Ademi, Wolfram Doehner, Gregory Y.H. Lip, Patrick Mark, Kazunori Toyoda, Christopher X. Wong, Mark Sarnak, Michael Cheung, Charles A. Herzog, Kirsten L. Johansen, Holger Reinecke, Manish M. Sood
doi : 10.1161/STROKEAHA.120.029680
Stroke. 2021;52:e328–e346
The global health burden of chronic kidney disease is rapidly rising, and chronic kidney disease is an important risk factor for cerebrovascular disease. Proposed underlying mechanisms for this relationship include shared traditional risk factors such as hypertension and diabetes, uremia-related nontraditional risk factors, such as oxidative stress and abnormal calcium-phosphorus metabolism, and dialysis-specific factors such as cerebral hypoperfusion and changes in cardiac structure. Chronic kidney disease frequently complicates routine stroke risk prediction, diagnosis, management, and prevention. It is also associated with worse stroke severity, outcomes and a high burden of silent cerebrovascular disease, and vascular cognitive impairment. Here, we present a summary of the epidemiology, pathophysiology, diagnosis, and treatment of cerebrovascular disease in chronic kidney disease from the Kidney Disease: Improving Global Outcomes Controversies Conference on central and peripheral arterial disease with a focus on knowledge gaps, areas of controversy, and priorities for research.
Detection of Large Vessel Occlusion Stroke in the Prehospital Setting
Laura C.C. van Meenen, Maritta N. van Stigt, Arjen Siegers, Martin D. Smeekes, Joffry A.F. van Grondelle, Geertje Geuzebroek, Henk A. Marquering, Charles B.L.M. Majoie, Yvo B.W.E.M. Roos, Johannes H.T.M. Koelman, Wouter V. Potters, Jonathan M. Coutinho
doi : 10.1161/STROKEAHA.120.033053
Stroke. 2021;52:e347–e355
A reliable and fast instrument for prehospital detection of large vessel occlusion (LVO) stroke would be a game-changer in stroke care, because it would enable direct transportation of LVO stroke patients to the nearest comprehensive stroke center for endovascular treatment. This strategy would substantially improve treatment times and thus clinical outcomes of patients. Here, we outline our view on the requirements of an effective prehospital LVO detection method, namely: high diagnostic accuracy; fast application and interpretation; user-friendliness; compactness; and low costs. We argue that existing methods for prehospital LVO detection, including clinical scales, mobile stroke units and transcranial Doppler, do not fulfill all criteria, hindering broad implementation of these methods. Instead, electroencephalography may be suitable for prehospital LVO detection since in-hospital studies have shown that quantification of hypoxia-induced changes in the electroencephalography signal have good diagnostic accuracy for LVO stroke. Although performing electroencephalography measurements in the prehospital setting comes with challenges, solutions for fast and simple application of this method are available. Currently, the feasibility and diagnostic accuracy of electroencephalography in the prehospital setting are being investigated in clinical trials.
Update of the World Stroke Organization Activities
Marc Fisher, Sheila Martins
doi : 10.1161/STROKEAHA.121.035357
Stroke. 2021;52:e356–e357
Transcranial Direct Current Stimulation for Activities After Stroke
Bernhard Elsner, Joachim Kugler, Marcus Pohl, Jan Mehrholz
doi : 10.1161/STROKEAHA.120.033757
Stroke. 2021;52:e358–e359
Applying for Junior Faculty Positions as a Research Scientist
Sylvie Lesage, Adrian Liston
doi : 10.1161/STROKEAHA.121.035332
Stroke. 2021;52:e360–e363
2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association
Dawn O. Kleindorfer, Amytis Towfighi, Seemant Chaturvedi, Kevin M. Cockroft, Jose Gutierrez, Debbie Lombardi-Hill, Hooman Kamel, Walter N. Kernan, Steven J. Kittner, Enrique C. Leira, Olive Lennon, James F. Meschia, Thanh N. Nguyen, Peter M. Pollak, Pasquale Santangeli, Anjail Z. Sharrief, Sidney C. Smith Jr, Tanya N. Turan, Linda S. Williams
doi : 10.1161/STR.0000000000000375
Stroke. 2021;52:e364–e467
Benefits and Risks of Dual Versus Single Antiplatelet Therapy for Secondary Stroke Prevention: A Systematic Review for the 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack
Devin L. Brown, Deborah A. Levine, Karen Albright, Moira K. Kapral, Lester Y. Leung, Mathew J. Reeves, Jason Sico, Brent Strong, William N. Whiteley, and on behalf of the American Heart Association Stroke Council
doi : 10.1161/STR.0000000000000377
Stroke. 2021;52:e468–e479
Dual antiplatelet therapy (DAPT) after ischemic stroke or transient ischemic attack may reduce recurrent stroke but also increase severe bleeding compared with single antiplatelet therapy (SAPT). The American Heart Association/American Stroke Association convened an evidence review committee to perform a systematic review and meta-analysis of the benefits and risks of DAPT compared with SAPT for secondary ischemic stroke prevention.
Correction to: Triage of 5 Noncontrast Computed Tomography Markers and Spot Sign for Outcome Prediction After Intracerebral Hemorrhage
doi : 10.1161/STR.0000000000000385
Stroke. 2021;52:e480
Correction to: 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
doi : 10.1161/STR.0000000000000379
Stroke. 2021;52:e481
Correction to: Vaccination Against Herpes Zoster and the Potential to Reduce the Global Burden of Stroke
doi : 10.1161/STR.0000000000000378
Stroke. 2021;52:e482
Correction to: 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association
doi : 10.1161/STR.0000000000000383
Stroke. 2021;52:e483–e484
Retraction of: Association of Lesion Location and Depressive Symptoms Poststroke
doi : 10.1161/STR.0000000000000380
Stroke. 2021;52:e485
