01 agosto 2016

THE LANCET. Neurology. Global burden of stroke and risk factors in 188 countries, during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Prof Valery L Feigin, MD, Gregory A Roth, MD, Prof Mohsen Naghavi, MD, Priya Parmar, PhD, Rita Krishnamurthi, PhD, Sumeet Chugh, MD, George A Mensah, MD, Prof Bo Norrving, MD, Ivy Shiue, PhD, Marie Ng, PhD, Kara Estep, BA, Kelly Cercy, BA, Prof Christopher J L Murray, MD, Prof Mohammad H Forouzanfar, PhD for the Global Burden of Diseases, Injuries and Risk Factors Study 2013 and Stroke Experts Writing Group†

Background: The contribution of modifiable risk factors to the increasing global and regional burden of stroke is unclear, but knowledge about this contribution is crucial for informing stroke prevention strategies. We used data from the Global Burden of Disease Study 2013 (GBD 2013) to estimate the population-attributable fraction (PAF) of stroke-related disability-adjusted life-years (DALYs) associated with potentially modifiable environmental, occupational, behavioural, physiological, and metabolic risk factors in different age and sex groups worldwide and in high-income countries and low-income and middle-income countries, from 1990 to 2013.

01 agosto 2016

THE LANCET. Neurology. Risk of intracerebral haemorrhage with alteplase after acute ischaemic stroke: a secondary analysis of an individual patient data meta-analysis

William N Whiteley, BM†, Jonathan Emberson, PhD†, Prof Kennedy R Lees, MD, Lisa Blackwell, BSc, Prof Gregory Albers, MD, Prof Erich Bluhmki, PhD, Prof Thomas Brott, MD, Geoff Cohen, MSc, Prof Stephen Davis, MD, Prof Geoffrey Donnan, MD, James Grotta, MD, Prof George Howard, DrPH, Prof Markku Kaste, MD, Masatoshi Koga, MD, Prof Rüdiger von Kummer, MD, Prof Maarten G Lansberg, MD, Prof Richard I Lindley, MD, Prof Patrick Lyden, MD, Prof Jean Marc Olivot, MD, Prof Mark Parsons, MD, Prof Danilo Toni, MD, Prof Kazunori Toyoda, MD, Prof Nils Wahlgren, MD, Prof Joanna Wardlaw, MD, Prof Gregory J del Zoppo, MD, Prof Peter Sandercock, DM, Prof Werner Hacke, MD, Prof Colin Baigent, BM for the Stroke Thrombolysis Trialists´ Collaboration

Background: Randomised trials have shown that alteplase improves the odds of a good outcome when delivered within 4·5 h of acute ischaemic stroke. However, alteplase also increases the risk of intracerebral haemorrhage; we aimed to determine the proportional and absolute effects of alteplase on the risks of intracerebral haemorrhage, mortality, and functional impairment in different types of patients.

12 julio 2016

STROKE. Clinical Sciences. Remote Intracerebral Hemorrhage After Intravenous Thrombolysis. Results From a Multicenter Study

Luis Prats-Sánchez, MD; Pol Camps-Renom, MD; Javier Sotoca-Fernández, MD; Raquel Delgado-Mederos, MD, PhD; Alejandro Martínez-Domeño, MD; Rebeca Marín, RN; Miriam Almendrote, MD; Laura Dorado, MD, PhD; Meritxell Gomis, MD, PhD; Javier Codas, MD; Laura Llull, MD; Alejandra Gómez González, MD; Jaume Roquer, MD, PhD; Francisco Purroy, MD, PhD; Manuel Gómez-Choco, MD; David Cánovas, MD; Dolores Cocho, MD, PhD; Moises Garces, MD; Sonia Abilleira, MD, PhD; Joan Martí-Fàbregas, MD, PhD; on behalf of the Catalan Stroke Code and Reperfusion Consortium (Cat-SCR)

Background and Purpose: Remote parenchymal hemorrhage (rPH) after intravenous thrombolysis with recombinant tissue-type plasminogen activator may be associated with cerebral amyloid angiopathy, although supportive data are limited. We aimed to investigate risk factors of rPH after intravenous thrombolysis with recombinant tissue-type plasminogen activator.

30 junio 2016

STROKE. Clinical Sciences. Safety of Computed Tomographic Angiography in the Evaluation of Patients With Acute Stroke. A Single-Center Experience

Matthew E. Ehrlich, MD, MPH; Heather L. Turner, BSN; Lillian J. Currie, PhD, RN; Max Wintermark, MD; Bradford B. Worrall, MD, MSc; Andrew M. Southerland, MD, MSc

Background and Purpose: Noncontrasted head computed tomography (NCHCT) has long been the standard of care for acute stroke imaging. New guidelines recommending advanced vascular imaging to identify eligible patients for endovascular therapy have renewed safety concerns on the use of contrast in the emergent setting without laboratory confirmation of renal function.

12 junio 2016

STROKE. Clinical Sciences. Long-Term Outcome After Carotid Artery Stenting. A Population-Based Matched Cohort Study

Magnus Jonsson, MD; David Lindström, MD, PhD; Peter Gillgren, MD, PhD; Anders Wanhainen, MD, PhD; Jonas Malmstedt, MD, PhD

Background and Purpose: Long-term outcome after carotid artery stenting (CAS), a less invasive technique than carotid endarterectomy (CEA), for prevention of stroke, is unclear. The aim was to assess long-term outcomes after CAS, compared with CEA, in a nationwide cohort study.

30 junio 2016

STROKE. Brief Report. Repeated Intravenous Thrombolysis for Early Recurrent Stroke. Challenging the Exclusion Criterion

Timo Kahles, MD*; Marie-Luise Mono, MD*; Mirjam Rachel Heldner, MD; Ralf Werner Baumgartner, MD; Hakan Sarikaya, MD; Andreas Luft, MD; Stephan Bohlhalter, MD; Christopher Traenka, MD; Stefan T. Engelter, MD; Natalia Kurka, MD; Martin Köhrmann, MD; Sami Curtze, MD; Patrik Michel, MD; Turgut Tatlisumak, MD; Krassen Nedeltchev, MD

Background and Purpose: Intravenous thrombolysis (IVT) within 4.5 hours from symptom onset improves functional outcome in patients with acute ischemic stroke. Its use in patients with previous stroke within the preceding 3 months is contraindicated because of the assumed higher risk of intracranial hemorrhage. In addition, tissue-type plasminogen activator may itself promote neurotoxicity and blood–brain barrier disruption. However, safety and effectiveness of repeated IVT is essentially unknown in patients with early (<3 months) recurrent stroke (ERS), because they were excluded from thrombolysis trials. This article reports the largest case series of repeated IVT in ERS.

21 junio 2016

STROKE. Brief Report. Predictors of Restenosis Following Carotid Angioplasty and Stenting

Elena Zapata-Arriaza, MD; Francisco Moniche, MD, PhD; Alejandro González, MD, PhD; Alejandro Bustamante, MD; Irene Escudero-Martínez, MD; Francisco Javier De la Torre Laviana, MD; María Prieto, MD; Fernando Mancha, PhD; Joan Montaner, MD, PhD

Background and Purpose: Restenosis after carotid angioplasty (with or without stent) is associated with increased rate of stroke and death. Our aim was to determine risk and predictive factors related to carotid restenosis post carotid angioplasty and its association to recurrent cerebrovascular events.

21 junio 2016

STROKE. Brief Report. Influence of Distance to Scene on Time to Thrombolysis in a Specialized Stroke Ambulance

Peter M. Koch, MD; Alexander Kunz, MD; Martin Ebinger, MD; Frederik Geisler, MD; Michal Rozanski, MD; Carolin Waldschmidt, MD; Joachim E. Weber, MD; Matthias Wendt, MD; Benjamin Winter, MD; Katja Zieschang, MD; Kerstin Bollweg, PhD; Sabina Kaczmarek; Matthias Endres, MD; Heinrich J. Audebert, MD

Background and Purpose: Specialized computed tomography–equipped stroke ambulances shorten time to intravenous thrombolysis in acute ischemic stroke by starting treatment before hospital arrival. Because of longer travel-time-to-scene, time benefits of this concept are expected to diminish with longer distances from base station to scene.

12 julio 2016

STROKE. Clinical Sciences. Family History and Risk of Recurrent Stroke

Jong-Won Chung, MD, MSc; Beom Joon Kim, MD, PhD; Moon-Ku Han, MD, PhD; Kyusik Kang, MD, PhD; Jong-Moo Park, MD, PhD; Sang-Soon Park, MD, PhD; Tai Hwan Park, MD, PhD; Yong-Jin Cho, MD, PhD; Keun-Sik Hong, MD, PhD; Kyung Bok Lee, MD, PhD; Jae Guk Kim, MD, PhD; Youngchai Ko, MD, PhD; SooJoo Lee, MD, PhD; Hyun-Wook Nah, MD, PhD; Dae-Hyun Kim, MD, PhD; Jae-Kwan Cha, MD, PhD; Mi-Sun Oh, MD, PhD; Kyung-Ho Yu, MD, PhD; Byung-Chul Lee, MD, PhD; Myung Suk Jang, AS; Ji Sung Lee, PhD; Juneyoung Lee, PhD; Hee-Joon Bae, MD, PhD; on behalf of the CRCS-5 Investigators

Background and Purpose: The association between family history of stroke and stroke recurrence remains unclear.

01 julio 2016

THE LANCET. Neurology. Dementia risk after spontaneous intracerebral haemorrhage: a prospective cohort study

Solène Moulin, MD, Julien Labreuche, Bst, Stéphanie Bombois, PhD, Costanza Rossi, PhD, Gregoire Boulouis, MD, Hilde Hénon, PhD, Prof Alain Duhamel, PhD, Prof Didier Leys, PhD, Prof Charlotte Cordonnier, PhD

Background: Dementia occurs in at least 10% of patients within 1 year after stroke. However, the risk of dementia after spontaneous intracerebral haemorrhage that accounts for about 15% of all strokes has not been investigated in prospective studies. We aimed to determine the incidence of dementia and risk factors after an intracerebral haemorrhage.

01 junio 2016

THE LANCET. Neurology. Effect of baseline Alberta Stroke Program Early CT Score on safety and efficacy of intra-arterial treatment: a subgroup analysis of a randomised phase 3 trial (MR CLEAN)

Dr Albert J Yoo, MD, Olvert A Berkhemer, MD*, Puck S S Fransen, MD, Lucie A van den Berg, MD, Debbie Beumer, MD, Hester F Lingsma, PhD, Wouter J Schonewille, MD, Marieke E S Sprengers, MD, René van den Berg, MD, Marianne A A van Walderveen, MD, Ludo F M Beenen, MD, Marieke J H Wermer, MD, Geert J Lycklama à Nijeholt, MD, Jelis Boiten, MD, Sjoerd F M Jenniskens, MD, Joseph C J Bot, MD, Anna M M Boers, MSc, Henk A Marquering, PhD, Prof Yvo B W E M Roos, MD†, Prof Robert J van Oostenbrugge, MD†, Prof Diederik W J Dippel, MD†, Prof Aad van der Lugt, MD†, Wim H van Zwam, MD†, Prof Charles B L M Majoie, MD† for the MR CLEAN investigators

Background: Whether infarct size modifies intra-arterial treatment effect is not certain, particularly in patients with large infarcts. We examined the effect of the baseline Alberta Stroke Program Early CT Score (ASPECTS) on the safety and efficacy of intra-arterial treatment in a subgroup analysis of the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN).

01 junio 2016

THE LANCET. Neurology. Identification of additional risk loci for stroke and small vessel disease: a meta-analysis of genome-wide association studies

Neurology Working Group of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium the Stroke Genetics Network (SiGN) and the International Stroke Genetics Consortium (ISGC)†

Background: Genetic determinants of stroke, the leading neurological cause of death and disability, are poorly understood and have seldom been explored in the general population. Our aim was to identify additional loci for stroke by doing a meta-analysis of genome-wide association studies.

07 junio 2016

STROKE. Clinical Sciences. Hemorrhagic Reversible Cerebral Vasoconstriction Syndrome. Features and Mechanisms

Mehmet A. Topcuoglu, MD; Aneesh B. Singhal, MD

Background and Purpose: To compare hemorrhagic and nonhemorrhagic reversible cerebral vasoconstriction syndromes (RCVS) with a view to understand mechanisms.

14 junio 2016

STROKE. Clinical Sciences. Interaction of Recanalization, Intracerebral Hemorrhage, and Cerebral Edema After Intravenous Thrombolysis

Bharath Kumar Cheripelli, MRCP; Xuya Huang, MRCP; Rachael MacIsaac, PhD; Keith W. Muir, MD, FRCP

Background and Purpose: Both intracerebral hemorrhage (ICH) and brain edema have been attributed to reperfusion after intravenous thrombolysis. We explored the interaction of recanalization and core size for imaging outcomes (ICH and vasogenic brain edema).

12 mayo 2016

STROKE. Clinical Sciences. Impact of Target Arterial Residual Stenosis on Outcome After Endovascular Revascularization

Yang-Ha Hwang, MD, PhD; Yong-Won Kim, MD; Dong-Hun Kang, MD; Yong-Sun Kim, MD, PhD; David S. Liebeskind, MD

Background and Purpose: Acute intracranial occlusion can be associated with in situ thrombo-occlusion in relation to preexisting intracranial atherosclerotic disease. We aimed to assess residual stenosis at the site of a target arterial lesion (TAL) to determine whether residual stenosis at the TAL is associated with underlying intracranial atherosclerotic disease.