|
1
|
Li W, Zhang J, Zhang Y, Shentu W, Yan S, Chen Q, Qiao S, Kong Q. Clinical research progress on pathogenesis and treatment of Patent Foramen Ovale-associated stroke. Front Neurol 2025; 16:1512399. [PMID: 40291846 PMCID: PMC12021896 DOI: 10.3389/fneur.2025.1512399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2024] [Accepted: 03/24/2025] [Indexed: 04/30/2025] Open
Abstract
Patent Foramen Ovale (PFO), a common cardiac abnormality, has been established as the most prevalent cause of Cryptogenic Stroke (CS). In 2022, the American Society of Cardiovascular Angiography and Interventions (SCAI) officially defined PFO-induced CS as PFO-Associated Stroke (PFO-AS), whose onset characteristics and treatment methods are currently the focus of pertinent clinical research. Previously, the pathogenesis of PFO-AS was commonly believed to be related to Paradoxical Embolism (PDE) or in situ thrombosis. Recently, atrial heart disease, which could lead to abnormal cardiac structure and circulating biomarker accumulation, potentially causing vascular endothelial injury and promoting thrombosis, has also been associated with the pathogenesis of PFO-AS. Therefore, PFO-AS could be the outcome of multiple pathogenesis mechanisms. Furthermore, significant research progress has been made in elucidating the pathogenic PFO gene. Nonetheless, additional in-depth research is still required to better elucidate the precise mechanisms underlying PFO-AS. Notably, the clinical and imaging characteristics of PFO-related Ischemic Stroke (IS) are slightly different from those of other IS causes. Furthermore, the assessment of the correlation between PFO and stroke mostly relies on The Risk of Paradoxical Embolism Score (RoPE) and PFO-Associated Stroke Causal Likelihood classification (PASCAL) system, which could be a limitation. Additionally, PFO examinations mainly relied on cardiac anatomy evaluation in the past, highlighting another potential gap. Moreover, recent research suggests that PFO closure may increase the risk of Heart Failure (HF) with preserved Ejection Fraction (HFpEF). Conversely, after 2017, four Randomized Controlled Trials (RCTs): CLOSE, RESPECT, REDUCE, and DEFENSE-PFO, demonstrated that transcatheter PFO closure is more effective in preventing various risk events than conventional pharmacotherapy. This review comprehensively summarizes the latest research progress on PFO-AS pathogenesis, treatment, prevention, and management decisions, providing a valuable clinical reference.
Collapse
Affiliation(s)
- Wenyao Li
- Department of Special Inspection, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | | | - Yier Zhang
- Zhejiang Hospital, Hangzhou, China
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Wuyue Shentu
- Zhejiang Chinese Medical University, Hangzhou, China
| | | | - Qiulu Chen
- Department of Neurology, Zhejiang Medical and Health Group Hangzhou Hospital, Hangzhou, China
| | | | - Qi Kong
- Zhejiang Hospital, Hangzhou, China
| |
Collapse
|
|
2
|
Chen PY, Chang WL, Hsiao CL, Lin SK. Seasonal Variations in Stroke and a Comparison of the Predictors of Unfavorable Outcomes among Patients with Acute Ischemic Stroke and Cardioembolic Stroke. Biomedicines 2024; 12:223. [PMID: 38275394 PMCID: PMC10813505 DOI: 10.3390/biomedicines12010223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/13/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
We investigated the seasonal variations in stroke in 4040 retrospectively enrolled patients with acute ischemic stroke (AIS) admitted between January 2011 and December 2022, particularly those with cardioembolic (CE) stroke, and compared predictors of unfavorable outcomes between AIS patients and CE stroke patients. The classification of stroke subtypes was based on the Trial of ORG 10172 in Acute Stroke Treatment. Stroke occurrence was stratified by seasons and weekdays or holidays. Of all AIS cases, 18% were of CE stroke. Of all five ischemic stroke subtypes, CE stroke patients were the oldest; received the most thrombolysis and thrombectomy; had the highest initial National Institutes of Stroke Scale (NIHSS) and discharge modified Rankin Scale (mRS) scores; and had the highest rate of in-hospital complications, unfavorable outcomes (mRS > 2), and mortality. The highest CE stroke prevalence was noted in patients aged ≥ 85 years (30.9%); moreover, CE stroke prevalence increased from 14.9% in summer to 23.0% in winter. The main predictors of death in patients with CE stroke were age > 86 years, heart rate > 79 beats/min, initial NIHSS score > 16, neutrophil-to-lymphocyte ratio (NLR) > 6.4, glucose > 159 mg/dL, cancer history, in-hospital complications, and neurological deterioration (ND). The three most dominant factors influencing death, noted in not only patients with AIS but also those with CE stroke, are high initial NIHSS score, ND, and high NLR. We selected the most significant factors to establish nomograms for predicting fatal outcomes. Effective heart rhythm monitoring, particularly in older patients and during winter, may help develop stroke prevention strategies and facilitate early AF detection.
Collapse
Affiliation(s)
- Pei-Ya Chen
- Stroke Center, Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan; (P.-Y.C.); (W.-L.C.); (C.-L.H.)
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
| | - Wan-Ling Chang
- Stroke Center, Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan; (P.-Y.C.); (W.-L.C.); (C.-L.H.)
| | - Cheng-Lun Hsiao
- Stroke Center, Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan; (P.-Y.C.); (W.-L.C.); (C.-L.H.)
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
| | - Shinn-Kuang Lin
- Stroke Center, Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan; (P.-Y.C.); (W.-L.C.); (C.-L.H.)
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
| |
Collapse
|
|
3
|
Wang L, Chen Y, Shen W, Fan X, Jia M, Fu G, Chi X, Liang X, Zhang Y. A Bibliometric Analysis of Cardioembolic Stroke From 2012 to 2022. Curr Probl Cardiol 2023; 48:101537. [PMID: 36529228 DOI: 10.1016/j.cpcardiol.2022.101537] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
Cardioembolic stroke, a subtype of ischemic stroke with the worst prognosis, is quietly threatening public health. We aimed to visualize the development trend and hotspots of research on cardioembolic stroke. A total of 2886 papers about cardioembolic stroke published from 2012 to 2022 were retrieved in the Web of Science Core Collection (WoSCC) database. Further, we performed a bibliometric analysis of these publications, such as generating cooperation maps, co-citation analysis of journals and references, and cluster analysis of keywords. According to the results, cardioembolic stroke research faces many clinical challenges. We obtained the knowledge maps of countries/institutions, authors, journals with high publications and citations, and representative references in this field. Studies about optimal prevention strategies for cardioembolic stroke, identification of cardioembolism in cryptogenic stroke, and prophylactic anticoagulation for patients with embolic stroke of undetermined source (ESUS) or at high risk of left ventricle (LV) thrombus are in the spotlight.
Collapse
Affiliation(s)
- Liuding Wang
- Department of Neurology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yifan Chen
- Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wei Shen
- Department of Neurology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xueming Fan
- Department of Neurology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Min Jia
- Medical Ethics Committee, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Guojing Fu
- Department of Neurology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiansu Chi
- Department of Neurology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiao Liang
- Department of Neurology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Yunling Zhang
- Department of Neurology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| |
Collapse
|
|
4
|
Fan ZX, Liu RX, Liu GZ. Development and refinement of diagnostic and therapeutic strategies for managing patients with cardiogenic stroke: An arduous journey. World J Clin Cases 2023; 11:719-724. [PMID: 36818629 PMCID: PMC9928701 DOI: 10.12998/wjcc.v11.i4.719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/22/2022] [Accepted: 01/12/2023] [Indexed: 02/03/2023] Open
Abstract
Cardioembolic stroke, referred to as cardiogenic stroke, is a clinical syndrome in which emboli from the heart pass through the circulatory system and cause cerebral artery embolism and corresponding brain dysfunction. Compared to other subtypes of ischemic stroke, cardiogenic stroke presents with more etiologies, greater severity, worse prognosis, and a higher recurrence rate. In this minireview, we provide new insights into the etiological classification, diagnostic methods, and interventions of cardiogenic stroke.
Collapse
Affiliation(s)
- Ze-Xin Fan
- Department of Neurology, Beijing Anzhen Hospital, Beijing 100029, China
| | - Ri-Xia Liu
- Department of Neurology, Beijing Anzhen Hospital, Beijing 100029, China
| | - Guang-Zhi Liu
- Department of Neurology, Beijing Anzhen Hospital, Beijing 100029, China
| |
Collapse
|
|
5
|
Cao J, Xing P, Zhu X, Chen R, Shao H, Xuan J, Jiang T, Yang P, Zhang Y, Li Z, Chen W, Li T, Wang S, Lou M, Peng Y, Liu J. Mild and moderate cardioembolic stroke patients may benefit more from direct mechanical thrombectomy than bridging therapy: A subgroup analysis of a randomized clinical trial (DIRECT-MT). Front Neurol 2022; 13:1013819. [PMID: 36504640 PMCID: PMC9730510 DOI: 10.3389/fneur.2022.1013819] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/31/2022] [Indexed: 11/26/2022] Open
Abstract
Background The benefit of intravenous alteplase before endovascular thrombectomy is unclear in patients with acute cardioembolic stroke. Methods We collected cardioembolic (CE) stroke patient data from the multicentre randomized clinical trial of Direct Intra-arterial Thrombectomy to Revascularize Acute Ischaemic Stroke Patients with Large Vessel Occlusion Efficiently in Chinese Tertiary Hospitals (DIRECT-MT). The primary outcome was the 90-day modified Rankin Scale (mRS) score. Five subgroups of cardioembolic stroke patients were analyzed. A multivariable ordinal logistic regression analysis analyzed the difference in the primary outcome between the direct mechanical thrombectomy (MT) and bridging therapy groups. An interaction term was entered into the model to test for subgroup interaction. The DIRECT-MT trial is registered with clinicaltrials.gov Identifier: NCT03469206. Results A total of 290 CE stroke patients from the DIRECT-MT trial were enrolled in this study: 146 patients in the direct MT group and 144 patients in the bridging therapy group. No difference between the two treatment groups in the primary outcome was found (adjusted common odds ratio, 1.218; 95% confidence interval, 0.806 to 1.841; P = 0.34). In the subgroup analysis, CE stroke patients with an NIHSS ≤ 15 in the direct MT group were associated with better outcomes (47 vs. 53, acOR, 3.14 [1.497, 6.585]) and lower mortality (47 vs. 53, aOR, 0.16 [0.026, 0.986]) than those in the bridging therapy group, while there were no significant differences between the two treatment groups in the outcome and mortality of CE stroke patients with an NIHSS >15. Conclusion Mild and moderate cardioembolic stroke patients may benefit more from direct mechanical thrombectomy than bridging therapy. This need to be confirmed by further prospective studies in a larger number of patients.
Collapse
Affiliation(s)
- Jie Cao
- Department of Neurosurgery, The First People's Hospital of Changzhou/The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Pengfei Xing
- Department of Neurosurgery, Naval Medical University Changhai Hospital, Shanghai, China
| | - Xucheng Zhu
- Department of Neurosurgery, The First People's Hospital of Changzhou/The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Ronghua Chen
- Department of Neurosurgery, The First People's Hospital of Changzhou/The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Huaming Shao
- Department of Neurosurgery, The First People's Hospital of Changzhou/The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Jinggang Xuan
- Department of Neurosurgery, The First People's Hospital of Changzhou/The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Tianwei Jiang
- Department of Neurosurgery, The First People's Hospital of Changzhou/The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Pengfei Yang
- Department of Neurosurgery, Naval Medical University Changhai Hospital, Shanghai, China
| | - Yongwei Zhang
- Department of Neurology, Naval Medical University Changhai Hospital, Shanghai, China
| | - Zifu Li
- Department of Neurosurgery, Naval Medical University Changhai Hospital, Shanghai, China
| | - Wenhuo Chen
- Department of Neurology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Tianxiao Li
- Department of Radiology, Henan Provincial People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Shouchun Wang
- Department of Neurology, First Affiliated Hospital of Jilin University, Changchun, China
| | - Min Lou
- Department of Neurology, Second Affiliated Hospital of Zhejiang University, Hangzhou, China,*Correspondence: Min Lou
| | - Ya Peng
- Department of Neurosurgery, The First People's Hospital of Changzhou/The Third Affiliated Hospital of Soochow University, Changzhou, China,Ya Peng
| | - Jianmin Liu
- Department of Neurosurgery, Naval Medical University Changhai Hospital, Shanghai, China
| |
Collapse
|
|
6
|
Tang H, Yan S, Wu C, Zhang Y. Characteristics and Outcomes of Intravenous Thrombolysis in Mild Ischemic Stroke Patients. Front Neurol 2021; 12:744909. [PMID: 34777212 PMCID: PMC8586409 DOI: 10.3389/fneur.2021.744909] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/28/2021] [Indexed: 01/01/2023] Open
Abstract
Objective: This study assessed the characteristics of intravenous thrombolysis (IVT) with respect to early neurological deterioration (END) and functional outcome in mild ischemic stroke patients. Methods: Data were obtained from acute mild ischemic stroke patients (defined as having a National Institute of Health Stroke Score (NIHSS) ≤ 5) treated with IVT in our hospital from July 2017 to December 2020. END was defined as the NIHSS increased ≥1 over the baseline at 24 h after IVT. A modified Rankin scale (mRS) ≤ 1 at 3 months was considered as a favorable outcome, and an mRS ≥2 at 3 months was an unfavorable outcome. Results: Two hundred thirty-three acute mild ischemic stroke patients (all patients underwent MRI and DWI restriction) with IVT were included in this study. Thirty-one patients experienced END, and 57 patients experienced an unfavorable outcome at 3 months. With multivariate analysis, END was associated with an elevated baseline systolic blood pressure (SBP) (OR = 1.324, 95% CI, 1.053–1.664, p = 0.016) and coronary heart disease (OR = 4.933, 95% CI, 1.249–19.482, p = 0.023). An unfavorable outcome at 3 months after IVT was independently associated with a baseline elevated SBP (OR = 1.213, 95% CI, 1.005–1.465, p = 0.045), baseline NIHSS (OR = 1.515, 95% CI, 1.186–1.935, p = 0.001), prior hyperlipemia (OR = 3.065, 95% CI, 1.107–8.482, p = 0.031), cardioembolic stroke (OR = 0.323, 95% CI, 0.120–0.871, p = 0.025), and END at 24 h (OR = 4.531, 95% CI, 1.950–10.533, p < 0.001) in mild ischemic stroke patients. Conclusion: In mild ischemic stroke patients with IVT, an elevated baseline SBP and coronary heart disease were associated with END. The elevated baseline SBP, baseline NIHSS, a history of prior hyperlipemia, cardioembolic stroke, and END at 24 h after IVT were useful in predicting an unfavorable outcome at 3 months.
Collapse
Affiliation(s)
- Huan Tang
- Department of Neurology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
| | - Shenqiang Yan
- Department of Neurology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Chenglong Wu
- Department of Neurology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
| | - Yanxing Zhang
- Department of Neurology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
| |
Collapse
|
|
7
|
Siniscalchi A, Murphy S, Gray C, De Sarro G, Gallelli L. Biomarkers in unstable carotid plaque: Physiopathology and Prediction. Cardiovasc Hematol Agents Med Chem 2021; 20:13-19. [PMID: 34468303 DOI: 10.2174/1871525719666210901131509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/17/2021] [Accepted: 07/14/2021] [Indexed: 11/22/2022]
Abstract
AIMS To study the role of cytokines and vascular inflammatory biomarkers in unstable carotid plaque. BACKGROUND Clinical studies showed that not only the degree of stenosis but also the type of carotid plaque can be responsible for ipsilateral ischemic stroke. OBJECTIVE The objective of this study is to suggest a role for vulnerable carotid atherosclerotic disease in the occurrence of ischemic stroke. METHODS PubMed, Embase, Cochrane library, and reference lists have been used to evaluate articles published until February 15, 2021. RESULTS Several factors may be involved in unstable plaque. Clinical studies support the involvement of brain inflammatory biomarkers as well as cytokines in the unstable carotid plaque. CONCLUSIONS Biomarkers could help to stratify patients with a vulnerable carotid plaque and to personalize the drug treatment. In this review, we briefly discuss the characteristics of vulnerable plaque and the role of biomarkers in the vulnerable carotid plaque.
Collapse
Affiliation(s)
- Antonio Siniscalchi
- Department of Neurology and Stroke Unit, Annunziata Hospital of Cosenza, Cosenza, Italy
| | - Sean Murphy
- General Medicine, Stroke Unit, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Cleona Gray
- Vascular and Endovascular Surgery Unit, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Giovambattista De Sarro
- Chair of Pharmacology, Department of Health Science, School of Medicine, University of Catanzaro, Clinical Pharmacology Unit, Mater Domini University Hospital, Catanzaro, Italy
| | - Luca Gallelli
- Department of Health Science, School of Medicine, University of Catanzaro, Catanzaro, Italy
| |
Collapse
|
|
8
|
Pisani E, Gaudiano C, Petrone A, Stancati F, Siniscalchi A. Isolated tongue angioedema after alteplase infusion in acute ischemic stroke. Curr Drug Saf 2021; 17:75-77. [PMID: 34323196 DOI: 10.2174/1574886316666210728104331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/20/2021] [Accepted: 05/18/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Angioedema, like anaphylaxis, has been reported as a rare adverse event of alteplase infusion in acute ischemic stroke. OBJECTIVE We report the case of a patient with acute ischemic stroke who after treatment of alteplase developed angioedema. METHODS We report the case of an 81-year-old woman who presented to our observation with acute ischemic stroke. The patient was on therapy with 100 mg acetylsalicylic acid and a triple combination antihypertensive drug (perindopril 10 mg + 2.5 mg indapamide + 5 mg amlodipine). The patient was treated with alteplase infusion. RESULTS Five minutes after the end of the alteplase infusion (0.9 mg/kg for 1 hour) the patient developed isolated angioedema of the lips and tongue. CONCLUSION Although the incidence of alteplase-induced angiodema in these patients is rare, this case report suggests the need for routine inspection of the tongue in acute ischemic patient in treatment with alteplase infusion, especially in female patients in treatment with ACE inhibitors.
Collapse
Affiliation(s)
- Ermanno Pisani
- Department of Neurology and Stroke Unit, Annunziata Hospital of Cosenza, Cosenza, Italy
| | - Carmen Gaudiano
- Department of Neurology and Stroke Unit, Annunziata Hospital of Cosenza, Cosenza, Italy
| | - Alfredo Petrone
- Department of Neurology and Stroke Unit, Annunziata Hospital of Cosenza, Cosenza, Italy
| | - Furio Stancati
- Department of Neurology and Stroke Unit, Annunziata Hospital of Cosenza, Cosenza, Italy
| | - Antonio Siniscalchi
- Department of Neurology and Stroke Unit Annunziata Hospital of Cosenza Via F. Migliori, 1 87100 Cosenza, Italy
| |
Collapse
|
|
9
|
Kotov SV, Isakova EV, Belova YA, Zmislinskiy AV, Kolchu IG, Kucheryavaya MV, Pustinnikov YA, Smetana LV, Sashin VV, Chernih NP. [The efficacy of systemic thrombolysis in patients with cardioembolic stroke]. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:57-60. [PMID: 29798982 DOI: 10.17116/jnevro20181183257-60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To compare the efficacy and safety of systemic thrombolytic therapy (STLT) in patients with cardioembolic stroke (CE) versus other pathogenic subtypes of ischemic stroke (IS). MATERIAL AND METHODS The study included 147 patients, 62 women and 85 men (mean age - 62.9±0.8 years) including 37 patients (25.2%) with CE subtype of IS (group 1) and 110 patients with other pathogenetic subtypes of IS (group 2). NIHSS and Rankin scale were used to assess patient's neurological status. RESULTS One hundred and twenty-six patients were discharged, 21 (14.3%) died. In 11 patients, the cause of death was the development of symptomatic hemorrhagic transformation (SHT). There were no significant differences in the lethality between groups 1 and 2. Tolerability to STLT in these groups did not differ as well. As a result of treatment, the condition of patients surviving to the end of the hospital stay improved, which was reflected in a significant decrease in the NIHSS scores, despite the higher NIHSS scores in group 1. CONCLUSION The results confirm the efficacy of STLT in patients with CE IS and indicate the increase in the frequency of favorable functional recovery in these patients.
Collapse
Affiliation(s)
- S V Kotov
- Vladimirsky Moscow Regional Scientific Research Clinical Institute, Moscow, Russia
| | - E V Isakova
- Vladimirsky Moscow Regional Scientific Research Clinical Institute, Moscow, Russia
| | - Yu A Belova
- Vladimirsky Moscow Regional Scientific Research Clinical Institute, Moscow, Russia
| | - A V Zmislinskiy
- Vladimirsky Moscow Regional Scientific Research Clinical Institute, Moscow, Russia
| | - I G Kolchu
- Vladimirsky Moscow Regional Scientific Research Clinical Institute, Moscow, Russia
| | - M V Kucheryavaya
- Vladimirsky Moscow Regional Scientific Research Clinical Institute, Moscow, Russia
| | - Ya A Pustinnikov
- Vladimirsky Moscow Regional Scientific Research Clinical Institute, Moscow, Russia
| | - L V Smetana
- Vladimirsky Moscow Regional Scientific Research Clinical Institute, Moscow, Russia
| | - V V Sashin
- Vladimirsky Moscow Regional Scientific Research Clinical Institute, Moscow, Russia
| | - N P Chernih
- Vladimirsky Moscow Regional Scientific Research Clinical Institute, Moscow, Russia
| |
Collapse
|
|
10
|
Siniscalchi A, Lochner P, Perrotta P, Rizzuto S, De Sarro G, Gallelli L. Isolated Hand Palsy in National Institutes of Health Stroke Scale (NIHSS): Is It Useful? West J Emerg Med 2018; 19:524-526. [PMID: 29760851 PMCID: PMC5942020 DOI: 10.5811/westjem.2018.2.37654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 02/19/2018] [Indexed: 11/11/2022] Open
Affiliation(s)
| | - Piergiorgio Lochner
- Saarland University Medical Center, Department of Neurology, Hamburg, Germany.,University of Piedmont East A. Avogadro, Department of Translational Medicine, Section of Neurology, Novara, Italy
| | - Paolo Perrotta
- Annunziata Hospital, Department of Neuroradiology, Cosenza, Italy
| | - Stefano Rizzuto
- Annunziata Hospital, Department of Neurology, Cosenza, Italy
| | - Giovambattista De Sarro
- University of Catanzaro Clinical Pharmacology, School of Medicine, Department of Health Science, Catanzaro, Italy.,Mater Domini University Hospital, Pharmacovigilance Unit, Catanzaro, Italy
| | - Luca Gallelli
- University of Catanzaro Clinical Pharmacology, School of Medicine, Department of Health Science, Catanzaro, Italy.,Mater Domini University Hospital, Pharmacovigilance Unit, Catanzaro, Italy
| |
Collapse
|