Hemorrhagic Stroke Research Articles

Socioeconomic Disparities in Rate of Poststroke Dementia: A Nationwide Cohort Study.

Socioeconomic disparities exist in acute stroke care as well as in long-term stroke outcomes. We aimed to investigate whether socioeconomic status was associated with the rate of poststroke dementia (PSD). This was a nationwide register-based cohort study including all patients with incident ischemic or hemorrhagic stroke in Denmark from 2010 to 2020. Socioeconomic status was defined by prestroke income, education, and employment. PSD was defined as a dementia diagnosis in the National Patient Registry or a dispensed prescription of dementia medication after a stroke. PSD incidence rates were compared between socioeconomic status groups using Poisson regression. A total of 98 489 patients with incident stroke without a diagnosis of prestroke dementia were identified and followed for a median (IQR) of 4.2 (IQR, 2.1-7.3) years. Median age was 72 (62-80) years, 56% were male, 5.1% were immigrants, and 86% had ischemic stroke. Dementia was diagnosed in 5680 patients at a median of 2.4 (IQR, 0.9-4.8) years after stroke (incidence rate=12.1/1000 person-years). After adjusting for age, sex, and immigrant status, PSD rates were 1.24 (1.15-1.34) times higher for low income compared with high income, 1.11 (1.03-1.20) times higher for low education compared with high education, and 1.57 (1.38-1.77) times higher for patients without employment compared with patients with employment. Further adjustments for stroke severity, cohabitation, and comorbidities showed similar results. Stratified analyses showed that the socioeconomic disparities in PSD rates were more pronounced among women, immigrants, and patients <70 years of age. Low socioeconomic status measured by prestroke income, education, and employment status was associated with higher rates of PSD. These socioeconomic disparities extended beyond what could be explained by common PSD risk factors.

Addressing Systemic Complications of Acute Stroke: A Scientific Statement From the American Heart Association.

Systemic, nonneurological complications are common after ischemic and hemorrhagic strokes, affect different organ systems, and have a major impact on patient outcomes. Despite their obvious implications, this area in stroke management remains inadequately researched, and current literature offers fragmentary guidance for care. The purpose of this scientific statement is to elucidate the major systemic complications of strokes that occur during hospitalization, to synthesize evidence from current literature and existing guidelines, to address gaps in knowledge, and to provide a coherent set of suggestions for clinical care based on interpretation of existing evidence and expert opinion. This document advocates for improved interdisciplinary collaboration, team effort, and effective implementation strategies to reduce the burden of these events in clinical practice. It also calls for further research on strategies for preventing and managing systemic complications after stroke that improve outcomes in stroke survivors.

Exploration and comparison of stress hyperglycemia-related indicators to predict clinical outcomes in patients with spontaneous intracerebral hemorrhage.

Spontaneous intracerebral hemorrhage (ICH) is a prevalent hemorrhagic stroke characterized by a significant fatality rate and severe neurological impairments. Stress hyperglycemia has been confirmed to have a significant prognostic role in a range of diseases. However, studies on the association between stress hyperglycemia and the outcome of ICH have not currently been reported. Critically ill patients diagnosed with ICH in the Medical Information Mart for Intensive Care IV (MIMIC-IV) database were included in our study. Logistic regression and Cox regression were used to analyze the correlation between stress hyperglycemia and the outcome of ICH. The predictive ability of different glucose metrics was demonstrated by the receiver-operating characteristic (ROC) curve and was further compared by the integrated discrimination improvement (IDI) index. A total of 880 ICH patients in the MIMIC-IV database were included in this study. In logistic regression and Cox regression, blood glucose level (BGL), glycemic gap (GG), and stress hyperglycemia ratio (SHR) were independent predictors of unfavorable outcomes in ICH after adjustment for other confounders. The IDI results indicated that the 5-day maximum stress hyperglycemia ratio had better predictive performance than glycemic gap and blood glucose level in-hospital mortality and 1-year mortality, and the predictive performance of the 5-day maximum stress hyperglycemia ratio was better than that of stress hyperglycemia ratio measured at admission. In the age-stratified subgroup analysis, the 5-day maximum stress hyperglycemia ratio was more sensitive in predicting long-term outcomes in the young subgroup than in the elderly subgroup. The 5-day maximum stress hyperglycemia ratio is strongly correlated with an elevated risk of mortality in ICH patients and displays a better predictive ability than glycemic gap and blood glucose level in the short/long-term prognosis of ICH.

Recent advances in portable, low-field magnetic resonance imaging in cerebrovascular disease.

This review aims to describe recent advances in low-field (0.064 T) magnetic resonance imaging (LF-MRI) of cerebrovascular disease, including ischemic and hemorrhagic stroke and white matter hyperintensities. Since 2023, several studies have highlighted the rapidly changing landscape of portable, low-field MRI (LF-MRI) and its applications in stroke and cerebrovascular disease. The advantages of using LF-MRI in these settings are multifold: cheaper and dynamic imaging of this patient population confers closer observation during the acute and chronic stages of cerebrovascular disease. Initial deployments of the device span a variety of acute and emergency settings, including imaging around thrombolytic administration, endovascular reperfusion, intracerebral hemorrhage management, and cardiovascular intensive care. LF-MRI also has an important role in cerebrovascular disease monitoring and prevention, namely white matter hyperintensity (WMH) progression and vascular and Alzheimer's dementia. Early studies suggest reliable sensitivity and specificity for these pathologies. With further improvements to LF-MRI hardware, software and postprocessing on the horizon, we anticipate the device's ability to provide inexpensive and flexible neuroimaging to a wide array of healthcare settings that treat, prevent, and manage cerebrovascular disease. Recent studies indicate that LF-MRI promotes rapid, cost-effective, and clinically useful neuroimaging at various clinical timepoints throughout stroke and cerebrovascular disease progression and management.

Evaluating the Efficacy of Artificial Intelligence Using Machine Learning Models in Predicting Functional Recovery Post-Stroke

Abstract Background: Stroke is a significant health problem in India, with an uneven prevalence and high early mortality rates. Worldwide, stroke is the second leading cause of death. In the initial months post-stroke, motor impairment is a primary concern, in addition to various other deficits. Predicting recovery after a stroke is crucial for optimizing resource allocation. Utilizing machine learning offers the potential to enhance therapeutic decision-making and predict individual recovery outcomes in stroke rehabilitation. Objectives: We aimed to employ machine learning algorithms to predict functional recovery after stroke by estimating Barthel Index scores, identifying patterns and correlations within the dataset, and determining the most effective machine learning model among the five algorithms that were tested. Materials and Methods: Participants were screened for eligibility before enrollment, and demographic information, stroke characteristics, and Barthel Index scores were recorded. The dataset was split into training and testing subsets for analysis. Five machine learning algorithms were trained using the initial dataset to develop predictive models. Results: High alcohol and tobacco use potentially influenced Barthel Index scores and stroke recovery. The recovery process varied based on stroke type, with ischemic and hemorrhagic strokes. The Random Forest model exhibited the highest predictive accuracy among the models. Conclusion: The study highlights the role of demographics, lifestyle habits, comorbidities, and stroke type in functional recovery poststroke. The Random Forest model demonstrated the most reliable predictive capability, indicating artificial intelligence’s potential in stroke recovery prediction. Furthermore, research studies are needed to develop and evaluate robust prediction models.

The Role of Induced Pluripotent Stem Cells in the Treatment of Stroke.

Stroke is a neurological disorder with high disability and mortality rates. Almost 80% of stroke cases are ischemic stroke, and the remaining are hemorrhagic stroke. The only approved treatment for ischemic stroke is thrombolysis and/or thrombectomy. However, these treatments cannot sufficiently relieve the disease outcome, and many patients remain disabled even after effective thrombolysis. Therefore, rehabilitative therapies are necessary to induce remodeling in the brain. Currently, stem cell transplantation, especially via the use of induced pluripotent stem cells (iPSCs), is considered a promising alternative therapy for stimulating neurogenesis and brain remodeling. iPSCs are generated from somatic cells by specific transcription factors. The biological functions of iPSCs are similar to those of embryonic stem cells (ESCs), including immunomodulation, reduced cerebral blood flow, cerebral edema, and autophagy. Although iPSC therapy plays a promising role in both hemorrhagic and ischemic stroke, its application is associated with certain limitations. Tumor formation, immune rejection, stem cell survival, and migration are some concerns associated with stem cell therapy. Therefore, cell-free therapy as an alternative method can overcome these limitations. This study reviews the therapeutic application of iPSCs in stroke models and the underlying mechanisms and constraints of these cells. Moreover, cell-free therapy using exosomes, apoptotic bodies, and microvesicles as alternative treatments is discussed.

Characteristics and outcomes of adults with acute brain injuries admitted to intensive care units in Australia and New Zealand from 2013 to 2022

BackgroundThe characteristics and outcomes of patients with acute brain injuries admitted to the intensive care unit (ICU) in Australia and New Zealand (ANZ) are insufficiently described. ObjectiveThis study aimed to describe the epidemiology of acute brain injury in ICU patients in ANZ. MethodsA binational retrospective cohort study was conducted using the ANZ Intensive Care Society Adult Patient Database. Adult unplanned admissions from 2013 to 2022 were eligible unless the presence of acute brain injury could not be determined or the admission was for end-of-life care. In cases where a patient had multiple admissions, only the first was included. The population was divided into two cohorts: acute brain injury diagnoses and other diagnoses. The primary outcome was in-hospital mortality. Secondary outcomes included 90- and 180-day mortality, ICU and hospital lengths of stay, duration of invasive ventilation, and the proportion discharged home. ResultsAcute brain injuries accounted for 92,948 of 684,981 unplanned ICU admissions (14%). Hypoxic ischaemic encephalopathy, traumatic brain injury, and seizures were the most common diagnoses. A total of 24,568 of 92,948 (26%) and 62,603 of 592,033 (10%) patients with acute brain injuries and other diagnoses, respectively, died in hospital. Among the brain-injured patients, the highest hospital mortality was in hypoxic ischaemic encephalopathy (53%), intracerebral haemorrhage (36%), subarachnoid haemorrhage (22%), and ischaemic stroke (22%); the lowest mortality was in traumatic brain injury (14%), central nervous system infection (10%), and seizures (4%). Acute brain injury patients were more likely to receive invasive mechanical ventilation, had longer ICU and hospital lengths of stay, had higher 90- and 180-day mortality, and were more likely to be discharged to chronic care than other patients. ConclusionsAcute brain injuries accounted for a disproportionally high number of in-hospital deaths occurring in our cohort of adults who received unplanned ICU care; however, the mortality rates varied, and patients with central nervous system infections and seizures had similar or lower mortality compared to patients without brain injury.

Analysis of the effect of range of motion exercises on the quality of life of post-stroke patients at royal prima hospital Medan in 2024

Stroke is a severe medical condition that occurs due to the interruption of blood supply to the brain, either through blockage (ischemic stroke) or rupture of blood vessels (hemorrhagic stroke). With more than 15 million cases each year worldwide, stroke is a leading cause of disability and death, with a significant impact on patients' quality of life. In Indonesia, the prevalence of stroke is very high, especially among adult patients, which contributes to the high mortality and disability rates. This study aims to evaluate the effect of Range of Motion Exercises on the physical condition and quality of life of post-stroke patients at the Rehabilitation Polyclinic of Royal Prima Hospital Medan. Using a correlational descriptive research design with the One Group Pretest-Posttest approach, this study involved 30 respondents who underwent a range of motion exercises. The results of the analysis showed that before the intervention, the majority of patients were in the poor quality of life category. However, after undergoing a rehabilitation program, there was a significant improvement in the patient's quality of life, where 50% of the respondents reported an excellent quality of life. This study indicates that range of motion exercises are effective in improving the quality of life of stroke patients, which has the potential to make an essential contribution to the development of stroke rehabilitation programs in Indonesia.

Differences in the Degree of Spasticity in Post-Haemorrhagic and Non-Haemorrhagic Stroke Patients Based on the Modified Ashworth Scale

Background : Stroke is a brain function disorder caused by vascular disturbances with manifestations ranging from paralysis to death. Stroke is a health issue with high incidence and mortality rates. Furthermore, post-stroke patients can experience various residual symptoms such as spasticity, which can lead to decreased productivity and socio- economic impacts. Spasticity is a common symptom in stroke survivors, with a prevalence ranging from 30% to 80%. This symptom typically appears several weeks after a stroke and can persist for up to 12 months, causing reduced productivity and socio-economic challenges. Hemorrhagic strokes result from blood vessel rupture, while non- hemorrhagic strokes are caused by ischemia. Both types can damage motor pathways, leading to spasticity. Understanding the differences in spasticity severity between stroke types may guide targeted rehabilitation strategies. The aimsof ths study was to determine the difference in the degree of spasticity in post-stroke patients between hemorrhagic and non-hemorrhagic strokes based on the Modified Ashworth Scale. Methods : An analytical observational study with a cross-sectional design was conducted. The study included 33 post-hemorrhagic stroke patients and 33 post-non- hemorrhagic stroke patients. The degree of spasticity was measured using the Modified Ashworth Scale. Statistical analysis was performed using the Chi-Square test. Results : The Chi-Square test for the variable "stroke type" and "degree of spasticity" yielded a p-value of 0.428 (p &gt; 0.05). The Chi-Square test is considered significant when the p-value is &lt; 0.05. Conclusion : There is no difference in the degree of spasticity

Application of Multidisciplinary Collaborative Interventions in the Early Rehabilitation of Patients with Hemorrhagic Stroke and Kinesiophobia

Objective: This study aims to explore the role of multidisciplinary collaborative interventions in the early rehabilitation of patients with hemorrhagic stroke and kinesiophobia. Methods: Using a convenience sampling method, 100 patients with hemorrhagic stroke and kinesiophobia admitted to the Department of Neurology at Nantong First People’s Hospital between January 2022 and December 2023 were selected as subjects. Fifty patients admitted between January 2022 and January 2023 were assigned to the control group, while 50 patients admitted between February 2023 and December 2023 were assigned to the experimental group. The control group received conventional care, while the experimental group received multidisciplinary collaborative interventions provided by a team consisting of neurologists, rehabilitation therapists, psychological counselors, and nurses. The study evaluated the differences in emotional state (using the Hospital Anxiety and Depression Scale, HAD), kinesiophobia level (using the Tampa Scale for Kinesiophobia, TSK), functional recovery (using the modified Rankin Scale, mRS), and daily living abilities (using the Barthel Index, BI) before and after intervention. Results: After the intervention, the HAD scores in the experimental group were significantly lower than those in the control group (P &lt; 0.05). The TSK scores in the experimental group were also significantly lower than in the control group (P &lt; 0.05), while mRS and BI scores showed significant improvement compared to the control group (P &lt; 0.05). Conclusion: Multidisciplinary collaborative interventions have significant effects in reducing kinesiophobia, promoting functional recovery, and improving the quality of life in patients with hemorrhagic stroke.

TEleRehabilitation foR Aphasia (TERRA) phase II trial design

Background and purposeDespite comprehensive evidence that supports the utility of aphasia therapy in persons with chronic (≥6 months) stroke-induced aphasia, the amount of therapy provided to patients in the United States is typically far less than what is likely necessary to maximize recovery. Two potential contributors to this discrepancy are limited access to rehabilitation services due to the availability of providers and logistical difficulties with transportation. One way to increase access to aphasia therapy is to rely on telerehabilitation. MethodsThe TEleRehabilitation foR Aphasia (TERRA) trial is a prospective, randomized, rater-blinded, multicenter phase II non-inferiority trial to evaluate telerehabilitation for aphasia therapy in persons with chronic post-stroke aphasia. Participants are randomized (1:1) to receive either aphasia remote therapy or in-clinic therapy for 30 total days of treatment (15 days of a semantically focused approach and 15 days of a phonologically focused approach) for 45 min per day. A total of 100 adults (ages 21–80) with a history of left hemisphere ischemic or hemorrhagic stroke incurred at least 12 months prior to study enrollment will be randomized. The trial will be conducted at the clinical research facilities at two sites: the Medical University of South Carolina and the University of South Carolina. ConclusionsThis paper details the design of the TERRA trial, which aims to test whether aphasia therapy delivered by a remote speech-language pathologist through videoconferencing (i.e., via telerehabilitation) is not clinically worse than in-clinic therapy for individuals with chronic post-stroke aphasia to provide an opportunity to move to a definitive phase III trial.

Haemorrhagic Stroke in Young People in Intensive Care: Prognostic Factors in Cote d’Ivoire

Introduction: Hemorrhagic cerebrovascular accident (HCVA) is a medical or medico- surgical emergency requiring treatment in neurovascular or intensive care units. The aim of this work was to determine the prognostic factors of hemorrhagic stroke in young subjects in intensive care in the 3 university hospitals of Abidjan. Method: This is a descriptive and analytical retrospective study covering, which extends from January 2018 to December 2022, taking into account All patients aged 18 to 50 admitted to intensive care for a hemorrhagic stroke during the study period. Results: 146 patients including 100 men were included. The average age was 43 years old. High blood pressure was the main modifiable risk factor. The average Glasgow score was 8.2 and 98% of cases presented with impaired consciousness. Grade 3 hypertension was found in 73 patients on admission. The main location of the hemorrhage on imaging was parenchymal and 45% of subjects had an ICH score greater than or equal to 3 in almost 50% of cases. Nicardipine was the antihypertensive of choice. 103 patients were intubated and ventilated. 52% underwent neurosedation 13% underwent neurosurgery. The average length of hospitalization was 8.3 days during which 72.6% of patients presented complications, mostly infectious. Mortality remains high at 66.44% of cases. We listed as prognostic factors, inaugural deep coma, inaugural grade 3 arterial hypertension, ICH severity score greater than or equal to 3, renal failure and length of stay less than 7 days. Conclusion: Hemorrhagic strokes in young subjects remain a common condition in our country. Mortality in intensive care is high and is linked to clinical and neurological severity, biological disorders, the occurrence of complications and the length of stay in intensive care.

Efferocytosis: the resolution of inflammation in cardiovascular and cerebrovascular disease

Cardiovascular and cerebrovascular diseases have surpassed cancer as significant global health challenges, which mainly include atherosclerosis, myocardial infarction, hemorrhagic stroke and ischemia stroke. The inflammatory response immediately following these diseases profoundly impacts patient prognosis and recovery. Efficient resolution of inflammation is crucial not only for halting the inflammatory process but also for restoring tissue homeostasis. Efferocytosis, the phagocytic clearance of dying cells by phagocytes, especially microglia and macrophages, plays a critical role in this resolution process. Upon tissue injury, phagocytes are recruited to the site of damage where they engulf and clear dying cells through efferocytosis. Efferocytosis suppresses the secretion of pro-inflammatory cytokines, stimulates the production of anti-inflammatory cytokines, modulates the phenotype of microglia and macrophages, accelerates the resolution of inflammation, and promotes tissue repair. It involves three main stages: recognition, engulfment, and degradation of dying cells. Optimal removal of apoptotic cargo by phagocytes requires finely tuned machinery and associated modifications. Key molecules in efferocytosis, such as ‘Find-me signals’, ‘Eat-me signals’, and ‘Don’t eat-me signals’, have been shown to enhance efferocytosis following cardiovascular and cerebrovascular diseases. Moreover, various additional molecules, pathways, and mitochondrial metabolic processes have been identified to enhance prognosis and outcomes via efferocytosis in diverse experimental models. Impaired efferocytosis can lead to inflammation-associated pathologies and prolonged recovery periods. Therefore, this review consolidates current understanding of efferocytosis mechanisms and its application in cardiovascular and cerebrovascular diseases, proposing future research directions.

Current Stroke Solutions Using Artificial Intelligence: A Review of the Literature

Introduction: In recent years, artificial intelligence (AI) has emerged as a transformative tool for enhancing stroke diagnosis, aiding treatment decision making, and improving overall patient care. Leading AI-driven platforms such as RapidAI, Brainomix®, and Viz.ai have been developed to assist healthcare professionals in the swift and accurate assessment of stroke patients. Methods: Following the PRISMA guidelines, a comprehensive systematic review was conducted using PubMed, Embase, Web of Science, and Scopus. Characteristic descriptive measures were gathered as appropriate from all included studies, including the sensitivity, specificity, accuracy, and comparison of the available tools. Results: A total of 31 studies were included, of which 29 studies focused on detecting acute ischemic stroke (AIS) or large vessel occlusions (LVOs), and 2 studies focused on hemorrhagic strokes. The four main tools used were Viz.ai, RapidAI, Brainomix®, and deep learning modules. Conclusions: AI tools in the treatment of stroke have demonstrated usefulness for diagnosing different stroke types, providing high levels of accuracy and helping to make quicker and more precise clinical judgments.

Comparative Evaluation of Variations in Cerebral Arterial Circulation on Imaging in Stroke and Non-Stroke Patients

Comparative Evaluation of Variations in Cerebral Arterial Circulation on Imaging in Stroke and Non-Stroke Patients

Risk of stroke after traumatic brain injury: a systematic review and meta-analysis.

Traumatic brain injury (TBI) is a major cause of death and disability in the United States. There is a suggested association between TBI and stroke, emphasizing the need for increased medical monitoring post-trauma. We conducted a systematic review and meta-analysis to investigate the link between previous TBI and the future diagnosis of any type of stroke. A comprehensive search was conducted on PubMed, Google Scholar, and Cochrane Library to find eligible studies investigating the association between TBI and long-term risk of stroke. Out of 2,378 studies, 11 articles met the inclusion criteria for our meta-analysis. The pooled analysis showed that the patients who had a history of TBI were at greater risk for stroke than patients in the control group (random-effect HR = 1.59, 95% CI 1.37-1.85, p < 0.001, I2 = 97%). The risk of ischemic stroke in TBI patients was greater than in non-TBI patients (random-effect HR = 1.52, 95% CI 1.36-1.70, p < 0.001, I2 = 93%). Additionally, there is a strong correlation between TBI and hemorrhagic stroke (random-effect HR = 4.68, 95% CI 2.93-7.49, p < 0.001, I2 = 93%). Our results indicate that there is a relationship between TBI and long-term risk of stroke, regardless of the stroke type. The risk is elevated in the first months post-injury and continues to be high in the years following the trauma. Individuals with moderate to severe TBI face a higher risk of developing a post-TBI stroke than those with mild TBI.

CRISPR/CasRx suppresses KRAS-induced brain arteriovenous malformation developed in postnatal brain endothelial cells in mice.

Brain arteriovenous malformations (bAVMs) are anomalies forming vascular tangles connecting the arteries and veins, which cause hemorrhagic stroke in young adults. Current surgical approaches are highly invasive, and alternative therapeutic methods are warranted. Recent genetic studies identified KRAS mutations in endothelial cells of bAVMs; however, the underlying process leading to malformation in the postnatal stage remains unknown. Here we established a mouse model of bAVM developing during the early postnatal stage. Among 4 methods tested, mutant KRAS specifically introduced in brain endothelial cells by brain endothelial cell-directed adeno-associated virus (AAV) and endothelial cell-specific Cdh5-CreERT2 mice successfully induced bAVMs in the postnatal period. Mutant KRAS led to the development of multiple vascular tangles and hemorrhage in the brain with increased MAPK/ERK signaling and growth in endothelial cells. Three-dimensional analyses in cleared tissue revealed dilated vascular networks connecting arteries and veins, similar to human bAVMs. Single-cell RNA-Seq revealed dysregulated gene expressions in endothelial cells and multiple cell types involved in the pathological process. Finally, we employed CRISPR/CasRx to knock down mutant KRAS expression, which efficiently suppressed bAVM development. The present model reveals pathological processes that lead to postnatal bAVMs and demonstrates the efficacy of therapeutic strategies with CRISPR/CasRx.

A Prospective Observational Study on Incidence, Implications and Management of Seizures Following Stroke

Background: Seizures following a stroke often indicate a more severe incident, typically resulting in extended hospital stays and a heightened risk of long-term disability. Management strategies generally include the use of anti-epileptic drugs to mitigate the frequency and severity of seizures. Objectives: this study aims to evaluate the incidence and risk factors assosciated for seizures after stroke, differentiating between acute symptomatic seizures and late seizures. Additionally, it assess dependency levels of patients after stroke and management of seizures after stroke. Methodology: We conducted prospective observational study for 6 months which includes patients who were diagnosed with cerebrovascular accident, past history of cerebrovascular accident, experienced single or recurrent seizures of different types. Results: Out of 150 patients observed, 67 experienced seizures following stroke. Majority of these patients were male (99) predominantly aged between 50-75. Hypertension was found to be the major risk factor affecting 106(75.2%) individuals.Ischemic stroke were common. In terms of seizure occurrence, 27 patients experienced acute symptomatic seizure and 40 late onset seizure. Activity of daily living was assessed using Barthel Index Scale in which total dependency showed statistically significant relevance (P =0.01). Conclusion: In summary, the leading cause of seizure in adults is stroke. While both ischemic and hemorrhagic stroke may increase the risk of seizure, our study reveals that occurrence of seizure is greater following ischemic compared to hemorrhagic. A clinical pharmacist plays a vital role in determining prophylactic AED treatment for stroke patients and monitor to improve patient’s quality of life.

Contextual and clinical factors as explainers of stroke severity, residual motor impairments, and functional independence during hospitalization

ObjectiveTo investigate if contextual and clinical factors would explain stroke severity, residual motor impairments, and functional independence in people with stroke during hospitalization. Materials and methodsThis cross-sectional study retrieved data from medical records between January 2014 to December 2021. Explanatory independent variables were contextual (sex, age, marital status, occupation, and local of residence) and clinical (stroke type, length of hospital stay, and cognitive function) factors. Stroke severity (National Institutes of Health Stroke Scale), residual motor impairments (Fugl-Meyer scale), and functional independence (Functional Independence Measure) were the dependent variables. Stepwise multiple linear regression analysis was used (α=5%). ResultsData from 1.606 individuals (64±15 years old) were retrieved. Cognitive function was the strongest explainer of all models, as follows: severity (23%;p<0.001), residual motor impairment (16%;p<0.001), and functional independence (32%;p<0.001). Length of hospital stays was the second explainer, adding from 7% to 8% to the models, while stroke type was the third explainer, adding 1% to all models. Finally, age was the last explainer of the two models, adding 1% to the severity and functional independence model. ConclusionThe clinical variables explained more the dependent variables (all three were included in the models), than contextual variables (only age was included). Lower cognitive function, a clinical variable that is quick and easy to evaluate, best explained worse severity, residual motor impairments, and functional independence in people with stroke during hospitalization. Although higher length of hospital stays, hemorrhagic stroke, and older age added little to the explained variance, they should not be underlooked.

0.23-Tesla MRI to differentiate between ischaemic and haemorrhagic strokes within 24 hours of onset: a combined experimental–clinical study

Background and purposeThe low-field MRI is a promising tool to accurately diagnose strokes. We here report our study on the accuracy of a 0.23-Tesla (0.23-T) MRI using the haematoma enhanced...