Stroke Research and Treatment最新文献_第8页

Best Practices for The Interdisciplinary Rehabilitation Team: A Review of Mental Health Issues in Mild Stroke Survivors. 跨学科康复团队的最佳实践:轻度中风幸存者的心理健康问题综述

IF 1.5

Stroke Research and Treatment Pub Date : 2018-06-04 eCollection Date: 2018-01-01 DOI: 10.1155/2018/6187328

Alexandra L Terrill, Jaclyn K Schwartz, Samir R Belagaje

引用次数: 16

Dual-Task Walking in Challenging Environments in People with Stroke: Cognitive-Motor Interference and Task Prioritization. 中风患者在具有挑战性的环境中进行双任务行走：认知-运动干扰和任务优先级。

IF 1.5

Stroke Research and Treatment Pub Date : 2018-05-02 eCollection Date: 2018-01-01 DOI: 10.1155/2018/7928597

Celine Timmermans, Melvyn Roerdink, Thomas W J Janssen, Carel G M Meskers, Peter J Beek

{"title":"Dual-Task Walking in Challenging Environments in People with Stroke: Cognitive-Motor Interference and Task Prioritization.","authors":"Celine Timmermans, Melvyn Roerdink, Thomas W J Janssen, Carel G M Meskers, Peter J Beek","doi":"10.1155/2018/7928597","DOIUrl":"10.1155/2018/7928597","url":null,"abstract":"Cognitive-motor interference may contribute to the risk of falling in people with stroke, as may be the associated phenomenon of inappropriate task prioritization. Examining dual-task walking could provide valuable insights as to how to best evaluate and treat walking in people with stroke. This study aimed to examine the effect of different walking environments on cognitive-motor interference and task prioritization in dual-task walking in people with stroke. Using a repeated-measures design, cognitive-motor interference and task prioritization were assessed in 30 stroke survivors, while walking in a plain environment and in two challenging environments that were enriched with either stationary physical context or suddenly appearing projector-augmented context. All three walking environment conditions were performed with and without a concurrent serial-3 subtraction task. We found stronger cognitive-motor interference for the two challenging environments than for the plain walking environment. Cognitive-motor interference did not differ between challenging walking environments, but task prioritization did: motor performance was prioritized more in the environment with physical context than in the environment with projector-augmented context and vice versa for cognitive-task performance. In conclusion, walking environment strongly influenced cognitive-motor interference and task prioritization during dual-task walking in people with stroke.","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2018 ","pages":"7928597"},"PeriodicalIF":1.5,"publicationDate":"2018-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36182567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Systematic Review of the Causes and Management of Nonthrombotic Embolic Stroke of Tissue Origin. 组织源性非血栓性栓塞性中风的病因和治疗的系统综述。

IF 1.5

Stroke Research and Treatment Pub Date : 2018-04-24 eCollection Date: 2018-01-01 DOI: 10.1155/2018/8092862

Sarah Mello, Ciaran Judge, Roisin Kelly, David Bradley, Joseph Harbison

{"title":"A Systematic Review of the Causes and Management of Nonthrombotic Embolic Stroke of Tissue Origin.","authors":"Sarah Mello, Ciaran Judge, Roisin Kelly, David Bradley, Joseph Harbison","doi":"10.1155/2018/8092862","DOIUrl":"https://doi.org/10.1155/2018/8092862","url":null,"abstract":"Introduction: Various bodily tissues have been reported to enter the arterial circulation and embolize to the brain resulting in ischemic stroke. Most frequently nonthrombotic embolic stroke (NTES) of tissue origin is iatrogenic or related to an underlying disease process. With the increase in elective surgery and intravascular procedures, NTES may increase in prevalence.Aim: To compile a summary of the background, incidence, presentation, and treatment of NTES of tissue origin, by conducting a systematic review of the current literature.Summary of review: We searched EMBASE and MEDLINE for articles on NTES of tissue origin published in English with no restriction on publication date (search date June 2017). 800 articles were identified and screened and 159 articles were ultimately reviewed in full text and included in qualitative analysis. Articles deemed relevant were assessed by a second reviewer to confirm compatibility with the inclusion criteria. References of included articles were reviewed for relevant publications. We categorized the pathology of the emboli into the following groups: amniotic fluid (4 publications), tumour (60 publications), fat (43 publications), cholesterol (19 publications), and intravascular debris (12 publications). We then summarized the available literature on each cause of NTES.Conclusions: NTES of tissue origin is an uncommon but important diagnosis to consider particularly in younger stroke patients and in certain clinical settings. Treatment for NTES is currently anecdotal and based on small case series. Embolectomy may emerge as the therapy of choice due to the longer treatment timeframe and heterogeneity of the emboli.","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2018 ","pages":"8092862"},"PeriodicalIF":1.5,"publicationDate":"2018-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/8092862","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36182569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Validity of Multisensor Array for Measuring Energy Expenditure of an Activity Bout in Early Stroke Survivors. 多传感器阵列测量早期脑卒中幸存者活动回合能量消耗的有效性。

IF 1.5

Stroke Research and Treatment Pub Date : 2018-03-07 eCollection Date: 2018-01-01 DOI: 10.1155/2018/9134547

Sharon Flora Kramer, Liam Johnson, Julie Bernhardt, Toby Cumming

{"title":"Validity of Multisensor Array for Measuring Energy Expenditure of an Activity Bout in Early Stroke Survivors.","authors":"Sharon Flora Kramer, Liam Johnson, Julie Bernhardt, Toby Cumming","doi":"10.1155/2018/9134547","DOIUrl":"https://doi.org/10.1155/2018/9134547","url":null,"abstract":"Introduction. Stroke survivors use more energy than healthy people during activities such as walking, which has consequences for the way exercise is prescribed for stroke survivors. There is a need for wearable device that can validly measure energy expenditure (EE) of activity to inform exercise prescription early after stroke. We aimed to determine the validity and reliability of the SenseWear-Armband (SWA) to measure EE and step-counts during activity <1 month after stroke. Materials and Methods. EE was measured using the SWA and metabolic cart and steps-counts were measured using the SWA and direct observation. Based on walking ability, participants performed 2x six-minute walks or repeated sit-to-stands. Concurrent validity and test-retest reliability were determined by calculating intraclass and concordance correlation coefficients. Results and Discussion. Thirteen participants walked; nine performed sit-to-stands. Validity of the SWA measuring EE for both activities was poor (ICC/CCC < 0.40). The SWA overestimates EE during walking and underestimated EE during sit-to-stands. Test-retest agreement showed an ICC/CCC of <0.40 and >0.75 for walking and sit-to-stand, respectively. However, agreement levels changed with increasing EE levels (i.e., proportional bias). The SWA did not accurately measure step-counts. Conclusion. The SWA should be used with caution to measure EE of activity of mild to moderate stroke survivors <1 month after stroke.","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2018 ","pages":"9134547"},"PeriodicalIF":1.5,"publicationDate":"2018-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/9134547","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36053109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Increased Zinc Serum Level: New Clues in Babol Stroke Patients, Northern Iran. 血清锌水平升高:伊朗北部巴博尔中风患者的新线索。

IF 1.5

Stroke Research and Treatment Pub Date : 2018-02-27 eCollection Date: 2018-01-01 DOI: 10.1155/2018/7681682

Alijan Ahmadi Ahangar, Payam Saadat, Sona Niroomand, Shayan Alijanpour, Reza Sohrabnezhad, Alireza Firozejahi, Mohamad Ali Biani, Fatemeh Arab, Hamed Hosseinzadeh, Sekine Faraji, Jalal Niroomand

{"title":"Increased Zinc Serum Level: New Clues in Babol Stroke Patients, Northern Iran.","authors":"Alijan Ahmadi Ahangar, Payam Saadat, Sona Niroomand, Shayan Alijanpour, Reza Sohrabnezhad, Alireza Firozejahi, Mohamad Ali Biani, Fatemeh Arab, Hamed Hosseinzadeh, Sekine Faraji, Jalal Niroomand","doi":"10.1155/2018/7681682","DOIUrl":"https://doi.org/10.1155/2018/7681682","url":null,"abstract":"Background: Stroke is the second leading cause of death worldwide. The role of zinc as a new predictor of stroke was considered.Methods: This prospective study was conducted in Ayatollah Rouhani Hospital within a year on 100 stroke and 100 control patients.Findings: The difference in zinc serum level in two groups was significant (deficiency: 3 (3%) in patients versus 20 (20%) in control group, normal: 25 (25%) versus 54 (54%), and increased level: 72 (72%) versus 26 (26%); p < 0.001). Difference in zinc serum levels was statistically significant with ischemic heart disease (deficiency: 0 cases (0%), normal: 8 cases (24%), increased level: 24 cases (75%), p = 0.003). Increases in zinc serum level were significantly correlated with the frequency of hemorrhagic and ischemic patients (deficiency: 3 (3.3%) hemorrhagic versus 0 (0%) ischemic; normal: 19 (21%) versus 6 (60%), increased level: 68 (75.6%) versus 4 (40%); p = 0.025). Regression logistics showed that ischemic heart disease (p < 0.001; OR = 28.29, %95 CI: 5.53; 144.87), hyperlipidemia (p < 0.001; OR = 0.26, %95 CI: 0.12; 0.56), and zinc serum level (p < 0.001, OR = 15.53, %95 CI: 4.03; 59.83) each had a significant role.Conclusions: Babol stroke patients are prone to increased zinc serum level as a new parameter. Ischemic heart disease, increased levels of zinc, and hyperlipidemia were found to be probable predictor factors for stroke in Babol.","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2018 ","pages":"7681682"},"PeriodicalIF":1.5,"publicationDate":"2018-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/7681682","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36032132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

The Importance of Assessing Nutritional Status to Ensure Optimal Recovery during the Chronic Phase of Stroke. 评估营养状况对确保中风慢性期最佳康复的重要性。

IF 1.8

Stroke Research and Treatment Pub Date : 2018-01-11 eCollection Date: 2018-01-01 DOI: 10.1155/2018/1297846

Monica C Serra

{"title":"The Importance of Assessing Nutritional Status to Ensure Optimal Recovery during the Chronic Phase of Stroke.","authors":"Monica C Serra","doi":"10.1155/2018/1297846","DOIUrl":"10.1155/2018/1297846","url":null,"abstract":"Background: Despite evidence that many of the consequences of stroke that hinder recovery (i.e., obesity, muscle atrophy, and functional declines) have nutritionally modifiable behavior components, little attention has been focused on the significance of nutrition beyond the acute phase of stroke.Objective: This literature review summarizes the evidence for and against the influence of nutrition on optimal recovery and rehabilitation in chronic (>6 months) stroke.Results: The literature, which is mainly limited to cross-sectional studies, suggests that a suboptimal nutritional status, including an excess caloric intake, reduced protein intake, and micronutrient deficiencies, particularly the B-vitamins, vitamin D, and omega 3 fatty acids, may have deleterious effects on metabolic, physical, and psychological functioning in chronic stroke survivors.Conclusions: Careful evaluation of dietary intake, especially among those with eating disabilities and preexisting malnutrition, may aid in the identification of individuals at increased nutritional risk through which early intervention may benefit recovery and rehabilitation and prevent further complications after stroke.","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2018 ","pages":"1297846"},"PeriodicalIF":1.8,"publicationDate":"2018-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35939677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Renal Dysfunction Is an Independent Risk Factor for Poor Outcome in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis: A New Cutoff Value 肾功能障碍是急性缺血性脑卒中患者静脉溶栓治疗预后不良的独立危险因素:一个新的临界值

IF 1.5

Stroke Research and Treatment Pub Date : 2017-01-03 DOI: 10.1155/2017/2371956

Elyar Sadeghi-Hokmabadi, D. Baş, M. Farhoudi, A. Taheraghdam, Daryoush Savadi Oskouei, M. Yazdchi, M. Hashemilar, N. Uzuner, Reshad Mirnour, E. Çolak, A. Özdemi̇r

{"title":"Renal Dysfunction Is an Independent Risk Factor for Poor Outcome in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis: A New Cutoff Value","authors":"Elyar Sadeghi-Hokmabadi, D. Baş, M. Farhoudi, A. Taheraghdam, Daryoush Savadi Oskouei, M. Yazdchi, M. Hashemilar, N. Uzuner, Reshad Mirnour, E. Çolak, A. Özdemi̇r","doi":"10.1155/2017/2371956","DOIUrl":"https://doi.org/10.1155/2017/2371956","url":null,"abstract":"Objective. This study was set to assess the effect of renal dysfunction on outcome of stroke patients treated with intravenous thrombolysis (IVT). Methods. This multicenter research involved 403 patients from January 2009 to March 2015. Patients were divided into two groups: (1) control group with GFR ≥ 45 mL/min/1.73 m2 and (2) low GFR group with GFR < 45 mL/min/1.73 m2. Outcome measurements were poor outcome (mRS 3–6) and mortality at 3 months and symptomatic intracerebral hemorrhage (SICH) within the first 24–36 hours. Univariate and multivariate regression analyses were performed, and odds ratios (ORs) were determined at 95% confidence intervals (CIs). Results. Univariate analyses determined that every decrease of GFR by 10 mL/min/1.73 m2 significantly increased the risk of poor outcome (OR 1.19, 95% CI 1.09–1.30, p < 0.001) and mortality (OR 1.18, 95% CI 1.06–1.32, p = 0.002). In multivariate regression, adjusted for all variables with p value < 0.1, low GFR (GFR < 45 versus GFR equal to or more than 45) was associated with poor outcome (OR adjusted 2.15, 95% CI 1.01–4.56, p = 0.045). Conclusion. In IVT for acute stroke, renal dysfunction with GFR < 45 mL/min/1.73 m2 before treatment determined increased odds for poor outcome compared to GFR of more than 45 mL/min/1.73 m2.","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"23 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2017-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74780745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Factors Associated with Poststroke Anxiety: A Systematic Review and Meta-Analysis. 卒中后焦虑相关因素:系统回顾和荟萃分析。

IF 1.5

Stroke Research and Treatment Pub Date : 2017-01-01 Epub Date: 2017-02-22 DOI: 10.1155/2017/2124743

Francesca Wright, Simiao Wu, Ho-Yan Yvonne Chun, Gillian Mead

{"title":"Factors Associated with Poststroke Anxiety: A Systematic Review and Meta-Analysis.","authors":"Francesca Wright, Simiao Wu, Ho-Yan Yvonne Chun, Gillian Mead","doi":"10.1155/2017/2124743","DOIUrl":"https://doi.org/10.1155/2017/2124743","url":null,"abstract":"Background and Purpose. Anxiety affects 25% of stroke survivors. There are no effective treatments. Poststroke depression, prestroke anxiety and depression, locus of control, coping, confidence, fatigue, and sleep are factors that may be associated with poststroke anxiety and can potentially be targeted by therapy. We systematically reviewed the literature and performed a meta-analysis to identify associations with these factors. Methods. We searched electronic databases from January 2014 to July 2015 to complement a literature search performed from inception to May 2014. Study quality was assessed using an internationally endorsed checklist. We used odds ratios (ORs) to estimate the strength of associations and random-effects modelling to calculate summary effect sizes. Results. There were 24 studies recruiting 15448 patients. Quality of reporting was satisfactory. 13 studies with 2408 patients reported associations between poststroke anxiety and poststroke depression (OR = 4.66, 95% confidence interval: 2.23, 9.74). One study reported association with prestroke anxiety, three with prestroke depression, one with fatigue, and two with sleep. No studies reported on locus of control, coping, or confidence. Conclusion. Poststroke anxiety was associated with depression but there are limited data on other modifiable associations. Further research is needed to identify potential targets for treatment.","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2017 ","pages":"2124743"},"PeriodicalIF":1.5,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/2124743","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34836801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 38

Resistance Training and Stroke: A Critical Analysis of Different Training Programs. 阻力训练与中风：对不同训练计划的批判性分析。

IF 1.5

Stroke Research and Treatment Pub Date : 2017-01-01 Epub Date: 2017-12-20 DOI: 10.1155/2017/4830265

Bruno Bavaresco Gambassi, Hélio José Coelho-Junior, Paulo Adriano Schwingel, Fabiano de Jesus Furtado Almeida, Tânia Maria Gaspar Novais, Paula de Lourdes Lauande Oliveira, Bismarck Ascar Sauaia, Cristiane Dominice Melo, Marco Carlos Uchida, Bruno Rodrigues

{"title":"Resistance Training and Stroke: A Critical Analysis of Different Training Programs.","authors":"Bruno Bavaresco Gambassi, Hélio José Coelho-Junior, Paulo Adriano Schwingel, Fabiano de Jesus Furtado Almeida, Tânia Maria Gaspar Novais, Paula de Lourdes Lauande Oliveira, Bismarck Ascar Sauaia, Cristiane Dominice Melo, Marco Carlos Uchida, Bruno Rodrigues","doi":"10.1155/2017/4830265","DOIUrl":"10.1155/2017/4830265","url":null,"abstract":"The aim of this study was to carry out a literature review on the overall benefits of resistance training (RT) after stroke and undertake a critical analysis of the resistance exercise programs surveyed (rest interval between sets and exercises, number of sets, number of repetitions, intensity, duration of training, and weekly frequency). To obtain articles for the review, we searched PubMed, Google Scholar, and Physiotherapy Evidence Database (PEDro). Inclusion criteria were considered using the PICO (population, intervention, control/comparison, and outcome variables) model. The following characteristics were recorded for all articles: type of study, author, year of publication, participants (time after stroke, sample size, and age), benefits of RT, and structured resistance exercise programs. Positive effects of training were found on anxiety status, quality of life, muscle hypertrophy, cognitive function, strength, and muscle power. Only 5 studies described the main variables of RT in detail. Lack of control of some variables of RT may negatively affect the results of this practice. The findings of the present study may further inform health and physical conditioning professionals on the importance and necessity of using the main variables in the search for benefits for individuals with stroke.","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2017 ","pages":"4830265"},"PeriodicalIF":1.5,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5750509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35812341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Revisiting Hemicraniectomy: Late Decompressive Hemicraniectomy for Malignant Middle Cerebral Artery Stroke and the Role of Infarct Growth Rate. 再访半脑切除术:脑中动脉恶性卒中晚期减压半脑切除术及梗死生长速率的作用。

IF 1.5

Stroke Research and Treatment Pub Date : 2017-01-01 Epub Date: 2017-03-16 DOI: 10.1155/2017/2507834

Saadat Kamran, Naveed Akhtar, Abdul Salam, Ayman Alboudi, Kainat Kamran, Arsalan Ahmed, Rabia A Khan, Mohsin K Mirza, Jihad Inshasi, Ashfaq Shuaib

{"title":"Revisiting Hemicraniectomy: Late Decompressive Hemicraniectomy for Malignant Middle Cerebral Artery Stroke and the Role of Infarct Growth Rate.","authors":"Saadat Kamran, Naveed Akhtar, Abdul Salam, Ayman Alboudi, Kainat Kamran, Arsalan Ahmed, Rabia A Khan, Mohsin K Mirza, Jihad Inshasi, Ashfaq Shuaib","doi":"10.1155/2017/2507834","DOIUrl":"https://doi.org/10.1155/2017/2507834","url":null,"abstract":"Objective and Methods. The outcome in late decompressive hemicraniectomy in malignant middle cerebral artery stroke and the optimal timings of surgery has not been addressed by the randomized trials and pooled analysis. Retrospective, multicenter, cross-sectional study to measure outcome following DHC under 48 or over 48 hours using the modified Rankin scale [mRS] and dichotomized as favorable ≤4 or unfavorable >4 at three months. Results. In total, 137 patients underwent DHC. Functional outcome analyzed as mRS 0-4 versus mRS 5-6 showed no difference in this split between early and late operated on patients [P = 0.140] and mortality [P = 0.975]. Multivariate analysis showed that age ≥ 55 years, MCA with additional infarction, septum pellucidum deviation ≥1 cm, and uncal herniation were independent predictors of poor functional outcome at three months. In the \"best\" multivariate model, second infarct growth rate [IGR2] >7.5 ml/hr, MCA with additional infarction, and patients with temporal lobe involvement were independently associated with surgery under 48 hours. Both first infarct growth rate [IGR1] and second infarct growth rate [IGR2] were nearly double [P < 0.001] in patients with early surgery [under 48 hours]. Conclusions. The outcome and mortality in malignant middle cerebral artery stroke patients operated on over 48 hours of stroke onset were comparable to those of patients operated on less than 48 hours after stroke onset. Our data identifies IGR, temporal lobe involvement, and middle cerebral artery with additional infarct as independent predictors for early surgery.","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2017 ","pages":"2507834"},"PeriodicalIF":1.5,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/2507834","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34913530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 16