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Supplemental material, sj-docx-1-wso-10.1177_17474930231180451 for Reperfusion by endovascular thrombectomy and early cerebral edema in anterior circulation stroke: Results from the SITS-International Stroke Thrombectomy Registry by Magnus Thorén, Irene Escudero-Martínez, Tomas Andersson, Shih-Yin Chen, Nicole Tsao, Dheeraj Khurana, Simone Beretta, Andre Peeters, Georgios Tsivgoulis, Christine Roffe and Niaz Ahmed in International Journal of Stroke

Supplemental material, sj-docx-1-wso-10.1177_17474930231180451 for Reperfusion by endovascular thrombectomy and early cerebral edema in anterior circulation stroke: Results from the SITS-International Stroke Thrombectomy Registry by Magnus Thorén, Irene Escudero-Martínez, Tomas Andersson, Shih-Yin Chen, Nicole Tsao, Dheeraj Khurana, Simone Beretta, Andre Peeters, Georgios Tsivgoulis, Christine Roffe and Niaz Ahmed in International Journal of Stroke

Supplemental material, sj-docx-1-wso-10.1177_17474930221095965 for Association of statin pre-treatment with baseline stroke severity and outcome in patients with acute ischemic stroke and received reperfusion treatment: An observational study by Irene Escudero-Martínez, Marius Matusevicius, Ana Pavia-Nunes, Petr Sevcik, Miroslava Nevsimalova, Viiu-Marika Rand, Janika Kõrv, Manuel Cappellari, Robert Mikulik, Danilo Toni and Niaz Ahmed in International Journal of Stroke

Supplemental material, sj-docx-1-eso-10.1177_23969873221148229 for Association of cholesterol levels with hemorrhagic transformation and cerebral edema after reperfusion therapies by Irene Escudero-Martínez, Magnus Thorén, Marius Matusevicius, Charith Cooray, Andrea Zini, Christine Roffe, Danilo Toni, Georgios Tsivgoulis, Peter Ringleb, Nils Wahlgren and Niaz Ahmed in European Stroke Journal

Supplemental material, sj-docx-1-wso-10.1177_17474930221095965 for Association of statin pre-treatment with baseline stroke severity and outcome in patients with acute ischemic stroke and received reperfusion treatment: An observational study by Irene Escudero-Martínez, Marius Matusevicius, Ana Pavia-Nunes, Petr Sevcik, Miroslava Nevsimalova, Viiu-Marika Rand, Janika Kõrv, Manuel Cappellari, Robert Mikulik, Danilo Toni and Niaz Ahmed in International Journal of Stroke

To confirm the diagnostic accuracy of candidate biomarkers in stroke‐associated pneumonia (SAP), we prospectively enrolled ischemic stroke patients with NIHSS ≥ 10 on admission from March‐2016 to August‐2017. Blood samples were collected at baseline, 24 and 48 h after stroke onset. Biomarkers (MR‐proADM, suPAR, SAA) were determined by immunoassays. Regarding biomarkers, MR‐proADM at 24 h (P = 0.04) and both suPAR and SAA at 48 h (P = 0.036 and P = 0.057) were associated with pneumonia. The combination of SAA > 25.15 mg/dL and suPAR> 3.14 ng/mL at 48 h had 80% sensitivity and 95.8% specificity when both biomarkers were above the cut‐off. The evaluated biomarkers represent promising tools to be evaluated in future large, prospective studies on SAP. An accurate SAP diagnosis by thorax CT might help to reduce variability in such studies., This project was partially funded by the ISCIII project PI14/00971. The ITRIBiS project (Improving Translational Research Potential at the Institute of Biomedicine of Seville) has the registration number REGPOT‐2013‐1. Cooperative Cerebrovascular Disease Research Network (INVICTUS+) (RD16/0019/0015). AB is supported by a Juan Rodes research contract (JR16/0008) from Instituto de Salud Carlos III.

Silent brain infarcts (SBI), defined as a finding on neuroimaging without neurological symptoms, are associated with a higher risk of future stroke, cognitive decline and higher mortality rates. For these reasons, SBI should be considered as an initial manifestation of cerebrovascular disease that requires secondary prevention and not only as an incidental finding. Atrial Fibrillation (AF) has been previously identified as a cause of SBI. At present, the most commonly used tools to estimate the embolic risk in patients with AF are CHADS2 and CHA2DS2VASc scores. Patients who score ≥2 are treated with oral anticoagulation (OAC) for thromboembolism prevention, but in those who score less than 2, clinical practice is not constant, and a proportion of these patients might be undertreated. For both scoring systems, a previous history of stroke or TIA scores 2 points, which means a high embolic risk and therefore, indicates starting anticoagulation. A percentage of patients with AF who score 0–1 on the CHADS2 or CHA2DS2VASc score (or 2 if 1 point is female sex) might present SBI if scanned with a high field MRI (3 Tesla, [3T]). This theoretically low to moderate risk population would not receive any treatment as stroke prevention or they would receive antiplatelet treatment. However, if an SBI is detected on an MRI, we suggest that a more aggressive prevention strategy should be implemented in this population. We hypothesize that a significant percentage of patients with AF and theoretically low/moderate embolic risk might present SBI if screened with MRI and that SBI could be associated with less adherence to a healthy lifestyle and with cognitive decline. The main aim of this study is to determine the prevalence of and risk factors for SBI in patients with AF and low/moderate embolic risk according to CHADS2 and CHA2DS2VASc. Secondary aims include to determine the association of SBI with Mediterranean diet (MeD) and physical activity and to evaluate cognitive and psychological scores in this population. Patients with a history of AF based on medical records who scored 0–1 in the CHADS2 score were selected from the Seville urban area using the Andalusian electronic healthcare database (DIRAYA). Demographic and clinical data were collected, and a 3T brain MRI was performed on patients > 50 years and with absence of neurological symptoms. Physical activity and diet habits were assessed by two validated self-administered questionnaires. Food-frequency questionnaire, biomarkers and neuropsychology were assessed in patients with SBI and controls.

[Introduction]: The benefit of intravenous thrombolysis (IVT) in wake-up stroke (WUS), stroke of unknown time of onset (SUKO), or when time exceeds 4.5 h from last-seen-normal (LSN) guided by CT perfusion (CTP) or MRI has been recently suggested. However, there is limited information of IVT in those patients in real-world studies. Objective: Our aim was to evaluate safety and efficacy of IVT selected by CTP in patients with WUS, SUKO, or stroke of time onset beyond 4.5 h. [Material and Methods]: We studied a prospective cohort of patients who underwent IVT from January 2010 to December 2017. Two groups were defined: standard of care group (SC) included patients with time onset 4.5 h from LSN with penumbra area in CTP. We evaluated baseline characteristics, functional outcomes according to modified Rankin Scale (mRS) at discharge and at 90 days, and intracranial hemorrhages rates. [Results]: 657 patients were studied: 604 (92%) were treated in the SC group and 53 (8%) in the CTP group. The mean NIHSS score was 9.8 in the CTP group versus 13 in the SC group (p = 0.001). Seventeen patients in the CTP group (32.1%) received bridging therapy with mechanical thrombectomy (MT). Last time seen well-to-needle time was 538 versus 155 min (p < 0.001). The incidence of symptomatic intracranial hemorrhage was equal in both groups (3.8 vs. 3.8%, p = 1). Good functional outcome (mRS < 2) was achieved in both groups (72 vs. 60.4%, p = 0.107). [Conclusions]: IVT in patients with WUS, SUKO, or stroke beyond >4.5 h from LSN, with salvageable brain tissue on CTP, seems to be safe and has similar functional outcomes at 90 days to the standard therapeutic window, even when combined with MT.

Supplemental material, ESO863606 Supplemental Material for Consensus statements and recommendations from the ESO-Karolinska Stroke Update Conference, Stockholm 11–13 November 2018 by Niaz Ahmed, Heinrich Audebert, Guillaume Turc, Charlotte Cordonnier, Hanne Christensen, Simona Sacco, Else Charlotte Sandset, George Ntaios, Andreas Charidimou, Danilo Toni, Christian Pristipino, Martin Köhrmann, Joji B Kuramatsu, Götz Thomalla, Robert Mikulik, Gary A Ford, Joan Martí-Fàbregas, Urs Fischer, Magnus Thoren, Erik Lundström, Gabriel JE Rinkel, H Bart van der Worp, Marius Matusevicius, Georgios Tsivgoulis, Haralampos Milionis, Marta Rubiera, Robert Hart, Tiago Moreira, Maria Lantz, Christina Sjöstrand, Grethe Andersen, Peter Schellinger, Konstantinos Kostulas, Katharina Stibrant Sunnerhagen, Boris Keselman, Eleni Korompoki, Jan Purrucker, Pooja Khatri, William Whiteley, Eivind Berge, Michael Mazya, Diederik WJ Dippel, Satu Mustanoja, Mads Rasmussen, Åsa Kuntze Söderqvist, Irene Escudero-Martínez and Thorsten Steiner in European Stroke Journal

[Objectives] The aim of the HISPANIAS (HyperperfusIon Syndrome Post-carotid ANgIoplasty And Stenting) study was to define CHS rates and develop a clinical predictive model for cerebral hyperperfusion syndrome (CHS) after carotid artery stenting (CAS)., [Background] CHS is a severe complication following CAS. The presence of clinical manifestations is estimated on the basis of retrospective reviews and is still uncertain., [Methods] The HISPANIAS study was a national prospective multicenter study with 14 recruiting hospitals. CHS was classified as mild (headache only) and moderate-severe (seizure, impaired level of consciousness, or development of focal neurological signs)., [Results] A total of 757 CAS procedures were performed. CHS occurred in 22 (2.9%) patients, in which 16 (2.1%) had moderate-severe CHS and 6 (0.8%) had mild CHS (only headache). The rate of hemorrhages was 0.7% and was associated with high mortality (20%). Pre-operative predictors of moderate-severe CHS in multivariate analysis were female sex (odds ratio [OR]: 3.24; 95% confidence interval [CI]: 1.11 to 9.47; p = 0.03), older patients (OR: 1.09; 95% CI: 1.01 to 1.17; p = 0.02), left carotid artery treated (OR: 4.13; 95% CI: 1.11 to 15.40; p = 0.03), and chronic renal failure (OR: 6.29; 95% CI: 1.75 to 22.57; p = 0.005). The area under the curve of this clinical and radiological model was 0.86 (95% CI: 0.81 to 0.92; p = 0.001)., [Conclusions] The rate of CHS in the HISPANIAS study was 2.9%, with moderate-severe CHS of 2.1%. CHS was independently associated with female sex, older age, history of chronic kidney disease, and a treated left carotid artery. Although further investigations are needed, the authors propose a model to identify high-risk patients and develop strategies to decrease CHS morbidity and mortality in the future., This study was supported by a Spanish grant from the Instituto de Salud Carlos III (ISCIII-FIS IP14/00971, 2014–2017). The ITRIBIS project has the registration number REGPOT-2013-1. Cooperative Cerebrovascular Disease Research Network (INVICTUS+) (RD16/0019/0015). Dr. Mancha is supported by a Río Hortega contract (CM16/00015). Abbott and Grifols have partial financial supported the conduction of the HISPANIAS project but had no role in the design of the study, interpretation of the data, or manuscript approval.

The aim of the HISPANIAS (HyperperfusIon Syndrome Post-carotid ANgIoplasty And Stenting) study was to define CHS rates and develop a clinical predictive model for cerebral hyperperfusion syndrome (CHS) after carotid artery stenting (CAS). CHS is a severe complication following CAS. The presence of clinical manifestations is estimated on the basis of retrospective reviews and is still uncertain. The HISPANIAS study was a national prospective multicenter study with 14 recruiting hospitals. CHS was classified as mild (headache only) and moderate-severe (seizure, impaired level of consciousness, or development of focal neurological signs). A total of 757 CAS procedures were performed. CHS occurred in 22 (2.9%) patients, in which 16 (2.1%) had moderate-severe CHS and 6 (0.8%) had mild CHS (only headache). The rate of hemorrhages was 0.7% and was associated with high mortality (20%). Pre-operative predictors of moderate-severe CHS in multivariate analysis were female sex (odds ratio [OR]: 3.24; 95% confidence interval [CI]: 1.11 to 9.47; p = 0.03), older patients (OR: 1.09; 95% CI: 1.01 to 1.17; p = 0.02), left carotid artery treated (OR: 4.13; 95% CI: 1.11 to 15.40; p = 0.03), and chronic renal failure (OR: 6.29; 95% CI: 1.75 to 22.57; p = 0.005). The area under the curve of this clinical and radiological model was 0.86 (95% CI: 0.81 to 0.92; p = 0.001). The rate of CHS in the HISPANIAS study was 2.9%, with moderate-severe CHS of 2.1%. CHS was independently associated with female sex, older age, history of chronic kidney disease, and a treated left carotid artery. Although further investigations are needed, the authors propose a model to identify high-risk patients and develop strategies to decrease CHS morbidity and mortality in the future.

Se ha elaborado una revisión sistemática de la literatura con el objetivo de evaluar la eficacia, efectividad y seguridad de la DTC junto al tratamiento fibrinolítico con rt-PA IV en pacientes con ictus isquémico agudo. En ella, los autores concluyen que la evidencia localizada sobre eficacia y efectividad fue insuficiente así como en la seguridad de la técnica, al presentar resultados contradictorios. Yes

Treball final de Màster Universitari en Estudis internacionals de Pau, Conflictes i Desenvolupament. Codi: SBG120. Curs acadèmic 2015-2016 El presente trabajo desarrolla un recurso pedagógico para maestros y maestras de infantil que trabajen los temas de interculturalidad, derechos de la infancia, familias diversas y cooperación con el alumnado. El objetivo es introducir a maestros/as de Educación Infantil en el uso del títere como instrumento de aprendizaje. Esta iniciativa surge tras la labor realizada en la ONG Asamblea de Cooperación por la Paz (ACPP) durante el periodo de prácticas. La intención es poder ofrecer a profesionales de la educación una forma diferente de reflexionar sobre valores que integran la cultura de paz, revitalizando la herramienta del teatro de títeres de la cual dispone la entidad.