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1. Do stroke services still show sex differences? A multicenter study

Author

Nahas, Nevine El, Shokri, Hossam, Roushdy, Tamer, Dawood, Noha, Zaki, Amr, Farhoudi, Mehdi, Hokmabadi, Elyar Sadeghi, Al Hashmi, Amal, Brola, Waldemar, Kosno, Krystian, Falup-Pecurariu, Cristian, Ciopleias, Bogdan, Montaner, Joan, Pérez-Sánchez, Soledad, Mittal, Manoj, Dowd, Kandis, Banke, Annie, Vigilante, Nicholas, Siegler, James, Ozdemir, Atilla Ozcan, Aykac, Ozlem, Kocabas, Zehra Uysal, Melgarejo, Donoband, Cardozo, Analia, Peralta, Lorena, Aref, Hany, and Caso, Valeria

Published
2024
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2. SARS-CoV-2 infection might be a predictor of mortality in intracerebral hemorrhage

Author

Mowla, Ashkan, Shakibajahromi, Banafsheh, Shahjouei, Shima, Baharvahdat, Humain, Harandi, Ali Amini, Rahmani, Farzad, Mondello, Stefania, Rahimian, Nasrin, Cernigliaro, Achille, Hokmabadi, Elyar Sadeghi, Ebrahimzadeh, Seyed Amir, Ramezani, Mahtab, Mehrvar, Kaveh, Farhoudi, Mehdi, Naderi, Soheil, Fenderi, Shahab Mahmoudnejad, Pishjoo, Masoud, Alizada, Orkhan, Purroy, Francisco, Requena, Manuel, Tsivgoulis, Georgios, and Zand, Ramin

Published
2023
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3. Did COVID-19 impact stroke services? A multicenter study

Author

Shokri, Hossam, Nahas, Nevine El, Basiony, Ahmed El, Nguyen, Thanh N., Abdalkader, Mohamad, Klein, Piers, Lavados, Pablo M., Olavarría, Verónica V., Amaya, Pablo, Llanos-Leyton, Natalia, Brola, Waldemar, Michał, Lipowski, Fariña, Donoband Edson Dejesus Melgarejo, Cardozo, Analia, Caballero, Cesar David, Pedrozo, Fatima, Rahman, Aminur, Hokmabadi, Elyar Sadeghi, Jalili, Javad, Farhoudi, Mehdi, Aref, Hany, and Roushdy, Tamer

Published
2022
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4. Do stroke services still show sex differences? A multicenter study

Author

Nahas, Nevine El, primary, Shokri, Hossam, additional, Roushdy, Tamer, additional, Dawood, Noha, additional, Zaki, Amr, additional, Farhoudi, Mehdi, additional, Hokmabadi, Elyar Sadeghi, additional, Al Hashmi, Amal, additional, Brola, Waldemar, additional, Kosno, Krystian, additional, Falup-Pecurariu, Cristian, additional, Ciopleias, Bogdan, additional, Montaner, Joan, additional, Pérez-Sánchez, Soledad, additional, Mittal, Manoj, additional, Dowd, Kandis, additional, Banke, Annie, additional, Vigilante, Nicholas, additional, Siegler, James, additional, Ozdemir, Atilla Ozcan, additional, Aykac, Ozlem, additional, Kocabas, Zehra Uysal, additional, Melgarejo, Donoband, additional, Cardozo, Analia, additional, Peralta, Lorena, additional, Aref, Hany, additional, and Caso, Valeria, additional

Published
2023
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5. Stroke services in MENA: What is there and what is needed

Author

Aref, Hany, primary, El Nahas, Nevine, additional, Alrukn, Suhail Abdulla, additional, Khan, Maria, additional, Kesraoui, Selma, additional, Alnidawi, Firas, additional, Hokmabadi, Elyar Sadeghi, additional, Farhoudi, Mehdi, additional, Fairooz, Muataz, additional, Batayha, Waleed, additional, Salmeen, Athari, additional, Abdulrahman, Husen, additional, Belahsen, Mohammed Faouzi, additional, Al Hashmi, Amal M., additional, Akhtar, Naveed, additional, Al-Johani, Mohammed, additional, Seidi, Osheik Abu’Asha, additional, Jouhar, Anas, additional, Mhiri, Chokri, additional, Elbassiouny, Ahmed, additional, Shokri, Hossam, additional, and Roushdy, Tamer, additional

Published
2023
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6. In-Hospital Complications and Long-Term Outcomes of Carotid Artery Stenting: Incarcerate Study

Author

Mohebbi, Bahram, primary, Amiri, Faramarz, additional, Golmohammadi, Neda, additional, Shishehbor, Mehdi H., additional, Shafe, Omid, additional, Moosavi, Jamal, additional, Sadeghipour, Parham, additional, Hashemi, Gelareh Bani, additional, Zolfaghari, Reza, additional, Firouzi, Ata, additional, Hokmabadi, Elyar Sadeghi, additional, Bakhshandeh, Hooman, additional, and Ghorbani, Askar, additional

Published
2023
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7. Global impact of the COVID-19 pandemic on stroke volumes and cerebrovascular events : a 1-year follow-up

Author

Nguyen, Thanh N., Qureshi, Muhammad M., Klein, Piers, Yamagami, Hiroshi, Mikulik, Robert, Czlonkowska, Anna, Abdalkader, Mohamad, Sedova, Petra, Sathya, Anvitha, Lo, Hannah C., Mansour, Ossama Yassin, Vanguru, Husitha Reddy, Lesaine, Emilie, Tsivgoulis, Georgios, Loochtan, Aaron, I, Demeestere, Jelle, Uchino, Ken, Inoa, Violiza, Goyal, Nitin, Charidimou, Andreas, Siegler, James E., Yaghi, Shadi, de Sousa, Diana Aguiar, Mohammaden, Mahmoud H., Haussen, Diogo C., Kristoffersen, Espen Saxhaug, Lereis, Virginia Pujol, Scollo, Sergio Daniel, Campbell, Bruce C.V., Ma, Alice, Thomas, James Orton, Parsons, Mark W., Singhal, Shaloo, Slater, Lee-Anne, Martins, Rodrigo Tomazini, Enzinger, Chris, Gattringer, Thomas, Rahman, Aminur, Bonnet, Thomas, Ligot, Noemie, De Raedt, Sylvie, Lemmens, Robin, Vanacker, Peter, Vandervorst, Fenne, Conforto, Adriana Bastos, Hidalgo, Raquel C.T., de Neves, Luciana Oliveira, Martins, Rodrigo Targa, Mora Cuervo, Daissy Liliana, Rebello, Leticia C., Santiago, Igor Bessa, de Silva, Isabelle Lameirinhas, Sakelarova, Teodora, Kalpachki, Rosen, Alexiev, Filip, Catanese, Luciana, Cora, Elena Adela, Goyal, Mayank, Hill, Michael D., Kelly, Michael E., Khosravani, Houman, Lavoie, Pascale, Peeling, Lissa, Pikula, Aleksandra, Rivera, Rodrigo, Chen, Hui-Sheng, Chen, Yimin, Huo, Xiaochuan, Miao, Zhongrong, Yang, Shuiquan, Bedekovic, Marina Roje, Bralic, Marina, Budincevic, Hrvoje, Corredor-Quintero, Angel Basilio, Lara-Sarabia, Osvaldo E., Cabal, Martin, Tenora, Dusan, Fibrich, Petr, Herzig, Roman, Hrabanovska, Emanuela, Hlinovsky, David, Jurak, Lubomir, Kadlcikova, Jana, Karpowicz, Igor, Klecka, Lukas, Kovar, Martin, Lauer, David, Neumann, Jiri, Palouskova, Hana, Reiser, Martin, Rekova, Petra, Rohan, Vladimir, Skoda, Ondrej, Skorna, Miroslav, Sramek, Martin, Zakova, Lenka, Christensen, Hanne, Drenck, Nicolas, Iversen, Helle Klingenberg, Truelsen, Thomas Clement, Wienecke, Troels, Sobh, Khalid, Ylikotila, Pauli, Alpay, Kemal, Strbian, Daniel, Bernady, Patricia, Casenave, Philippe, Dan, Maria, Faucheux, Jean-Marc, Gentric, Jean-Christophe, Magro, Elsa, Sabben, Candice, Reiner, Peggy, Rouanet, Francois, Bohmann, Ferdinand O., Boskamp, Stefan, Mbroh, Joshua, Nagel, Simon, Nolte, Christian H., Ringleb, Peter A., Rosenkranz, Michael, Poli, Sven, Thomalla, Gotz, Karapanayiotides, Theodoros, Koutroulou, Ioanna, Kargiotis, Odysseas, Palaiodimou, Lina, Barrientos Guerra, Jose Dominguo, Huded, Vikram, Menon, Bindu, Nagendra, Shashank, Prajapati, Chintan, Sylaja, P.N., Pramana, Nyoman Angga Krishna, Sani, Achmad Firdaus, Ghoreishi, Abdoreza, Farhoudi, Mehdi, Hokmabadi, Elyar Sadeghi, Abu Raya, Tariq, Kalmanovich, Shani Avnery, Ronen, Levite, Sabetay, Sergiu Ionut, Acampa, Maurizio, Adami, Alessandro, Castellan, Lucio, Longoni, Marco, Ornello, Raffaele, Renieri, Leonardo, Bigliani, Claudia Rolla, Romoli, Michele, Sacco, Simona, Salmaggi, Andrea, Sangalli, Davide, Zini, Andrea, Doijiri, Ryosuke, Fukuda, Hiroki, Fujinaka, Toshiyuki, Fujita, Kyohei, Imamura, Hirotoshi, Sakai, Nobuyuki, Kanamaru, Takuya, Kimura, Naoto, Kono, Ryuhei, Miyake, Kosuke, Sakaguchi, Manabu, Sakai, Kenichiro, Sonoda, Kazutaka, Todo, Kenichi, Miyashita, Fumio, Tokuda, Naoki, Matsumaru, Yuji, Matsumoto, Shoji, Ohara, Nobuyuki, Shindo, Seigo, Takenobu, Yohei, Yoshimoto, Takeshi, Toyoda, Kazunori, Uwatoko, Takeshi, Yagita, Yoshiki, Yamada, Takehiro, Yamamoto, Nobuaki, Yamamoto, Ryoo, Yazawa, Yukako, Sugiura, Yuri, Waweru, Peter Kuria, Baek, Jang-Hyun, Lee, Si Baek, Seo, Kwon-Duk, Sohn, Sung-Il, Arsovska, Anita Ante, Chan, Yong Chieh, Zaidi, Wan Asyraf Wan, Jaafar, Ainul Syahrilfazli, Gongora-Rivera, Fernando, Martinez-Marino, Manuel, Infante-Valenzuela, Adrian, Groppa, Stanislav, Leahu, Pavel, Coutinho, Jonathan M., Rinkel, Leon A., Dippel, Diederik W.J., Van dam-Nolen, Dianne H.K., Ranta, Annemarei, Wu, Teddy Y., Adebayo, Tajudeen Temitayo, Bello, Abiodun H., Nwazor, Ernest Okwundu, Sunmonu, Taofiki Ajao, Wahab, Kolawole Wasiu, Ronning, Ole Morten, Sandset, Else Charlotte, Al Hashmi, Amal M., Ahmad, Saima, Rashid, Umair, Rodriguez-Kadota, Liliana, Yalung, Patrick Matic, Dy, Jon Stewart Hao, Pineda-Franks, Maria Carissa, Co, Christian Oliver, Brola, Waldemar, Debiec, Aleksander, Dorobek, Malgorzata, Karlinski, Michal Adam, Labuz-Roszak, Beata M., Lasek-Bal, Anetta, Sienkiewicz-Jarosz, Halina, Staszewski, Jacek, Sobolewski, Piotr, Wiacek, Marcin, Zielinska-Turek, Justyna, Araujo, Andre Pinho, Rocha, Mariana, Castro, Pedro, Cruz, Vitor Tedim, Ferreira, Paulo Venancio, Ferreira, Patricia, Nunes, Ana Paiva, Fonseca, Luisa, Marto, Joao Pedro, Pinho e Melo, Teresa, Rodrigues, Miguel, Silva, M. Luis, Dimitriade, Adela, Falup-Pecurariu, Cristian, Hamid, May Adel, Venketasubramanian, Narayanaswamy, Krastev, Georgi, Mako, Miroslav, Ayo-Martin, Oscar, Hernandez-Ferandez, Francisco, Blasco, Jordi, Rodriguez-Vazquez, Alejandro, Cruz-Culebras, Antonio, Moniche, Francisco, Montaner, Joan, Perez-Sanchez, Soledad, Garcia Sanchez, Maria Jesas, Guillan Rodriguez, Marta, Jood, Katarina, Nordanstig, Annika, Mazya, Michael V., Moreira, Tiago T.P., Bernava, Gianmarco, Beyeler, Morin, Bolognese, Manuel, Carrera, Emmanuel, Dobrocky, Tomas, Karwacki, Grzegorz Marek, Keller, Emanuela, Hsieh, Chang Yang, Boonyakarnkul, Surawan, Churojana, Anchalee, Aykac, Ozlem, Ozdemir, Atilla Azcan, Bajrami, Arsida, Senadim, Songul, Hussain, Syed Irteza, John, Seby, Banerjee, Soma, Kwan, Joseph, Krishnan, Kailash, Lenthall, Robert, Matthews, Ashok, Wong, Ken, Zhang, Liqun, Altschul, Dorothea, Asif, Kaiz S., Bahiru, Zeelalem, Below, Kristine, Ruland, Sean, Chaudry, Saqib A., Chen, Michael, Chebl, Alex, Cibulka, Jackie, Cistrunk, Leon, Clark, Judith, Colasurdo, Marco, Czap, Alexandra, de Havenon, Adam, D'Amato, Salvatore, Dharmadhikari, Sushrut, Grimmett, Kasey B., Dmytriw, Adam A., Etherton, Mark R., Ezepue, Chizoba, Farooqui, Mudassir, Feske, Steven K., Fink, Lauren, Gasimova, Ulviyya, Guzik, Amy K., Hakemi, Maryam, Hovingh, Majesta, Khan, Muhib, Jillela, Dinesh, Khatri, Rakesh, Khawaja, Ayaz M., Khoury, Naim N., Kiley, Nicole L., Kim, Benny S., Kolikonda, Murali K., Kuhn, Anna Luisa, Lara, Stephanie, Linares, Guillermo, Linfante, Italo, Lukovits, Timothy G., Lycan, Sarah, Male, Shailesh S., Maali, Laith, Mancin, John, Masoud, Hesham, Mohamed, Ghada A., Monteiro, Andre, Nahab, Fadi, Nalleballe, Krishna, Ortega-Gutierrez, Santiago, Puri, Ajit S., Radaideh, Yazan, Rahangdale, Rahul H., Rai, Ansaar, Ramakrishnan, Pankajavalli, Reddy, Aravind B., Rojas-Soto, Diana M., Romero, Jose Rafael, Rost, Natalia S., Rothstein, Aaron, Omran, Setareh Salehi, Sheth, Sunil A., Siddiqui, Adnan H., Starosciak, Amy K., Tarlov, Nicholas E., Taylor, Robert A., Wang, Michael J., Wolfe, Jared, Wong, Ka-Ho, Huynh Vu Le, Quy Viet Nguyen, Thong Nhu Pham, Trung Thanh Nguyen, Hoang Thi Phan, Mai Duy Ton, Fischer, Urs, Michel, Patrik, Strambo, Davide, Martins, Sheila O., Zaidat, Osama O., Nogueira, Raul G., SVIN COVID-19 Global Stroke Registry, Neurology, ACS - Atherosclerosis & ischemic syndromes, ANS - Neurovascular Disorders, Graduate School, and Radiology & Nuclear Medicine

Subjects
Neurology (clinical), Human medicine
Abstract

Background and ObjectivesDeclines in stroke admission, IV thrombolysis (IVT), and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the effect of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), IVT, and mechanical thrombectomy over a 1-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year (March 1, 2019, to February 29, 2020).MethodsWe conducted a longitudinal retrospective study across 6 continents, 56 countries, and 275 stroke centers. We collected volume data for COVID-19 admissions and 4 stroke metrics: ischemic stroke admissions, ICH admissions, IVT treatments, and mechanical thrombectomy procedures. Diagnoses were identified by theirICD-10codes or classifications in stroke databases.ResultsThere were 148,895 stroke admissions in the 1 year immediately before compared with 138,453 admissions during the 1-year pandemic, representing a 7% decline (95% CI [95% CI 7.1–6.9];p< 0.0001). ICH volumes declined from 29,585 to 28,156 (4.8% [5.1–4.6];p< 0.0001) and IVT volume from 24,584 to 23,077 (6.1% [6.4–5.8];p< 0.0001). Larger declines were observed at high-volume compared with low-volume centers (allp< 0.0001). There was no significant change in mechanical thrombectomy volumes (0.7% [0.6–0.9];p= 0.49). Stroke was diagnosed in 1.3% [1.31–1.38] of 406,792 COVID-19 hospitalizations. SARS-CoV-2 infection was present in 2.9% ([2.82–2.97], 5,656/195,539) of all stroke hospitalizations.DiscussionThere was a global decline and shift to lower-volume centers of stroke admission volumes, ICH volumes, and IVT volumes during the 1st year of the COVID-19 pandemic compared with the prior year. Mechanical thrombectomy volumes were preserved. These results suggest preservation in the stroke care of higher severity of disease through the first pandemic year.Trial Registration InformationThis study is registered underNCT04934020.

Published
2023

8. Global impact of the COVID-19 pandemic on stroke volumes and cerebrovascular events

Author

Nguyen, Thanh N., Qureshi, Muhammad M., Klein, Piers, Yamagami, Hiroshi, Mikulik, Robert, Czlonkowska, Anna, Abdalkader, Mohamad, Sedova, Petra, Sathya, Anvitha, Lo, Hannah C., Mansour, Ossama Yassin, Iversen, Helle Klingenberg, Truelsen, Thomas Clement, Wienecke, Troels, Sobh, Khalid, Ylikotila, Pauli, Alpay, Kemal, Strbian, Daniel, Bernady, Patricia, Casenave, Philippe, Dan, Maria, Vanguru, Husitha Reddy, Faucheux, Jean-Marc, Gentric, Jean-Christophe, Magro, Elsa, Sabben, Candice, Reiner, Peggy, Rouanet, Francois, Bohmann, Ferdinand O., Boskamp, Stefan, Mbroh, Joshua, Nagel, Simon, Lesaine, Emilie, Nolte, Christian H., Ringleb, Peter A., Rosenkranz, Michael, Poli, Sven, Thomalla, Götz, Karapanayiotides, Theodoros, Koutroulou, Ioanna, Kargiotis, Odysseas, Palaiodimou, Lina, Barrientos Guerra, Jose Dominguo, Tsivgoulis, Georgios, Huded, Vikram, Menon, Bindu, Nagendra, Shashank, Prajapati, Chintan, Sylaja, P.N., Krishna Pramana, Nyoman Angga, Sani, Achmad Firdaus, Ghoreishi, Abdoreza, Farhoudi, Mehdi, Hokmabadi, Elyar Sadeghi, Loochtan, Aaron I., Raya, Tariq Abu, Kalmanovich, Shani Avnery, Ronen, Levite, Sabetay, Sergiu Ionut, Acampa, Maurizio, Adami, Alessandro, Castellan, Lucio, Longoni, Marco, Ornello, Raffaele, Renieri, Leonardo, Demeestere, Jelle, Bigliani, Claudia Rolla, Romoli, Michele, Sacco, Simona, Salmaggi, Andrea, Sangalli, Davide, Zini, Andrea, Doijiri, Ryosuke, Fukuda, Hiroki, Fujinaka, Toshiyuki, Fujita, Kyohei, Uchino, Ken, Imamura, Hirotoshi, Sakai, Nobuyuki, Kanamaru, Takuya, Kimura, Naoto, Kono, Ryuhei, Miyake, Kosuke, Sakaguchi, Manabu, Sakai, Kenichiro, Sonoda, Kazutaka, Todo, Kenichi, Inoa, Violiza, Miyashita, Fumio, Tokuda, Naoki, Matsumaru, Yuji, Matsumoto, Shoji, Ohara, Nobuyuki, Shindo, Seigo, Takenobu, Yohei, Yoshimoto, Takeshi, Toyoda, Kazunori, Uwatoko, Takeshi, Goyal, Nitin, Yagita, Yoshiki, Yamada, Takehiro, Yamamoto, Nobuaki, Yamamoto, Ryoo, Yazawa, Yukako, Sugiura, Yuri, Waweru, Peter Kuria, Baek, Jang-Hyun, Lee, Si Baek, Seo, Kwon-Duk, Charidimou, Andreas, Sohn, Sung-Il, Arsovska, Anita Ante, Chan, Yong Chieh, Wan Zaidi, Wan Asyraf, Jaafar, Ainul Syahrilfazli, Gongora-Rivera, Fernando, Martinez-Marino, Manuel, Infante-Valenzuela, Adrian, Groppa, Stanislav, Leahu, Pavel, Siegler, James E., Coutinho, Jonathan M., Rinkel, Leon A., Dippel, Diederik W.J., van Dam-Nolen, Dianne H.K., Ranta, Annemarei, Wu, Teddy Y., Adebayo, Tajudeen Temitayo, Bello, Abiodun H., Nwazor, Ernest Okwundu, Sunmonu, Taofiki Ajao, Yaghi, Shadi, Wahab, Kolawole Wasiu, Ronning, Ole Morten, Sandset, Else Charlotte, Al Hashmi, Amal M., Ahmad, Saima, Rashid, Umair, Rodriguez-Kadota, Liliana, Vences, Miguel Ángel, Yalung, Patrick Matic, Hao Dy, Jon Stewart, de Sousa, Diana Aguiar, Pineda-Franks, Maria Carissa, Co, Christian Oliver, Brola, Waldemar, Debiec, Aleksander, Dorobek, Malgorzata, Karlinski, Michal Adam, Labuz-Roszak, Beata M., Lasek-Bal, Anetta, Sienkiewicz-Jarosz, Halina, Staszewski, Jacek, Mohammaden, Mahmoud H., Sobolewski, Piotr, Wiacek, Marcin, Zielinska-Turek, Justyna, Araujo, Andre Pinho, Rocha, Mariana, Castro, Pedro, Cruz, Vitor Tedim, Ferreira, Paulo Venancio, Ferreira, Patricia, Nunes, Ana Paiva, Haussen, Diogo C., Fonseca, Luisa, Marto, João Pedro, Melo, Teresa Pinho e, Rodrigues, Miguel, Silva, M. Luis, Dimitriade, Adela, Falup-Pecurariu, Cristian, Hamid, May Adel, Venketasubramanian, Narayanaswamy, Krastev, Georgi, Kristoffersen, Espen Saxhaug, Mako, Miroslav, Ayo-Martin, Oscar, Hernández-Fernández, Francisco, Blasco, Jordi, Rodríguez-Vázquez, Alejandro, Cruz-Culebras, Antonio, Moniche, Francisco, Montaner, Joan, Perez-Sanchez, Soledad, García Sánchez, María Jesús, Lereis, Virginia Pujol, Guillán Rodríguez, Marta, Jood, Katarina, Nordanstig, Annika, Mazya, Michael V., Moreira, Tiago T.P., Bernava, Gianmarco, Beyeler, Morin, Bolognese, Manuel, Carrera, Emmanuel, Dobrocky, Tomas, Scollo, Sergio Daniel, Karwacki, Grzegorz Marek, Keller, Emanuela, Hsieh, Chang Yang, Boonyakarnkul, Surawan, Churojana, Anchalee, Aykac, Ozlem, Ozdemir, Atilla Özcan, Bajrami, Arsida, Senadim, Songul, Hussain, Syed Irteza, Campbell, Bruce C. V., John, Seby, Banerjee, Soma, Kwan, Joseph, Krishnan, Kailash, Lenthall, Robert, Matthews, Ashok, Wong, Ken, Zhang, Liqun, Altschul, Dorothea, Asif, Kaiz S., Ma, Alice, Bahiru, Zeelalem, Below, Kristine, Biller, José, Ruland, Sean, Chaudry, Saqib A., Chen, Michael, Chebl, Alex, Cibulka, Jackie, Cistrunk, Leon, Clark, Judith, Thomas, James Orton, Colasurdo, Marco, Czap, Alexandra, de Havenon, Adam, D'Amato, Salvatore, Dharmadhikari, Sushrut, Grimmett, Kasey B., Dmytriw, Adam A., Etherton, Mark R., Ezepue, Chizoba, Farooqui, Mudassir, Parsons, Mark W., Feske, Steven K., Fink, Lauren, Gasimova, Ulviyya, Guzik, Amy K., Hakemi, Maryam, Hovingh, Majesta, Khan, Muhib, Jillela, Dinesh, Kan, Peter T., Khatri, Rakesh, Singhal, Shaloo, Khawaja, Ayaz M., Khoury, Naim N., Kiley, Nicole L., Kim, Benny S., Kolikonda, Murali K., Kuhn, Anna Luisa, Lara, Stephanie, Linares, Guillermo, Linfante, Italo, Lukovits, Timothy G., Slater, Lee-Anne, Lycan, Sarah, Male, Shailesh S., Maali, Laith, Mancin, John, Masoud, Hesham, Mohamed, Ghada A., Monteiro, Andre, Nahab, Fadi, Nalleballe, Krishna, Ortega-Gutierrez, Santiago, Tomazini Martins, Rodrigo, Puri, Ajit S., Radaideh, Yazan, Rahangdale, Rahul H., Rai, Ansaar, Ramakrishnan, Pankajavalli, Reddy, Aravind B., Rojas-Soto, Diana M., Romero, Jose Rafael, Rost, Natalia S., Rothstein, Aaron, Enzinger, Chris, Omran, Setareh Salehi, Sheth, Sunil A., Siddiqui, Adnan H., Starosciak, Amy K., Tarlov, Nicholas E., Taylor, Robert A., Wang, Michael J., Wolfe, Jared, Wong, Ka-Ho, Le, Huynh Vu, Gattringer, Thomas, Nguyen, Quy Viet, Pham, Thong Nhu, Nguyen, Trung Thanh, Phan, Hoang Thi, Ton, Mai Duy, Fischer, Urs, Michel, Patrik, Strambo, Davide, Martins, Sheila O., Zaidat, Osama O., Rahman, Aminur, Nogueira, Raul G., Bonnet, Thomas, Ligot, Noemie, De Raedt, Sylvie, Lemmens, Robin, Vanacker, Peter, Vandervorst, Fenne, Conforto, Adriana Bastos, Hidalgo, Raquel C.T., de Oliveira Neves, Luciana, Martins, Rodrigo Targa, Mora Cuervo, Daissy Liliana, Rebello, Leticia C., Santiago, Igor Bessa, Lameirinhas da Silva, Isabelle, Sakelarova, Teodora, Kalpachki, Rosen, Alexiev, Filip, Catanese, Luciana, Cora, Elena Adela, Goyal, Mayank, Hill, Michael D., Kelly, Michael E., Khosravani, Houman, Lavoie, Pascale, Peeling, Lissa, Pikula, Aleksandra, Rivera, Rodrigo, Chen, Hui-Sheng, Chen, Yimin, Huo, Xiaochuan, Miao, Zhongrong, Yang, Shuiquan, Bedekovic, Marina Roje, Bralic, Marina, Budincevic, Hrvoje, Corredor-Quintero, Angel Basilio, Lara-Sarabia, Osvaldo E., Cabal, Martin, Tenora, Dusan, Fibrich, Petr, Herzig, Roman, Hlaváčová, Helena, Hrabanovska, Emanuela, Hlinovsky, David, Jurak, Lubomir, Kadlcikova, Jana, Karpowicz, Igor, Klecka, Lukas, Kovar, Martin, Lauer, David, Neumann, Jiri, Palouskova, Hana, Reiser, Martin, Rekova, Petra, Rohan, Vladimir, Skoda, Ondrej, Škorňa, Miroslav, Sobotková, Lenka, Sramek, Martin, Zakova, Lenka, Christensen, Hanne, Drenck, Nicolas, and Repositório da Universidade de Lisboa

Abstract

© 2022 American Academy of Neurology, Background and objectives: Declines in stroke admission, IV thrombolysis (IVT), and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the effect of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), IVT, and mechanical thrombectomy over a 1-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year (March 1, 2019, to February 29, 2020). Methods: We conducted a longitudinal retrospective study across 6 continents, 56 countries, and 275 stroke centers. We collected volume data for COVID-19 admissions and 4 stroke metrics: ischemic stroke admissions, ICH admissions, IVT treatments, and mechanical thrombectomy procedures. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. Results: There were 148,895 stroke admissions in the 1 year immediately before compared with 138,453 admissions during the 1-year pandemic, representing a 7% decline (95% CI [95% CI 7.1-6.9]; p < 0.0001). ICH volumes declined from 29,585 to 28,156 (4.8% [5.1-4.6]; p < 0.0001) and IVT volume from 24,584 to 23,077 (6.1% [6.4-5.8]; p < 0.0001). Larger declines were observed at high-volume compared with low-volume centers (all p < 0.0001). There was no significant change in mechanical thrombectomy volumes (0.7% [0.6-0.9]; p = 0.49). Stroke was diagnosed in 1.3% [1.31-1.38] of 406,792 COVID-19 hospitalizations. SARS-CoV-2 infection was present in 2.9% ([2.82-2.97], 5,656/195,539) of all stroke hospitalizations. Discussion: There was a global decline and shift to lower-volume centers of stroke admission volumes, ICH volumes, and IVT volumes during the 1st year of the COVID-19 pandemic compared with the prior year. Mechanical thrombectomy volumes were preserved. These results suggest preservation in the stroke care of higher severity of disease through the first pandemic year.

Published
2023

9. Stroke services in the Middle East and adjacent region: A survey of 34 hospital-based stroke services

Author

Al Hashmi, Amal. M., primary, Shuaib, Ashfaq, additional, Imam, Yahia, additional, Amr, Dareen, additional, Humaidan, Hani, additional, Al Nidawi, Firas, additional, Sarhan, Ahmed, additional, Mustafa, Wessam, additional, Khalefa, Wael, additional, Ramadan, Ismail, additional, Usman, Fritz Sumantri, additional, Hokmabadi, Elyar Sadeghi, additional, Ghorbani, Mohammed, additional, Nassir, Temeem, additional, Aladham, Farid, additional, Salmeen, Athari, additional, Kikano, Raghid, additional, Muda, Sobri, additional, Jose, Sachin, additional, Bulushi, Manal Al, additional, Sajwani, Badrai, additional, Wasay, Mohammad, additional, Bashir, Qasim, additional, Al Hazzani, Adel, additional, Khoja, Waleed, additional, Alkadere, Radwan, additional, Osman, Haytham, additional, Hussein, Abbashar, additional, Churojana, Anchalee, additional, Hammami, Nadia, additional, Ozdemir, Atilla Ozcan, additional, Giray, Semih, additional, Gurkas, Erdem, additional, Hussain, Seyd Irteza, additional, Sallam, Abdul Rahman, additional, and Mansour, Ossama Yassin, additional

Published
2022
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10. In-Hospital Complications and Long-term Outcomes of Carotid Artery Stenting: INCARCERATE Study

Author

Mohebbi, Bahram, primary, Amiri, Faramarz, additional, Golmohammadi, Neda, additional, Shishehbor, Mehdi H., additional, Shafe, Omid, additional, Moosavi, Jamal, additional, Sadeghipour, Parham, additional, Hashemi, Gelareh Bani, additional, Zolfaghari, Reza, additional, Firouzi, Ata, additional, Hokmabadi, Elyar Sadeghi, additional, Bakhshandeh, Hooman, additional, and Ghorbani, Askar, additional

Published
2022
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11. Global Impact of COVID-19 on Stroke Care and IV Thrombolysis

Author

Nogueira, Raul, Qureshi, Muhammad, Abdalkader, Mohamad, Martins, Sheila Ouriques, Yamagami, Hiroshi, Qiu, Zhongming, Mansour, Ossama Yassin, Sathya, Anvitha, Czlonkowska, Anna, Tsivgoulis, Georgios, Aguiar de Sousa, Diana, Demeestere, Jelle, Mikulik, Robert, Vanacker, Peter, Siegler, James, Kõrv, Janika, Biller, Jose, Liang, Conrad, Sangha, Navdeep, Zha, Alicia, Czap, Alexandra, Holmstedt, Christine Anne, Turan, Tanya, Ntaios, George, Malhotra, Konark, Tayal, Ashis, Loochtan, Aaron, Ranta, Annamarei, Mistry, Eva, Alexandrov, Anne, Huang, David, Yaghi, Shadi, Raz, Eytan, Sheth, Sunil, Mohammaden, Mahmoud, Frankel, Michael, Bila Lamou, Eric Guemekane, Aref, Hany, Elbassiouny, Ahmed, Hassan, Farouk, Menecie, Tarek, Mustafa, Wessam, Shokri, Hossam, Roushdy, Tamer, Sarfo, Fred, Alabi, Tolulope Oyetunde, Arabambi, Babawale, Nwazor, Ernest, Sunmonu, Taofiki Ajao, Wahab, Kolawole, Yaria, Joseph, Mohammed, Haytham Hussein, Adebayo, Philip, Riahi, Anis, Sassi, Samia Ben, Gwaunza, Lenon, Ngwende, Gift Wilson, Sahakyan, David, Rahman, Aminur, Ai, Zhibing, Bai, Fanghui, Duan, Zhenhui, Hao, Yonggang, Huang, Wenguo, Li, Guangwen, Li, Wei, Liu, Ganzhe, Luo, Jun, Shang, Xianjin, Sui, Yi, Tian, Ling, Wen, Hongbin, Wu, Bo, Yan, Yuying, Yuan, Zhengzhou, Zhang, Hao, Zhang, Jun, Zhao, Wenlong, Zi, Wenjie, Leung, Thomas, Chugh, Chandril, Huded, Vikram, Menon, Bindu, Pandian, Jeyaraj Durai, Sylaja, Pn, Usman, Fritz Sumantri, Farhoudi, Mehdi, Hokmabadi, Elyar Sadeghi, Horev, Anat, Reznik, Anna, Sivan Hoffmann, Rotem, Ohara, Nobuyuki, Sakai, Nobuyuki, Watanabe, Daisuke, Yamamoto, Ryoo, Doijiri, Ryosuke, Tokuda, Naoki, Yamada, Takehiro, Terasaki, Tadashi, Yazawa, Yukako, Uwatoko, Takeshi, Dembo, Tomohisa, Shimizu, Hisao, Sugiura, Yuri, Miyashita, Fumio, Fukuda, Hiroki, Miyake, Kosuke, Shimbo, Junsuke, Sugimura, Yusuke, Yagita, Yoshiki, Takenobu, Yohei, Matsumaru, Yuji, Yamada, Satoshi, Kono, Ryuhei, Kanamaru, Takuya, Yamazaki, Hidekazu, Sakaguchi, Manabu, Todo, Kenichi, Yamamoto, Nobuaki, Sonoda, Kazutaka, Yoshida, Tomoko, Hashimoto, Hiroyuki, Nakahara, Ichiro, Kondybayeva, Aida, Faizullina, Kamila, Kamenova, Saltanat, Zhanuzakov, Murat, Baek, Jang-Hyun, Hwang, Yangha, Lee, Jin Soo, Lee, Si Baek, Moon, Jusun, Park, Hyungjong, Seo, Jung Hwa, Seo, Kwon-Duk, Sohn, Sung Il, Young, Chang Jun, Ahdab, Rechdi, Wan Zaidi, Wan Asyraf, Aziz, Zariah Abdul, Basri, Hamidon Bin, Chung, Law Wan, Ibrahim, Aznita Binti, Ibrahim, Khairul Azmi, Looi, Irene, Tan, Wee Yong, Yahya, Nafisah Wan, Groppa, Stanislav, Leahu, Pavel, Al Hashmi, Amal, Imam, Yahia Zakaria, Akhtar, Naveed, Pineda-Franks, Maria Carissa, Co, Christian Oliver, Kandyba, Dmitriy, Alhazzani, Adel, Al-Jehani, Hosam, Tham, Carol Huilian, Mamauag, Marlie Jane, Venketasubramanian, Narayanaswamy, Chen, Chih-Hao, Tang, Sung-Chun, Churojana, Anchalee, Akil, Esref, Aykaç, Özlem, Ozdemir, Atilla Ozcan, Giray, Semih, Hussain, Syed Irteza, John, Seby, Le Vu, Huynh, Tran, Anh Duc, Nguyen, Huy Hoang, Nhu Pham, Thong, Nguyen, Thang Huy, Nguyen, Trung Quoc, Gattringer, Thomas, Enzinger, Christian, Killer-Oberpfalzer, Monika, Bellante, Flavio, de Blauwe, Sofie, Vanhooren, Geert, de Raedt, Sylvie, Dusart, Anne, Lemmens, Robin, Ligot, Noemie, Pierre Rutgers, Matthieu, Yperzeele, Laetitia, Alexiev, Filip, Sakelarova, Teodora, Bedeković, Marina Roje, Budincevic, Hrvoje, Cindric, Igor, Hucika, Zlatko, Ozretic, David, Saric, Majda Seferovic, Pfeifer, František, Karpowic, Igor, Cernik, David, Sramek, Martin, Skoda, Miroslav, Hlavacova, Helena, Klecka, Lukas, Koutny, Martin, Vaclavik, Daniel, Skoda, Ondrej, Fiksa, Jan, Hanelova, Katerina, Nevsimalova, Miroslava, Rezek, Robert, Prochazka, Petr, Krejstova, Gabriela, Neumann, Jiri, Vachova, Marta, Brzezanski, Henryk, Hlinovsky, David, Tenora, Dusan, Jura, Rene, Jurák, Lubomír, Novak, Jan, Novak, Ales, Topinka, Zdenek, Fibrich, Petr, Sobolova, Helena, Volny, Ondrej, Krarup Christensen, Hanne, Drenck, Nicolas, Klingenberg Iversen, Helle, Simonsen, Claus, Truelsen, Thomas Clement, Wienecke, Troels, Vibo, Riina, Gross-Paju, Katrin, Toomsoo, Toomas, Antsov, Katrin, Caparros, Francois, Cordonnier, Charlotte, Dan, Maria, Faucheux, Jean-Marc, Mechtouff, Laura, Eker, Omer, Lesaine, Emilie, Ondze, Basile, Peres, Roxane, Pico, Fernando, Piotin, Michel, Pop, Raoul, Rouanet, Francois, Gubeladze, Tatuli, Khinikadze, Mirza, Lobjanidze, Nino, Tsiskaridze, Alexander, Nagel, Simon, Ringleb, Peter Arthur, Rosenkranz, Michael, Schmidt, Holger, Sedghi, Annahita, Siepmann, Timo, Szabo, Kristina, Thomalla, Götz, Palaiodimou, Lina, Sagris, Dimitrios, Kargiotis, Odysseas, Klivenyi, Peter, Szapary, Laszlo, Tarkanyi, Gabor, Adami, Alessandro, Bandini, Fabio, Calabresi, Paolo, Frisullo, Giovanni, Renieri, Leonardo, Sangalli, Davide, Pirson, Anne, Uyttenboogaart, Maarten, van den Wijngaard, Ido, Kristoffersen, Espen Saxhaug, Brola, Waldemar, Fudala, Małgorzata, Horoch-Lyszczarek, Ewa, Karlinski, Michal, Kazmierski, Radoslaw, Kram, Pawel, Rogoziewicz, Marcin, Kaczorowski, Rafal, Luchowski, Piotr, Sienkiewicz-Jarosz, Halina, Sobolewski, Piotr, Fryze, Waldemar, Wisniewska, Anna, Wiszniewska, Malgorzata, Ferreira, Patricia, Ferreira, Paulo, Fonseca, Luisa, Marto, João Pedro, Pinho E Melo, Teresa, Nunes, Ana Paiva, Rodrigues, Miguel, Tedim Cruz, Vítor, Falup-Pecurariu, Cristian, Krastev, Georgi, Mako, Miroslav, de Leciñana, María Alonso, Arenillas, Juan, Ayo-Martin, Oscar, Cruz Culebras, Antonio, Tejedor, Exuperio Diez, Montaner, Joan, Pérez-Sánchez, Soledad, Tola Arribas, Miguel Angel, Rodriguez Vasquez, Alejandro, Mayza, Michael, Bernava, Gianmarco, Brehm, Alex, Machi, Paolo, Fischer, Urs, Gralla, Jan, Michel, Patrik, Psychogios, Marios-Nikos, Strambo, Davide, Banerjee, Soma, Krishnan, Kailash, Kwan, Joseph, Butt, Asif, Catanese, Luciana, Demchuk, Andrew, Field, Thalia, Haynes, Jennifer, Hill, Michael, Khosravani, Houman, Mackey, Ariane, Pikula, Aleksandra, Saposnik, Gustavo, Scott, Courtney Anne, Shoamanesh, Ashkan, Shuaib, Ashfaq, Yip, Samuel, Barboza, Miguel, Barrientos, Jose Domingo, Portillo Rivera, Ligia Ibeth, Gongora-Rivera, Fernando, Novarro-Escudero, Nelson, Blanco, Anmylene, Abraham, Michael, Alsbrook, Diana, Altschul, Dorothea, Alvarado-Ortiz, Anthony, Bach, Ivo, Badruddin, Aamir, Barazangi, Nobl, Brereton, Charmaine, Castonguay, Alicia, Chaturvedi, Seemant, Chaudry, Saqib, Choe, Hana, Choi, Jae, Dharmadhikari, Sushrut, Desai, Kinjal, Devlin, Thomas, Doss, Vinodh, Edgell, Randall, Etherton, Mark, Farooqui, Mudassir, Frei, Don, Gandhi, Dheeraj, Grigoryan, Mikayel, Gupta, Rishi, Hassan, Ameer, Helenius, Johanna, Kaliaev, Artem, Kaushal, Ritesh, Khandelwal, Priyank, Khawaja, Ayaz, Khoury, Naim, Kim, Benny, Kleindorfer, Dawn, Koyfman, Feliks, Lee, Vivien, Leung, Lester, Linares, Guillermo, Linfante, Italo, Lutsep, Helmi, Macdougall, Lisa, Male, Shailesh, Malik, Amer, Masoud, Hesham, Mcdermott, Molly, Mehta, Brijesh, Min, Jiangyong, Mittal, Manoj, Morris, Jane, Multani, Sumeet, Nahab, Fadi, Nalleballe, Krishna, Nguyen, Claude, Novakovic-White, Roberta, Ortega-Gutierrez, Santiago, Rahangdale, Rahul, Ramakrishnan, Pankajavalli, Romero, Jose Rafael, Rost, Natalia, Rothstein, Aaron, Ruland, Sean, Shah, Ruchir, Sharma, Malveeka, Silver, Brian, Simmons, Marc, Singh, Abhishek, Starosciak, Amy, Strasser, Sheryl, Szeder, Viktor, Teleb, Mohamed, Tsai, Jenny, Voetsch, Barbara, Balaguera, Oscar, Pujol Lereis, Virginia, Luraschi, Adriana, Almeida, Marcele Schettini, Cardoso, Fabricio Buchdid, Conforto, Adriana, de Deus Silva, Leonardo, Varrone Giacomini, Luidia, Oliveira Lima, Fabricio, Longo, Alexandre, Magalhães, Pedro, Martins, Rodrigo Targa, Mont'Alverne, Francisco, Mora Cuervo, Daissy Liliana, Costa Rebello, Leticia, Valler, Lenise, Zetola, Viviane Flumignan, Lavados, Pablo, Navia, Victor, Olavarría, Verónica, Almeida Toro, Juan Manuel, Amaya, Pablo Felipe Ricardo, Bayona, Hernan, Corredor, Angel, Rivera Ordonez, Carlos Eduardo, Mantilla Barbosa, Diana Katherine, Lara, Osvaldo, Patiño, Mauricio, Diaz Escobar, Luis Fernando, Dejesus Melgarejo Fariña, Donoband Edson, Cardozo Villamayor, Analia, Zelaya Zarza, Adolfo Javier, Barrientos Iman, Danny Moises, Rodriguez Kadota, Liliana, Campbell, Bruce, Hankey, Graeme, Hair, Casey, Kleinig, Timothy, Ma, Alice, Tomazini Martins, Rodrigo, Sahathevan, Ramesh, Thijs, Vincent, Salazar, Daniel, Yuan-Hao Wu, Teddy, Haussen, Diogo, Liebeskind, David, Yavagal, Dileep, Jovin, Tudor, Zaidat, Osama, Nguyen, Thanh, Magalhães, Pedro S.C., Emory University School of Medicine, Emory University [Atlanta, GA], Boston University School of Medicine (BUSM), Boston University [Boston] (BU), Lille Neurosciences & Cognition - U 1172 (LilNCog), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Max Super Speciality Hospital -Saket [New Delhi, Inde] (Max Saket), Dupuis, Christine, Lille Neurosciences & Cognition - U 1172 (LilNCog (ex-JPARC)), and Repositório da Universidade de Lisboa

Subjects
medicine.medical_specialty, MESH: Pandemics, HSJ NEU, Cross-sectional study, medicine.medical_treatment, [SDV]Life Sciences [q-bio], SVIN COVID-19 Global Stroke Registry, MESH: Hospitalization, 030204 cardiovascular system & hematology, Article, MESH: Stroke, COVID-19, cross-sectional studies, hospitalization, humans, pandemics, retrospective studies, SARS-CoV-2, stroke, 03 medical and health sciences, 0302 clinical medicine, MESH: Cross-Sectional Studies, Pandemic, Medicine, Humans, MESH: COVID-19, Thrombolytic Therapy, MESH: SARS-CoV-2, Stroke, Pandemics, Retrospective Studies, MESH: Thrombolytic Therapy, Rehabilitation, MESH: Humans, business.industry, Retrospective cohort study, MESH: Retrospective Studies, medicine.disease, Thrombolysis, Confidence interval, 3. Good health, Hospitalization, [SDV] Life Sciences [q-bio], Clinical research, Cross-Sectional Studies, Emergency medicine, Observational study, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

© 2021 American Academy of Neurology, Objective: To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. Methods: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. Results: There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] -11.7 to -11.3, p < 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI -13.8 to -12.7, p < 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI -13.7 to -10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2-9.8, p < 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. Conclusions: The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months.

Published
2021

12. Safety and Outcomes of Intravenous Thrombolytic Therapy in Ischemic Stroke Patients with COVID-19: CASCADE Initiative

Author

Sasanejad, Payam Hezarkhani, Leila Afshar Arsang-Jang, Shahram and Tsivgoulis, Georgios Ghoreishi, Abdoreza Kristian, Barlinn and Rahmig, Jan Farhoudi, Mehdi Hokmabadi, Elyar Sadeghi and Borhani-Haghighi, Afshin Sariaslani, Payam Sharifi-Razavi, Athena Ghandehari, Kavian Khosravi, Alireza Smith, Craig and Nilanont, Yongchai Akbari, Yama Nguyen, Thanh N. Bersano, Anna Yassi, Nawaf Yoshimoto, Takeshi Lattanzi, Simona and Gupta, Animesh Zand, Ramin Rafie, Shahram Mousavian, Seyede Pourandokht Shahsavaripour, Mohammad Reza Amini, Shahram and Kamenova, Saltanat U. Kondybayeva, Aida Zhanuzakov, Murat and Macri, Elizabeth M. Nobleza, Christa O'Hana S. Ruland, Sean and Cervantes-Arslanian, Anna M. Desai, Masoom J. Ranta, Annemarei and Ahmadi, Amir Moghadam Rostamihosseinkhani, Mahtab Foroughi, Razieh Hooshmandi, Etrat Akhoundi, Fahimeh H. Shuaib, Ashfaq and Liebeskind, David S. Siegler, James Romano, Jose G. and Mayer, Stephan A. Shahripour, Reza Bavarsad Zamani, Babak and Woolsey, Amadene Fazli, Yasaman Mojtaba, Khazaei Isaac, Christian F. Biller, Jose Di Napoli, Mario Azarpazhooh, M. Reza

Abstract

Background: There is little information regarding the safety of intravenous tissue plasminogen activator (IV-tPA) in patients with stroke and COVID-19. Methods: This multicenter study included consecutive stroke patients with and without COVID-19 treated with IV-tPA between February 18, 2019, to December 31, 2020, at 9 centers participating in the CASCADE initiative. Clinical outcomes included modified Rankin Scale (mRS) at hospital discharge, in-hospital mortality, the rate of hemorrhagic transformation. Using Bayesian multiple regression and after adjusting for variables with significant value in univariable analysis, we reported the posterior adjusted odds ratio (OR, with 95% Credible Intervals [CrI]) of the main outcomes. Results: A total of 545 stroke patients, including 101 patients with COVID-19 were evaluated. Patients with COVID-19 had a more severe stroke at admission. In the study cohort, 85 (15.9%) patients had a hemorrhagic transformation, and 72 (13.1%) died in the hospital. After adjustment for confounding variables, discharge mRS score >2 (OR: 0.73, 95% CrI: 0.16, 3.05), in-hospital mortality (OR: 2.06, 95% CrI: 0.76, 5.53), and hemorrhagic transformation (OR: 1.514, 95% CrI: 0.66, 3.31) were similar in COVID-19 and non COVID-19 patients. High -sensitivity C reactive protein level was a predictor of hemorrhagic transformation in all cases (OR:1.01, 95%CI: 1.0026, 1.018), including those with COVID-19 (OR:1.024, 95%CI:1.002, 1.054). Conclusion: IV-tPA treatment in patients with acute ischemic stroke and COVID-19 was not associated with an increased risk of disability, mortality, and hemorrhagic transformation compared to those without COVID-19. IVtPA should continue to be considered as the standard of care in patients with hyper acute stroke and COVID-19.

Published
2021

13. Global Impact of COVID-19 on Stroke Care and Intravenous Thrombolysis

Author

Nogueira, Raul G, Qureshi, Muhammed M, Abdalkader, Mohamad, Martins, Sheila Ouriques, Yamagami, Hiroshi, Qiu, Zhongming, Mansour, Ossama Yassin, Sathya, Anvitha, Czlonkowska, Anna, Tsivgoulis, Georgios, Aguiar de Sousa, Diana, Demeestere, Jelle, Mikulik, Robert, Vanacker, Peter, Siegler, James E, Kõrv, Janika, Biller, Jose, Liang, Conrad W, Sangha, Navdeep S, Zha, Alicia M, Czap, Alexandra L, Holmstedt, Christine Anne, Turan, Tanya N, Ntaios, George, Malhotra, Konark, Tayal, Ashis, Loochtan, Aaron, Ranta, Annamarei, Mistry, Eva A, Alexandrov, Anne W, Huang, David Y, Yaghi, Shadi, Raz, Eytan, Sheth, Sunil A, Mohammaden, Mahmoud H, Frankel, Michael, Bila Lamou, Eric Guemekane, Aref, Hany M, Elbassiouny, Ahmed, Hassan, Farouk, Menecie, Tarek, Mustafa, Wessam, Shokri, Hossam M, Roushdy, Tamer, Sarfo, Fred S, Alabi, Tolulope Oyetunde, Arabambi, Babawale, Nwazor, Ernest O, Sunmonu, Taofiki Ajao, Wahab, Kolawole, Yaria, Joseph, Mohammed, Haytham Hussein, Adebayo, Philip B, Riahi, Anis D, Ben Sassi, Samia, Gwaunza, Lenon, Ngwende, Gift Wilson, Sahakyan, David, Rahman, Aminur, Ai, Zhibing, Bai, Fanghui, Duan, Zhenhui, Hao, Yonggang, Huang, Wenguo, Li, Guangwen, Li, Wei, Liu, Ganzhe, Luo, Jun, Shang, Xianjin, Sui, Yi, Tian, Ling, Wen, Hongbin, Wu, Bo, Yan, Yuying, Yuan, Zhengzhou, Zhang, Hao, Zhang, Jun, Zhao, Wenlong, Zi, Wenjie, Leung, Thomas W, Chugh, Chandril, Huded, Vikram, Menon, Bindu, Pandian, Jeyaraj Durai, Sylaja, P N, Usman, Fritz Sumantri, Farhoudi, Mehdi, Hokmabadi, Elyar Sadeghi, Horev, Anat, Reznik, Anna, Hoffmann, Rotem Sivan, Ohara, Nobuyuki, Sakai, Nobuyuki, Watanabe, Daisuke, Yamamoto, Ryoo, Doijiri, Ryosuke, Tokuda, Naoki, Yamada, Takehiro, Terasaki, Tadashi, Yazawa, Yukako, Uwatoko, Takeshi, Dembo, Tomohisa, Shimizu, Hisao, Sugiura, Yuri, Miyashita, Fumio, Fukuda, Hiroki, Miyake, Kosuke, Shimbo, Junsuke, Sugimura, Yusuke, Yagita, Yoshiki, Takenobu, Yohei, Matsumaru, Yuji, Yamada, Satoshi, Kono, Ryuhei, Kanamaru, Takuya, Yamazaki, Hidekazu, Sakaguchi, Manabu, Todo, Kenichi, Yamamoto, Nobuaki, Sonoda, Kazutaka, Yoshida, Tomoko, Hashimoto, Hiroyuki, Nakahara, Ichiro, Kondybayeva, Aida, Faizullina, Kamila, Kamenova, Saltanat, Zhanuzakov, Murat, Baek, Jang-Hyun, Hwang, Yangha, Lee, Jin Soo, Lee, Si Baek, Moon, Jusun, Park, Hyungjong, Seo, Jung Hwa, Seo, Kwon-Duk, Sohn, Sung Il, Young, Chang Jun, Ahdab, Rechdi, Wan Zaidi, Wan Asyraf, Aziz, Zariah Abdul, Basri, Hamidon Bin, Chung, Law Wan, Ibrahim, Aznita Binti, Ibrahim, Khairul Azmi, Looi, Irene, Tan, Wee Yong, Yahya, Nafisah Wan, Groppa, Stanislav, Leahu, Pavel, Al Hashmi, Amal M, Imam, Yahia Zakaria, Akhtar, Naveed, Pineda-Franks, Maria Carissa, Co, Christian Oliver, Kandyba, Dmitriy, Alhazzani, Adel, Al-Jehani, Hosam, Tham, Carol Huilian, Mamauag, Marlie Jane, Venketasubramanian, Narayanaswamy, Chen, Chih-Hao, Tang, Sung-Chun, Churojana, Anchalee, Akil, Esref, Aykaç, Ozlem, Ozdemir, Atilla Ozcan, Giray, Semih, Hussain, Syed Irteza, John, Seby, Le Vu, Huynh, Tran, Anh Duc, Nguyen, Huy Hoang, Pham, Thong Nhu, Nguyen, Thang Huy, Nguyen, Trung Quoc, Gattringer, Thomas, Enzinger, Christian, Killer-Oberpfalzer, Monika, Bellante, Flavio, De Blauwe, Sofie, Vanhooren, Geert, De Raedt, Sylvie, Dusart, Anne, Lemmens, Robin, Ligot, Noemie, Rutgers, Matthieu Pierre, Yperzeele, Laetitia, Alexiev, Filip, Sakelarova, Teodora, Bedeković, Marina Roje, Budincevic, Hrvoje, Cindrić, Igor, Hucika, Zlatko, Ozretic, David, Saric, Majda Seferovic, Pfeifer, Frantiek, Karpowic, Igor, Cernik, David, Sramek, Martin, Skoda, Miroslav, Hlavacova, Helena, Klecka, Lukas, Koutny, Martin, Vaclavik, Daniel, Skoda, Ondrej, Fiksa, Jan, Hanelova, Katerina, Nevsimalova, Miroslava, Rezek, Robert, Prochazka, Petr, Krejstova, Gabriela, Neumann, Jiri, Vachova, Marta, Brzezanski, Henryk, Hlinovsky, David, Tenora, Dusan, Jura, Rene, Jurák, Lubomír, Novak, Jan, Novak, Ales, Topinka, Zdenek, Fibrich, Petr, Sobolova, Helena, Volny, Ondrej, Christensen, Hanne Krarup, Drenck, Nicolas, Iversen, Helle Klingenberg, Simonsen, Claus Z, Truelsen, Thomas Clement, Wienecke, Troels, Vibo, Riina, Gross-Paju, Katrin, Toomsoo, Toomas, Antsov, Katrin, Caparros, Francois, Cordonnier, Charlotte, Dan, Maria, Faucheux, Jean-Marc, Mechtouff, Laura, Eker, Omer, Lesaine, Emilie, Ondze, Basile, Peres, Roxane, Pico, Fernando, Piotin, Michel, Pop, Raoul, Rouanet, Francois, Gubeladze, Tatuli, Khinikadze, Mirza, Lobjanidze, Nino, Tsikaridze, Alexander, Nagel, Simon, Ringleb, Peter Arthur, Rosenkranz, Michael, Schmidt, Holger, Sedghi, Annahita, Siepmann, Timo, Szabo, Kristina, Thomalla, Götz, Palaiodimou, Lina, Sagris, Dimitrios, Kargiotis, Odysseas, Klivenyi, Peter, Szapary, Laszlo, Tarkanyi, Gabor, Adami, Alessandro, Bandini, Fabio, Calabresi, Paolo, Frisullo, Giovanni, Renieri, Leonardo, Sangalli, Davide, Pirson, Anne V, Uyttenboogaart, Maarten, van den Wijngaard, Ido, Kristoffersen, Espen Saxhaug, Brola, Waldemar, Fudala, Małgorzata, Horoch-Lyszczarek, Ewa, Karlinski, Michal, Kazmierski, Radoslaw, Kram, Pawel, Rogoziewicz, Marcin, Kaczorowski, Rafal, Luchowski, Piotr, Sienkiewicz-Jarosz, Halina, Sobolewski, Piotr, Fryze, Waldemar, Wisniewska, Anna, Wiszniewska, Malgorzata, Ferreira, Patricia, Ferreira, Paulo, Fonseca, Luisa, Marto, João Pedro, Pinho E Melo, Teresa, Nunes, Ana Paiva, Rodrigues, Miguel, Cruz, Vítor Tedim, Falup-Pecurariu, Cristian, Krastev, Georgi, Mako, Miroslav, Alonso de Leciñana, María, Arenillas, Juan F, Ayo-Martin, Oscar, Culebras, Antonio Cruz, Tejedor, Exuperio Diez, Montaner, Joan, Pérez-Sánchez, Soledad, Tola Arribas, Miguel Angel, Vasquez, Alejandro Rodriguez, Mazya, Michael, Bernava, Gianmarco, Brehm, Alex, Machi, Paolo, Fischer, Urs, Gralla, Jan, Michel, Patrik L, Psychogios, Marios-Nikos, Strambo, Davide, Banerjee, Soma, Krishnan, Kailash, Kwan, Joseph, Butt, Asif, Catanese, Luciana, Demchuk, Andrew, Field, Thalia, Haynes, Jennifer, Hill, Michael D, Khosravani, Houman, Mackey, Ariane, Pikula, Aleksandra, Saposnik, Gustavo, Scott, Courtney Anne, Shoamanesh, Ashkan, Shuaib, Ashfaq, Yip, Samuel, Barboza, Miguel A, Barrientos, Jose Domingo, Portillo Rivera, Ligia Ibeth, Gongora-Rivera, Fernando, Novarro-Escudero, Nelson, Blanco, Anmylene, Abraham, Michael, Alsbrook, Diana, Altschul, Dorothea, Alvarado-Ortiz, Anthony J, Bach, Ivo, Badruddin, Aamir, Barazangi, Nobl, Brereton, Charmaine, Castonguay, Alicia, Chaturvedi, Seemant, Chaudhry, Saqib A, Choe, Hana, Choi, Jae H, Dharmadhikari, Sushrut, Desai, Kinjal, Devlin, Thomas G, Doss, Vinodh T, Edgell, Randall, Etherton, Mark, Farooqui, Mudassir, Frei, Don, Gandhi, Dheeraj, Grigoryan, Mikayel, Gupta, Rishi, Hassan, Ameer E, Helenius, Johanna, Kaliaev, Artem, Kaushal, Ritesh, Khandelwal, Priyank, Khawaja, Ayaz M, Khoury, Naim N, Kim, Benny S, Kleindorfer, Dawn O, Koyfman, Feliks, Lee, Vivien H, Leung, Lester Y, Linares, Guillermo, Linfante, Italo, Lutsep, Helmi L, Macdougall, Lisa, Male, Shailesh, Malik, Amer, Masoud, Hesham, McDermott, Molly, Mehta, Brijesh P, Min, Jiangyong, Mittal, Manoj, Morris, Jane G, Multani, Sumeet S, Nahab, Fadi, Nalleballe, Krishna, Nguyen, Claude B, Novakovic-White, Roberta, Ortega-Gutierrez, Santiago, Rahangdale, Rahul H, Ramakrishnan, Pankajavalli, Romero, Jose Rafael, Rost, Natalia, Rothstein, Aaron, Ruland, Sean, Shah, Ruchir, Sharma, Malveeka, Silver, Brian, Simmons, Marc, Singh, Abhishek, Starosciak, Amy K, Strasser, Sheryl L, Szeder, Viktor, Teleb, Mohamed, Tsai, Jenny P, Voetsch, Barbara, Balaguera, Oscar, Pujol Lereis, Virginia A, Luraschi, Adriana, Almeida, Marcele Schettini, Cardoso, Fabricio Buchdid, Conforto, Adriana, De Deus Silva, Leonardo, Giacomini, Luidia Varrone, Lima, Fabricio Oliveira, Longo, Alexandre L, Magalhães, Pedro Sc, Martins, Rodrigo Targa, Mont'alverne, Francisco, Mora Cuervo, Daissy Liliana, Rebello, Leticia Costa, Valler, Lenise, Zetola, Viviane Flumignan, Lavados, Pablo M, Navia, Victor, Olavarría, Verónica V, Almeida Toro, Juan Manuel, Ricardo Amaya, Pablo Felipe, Bayona, Hernan, Corredor-Quintero, Angel Basilio, Rivera Ordonez, Carlos Eduardo, Mantilla Barbosa, Diana Katherine, Lara, Osvaldo, Patiño, Mauricio R, Diaz Escobar, Luis Fernando, Dejesus Melgarejo Farina, Donoband Edson, Villamayor, Analia Cardozo, Zelaya Zarza, Adolfo Javier, Barrientos Iman, Danny Moises, Kadota, Liliana Rodriguez, Campbell, Bruce, Hankey, Graeme J, Hair, Casey, Kleinig, Timothy, Ma, Alice, Martins, Rodrigo Tomazini, Sahathevan, Ramesh, Thijs, Vincent, Salazar, Daniel, Yuan-Hao Wu, Teddy, Haussen, Diogo C, Liebeskind, David, Yavagal, Dileep, Jovin, Tudor G, Zaidat, Osama O, and Nguyen, Thanh N

Subjects
610 Medicine & health
Abstract

OBJECTIVE The objectives of this study were to measure the global impact of the pandemic on the volumes for intravenous thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with two control 4-month periods. METHODS We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes and/or classifications in stroke databases. RESULTS There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95%CI, -11.7 to - 11.3, p

Published
2021
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14. Factors Affecting Complications and Mortality of Stroke Patients in Stroke Care Unit.

Author

Vahdati, Samad Shams, Ala, Alireza, Hejazian, Sina, Hokmabadi, Elyar Sadeghi, Majidi, Taraneh, Ghanbari, Faezeh, and Hosseinzadeh, Naeimeh

Subjects
ASPIRATION pneumonia, STROKE units, PULMONARY embolism, STROKE patients, URINARY tract infections, CORONARY disease, MYOCARDIAL ischemia
Abstract

Objective: Stroke remains the second greatest cause of mortality worldwide, causing more than 5 million deaths annually. Hypertension (HTN), diabetes mellitus (DM), male sex, and an age >60 years have been associated with a higher incidence of stroke. Materials and Methods: The clinical data of 896 patients of the stroke care unit (SCU) of Tabriz University of Medical Sciences in Iran were retrieved and studied to examine the correlation between clinical features and complications. Results: Patients who presented with dysarthria, loss of consciousness, and vertigo had a significantly higher risk of mortality. A history of HTN, DM, ischemic heart disease, congestive heart failure, or carotid stenosis also meaningfully contributed to higher rates of mortality. The main complications associated with higher risks of mortality included aspiration pneumonia, pulmonary embolism, urinary tract infection, sepsis, bedsores, myocardial infarction, gastrointestinal bleeding, hydrocephaly, and brain herniation. Conclusion: Age and several other factors played a significant role in increasing the in-hospital mortality of patients admitted to the SCU. However, no significant correlation was observed between mortality and sex, previous cerebrovascular accident, or the length of in-hospital stay. [ABSTRACT FROM AUTHOR]

Published
2022
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16. Effects of Alpha Lipoic Acid Supplementation on Serum Levels of Oxidative Stress, Inflammatory Markers and Clinical Prognosis among Acute Ischemic Stroke Patients: A Randomized, Double Blind, TNS Trial.

Author

Shaafi, Sheyda, Ebrahimpour-Koujan, Soraiya, Khalili, Mohammad, Shamshirgaran, Seyed Morteza, Hashemilar, Mazyar, Taheraghdam, Aliakbar, Shakouri, Seyed Kazem, Hokmabadi, Elyar Sadeghi, Ahmadi, Yaeghoub, Farhoudi, Mehdi, Rezaeimanesh, Nasim, and Osgouei, Daryoush Savadi

Subjects
STROKE patients, LIPOIC acid, OXIDATIVE stress, ALPHA-linolenic acid, OXIDANT status, BIOMARKERS
Abstract

Purpose: Stroke is one of the most common conditions causing death. There have been few studies examining the effects of alpha lipoic acid (ALA) on stroke patients. In this regard, the present randomized controlled clinical trial was conducted to examine the effects of ALA supplementation on serum albumin, and inflammatory and oxidative stress markers in stroke patients. Methods: The present paralleled randomized controlled clinical trial involved 42 stroke patients who were over 40 years and under enteral feeding. The participants were randomly assigned into two groups and finally 40 patients completed the study. Patients in alpha lipoic acid group (n = 19) took 1200 mg ALA supplement daily along with their meal, and participants in control group (n = 21) underwent the routine hospital diet for 3 weeks. Fasting blood samples were obtained and albumin, oxidative stress, and inflammatory indices were assessed at baseline, as well as at the end of the trial. Results: After 3 weeks, treatment of patients with ALA led to a significant decrease in tumor necrosis factor alpha (TNF-á) and interleukin 6 (IL-6) levels (P = 0.01) compared to baseline. But serum levels of albumin, total antioxidant capacity (TAC), malondialdehyde (MDA), highsensitivity C-reactive protein (hs-CRP), IL-6 and TNF-á did not change significantly vs. control group (P > 0.05). Conclusion: ALA did not significantly change the serum levels of albumin and inflammatory as well as antioxidant capacity indices in stroke patients compared with the control group. More clinical trials with large sample sizes and long duration are needed to clarify the effects of ALA on these patients. [ABSTRACT FROM AUTHOR]

Published
2020
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17. Effect of Whey Protein Supplementation on Inflammatory and Antioxidant Markers, and Clinical Prognosis in Acute Ischemic Stroke (TNS Trial): A Randomized, Double Blind, Controlled, Clinical Trial.

Author

Hashemilar, Mazyar, Khalili, Mohammad, Rezaeimanesh, Nasim, Hokmabadi, Elyar Sadeghi, Rasulzade, Sevin, Shamshirgaran, Seyed Morteza, Taheraghdam, Aliakbar, Farhoudi, Mehdi, Shaafi, Sheyda, Shakouri, Seyed Kazem, and Osgouei, Daryoush Savadi

Subjects
WHEY proteins, OXIDANT status, INTERLEUKIN-6, TUMOR necrosis factors, CLINICAL trials, STROKE, OXIDATIVE stress
Abstract

Purpose: Malnutrition is extensively prevalent amongst critically ill patients afflicted by ischemic stroke (IS). This study purpose was to evaluate the protein whey effect on inflammatory and antioxidant markers and functional prognosis in acute IS patients. Methods: out of 42 patients with acute IS who were referred to Imam Reza Educational Hospital, Tabriz, Iran, 40 patients participated in the study. Twenty-one patients as control group received the hospital routine formula, and 19 patients as intervention group received 20 g/daily of whey protein through oral gavage. Inflammation and oxidative stress indicators (e.g., albumin, malondialdehyde (MDA), total antioxidant capacity (TAC), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and high sensitivity C reactive protein (hs-CRP)and clinical variables included in were evaluated using National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) during admission and also 3 weeks after intervention. Results: Whey protein supplementation significantly decreased the NIHSS and mRS scores, TNF-α, IL-6, and hs-CRP by passing 3 weeks from intervention (P < 0.05). However, whey formula had no significant effect on other markers including albumin, and MDA. The hs-CRP (P = 0.02) reduction was significantly higher in whey protein group in comparison with control group. Conclusion: Whey protein supplementation reduced inflammation markers in those patients with IS. However, these changes should be studied in larger-scale trials. [ABSTRACT FROM AUTHOR]

Published
2020
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21. Early and intermediate prognosis of intravenous thrombolytic therapy in acute ischemic stroke subtypes according to the causative classification of stroke system.

Author

Pashapour, Ali, Atalu, Abolfazl, Farhoudi, Mehdi, Taheraghdam, Ali-Akbar, Hokmabadi, Elyar Sadeghi, Sharifipour, Ehsan, and NajafiNeshli, Mehdi

Subjects
INTRAVENOUS therapy, THROMBOLYTIC therapy, ISCHEMIA, STROKE, HEALTH outcome assessment, PLASMINOGEN activators, MEDICAL emergencies
Abstract

Objectives: Intravenous thrombolytic therapy has established acceptable results in treating ischemic stroke. However, there is little information on treatment outcome especially in different subtypes. The aim of current study was to evaluate early and intermediate prognosis in intravenous thrombolytic therapy for acute ischemic stroke subtypes. Methodology: Forty eligible patients (57.5% male with mean age of 63.18±13.49 years) with definite ischemic stroke who were admitted to emergency department of Imam Reza University Hospital, in the first 180 minutes after occurrence received recombinant tissue plasminogen activator. All investigation findings were recorded and stroke subtypes were determined according to the Causative Classification of Stroke System. Stroke severity forms including modified Rankin Scale (mRS) and National Institutes of Health Stroke Scale (NIHSS) scores were recorded for all patients in first, seven and 90 days after stroke and disease outcome was evaluated. Results: The etiology of stroke was large artery atherosclerosis in 20%, cardio-aortic embolism in 45%, small artery occlusion in 17.5% and undetermined causes in 17.5%. NIHSS and mRS scores were significantly improved during time (P < 0.001 in both cases). Three months mortality rate was 25%. Among the etiologies, patients with small artery occlusion and then cardio-aortic embolism had lower NIHSS score at arrival (P = 0.04). Caplan-meier analysis showed that age, sex and symptom to needle time could predict disease outcome. Conclusion: Intravenous thrombolytic therapy is accompanied by good early and intermediate outcome in most patients with ischemic stroke. Small artery occlusion subtype had less disease severity and higher improvement. [ABSTRACT FROM AUTHOR]

Published
2013
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22. Atypical presentation of vitamin B12 deficiency.

Author

Soleimanpour H, Taheraghdam A, Pashapour A, Hokmabadi ES, and Mohammadi N

Subjects
Brain pathology, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Spine pathology, Vitamin B 12 Deficiency complications, Vitamin B 12 Deficiency diagnosis
Abstract

Vitamin B12 deficiency (B12D) has wide variety of neurological and non-neurological signs and symptoms. We describe a 61-year-old man who was admitted to Emergency Department (ED) with trouble to walk independently, suffering from weakness and a long history of dyspepsia that had worsened in the last four weeks. He had mild impairment of cognitive functions; motor strength was normal and his patellar and achilles reflexes were absent, also the plantar reflexes were abolished. All blood tests were normal except hemoglobin concentration which showed mild anemia. At further studies regarding trouble walking of this patient, he was candidated for lumbar disk surgery based on mild disk bulging seen at L3-L4 level in the lumbar spine MRI. Further examinations before the surgery due to approach to anemia showed severely decreased serum vitamin B12 level. The patient's symptoms improved after treating with intramuscular cobalamin. Being a very commonly seen disorder in the general population, B12 deficiency should be born in mind as a probable diagnosis in patients with peripheral neuropathy and no clear underlying cause presenting to the ED. Therefore, simple screening with a CBC might decrease the neurologic complications, morbidity and inappropriate workups through early diagnosis and treatment.

Published
2012
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