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Early anticoagulation with non-vitamin K oral anticoagulants reduces recurrent ischemic stroke risk in acute ischemic stroke patients with atrial fibrillation, as confirmed by randomized controlled trials and meta-analyses. Safety concerns remain in high-risk subgroups including severe stroke, hemorrhagic transformation, and Asian populations who are underrepresented in clinical trial data.
This review examines how adaptive neuroplasticity promotes genuine motor recovery through neural reorganization, while maladaptive plasticity may reinforce compensatory patterns that limit functional restoration. Evidence supports intensive, repetitive, task-specific physiotherapy combined with emerging multimodal approaches (constraint-induced movement therapy, mirror therapy, robotic training, virtual reality, and non-invasive brain stimulation) as effective strategies to enhance stroke recovery.
A meta-analysis of 15 studies (506 participants) evaluated enhanced external counterpulsation (EECP) as treatment for ischemic stroke, finding uncertain effects on cerebral blood flow but significant improvements in daily living activities, disability level, and neurological function. The study applies conservative statistical methods and acknowledges heterogeneity, indicating EECP may have clinical benefit despite unclear mechanisms.
This retrospective study of 369 acute ischemic stroke/TIA patients found that prolonged arterial input function dispersal on computed tomography perfusion correlates with higher burden of cerebral small vessel disease markers including white matter hyperintensities and microbleeds. Each 1-second increase in dispersal independently predicted increased odds of severe small vessel disease, suggesting cardiac hemodynamic dysfunction contributes to microvascular pathology in stroke.
This meta-analysis of 34 studies evaluated the ROSIER scale's ability to identify stroke and TIA cases in emergency settings, finding sensitivity of 0.89 and specificity of 0.76 at a cutoff score of ≥1. Performance varied by setting and assessor type, with higher sensitivity in pre-hospital EMS/paramedic administration and higher specificity in emergency department physician/neurologist assessments.