Accident vascular cerebral și recuperare, la orice vârstă.
64 de articoleThis cross-sectional study of 100 acute ischemic stroke patients examined whether signal intensity in normal-appearing white matter on FLAIR MRI correlates with leukoaraiosis burden. Results showed that white matter signal intensity increased near leukoaraiosis borders and was independently associated with leukoaraiosis volume, suggesting structural abnormalities extend into apparently normal brain tissue.
This retrospective study of 970 stroke/TIA patients found that elevated sST2 levels independently predicted atrial fibrillation detection after stroke (AFDAS), with sST2 showing superior predictive value (AUC 0.815) compared to conventional risk factors. Adding sST2 to a conventional risk model significantly improved prediction accuracy for AFDAS in acute stroke patients.
A clinical trial compared the effectiveness of the Bimanual Arm Trainer device with standard occupational therapy in 27 stroke patients with upper extremity dysfunction. Both treatment groups showed significant improvements in arm function, with no statistically significant difference between the intervention and control groups, suggesting device-assisted therapy may provide comparable benefits to traditional therapy.
This systematic review synthesizes evidence from four studies to estimate the prevalence of familial hypercholesterolemia (FH) in stroke and TIA patients, finding a pooled prevalence of 0.96% overall and 2.89% in large artery atherosclerosis strokes. The authors acknowledge significant heterogeneity between studies and conclude that while evidence suggests FH may be relevant to cerebrovascular disease beyond cardiology, more research is needed for firm quantitative conclusions.
A 'MultiSensy' platform combines immersive virtual reality with transcutaneous electrical nerve stimulation to improve motor recovery in chronic stroke patients. The approach reportedly achieves twice the upper limb motor recovery compared to conventional therapy by reintegrating movement sensation with motor control.
Researchers developed a rehabilitation platform combining virtual reality with targeted sensory nerve stimulation for stroke recovery. A randomized clinical trial published in Nature Medicine showed improvements in arm/hand function and tactile awareness, offering potential for more personalized rehabilitation beyond conventional therapy.
This post hoc analysis of a randomized controlled trial in China examined whether liraglutide (a GLP-1 receptor agonist) reduces stroke recurrence differently based on insulin resistance levels in patients with minor ischemic stroke or TIA and type 2 diabetes. Treatment efficacy varied significantly by insulin resistance status, with greater benefit observed in patients with elevated baseline insulin resistance.
Patients with autoimmune rheumatic diseases (such as lupus and vasculitis) have significantly elevated stroke risk 1.3-2.5 times higher than the general population, often occurring at younger ages due to systemic inflammation and immune-mediated vascular injury. This review synthesizes evidence on stroke pathophysiology, prevention strategies, and post-stroke rehabilitation outcomes specific to rheumatologic populations.
This health economics study analyzed administrative healthcare data from Italian regions to assess direct medical costs for patients with atherosclerotic cardiovascular diseases, including ischemic stroke and transient ischemic attack, along with acute coronary syndrome and peripheral arterial disease. Over a 2-year period, approximately 350,000 patients were hospitalized annually with average direct costs of €7,190 per patient, with hospitalizations comprising nearly 70% of total expenses.
Duke University researchers developed a noninvasive imaging method to visualize the brain's glymphatic system, which removes metabolic waste. The technique enables examination of how this system is altered in conditions like ischemic stroke, aging, and anesthesia, with implications for understanding neurodegenerative diseases.
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.
This network meta-analysis evaluates different antiplatelet drug combinations for preventing recurrent strokes or transient ischemic attacks in patients with minor ischemic cerebrovascular events. The study provides comparative evidence to guide clinical decision-making regarding optimal secondary prevention strategies.
This meta-analysis of 11 clinical trials examined whether carotid endarterectomy (surgical removal of arterial plaque) performed within 14 days of stroke onset differs in safety and efficacy compared to surgery performed after 14 days. The analysis of over 5000 patients found no statistically significant differences in perioperative complications, recurrent stroke, or mortality rates between early and delayed surgical timing.
This multicenter study of 2,090 stroke/TIA patients examined whether elevated thyroid peroxidase antibody (TPO-Ab) levels are associated with the RNF213 p.R4810K genetic variant, known to increase vasculopathy risk. Variant carriers showed significantly higher TPO-Ab levels and increased frequency of elevated antibody titers, suggesting TPO-Ab may act as a second hit in RNF213-related stroke pathogenesis.
