Accident vascular cerebral și recuperare, la orice vârstă.
64 de articoleThis peer commentary examines clinical outcomes associated with different anticoagulation approaches in patients experiencing ischemic stroke while taking direct oral anticoagulants (DOACs). The response contributes to evidence-based discussion on stroke management strategies in anticoagulated populations.
This systematic review examines FLAIR vessel hyperintensity (FVH), an imaging finding reflecting critically slowed blood flow in large artery steno-occlusions, and its clinical significance for predicting prognosis, stroke severity, infarction volume, and functional outcomes in acute ischemic stroke and TIA. The authors address conflicting findings in the literature and propose key factors for individualizing clinical interpretation of this neuroimaging marker to guide clinical decision-making.
A pharmacoeconomic study evaluated whether personalizing antiplatelet therapy based on CYP2C19 genetic testing (using cilostazol or ticagrelor) is cost-effective compared to standard clopidogrel plus aspirin treatment for minor stroke and high-risk transient ischemic attack in China. The analysis found genotype-guided strategies were cost-effective with incremental cost-effectiveness ratios below accepted thresholds, with robust results across sensitivity analyses.
This study examined cardiac complications in 721 stroke patients across three cerebrovascular event types (ischemic stroke, transient ischemic attack, and hemorrhagic stroke). Results showed ECG changes were most frequent in ischemic stroke (81.7%), with myocardial alterations common across all groups, suggesting important brain-heart interactions following stroke.
This cohort study of 1,808 patients examined whether nocturnal blood pressure dipping patterns predict 1-year functional outcomes after stroke or TIA. While reverse dipping (less than 0% nocturnal systolic BP drop) was associated with worse outcomes in initial analysis, this association became non-significant after adjusting for confounding variables.
This randomized controlled study examined whether outpatient cardiac rehabilitation (CR) following in-hospital stroke rehabilitation improves motor function and health-related quality of life in 128 stroke survivors (mean age 73.5 years). Patients receiving 3 months of supervised outpatient CR showed significantly greater improvements in walking distance and leg muscle strength compared to controls, though quality of life measures did not significantly improve.
This prospective study of 7,396 stroke/TIA patients from China found that accelerated biological age—calculated using three established algorithms (PhenoAge, Klemera-Doubal, HD)—is associated with increased risk of poor stroke outcomes both short- and long-term. Patients with the highest PhenoAge acceleration showed nearly double the risk of adverse events compared to those with the lowest acceleration.
This prospective study of 271 stroke patients examined the relationship between telomere length (a cellular aging marker) and neurological disability measured by standardized clinical scales (NIHSS and mRS). Shorter telomeres were associated with higher stroke severity scores in ischemic stroke patients, both at emergency department admission and one day later.
This review examines the use of electromagnetic field therapies (including transcranial magnetic stimulation, transcranial direct current stimulation, and pulsed electromagnetic fields) as adjunctive rehabilitation approaches for stroke patients beyond conventional thrombolytic and thrombectomy interventions. The paper discusses the physical principles, molecular mechanisms, and evidence from preclinical and clinical studies supporting EMF applications in functional recovery and stroke monitoring.
This meta-analysis of 45 audits covering 1.18 million stroke patients found that 81.1% received antithrombotic therapy within 48 hours, falling below the 85% quality benchmark established by stroke care guidelines. Treatment delivery rates were comparable between high-income and low-to-middle-income countries, with improvements noted in studies published after 2008.
This study compares stroke diagnostic and secondary prevention recommendations between American Heart Association/American Stroke Association (AHA/ASA) and European Stroke Organization (ESO) guidelines, analyzing 63 ESO and 82 AHA/ASA recommendations across 7 key topics. While most recommendations are similar, the guidelines assign different levels of evidence quality to many recommendations, with notable discrepancies in high-level evidence classifications.
This retrospective study of 742 patients with carotid atherosclerosis found that non-alcoholic fatty liver disease (NAFLD) is independently associated with increased risk of recurrent ischemic stroke or transient ischemic attack during follow-up. A combined predictive model incorporating NAFLD status, clinical variables, and carotid plaque characteristics demonstrated superior performance in identifying high-risk patients for secondary stroke events.
A retrospective cohort study examined ischemic stroke and transient ischemic attack cases within 21 days of COVID-19 bivalent Pfizer vaccination in Kaiser Permanente patients aged 65+, finding an incidence of 34.3 per 100,000. While a safety signal was detected requiring further investigation, the authors appropriately note that validation of any causal association between vaccination and stroke risk is needed before conclusions can be drawn.
This retrospective study evaluated patients with acute ischemic stroke or transient ischemic attack to assess how many cases could have been prevented through better management of vascular risk factors such as hypertension, dyslipidemia, atrial fibrillation, and smoking. The researchers developed a 10-point preventability scale to classify the degree to which each event was avoidable based on the optimization of modifiable risk factors at presentation.
This systematic review evaluated 6 randomized controlled trials and 16 cohort studies (66,273 patients, mean age 65-79) examining statin use for secondary prevention after ischemic stroke or transient ischemic attack. Meta-analysis of cohort studies showed a positive association between statins and improved functioning, though individual trials had mixed results regarding quality of life, with significant methodological limitations noted across included studies.
This retrospective study evaluated left atrial reservoir strain using echocardiography in 79 stroke/TIA patients without prior atrial fibrillation history to identify cardiac sources of emboli. Reduced reservoir strain was associated with cardioembolic stroke mechanisms and atrial fibrillation occurrence, suggesting it may aid in stroke risk stratification and AF detection.
This systematic review and meta-analysis examines the incidence and risk factors for cerebrovascular events (including stroke) in patients with cervical fibromuscular dysplasia, a non-atherosclerotic vascular condition affecting arterial walls. The study synthesizes evidence to characterize stroke risk and associated factors in this patient population.
Researchers developed a surface-enhanced Raman scattering (SERS) detection platform coupled with machine learning algorithms to identify transient ischemic attacks (TIA) through inflammatory markers in serum. The system achieved 99.64% accuracy using LightGBM and demonstrated robust performance across multiple deep learning models (>90% accuracy), with results validated against clinical diagnoses.