European neurology
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The safety of intravenous (IV) thrombolysis when administered between 4.5 and 6 h after acute ischemic stroke with alteplase has not been established. ⋯ IV thrombolysis in patients who fulfill the NINDS study criteria may still be considered up to 6 h after ischemic stroke.
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We know little of the current status of stroke in Tibet Autonomous Region in China. This study was designed to investigate the characteristics of acute stroke in Tibet. ⋯ ICH is the dominant stroke subtype in Tibet Autonomous Region, and can be attributed to high rates of hypertension and heavy alcohol consumption. Greater public awareness of stroke and effective management of risk factors should be implemented immediately in Tibet.
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Recent research has suggested that a perfusion-weighted image (PWI) relative cerebral blood volume (rCBV) map after acute ischemic stroke (AIS) provides information about the collateral circulation in the ischemic region. In this study, we demonstrate the usefulness of the rCBV ratio in PWI in predicting poor outcome after using IV t-PA in AIS. We recruited 58 stroke patients who were treated with IV t-PA after diagnostic magnetic resonance imaging (MRI). ⋯ Poor outcome also correlated with diffusion-weighted MR images of the lesion volume (p < 0.01), lower rCBV ratio on PWI (p < 0.01), and non-recanalization (p < 0.01). Among these, non-recanalization (p < 0.01), reduced rCBV ratio on PWI (p < 0.01), age (p = 0.04), and serum glucose level (p = 0.01) had an independent significance for predicting it. This suggests that the rCBV ratio on PWI may be used to determine prognosis after thrombolysis in AIS.
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Epidemiological and radiological studies have previously been performed to identify the possible causes of hemiplegic shoulder pain (HSP). Many different etiologies have been postulated, though no clear correlations have emerged, and a multifactorial pathogenesis of HSP has been proposed. Recently, two MRI-based studies have described different shoulder findings as possible causes of pain in chronic stroke survivors. ⋯ Adhesive capsulitis was found to be a possible cause of HSP. However, MRI, which is more expensive than other diagnostic tools, may be considered the gold standard tool for understanding the etiology of HSP.
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Post-stroke complications may influence prognosis, and may even become potentially life-threatening. The aim of this prospective study was to examine the frequency and timing of medical complications during the acute stage of critical ischemic stroke in patients treated in a neurological intensive care unit. ⋯ Progression or recurrence of stroke, fever, and chest infection are common complications in the acute stage of critical ischemic stroke.