International journal of stroke : official journal of the International Stroke Society
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Patients with moderate to severe acute ischemic stroke without intracranial vessel occlusion are an intriguing subset of stroke patients. They pose diagnostic and therapeutic challenges to the physician. We sought to study these patients with an emphasis on their radiological and clinical outcomes. ⋯ Stroke without intracranial occlusions are not a benign entity. Factors that are independently associated with decreased likelihood of a good outcome are higher baseline NIHSS, and older age. Treatment with tissue plasminogen activator is not a predictor of outcome.
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As a leading cause of severe disability and death, stroke places an enormous burden on the health care system in China. There are limited data on the pattern of current medical practice and quality of care delivery for stroke patients at the national level. ⋯ The China National Stroke Registry is a large-scale nationwide registry in China. Rich data collected from this prospective registry may provide the opportunity to evaluate the quality of care for stroke patients in China.
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The fluoxetine for motor recovery after acute ischemic stroke study was a double blind, placebo-controlled trial examining the effects of fluoxetine in patients five- to 10 days after an ischemic stroke. The study found motor improvement to 90 days poststroke, measured as the change in the Fugl-Meyer score, was significantly greater in the fluoxetine group as compared with the placebo group, and that this finding was significant after adjusting for depression. Patients randomized to fluoxetine also had less disability (modified Rankin Scale 0-2). ⋯ Stroke remains among the leading causes of human disability. Currently, a minority of patients can access approved reperfusion therapies, and among those so treated a substantial fraction derives limited benefit. Therapies that target restorative events have a time window measured in days-weeks and so hold the potential to help many patients with stroke.