Stroke; a journal of cerebral circulation
-
Coil compaction is thought to be the main mechanism for recurrence in cerebral aneurysms with previously successful coil embolization. We hypothesize that sac growth may be equally or more important. The objective was to study the relative roles of coil compaction and sac growth as explanations for aneurysm recurrence requiring retreatment in a study population using quantitative 3D image processing methods. ⋯ In this study population, aneurysm sac growth, not coil compaction, was the primary mechanism associated with recurrence after initial coil embolization.
-
Comparative Study
ACTIVLIM-Stroke: a crosscultural Rasch-built scale of activity limitations in patients with stroke.
This study describes the development of a Rasch-built scale measuring activity limitations in stroke patients, named ACTIVLIM-Stroke. ⋯ The ACTIVLIM-Stroke questionnaire has good psychometric qualities and provides accurate measures of activity limitations in patients with stroke. It is recommended for evaluating clinical and research interventions in patients with stroke, because it provides a higher discrimination and might be more sensitive to change.
-
The purpose of this study was to understand factors related to increases in serum free fatty acid (FFA) levels and association with delayed cerebral ischemia (DCI) after subarachnoid hemorrhage. ⋯ Injury severity and oxygen consumption hypermetabolism are associated with higher n-FFA levels and an increased n-6:n-3 FFA ratio is associated with DCI. This may indicate a role for interventions that modulate both oxygen consumption and FFA levels to reduce the occurrence of DCI.
-
The purpose of this study was to determine the accuracy and optimal timing of physician prognostication in patients with subarachnoid hemorrhage, a prototypical neurological disease characterized by variable outcomes and frequent disability. ⋯ Neurologists were generally but not perfectly accurate in their prognostications of functional outcomes. The accuracy of prognoses did not correlate with the hospital day on which they were made but was affected by clinical factors that can cloud the neurological examination.
-
Patients with aneurysmal subarachnoid hemorrhage are typically kept in the intensive care unit to be monitored for signs of delayed cerebral ischemia (DCI). Identifying patients at lower risk for DCI could have a positive financial impact by allowing earlier transfer from the intensive care unit. ⋯ We propose a new model that can reliably identify patients with aneurysmal subarachnoid hemorrhage who are at very low risk for DCI. These patients could be candidates for early transfer to the general ward.