Transient ischemic attack versus transient ischemic attack mimics: frequency, clinical characteristics and outcome.

Background: There is insufficient evidence regarding which clinical features are best suited to distinguish between transient ischemic attack (TIA) and disorders mimicking TIA (TIA mimics).

Methods: We compared the frequency, clinical characteristics and outcome of patients with TIA and TIA mimics in a prospective, single-center emergency department cohort over 2 years.

Results: Of 303 patients, 248 (81.

Intravenous thrombolysis in nonagenarians with ischemic stroke.

Background And Purpose: Demographic changes will result in a rapid increase of patients age ≥90 years (nonagenarians), but little is known about outcomes in these patients after intravenous thrombolysis (IVT) for acute ischemic stroke. We aimed to assess safety and functional outcome in nonagenarians treated with IVT and to compare the outcomes with those of patients age 80 to 89 years (octogenarians).

Methods: We analyzed prospectively collected data of 284 consecutive stroke patients age ≥80 years treated with IVT in 7 Swiss stroke units.

Optimizing the risk estimation after a transient ischaemic attack - the ABCDE⊕ score.

Background And Purpose: The risk of stroke after a transient ischaemic attack (TIA) can be predicted by scores incorporating age, blood pressure, clinical features, duration (ABCD-score), and diabetes (ABCD2-score). However, some patients have strokes despite a low predicted risk according to these scores. We designed the ABCDE+ score by adding the variables 'etiology' and ischaemic lesion visible on diffusion-weighted imaging (DWI) -'DWI-positivity'- to the ABCD-score.

Association of vascular risk factors with cervical artery dissection and ischemic stroke in young adults.

Background: Little is known about the risk factors for cervical artery dissection (CEAD), a major cause of ischemic stroke (IS) in young adults. Hypertension, diabetes mellitus, smoking, hypercholesterolemia, and obesity are important risk factors for IS. However, their specific role in CEAD is poorly investigated.

Stress hormones predict cerebrovascular re-events after transient ischemic attacks.

Background: TIA is a strong predictor of subsequent stroke. The hypothalamic stress hormone copeptin is an accurate prognostic marker in acute ischemic stroke. This study assessed prognostic reliability of 2 distinct stress hormones, copeptin and cortisol, for the risk stratification of re-events in patients with TIA.

Anterior pituitary axis hormones and outcome in acute ischaemic stroke.

Background: Early and accurate prediction of outcome in acute stroke is important and influences risk-optimized therapeutic strategies. Endocrine alterations of the hypothalamic-pituitary axis are amongst the first measurable alterations after cerebral ischaemia. We therefore evaluated the prognostic value of cortisol, triiodothyronine (T3), free thyroxine (fT4), thyroid-stimulating hormone (TSH) and growth hormone (GH) in patients with an acute ischaemic stroke.

Safety of pharmacological augmentation of stroke rehabilitation.

Background: Based on experimental studies, pharmacological augmentation (PA) of stroke rehabilitation might be reasonable. Whether PA is beneficial in clinical practice is unclear.

Methods: We performed an observational study on the use of PA in addition to regular rehabilitative therapies in a stroke rehabilitation unit.

Antithrombotic drugs for carotid artery dissection.

Background: Extracranial internal carotid artery dissection (eICAD) is a leading cause of stroke in younger patients.

Objectives: 1. To determine whether, in patients with eICAD, treatment with anticoagulants, antiplatelet agents or control was associated with a better functional outcome.

Midregional pro-atrial natriuretic peptide and outcome in patients with acute ischemic stroke.

Objectives: The purpose of this study was to examine the prognostic value of midregional pro-atrial natriuretic peptide (MR-proANP) in patients with acute ischemic stroke.

Background: The rapid and reliable estimation of prognosis in acute ischemic stroke is pivotal to optimize clinical care. MR-proANP, a recently described, stable fragment of the ANP precursor hormone, may be useful in this setting.

Etiology of late cerebrovascular events after carotid endarterectomy.

Background: Progressive carotid artery disease has been shown to cause cerebrovascular events years after a patient's carotid thromboendarterectomy (CEA). Yet, some late cerebrovascular events in CEA patients are attributable to other etiologies.

Objective: We sought to determine frequency and characteristics of late cerebrovascular events in post-CEA patients attributable to etiologies other than progressive carotid disease.

Prognostic value of copeptin: one-year outcome in patients with acute stroke.

Background And Purpose: An accurate long-term outcome prediction may improve management of stroke patients. We investigated the ability of copeptin to predict 1-year outcome in stroke patients.

Methods: In this preplanned post hoc analysis, the National Institutes of Health Stroke Scale score and copeptin levels were measured on admission in a cohort of patients with ischemic stroke.

Use of decrease in apparent diffusion coefficient values to predict infarct age.

The purpose of the study was to determine the ability to predict infarct age based on decrease in apparent diffusion coefficient (ADC) values. We retrospectively identified 94 individuals (age range 16 years to 91 years; mean 63.7 + 14.

Prediction of discharge destination after neurological rehabilitation in stroke patients.

Background/aims: Returning home is one of the most important aims of stroke patients when admitted to rehabilitation.

Methods: A single-center prospectively ascertained database study was conducted.

Results: Among 1,332 eligible patients (median age = 76.

New ischaemic brain lesions on MRI after stenting or endarterectomy for symptomatic carotid stenosis: a substudy of the International Carotid Stenting Study (ICSS).

Background: The International Carotid Stenting Study (ICSS) of stenting and endarterectomy for symptomatic carotid stenosis found a higher incidence of stroke within 30 days of stenting compared with endarterectomy. We aimed to compare the rate of ischaemic brain injury detectable on MRI between the two groups.

Methods: Patients with recently symptomatic carotid artery stenosis enrolled in ICSS were randomly assigned in a 1:1 ratio to receive carotid artery stenting or endarterectomy.

Extracranial-intracranial arterial bypass surgery for occlusive carotid artery disease.

Background: The EC/IC Bypass Study Group found no benefit of extracranial to intracranial (EC/IC) bypass surgery over medical therapy in patients with symptomatic carotid artery occlusion (sCAO). However, the study was criticised for many reasons and the real effect of this treatment is still not known conclusively.

Objectives: To determine whether bypass surgery plus medical care is superior to medical care alone in patients with sCAO.

Intravenous thrombolysis in patients with stroke attributable to small artery occlusion.

Background: Intravenous thrombolysis (IVT) for stroke seems to be beneficial independent of the underlying etiology. Recent observations raised concern that IVT might cause harm in patients with strokes attributable to small artery occlusion (SAO).

Objective: The safety of IVT in SAO-patients is addressed in this study.

Copeptin: a novel, independent prognostic marker in patients with ischemic stroke.

Objective: Early prediction of outcome in patients with ischemic stroke is important. Vasopressin is a stress hormone. Its production rate is mirrored in circulating levels of copeptin, a fragment of provasopressin.

Restenosis after carotid endarterectomy: significance of newly acquired risk factors.

Background: In patients who had carotid endarterectomy (CEA), the significance of newly acquired cerebrovascular risk factors (CRFs) is unknown. Newly acquired CRFs are defined as CRFs not present prior to CEA (baseline CRFs) but acquired during long-term follow-up.

Objective: We sought to determine the significance of newly acquired CRFs in CEA patients with regard to progressive ICA disease (> or =50% restenosis; occurrence or progression of contralateral stenosis).

Cerebral venous thrombosis: diagnostic accuracy of combined, dynamic and static, contrast-enhanced 4D MR venography.

Background And Purpose: MR including MRV is an established method to diagnose CVT. However, it remains unsettled which MR imaging modalities offer the highest diagnostic accuracy. We evaluated the accuracy of a combined, dynamic (1.

Diffusion-weighted imaging findings differ between stroke attributable to spontaneous cervical artery dissection and patent foramen ovale.

Background And Purpose: Spontaneous cervical arterial dissection and patent foramen ovale (PFO) are important causes of stroke in younger patients. We tested whether characteristics of cerebral ischaemia visible on diffusion-weighted imaging (DWI) aid in differentiating between these two aetiologies.

Methods: Diffusion-weighted imaging was performed after a median of 2 days [interquartile range (IQR) 1-3 days] in 94 consecutive patients with an acute ischaemic stroke caused either by carotid or vertebral artery dissection (n = 33) or PFO (n = 61).

Intravenous thrombolysis in stroke attributable to cervical artery dissection.

Background And Purpose: Intravenous thrombolysis (IVT) for stroke seems to be beneficial independent of the underlying etiology. Whether this is also true for cervical artery dissection (CAD) is addressed in this study.

Methods: We used the Swiss IVT databank to compare outcome and complications of IVT-treated patients with CAD with IVT-treated patients with other etiologies (non-CAD patients).

Cortical and putamen age-related changes in the microvessel density and astrocyte deficiency in spontaneously hypertensive and stroke-prone spontaneously hypertensive rats.

Cerebral small vessel disease (SVD) is a major contributor to dementia in the elderly, and hypertension represents a major cause for developing the disease. However, little is known about its development and progression. Modifications of large cerebral arteries due hypertension are thought to participate to the development of small ischemic infarcts, but the status of the small vessels before the establishment of hypertension is not well defined.

Stroke severity, its correlates and impact on thrombolysis in a population-based study.

Objective: Data about the distribution of stroke severity and its correlates are sparse. In a population-based approach, we determined the NIH Stroke Scale Score (NIHSSS) and studied associations with demographic variables, stroke unit care, etiology, the onset assessment interval (OAI), and the rate of thrombolysis.

Methods: We performed a databank-based post-hoc analysis of data ascertained during the prospective, population-based stroke study among the 188,015 permanent residents of Basel City, Switzerland.

CADISP-genetics: an International project searching for genetic risk factors of cervical artery dissections.

Background: Cervical artery dissection (CAD) is a frequent cause of ischemic stroke, and occasionally death, in young adults. Several lines of evidence suggest a genetic predisposition to CAD. However, previous genetic studies have been inconclusive mainly due to insufficient numbers of patients.