Are there disparities in acute stroke treatment between the Jewish and Arab populations in Israel? Results from the National Acute Stroke Israeli registry.

Background: According to the latest reported data from the National Acute Stroke Israeli Survey (NASIS), around 18,000 strokes occur annually in Israel. Data regarding disparities in stroke care between the Jewish and the Arab populations in Israel are lacking.

Aims: We wished to compare demographics, comorbidities, stroke characteristics and outcomes between Jewish and Arab stroke patients in Israel that were acutely treated with intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT), in order to test if there are disparities or any ethnic-specific parameters.

The effect of TEE on treatment change in patients with acute ischemic stroke.

Background And Purpose: Ischemic stroke is a widespread disease carrying high morbidity and mortality. Transesophageal echocardiography (TEE) is considered an important tool in the work-up of patients with acute ischemic stroke (AIS) and transient ischemic attack (TIA) patients; its utility is limited by a semi-invasive nature. The purpose of this study was to evaluate the probability of treatment change due to TEE findings (yield) in the work-up of AIS and TIA patients.

Infarct Core Reliability by CT Perfusion is a Time-Dependent Phenomenon.

Background And Purpose: In the setting of an extended time window for endovascular treatment (EVT) for acute stroke patients, computed tomography perfusion (CTP) has become a major tool in patient selection. However, there are some data suggesting that the initial ischemic core may be overestimated by CTP depending on stroke onset time. This study aims to evaluate possible predictors of overestimation of infarct core by CTP.

Effect of time from onset to endovascular therapy on outcomes: the National Acute Stroke Israeli (NASIS)-REVASC registry.

Background: Endovascular therapy (EVT) is currently the most effective treatment for emergent large vessel occlusion (ELVO) stroke. Earlier treatment is associated with a better clinical outcome. Our aim was to examine the association between onset-to-EVT (OTE) time and clinical outcomes using real-world nationwide data from the National Acute Stroke ISraeli (NASIS)-REVASC registry.

Impact of previous stroke on outcome after thrombectomy in patients with large vessel occlusion.

Background: Many patients with large vessel occlusion (LVO) who are otherwise candidates for endovascular treatment (EVT) have had previous strokes. We aimed to examine the effect of previous stroke on outcome after EVT.

Methods: Consecutive patients with LVO were prospectively entered into a National Acute Stroke registry of patients undergoing EVT.

Direct Thrombectomy versus Bridging for Patients with Emergent Large-Vessel Occlusions.

Background And Aims: Patients with emergent large-vessel occlusion (ELVO) that present earlier than 4 h from onset are usually treated with bridging systemic thrombolysis followed by endovascular thrombectomy (EVT). Whether direct EVT (dEVT) could improve the chances of favorable outcome remains unknown.

Methods: Consecutively, prospectively enrolled patients with ELVO presenting within 4 h of onset were entered into a National Acute Stroke Registry of patients undergoing revascularization.

Internal carotid artery dissection among younger and older patients with acute ischemic stroke.

Unlabelled: Purpose/Aim of the study: Carotid artery dissection (CAD) is a known causative factor in the etiology of acute ischemic stroke in young patients. However, the significance of CAD in older patients with acute ischemic stroke is unclear with only a few prior clinical studies. In order to isolate the influence of CAD as an independent factor, we performed multivariate analyses of common covariables in acute ischemic stroke patients in northern Israel.

Pre-admission CHA2DS2-VASc score and outcome of patients with acute cerebrovascular events.

Background: The CHA2DS2-VASc score has been recommended for the assessment of thromboembolic risk in patients with atrial fibrillation. Data regarding the association between the pre-admission CHA2DS2-VASc score and the outcome of patients with stroke and TIA are scarce. We aimed to assess the predictive value of pre-admission CHA2DS2-VASc score for early risk stratification of patients with acute cerebrovascular event.

Clinical and imaging findings in patients with neurosyphilis: a study of a cohort and review of the literature.

Background: Most patients with neurosyphilis are considered asymptomatic. The diagnosis is challenging and the role of neuroimaging is not yet well established. The present study was conducted to focus on the clinical findings and further characterize the imaging features of the disease, along with a review of the pertinent literature.

Gender differences in characteristics, management and outcome at discharge and three months after stroke in a national acute stroke registry.

Background: The importance of gender as an independent risk factor for poor outcome is not clear. We examined gender differences in patients' characteristic, management and outcome at discharge and 3-months after acute stroke in a national hospital-based registry.

Methods: Data were derived from the triennial two-month national Acute Stroke Israeli Registry (Feb-March 2004, March-April 2007, April-May 2010).

Young patient with acute ischemic stroke due to papillary carcinoma of the thyroid.

Hypercoagulability is a condition predisposing to arterial or venous thrombosis and is associated frequently with malignancy. We present a rare acute ischemic stroke in a young patient that was the presenting feature for a newly diagnosed papillary carcinoma of the thyroid. Extensive vascular and hematological work-up was normal except for a large patent foramen ovale (PFO).

Microembolic signals in patients with acute nonembolic stroke.

Background: The nature of microembolic signals (MES) in patients without apparent sources of embolism remains elusive. We hypothesize that MES in acute stroke patients without an embolic source may represent a transient phenomenon related to blood rheology or clot dissolving, in which case the characteristics of such MES would differ from those with definitive sources of emboli.

Methods: We compared the intensity and duration of 250 MES in 62 acute nonembolic stroke patients (stroke group) and 217 MES in 57 patients with asymptomatic carotid stenosis (≥50%; carotid group).

Aortic atheromas in acute ischemic stroke patients in northern Israel.

Aim: There are currently no data on ethnic differences in aortic atherosclerosis in Arab and Jewish patients from northern Israel with acute ischemic stroke.

Methods: Data on demographic and risk factors alongside transesophageal echocardiography (TEE) data and treatment details for 509 patients with acute ischemic stroke were included in the study.

Results: The patients with aortic atheromas were older and had significantly more frequent vascular risk factors (hypertension, hyperlipidemia, and smoking), as well as vascular disease (ischemic heart disease, peripheral vascular disease, and carotid plaques).

Comparison of psychological symptoms in post-cryptogenic cerebral-vascular accident (CVA) and/or transient ischemic attack (TIA) patients who have undergone foramen ovale closure, and in post-CVA patients.

The patent foramen ovale (PFO) is a controversial risk factor for CVA or TIA. In our center, adult PFO patients diagnosed with post cryptogenic CVA/TIA undergo trans-catheter closure of the PFO to decrease the risk of recurrent stroke. The aim of the study was to compare levels of functioning, depression and anxiety in post PFO closure patients following cryptogenic CVA/TIA and in other patients post CVA/TIA without PFO.

Ethnic differences in ischemic stroke of working age in northern Israel.

Background: There are currently no comparative data about ethnic differences in ischemic stroke in Arab and Jewish populations.

Methods: Data on 727 consecutive Arab and Jewish patients of working age (
Results: The mean age was 59.

Ethnic disparities in first primary intracerebral hemorrhage in northern Israel.

Background: Ethnic differences among first primary intracerebral hemorrhage (PICH) patients in an Israeli biethnic population have not yet been studied.

Patients And Methods: We included in the study 546 patients (counting warfarin-related hemorrhages) hospitalized during the period from December 1999 through June 2008.

Results: The mean age was 71.

Microemboli monitoring by trans-cranial doppler in patient with acute cardioemboliogenic stroke due to atrial myxoma.

This is the first reported attempt to examine the emboliogenic potential of cardiac myxoma in patients with acute stroke through the monitoring of microembolic signals (MES) by transcranial doppler. A 43-year old woman was brought to the emergency department because of acute onset of generalized tonic-clonic seizures and left hemiplegia. A CT scan of the brain demonstrated a large acute infraction in the territory of the right middle cerebral artery (MCA) and another smaller one in the territory of the posterior cerebral artery on the same side.

Ischemic middle cerebral artery stroke missing the tissue plasminogen activator time window: transcranial Doppler evaluation.

We investigated the interconnection between natural history of middle cerebral artery (MCA) recanalization by transcranial Doppler (TCD) and stroke severity in patients not treated by fibrinolysis. A total of 54 patients with an acute MCA stroke were examined within the first 24 hours and again within 120 hours after stroke onset. The first TCD examination detected 16 patients (29.

Microemboli in MCA ipsilateral to occluded common carotid artery: an observation and short review of the literature.

Sixty-five years old patient suffering from acute stroke was treated by rTPA intravenously. TCD monitoring of both middle cerebral arteries (MCA) was carried out simultaneously with administration of rTPA. Seven microemboli were found in right and four in left MCA.

TCD evaluation before and after stenting in patients with severe primary carotid artery stenosis versus restenosis.

Purpose: To evaluate cerebral hemodynamics before and after carotid angioplasty and stenting (CAS) using transcranial Doppler (TCD).

Methods: Sixty-eight patients (52 men; mean age 69+/-9.5 years) with severe carotid stenosis (83.

Preoperative cerebral hemodynamics and shunting during carotid endarterectomy in patients with severe unilateral carotid stenosis.

Purpose: To estimate the possible predictors for the need for shunting during carotid endarterectomy in patients with severe unilateral carotid stenosis based on preoperative transcranial Doppler sonographic examination.

Materials And Methods: One hundred twenty-six patients were included in the study. Pulsatility index, flow acceleration, peak systolic velocity, and mean velocity were measured in the middle cerebral artery (MCA) and anterior cerebral artery on both sides.