Effect of early vs. delayed extubation on functional outcome among patients with acute ischemic stroke treated with endovascular thrombectomy under general anesthesia: the prospective, randomized controlled EDESTROKE trial study protocol.

Background: Recent meta-analyses and randomized studies have shown that among patients with acute ischemic stroke undergoing endovascular thrombectomy, general anesthesia with mechanical ventilation is associated with better functional status compared to local anesthesia and sedation, and they recommend its use. But once the procedure is completed, when is the optimal moment for extubation? Currently, there are no guidelines recommending the optimal moment for extubation. Prolonged mechanical ventilation time could potentially be linked to increased complications such as pneumonia or disturbances in cerebral blood flow due to the vasodilatation produced by most anesthetic drugs.

Pharmacological preclinical comparison of tenecteplase and alteplase for the treatment of acute stroke.

Alteplase (rtPA) remains the standard thrombolytic drug for acute ischemic stroke. However, new rtPA-derived molecules, such as tenecteplase (TNK), with prolonged half-lives following a single administration, have been developed. Although TNK is currently under clinical evaluation, the limited preclinical data highlight the need for additional studies to elucidate its benefits.

Results of a focused cardiac ultrasound program conducted by neurologists within a stroke care network with cardiac imaging units.

Introduction And Objectives: Recently, neurologists have begun to perform focused cardiac ultrasound for the detection of a cardiac source of embolism in stroke patients, requiring them to undergo a prior accredited training process. We designed a prospective study to analyze the incidence of heart disease detected by a focused cardiac ultrasound program within a stroke care network with cardiac imaging units and to identify the outcomes of detected structural heart disease at 1 year of follow-up.

Methods: We included patients admitted to a university hospital for ischemic stroke or a transient ischemic attack between 2017 and 2021 who were evaluated by focused cardiac ultrasound.

Amitriptyline for post-COVID headache: effectiveness, tolerability, and response predictors.

Background: Headache is one of the most frequently reported symptoms in post-COVID patients. The clinical phenotype of COVID-19 headache combines phenotypic features of both tension-type headache (TTH) and migraine. We aimed to assess the effectiveness, side effects and predictors of amitriptyline (AMT) response in a real-world study setting.

Carotid web: the challenging diagnosis of an under-recognized entity.

Background: Determining the cause of acute ischemic stroke is crucial for patient management, particularly for preventing future stroke. In recent years, carotid web (CW), a non-atherosclerotic disorder of the carotid wall, has been found to be an underestimated source of cerebral emboli.

Objective: The present study aimed to analyze the clinical, radiological, and pathological findings, along with the treatments performed in patients with CW and ipsilateral ischemic events.

Surrogate biomarkers of outcome for wake-up ischemic stroke.

Background: Wake-up ischemic stroke (IS) has been usually excluded from acute stroke therapy options for being outside of the safe treatment window. We identified risk factors, and clinical or molecular biomarkers that could be therapeutic targets for wake-up stroke prevention, thus hopefully leading to a decrease in its mortality and disability in medium to long-term outcome.

Methods: 4251 ischemic stroke (IS) patients from a prospectively registered database were recruited; 3838 (90.

Multi-ancestry GWAS reveals excitotoxicity associated with outcome after ischaemic stroke.

During the first hours after stroke onset, neurological deficits can be highly unstable: some patients rapidly improve, while others deteriorate. This early neurological instability has a major impact on long-term outcome. Here, we aimed to determine the genetic architecture of early neurological instability measured by the difference between the National Institutes of Health Stroke Scale (NIHSS) within 6 h of stroke onset and NIHSS at 24 h.

Oral Anticoagulation and Risk of Symptomatic Hemorrhagic Transformation in Stroke Patients Treated With Mechanical Thrombectomy: Data From the Nordictus Registry.

We aimed to evaluate if prior oral anticoagulation (OAC) and its type determines a greater risk of symptomatic hemorrhagic transformation in patients with acute ischemic stroke (AIS) subjected to mechanical thrombectomy. Consecutive patients with AIS included in the prospective reperfusion registry NORDICTUS, a network of tertiary stroke centers in Northern Spain, from January 2017 to December 2019 were included. Prior use of oral anticoagulants, baseline variables, and international normalized ratio (INR) on admission were recorded.

Early Neurological Change After Ischemic Stroke Is Associated With 90-Day Outcome.

Background And Purpose: Large-scale observational studies of acute ischemic stroke (AIS) promise to reveal mechanisms underlying cerebral ischemia. However, meaningful quantitative phenotypes attainable in large patient populations are needed. We characterize a dynamic metric of AIS instability, defined by change in National Institutes of Health Stroke Scale score (NIHSS) from baseline to 24 hours baseline to 24 hours (NIHSS - NIHSS = ΔNIHSS), to examine its relevance to AIS mechanisms and long-term outcomes.

Impact of COVID-19 outbreak on ischemic stroke admissions and in-hospital mortality in North-West Spain.

Background And Purpose: Spain has been one of the countries heavily stricken by COVID-19. But this epidemic has not affected all regions equally. We analyzed the impact of the COVID-19 pandemic on hospital stroke admissions and in-hospital mortality in tertiary referral hospitals from North-West Spain.

Regulatory T cells participate in the recovery of ischemic stroke patients.

Background: Recent preclinical studies have shown that regulatory T cells (Treg) play a key role in the immune response after ischemic stroke (IS). However, the role of Treg in human acute IS has been poorly investigated. Our aim was to study the relationship between circulating Treg and outcome in human IS patients.

Results of a Single Center's Stenting Procedure for the Treatment of Carotid Stenosis.

Background: Stenting may be a safer alternative to endarterectomy for treating carotid artery stenosis (CAS), but its long-term efficacy is uncertain. There is a lack of long-term and noncontrolled clinical trial data that reflects "real-world" CAS. This study aimed to analyze the long-term efficacy and safety of our center's CAS procedure.

Lesion location and other predictive factors of dysphagia and its complications in acute stroke.

Background And Aims: Early detection of dysphagia is crucial in stroke patients as a result of increased morbidity and mortality due to malnutrition and respiratory tract infections. The aim of this study was to identify possible predictors of the onset of dysphagia following stroke in order to be able to act precociously.

Methods: Observational, prospective study in which a Volume-Viscosity Swallow Test (V-VST) was carried out in the first 72 h following admission to assess dysphagia in acute stroke patients with a previous result of <3 in the Eating Assessment Tool-10.

NT-pro-BNP: A novel predictor of stroke risk after transient ischemic attack.

Background: Elevated levels of B-type natriuretic peptide (BNP) and NT-pro-BNP can predict an increased risk of cardiovascular events and ischemic stroke. The limited reliability to predict the risk of stroke after a transient ischemic attack (TIA) justifies the objective of our study to determine the role of NT-pro-BNP in patients with TIAs.

Methods: From our prospective stroke registry, we performed a retrospective study in all patients with the diagnosis of TIA admitted to the Stroke Unit of our Hospital between January 2008 and March 2018.

Obesity Paradox in Ischemic Stroke: Clinical and Molecular Insights.

It has recently emerged the concept of "obesity paradox," a term used to describe the unexpected improved prognosis and lower mortality rates found in several diseases in patients with higher body weight. Concerning stroke, few clinical studies have assessed this obesity paradox showing contradictory results. Therefore, our aim was to compare clinical evolution and inflammatory balance of obese and non-obese patients after ischemic stroke.

Trends in stroke outcomes in the last ten years in a European tertiary hospital.

Background: Studying the impact of demographic changes and progress in the management of stroke patients is necessary in order to organize care structures for the coming years. Consequently, we analyzed the prognostic trends of patients admitted to the Stroke Unit of a tertiary hospital in the last ten years.

Methods: The University Clinical Hospital of Santiago de Compostela is the referral hospital for stroke in a catchment area that accounts for 16.

The H-ATOMIC Criteria for the Etiologic Classification of Patients with Intracerebral Hemorrhage.

Background And Purpose: There are no generally accepted criteria for the etiologic classification of intracerebral hemorrhage (ICH). For this reason, we have developed a set of etiologic criteria and have applied them to a large number of patients to determine their utility.

Methods: The H-ATOMIC classification includes 7 etiologic categories: Hypertension, cerebral Amyloid angiopathy, Tumour, Oral anticoagulants, vascular Malformation, Infrequent causes and Cryptogenic.

[Urgent stroke care in hospitals with a stroke unit. Quick Project].

Introduction: A stroke is a time-dependent medical emergency. Swiftness in its recognition and in the care received by the patients plays a key role in the prognosis.

Aims: To analyse the medical intervention times, to evaluate possible areas where improvements can be made and to examine the allocation of resources in the centres.

[Rescue treatment in acute thrombosis of intracranial stents].

Introduction: Acute intrastent thrombosis is a potentially serious complication in intracranial stenting. It is essential to determine which therapy is the most suitable in intrastent thromboses.

Case Report: Female aged 58, the first case of acute thrombosis of an intracranial stent to be treated successfully by fibrinolysis after the implantation of a flow diverter device (Silk) in a fusiform basilar aneurysm.