Aim: To investigate stroke characteristics in patients with concomitant coronavirus disease 2019 (COVID-19) infection in Croatia during the second wave of the COVID-19 pandemic.
Methods: This retrospective study investigated the characteristics of two groups of ischemic stroke patients: those who developed COVID-19 infection before stroke and those who developed the infection during the hospital stay after stroke onset. Stroke etiology was classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification.
Results: We analyzed data from 255 stroke patients from 12 Croatian hospitals. The two groups of ischemic stroke patients differed in stroke etiology (P=0.038). Patients with COVID-19 infection before stroke had fewer cardioembolic strokes (46% vs 29.1%), more cryptogenic strokes (32.5% vs 14.3%), and more strokes in multiple vascular territories (12.4% vs 1.8%). The percentage of large-vessel occlusions was high in both groups (49.6% and 44.4%). Median modified Rankin Scale score on discharge was 4 in both groups. Mortality was 36.4% in the group with stroke after COVID-19 and 33.3% in the group with COVID-19 after stroke.
Conclusion: Ischemic stroke after COVID-19 differs in etiology from ischemic stroke complicated by COVID-19 infection. Both patient groups are characterized by severe disability and high mortality. Raising the awareness of prehospital stroke and optimization of clinical workflow are important if we want to improve the stroke outcomes by acute recanalization techniques.
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http://dx.doi.org/10.3325/cmj.2022.63.431 | DOI Listing |
J Clin Neurosci
January 2025
Faculty of Health and Medical Sciences, The University of Adelaide, Australia.
The Glasgow Coma Scale (GCS) was first published in The Lancet by Sir Graham Teasdale and Bryan Jennett 50 years ago based on their pioneering work on developing a numerical scale to describe coma in clear and reproducible terms and to avoid the confusion associated with the wide variety of descriptive terms for consciousness that were in use at the time. It's difficult to know if Teasdale and Jennett could have predicted how influential, widespread and long-lasting the GCS would become, but in retrospect it seems clear that the GCS was introduced at a perfect stage in the development of modern clinical neurosurgery and neuroscience research. The simplicity of the scale, its recognition by senior academics and the emerging radiology technologies in the 1970s heralded a new era of neuroscience and an approach to the management of not only traumatic brain injury (TBI) but other types of central nervous system disease in which consciousness was affected, such as aneurysmal subarachnoid haemorrhage and stroke.
View Article and Find Full Text PDFClin Neurol Neurosurg
December 2024
Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Geriatric Research, Education, and Clinical Center, Tennessee Valley Healthcare Center, Nashville, TN, USA; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address:
Background: Timely recognition of acute ischemic stroke (AIS) is essential to identify patients who may be eligible for acute intervention. Protocols to streamline systems-based care, such as "stroke alerts" in the emergency department (ED) can safely reduce time-to-care while enhancing safety. However, clinician adherence to stroke alert criteria is poorly described.
View Article and Find Full Text PDFJ Biochem Mol Toxicol
January 2025
Department of Neurosurgery, Jingjiang People's Hospital, Jingjiang, China.
Subarachnoid hemorrhage (SAH) is a specific type of stroke. Dihydroquercetin (DHQ), a flavonoid, is known for its various pharmacological properties. This study aimed to explore the roles and mechanisms of DHQ in influencing the progression of SAH.
View Article and Find Full Text PDFCNS Drugs
January 2025
Department of Cardiology, Second Affiliated Hospital of Dalian Medical University, Dalian, China.
Background: Early neurological deterioration (END) is associated with a poor prognosis in acute ischemic stroke (AIS). Effectively lowering low-density lipoprotein cholesterol (LDL-C) can improve the stability of atherosclerotic plaque and reduce post-stroke inflammation, which may be an effective means to lower the incidence of END. The objective of this study was to determine the preventive effects of evolocumab on END in patients with non-cardiogenic AIS.
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