Background and Purpose— The National Institutes of Health Stroke Scale (NIHSS) correlates with presence large anterior vessel occlusion (LAVO). However, the application full NIHSS in prehospital setting to select patients eligible for treatment thrombectomy is limited. Therefore, we aimed evaluate prognostic value simple clinical selection strategies. Methods— Data from Safe Implementation Thrombolysis International Registry (January 2012–May 2014) were analyzed retrospectively. Patients...

Purpose Beyond intravenous thrombolysis, evidence is lacking on acute treatment of minor stroke caused by large artery occlusion. To identify candidates for additional endovascular therapy, we aimed to determine the frequency non-haemorrhagic early neurological deterioration in patients with thrombolysis-treated occlusion proximal and distal cerebral arteries. Secondary aims were establish risk factors report three-month outcomes without deterioration. Method We analysed data from SITS...

Background and Purpose- The optimal level for blood pressure after endovascular thrombectomy in acute ischemic stroke is not well established. We sought to evaluate the association of post-endovascular systolic (SBP) levels with clinical outcomes. Methods- included thrombectomy-treated patients registered from 2014 2017 Safe Implementation Treatments Stroke International Thrombectomy Registry. mean 24-hour SBP treatment was analyzed both as a continuous variable intervals. primary outcome...

Data are limited on optimal threshold for baseline National Institutes of Health Stroke Scale in predicting outcome after stroke thrombolysis (intravenous thrombolysis).Finding thresholds scores that predict functional and vessel occlusion.We analyzed 44 331 patients with available modified Rankin score at three-months 11 632 computed tomography/magnetic resonance angiography documented occlusion the SITS-International Thrombolysis Register. Main outcomes were independency (modified 0-2)...

Patients with stroke mimics (SM), i.e. conditions stroke-like symptoms, may risk harm if treated intravenous thrombolysis (IVT). Current guidelines state low of intracerebral hemorrhage based on studies comprising a total <400 SM cases. We aimed to compare safety and outcomes following IVT between patients acute ischaemic mimicking conditions.We included IVT-treated in the SITS International Stroke Thrombolysis Register 2003-2017, examined magnetic resonance imaging 22-36 h after treatment....

To report the incidence rate of osmotic demyelination syndrome (ODS), associated risk factors, treatment, and long-term outcomes in a nationwide cohort.We conducted retrospective study individuals diagnosed with central pontine myelinolysis (ICD-10 code G37.2) Swedish National Patient Register during 1997-2011.During period, we identified 83 ODS, 47 women 36 men. Median age at diagnosis was 55 years. The ODS for entire period 0.611 (95% CI: 0.490-0.754) per million person-years increased...

Elevated intracranial pressure (ICP) is a serious complication in brain injury. Because of the risks involved, ICP not monitored all patients at risk. Noninvasive screening tools to identify with elevated are needed. Anisocoria, abnormal pupillary size, and light reflex signs high ICP, but manual pupillometry arbitrary subject interrater variability. We have evaluated quantitative as tool for ICP.

Abstract The optic nerve sheath diameter (ONSD) can predict elevated intracranial pressure (ICP) but it is not known whether diagnostic characteristics differ between men and women. This observational study was performed at the Karolinska University Hospital in Sweden to assess sex differences accuracy for ONSD. We included 139 patients (65 women), unconscious and/or sedated, with invasive ICP monitoring. Commonly used ONSD derived measurements associated were collected. Linear regression...

Background and Purpose— ASTRAL (Acute Stroke Registry Analysis of Lausanne) DRAGON (includes dense middle cerebral artery sign, prestroke modified Rankin Scale score, age, glucose, onset to treatment, National Institutes Health score) are 2 recently developed scores for predicting functional outcome after acute stroke in unselected ischemic patients treated with intravenous thrombolysis, respectively. We aimed perform external validation these assess their predictive performance the large...

Abstract Background and Purpose Treatment of elevated intracranial pressure (ICP) is central to neurocritical care, but not all patients are eligible for invasive ICP‐monitoring. A promising noninvasive option ultrasound measurement the optic nerve sheath diameter (ONSD). However, meta‐analyses ONSD ICP show wide confidence intervals. This might be due baseline variations, inter‐rater variability, varying methods. No standardized protocol has been validated. Corrections eyeball (ED) (OND)...

Abstract Background and Purpose Optic nerve sheath diameter (ONSD) is a promising metric to estimate intracranial pressure (ICP). There no consensus whether ONSD should be measured external (ONSDext) or internal (ONSDint) of the dura mater. Expert opinion favors ONSDint, though without clear evidence support this. Adjustments for eye (ED) optic (OND) have been suggested improve precision. We examined diagnostic accuracy ONSDext ONSDint estimating ICP, unadjusted as well adjusted ED OND....

The optic nerve sheath diameter (ONSD) is a commonly used estimate of intracranial pressure (ICP). rationale behind this that changes in the cerebrospinal fluid affect subarachnoid space (ONSAS) thickness. Still, possible effects on other compartments (ONS) have not been studied. This first study ever to analyze all measurable ONS for associations with elevated ICP.

Stroke is a common cause of adult-onset epilepsy (post-stroke epilepsy, PSE). Despite an increasing awareness, there concern for underdiagnosis the condition. We aimed to study adherence latest updated definition, as well incidence and diagnosis PSE in ischemic stroke cohort admitted tertiary University Hospital.We retrospectively investigated occurrence unprovoked seizures all patients Karolinska Hospital Stockholm during 2015 registered Swedish Register. Patient records were scrutinized...

Background and Purpose The influence of stroke etiology on outcomes after endovascular thrombectomy (EVT) is not well understood. We aimed to investigate whether subgrouped as large artery atherosclerosis (LAA) cardiac embolism (CE) influences in occlusion (LAO) treated by EVT.Methods included EVT LAO patients registered the Safe Implementation Treatment Stroke (SITS) register between January 1, 2014 September 3, 2019. Primary outcome was successful reperfusion (modified Cerebral Infarction...

Background— In many countries, a majority of stroke patients are not assessed for long-term functional outcome owing to limited resources and time. We investigated whether automatic assessment the modified Rankin Scale (mRS) based on mobile phone questionnaire may serve as an alternative mRS assessments at clinical visits after stroke. Methods Results— enrolled 62 acute admitted our unit during March May 2014. Forty-eight completed study. During stay, and/or caregivers were equipped with...

Intravenous thrombolysis (IVT) for lacunar stroke (LS) is debated, as the underlying pathophysiological mechanism may not be thrombogenic.To investigate outcomes after IVT in LS SITS International Stroke Thrombolysis Register and perform a meta-analysis.LS was identified by both baseline NIHSS-subscores discharge ICD-10 codes, contrasted to non-IVT treated. patients were predominantly from Europe, South America Asia. Outcome measurements functional independence (modified Rankin Scale [mRS]...

There are limited data on intravenous thrombolysis treatment in ischemic stroke patients with prestroke disability.We aimed to evaluate safety and outcomes of analyzed 88,094 treated thrombolysis, recorded the Safe Implementation Treatments Stroke (SITS) International Thrombolysis Register between January 2003 December 2017, available NIHSS at stroke-onset after 24 h. Of them, 4566 (5.2%) had disability, defined as a modified Rankin Scale score 3-5. Safety outcome measures included...

Since it is difficult to identify women at increased risk of fetal brachial plexus birth palsy (BPBP) during labor and delivery, we aimed construct validate a score.A retrospective case-control study was undertaken in 2001 2006 an urban context Malmö, Sweden. A score constructed for all who had received routine municipal maternal health care Skåne University Hospital (n = 10 459). The model validated among pregnant with BPBP controls Sweden between 2007.The likelihood as the rose: 3.1%...

Background and Purpose- There are limited data on intravenous thrombolysis treatment in patients with ischemic stroke who have received prophylactic doses of low molecular weight heparins (LMWHs). We aimed to evaluate the safety outcomes taking thromboprophylactic LMWH. Methods- analyzed 109 291patients treated thrombolysis, recorded Safe Implementation Treatments Stroke International Thrombolysis Register between 2003 2017 not oral anticoagulants or therapeutic heparin at onset. One...

Background and purpose Triage tools to identify candidates for thrombectomy are of utmost importance in acute stroke. No prognostic tool has yet gained any widespread use. We compared the predictive value various models based on National Institutes Health Stroke Scale (NIHSS) subitems, ranging from simple more complex models, predicting large artery occlusion (LAO) anterior circulation Methods Patients registered SITS international Register with available NIHSS radiological arterial data...

Abstract Neurological symptoms are common in Covid-19 and cerebral edema has been shown post-mortem. The mechanism behind this is unclear. Elevated intracranial pressure (ICP) not extensively studied Covid-19. ICP can be estimated noninvasively with measurements of the optic nerve sheath diameter (ONSD). We performed a cohort study ONSD ultrasound severe cases at an intensive care unit (ICU). measured adults ICU Karolinska University Hospital Sweden. Patients were classified as either having...

Abstract Clinical scalp electroencephalographic recordings from patients with epilepsy are distinguished by the presence of epileptic discharges i.e. spikes or sharp waves. These often occur randomly on a background fluctuating potentials. The spike rate varies between different brain states (sleep and awake) patients. Epileptogenic tissue regions near these show increased rates in comparison to other cortical regions. Several studies have shown relation activity although underlying reason...