Relevant bibliographies by topics / Stroke recurrence

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  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers
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Academic literature on the topic 'Stroke recurrence'

Author: Grafiati
Published: 4 June 2021
Last updated: 12 February 2022

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Journal articles on the topic "Stroke recurrence"

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Flach, Clare, Walter Muruet, Charles D. A. Wolfe, Ajay Bhalla, and Abdel Douiri. "Risk and Secondary Prevention of Stroke Recurrence." Stroke 51, no. 8 (August 2020): 2435–44. http://dx.doi.org/10.1161/strokeaha.120.028992.

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Background and Purpose: With recent advances in secondary prevention management, stroke recurrence rates may have changed substantially. We aim to estimate risks and trends of stroke recurrence over the past 2 decades in a population-based cohort of patients with stroke. Methods: Patients with a first-ever stroke between 1995 and 2018 in South London, United Kingdom (n=6052) were collected and analyzed. Rates of recurrent stroke with 95% CIs were stratified by 5-year period of index stroke and etiologic TOAST (Trial of ORG 10172 in Acute Stroke Treatment) subtype. Cumulative incidences were estimated and multivariate Cox models applied to examine associations of recurrence and recurrence-free survival. Results: The rate of stroke recurrence at 5 years reduced from 18% (95% CI, 15%–21%) in those who had their stroke in 1995 to 1999 to 12% (10%–15%) in 2000 to 2005, and no improvement since. Recurrence-free survival has improved (35%, 1995–1999; 67%, 2010–2015). Risk of recurrence or death is lowest for small-vessel occlusion strokes and other ischemic causes (36% and 27% at 5 years, respectively). For cardioembolic and hemorrhagic index strokes around half of first recurrences are of the same type (54% and 51%, respectively). Over the whole study period a 54% increased risk of recurrence was observed among those who had atrial fibrillation before the index stroke (hazard ratio, 1.54 [1.09–2.17]). Conclusions: The rate of recurrence reduced until mid-2000s but has not changed over the last decade. The majority of cardioembolic or hemorrhagic strokes that have a recurrence are stroke of the same type indicating that the implementation of effective preventive strategies is still suboptimal in these stroke subtypes.
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Ryu, Wi-Sun, Dawid Schellingerhout, Keun-Sik Hong, Sang-Wuk Jeong, Min Uk Jang, Man-Seok Park, Kang-Ho Choi, et al. "White matter hyperintensity load on stroke recurrence and mortality at 1 year after ischemic stroke." Neurology 93, no. 6 (July 15, 2019): e578-e589. http://dx.doi.org/10.1212/wnl.0000000000007896.

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ObjectiveTo define the role and risks associated with white matter hyperintensity (WMH) load in a stroke population with respect to recurrent stroke and mortality after ischemic stroke.MethodsA total of 7,101 patients at a network of university hospitals presenting with ischemic strokes were followed up for 1 year. Multivariable Cox proportional hazards model and competing risk analysis were used to examine the independent association between quartiles of WMH load and stroke recurrence and mortality at 1 year.ResultsOverall recurrent stroke risk at 1 year was 6.7%/y, divided between 5.6%/y for recurrent ischemic and 0.5%/y for recurrent hemorrhagic strokes. There was a stronger association between WMH volume and recurrent hemorrhagic stroke by quartile (hazard ratio [HR] 7.32, 14.12, and 33.52, respectively) than for ischemic recurrence (HR 1.03, 1.37, and 1.61, respectively), but the absolute incidence of ischemic recurrence by quartile was higher (3.8%/y, 4.5%/y, 6.3%/y, and 8.2%/y by quartiles) vs hemorrhagic recurrence (0.1%/y, 0.4%/y, 0.6%/y, and 1.3%/y). All-cause mortality (10.5%) showed a marked association with WMH volume (HR 1.06, 1.46, and 1.60), but this was attributable to nonvascular rather than vascular causes.ConclusionsThere is an association between WMH volume load and stroke recurrence, and this association is stronger for hemorrhagic than for ischemic stroke, although the absolute risk of ischemic recurrence remains higher. These data should be helpful to practitioners seeking to find the optimal preventive/treatment regimen for poststroke patients and to individualize risk-benefit ratios.
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Pramudita, Karina, and Hari Basuki Notobroto. "Analisis Survival Kecepatan Kekambuhan Stroke." Jurnal Biometrika dan Kependudukan 6, no. 1 (October 30, 2018): 62. http://dx.doi.org/10.20473/jbk.v6i1.2017.62-69.

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The objective of this study was to apply cox regression to factor analysis of stroke recurrence rate. This type of research was applied research on secondary data. The samples were 178 first stroke patients who are enrolled in inpatient period January to December 2011 and then made observations on the incidence of recurrent strokes up in February 2017 in medical record. Analysis techniques using Cox regression analysis on risk factors of stroke recurrence rate in RSAU dr. Esnawan Antariksa Halim Perdana Kusumah Jakarta. The analysis exhibited that the rate of recurrence of stroke has the same risk between categories of obesity. Stroke patients with a history of hypertension had a risk of a stroke recurrence rate of 5.594 times more likely than stroke patients with no history of hypertension, stroke patients with a history of diabetes mellitus had a risk of stroke recurrence rate of 1.912 times more likely than stroke patients with no history of diabetes mellitus, stroke patients with a history of dyslipidemia The risk of a recurrence rate of stroke was 2.153 times more likely than stroke patients without a history of dyslipidemia, and stroke patients with a history of heart abnormalities had a risk of recurrent stroke rates of 2.321 times more likely than stroke patients without a history of heart abnormalities. For stroke patients with a history of hypertension, diabetes mellitus, dyslipidemia and a history of cardiac abnormalities, need to do regular check-ups and controls every month to avoid recurrence of stroke.
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Masina, Marco, Annalena Cicognani, Carla Lofiego, Simona Malservisi, Riccardo Parlangeli, and Alessandro Lombardi. "Embolic stroke of undetermined source: a retrospective analysis from an Italian Stroke Unit." Italian Journal of Medicine 10, no. 3 (September 30, 2016): 202. http://dx.doi.org/10.4081/itjm.2016.690.

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The new clinical construct of embolic stroke of undetermined source (ESUS) suggests that many cryptogenic strokes are related to minor-risk covert embolic cardiac sources or to embolus from non-occlusive plaques in the aortic arch or in the cerebral arteries. The authors analyzed the prevalence of ESUS in a real-life condition in Italy and compared the recurrence rates in cryptogenic strokes, cardioembolic strokes, and ESUS. The authors retrospectively reassessed according to ESUS criteria 391 consecutive admissions in a stroke unit where extensive diagnostic search was routinely performed. Recurrences in each stroke type within a 3-year follow-up period (mean time: 25.44 months - standard deviation: 9.42) were also compared. The prevalence of ESUS in the aforementioned cohort was 10.5%. All ESUS patients received antiplatelet agents. Warfarin was prescribed in 56.9% of cardioembolic strokes. The recurrence rate in ESUS patients was 4.4% per year, slightly higher than in cardioembolic strokes (3.5%) and significantly higher than in cryptogenic non-ESUS (1.2%) (P<0.0001). This is the first description of a cohort of ESUS patients in an Italian stroke unit. Patients with ESUS have a significantly higher risk of recurrence than in those with non-ESUS cryptogenic strokes, and slightly higher than in those with cardioembolic strokes. Results support the hypothesis of a more extensive diagnostic evaluation in cryptogenic strokes and the feasibility of such approach.
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Kauw, Frans, Richard A. P. Takx, Hugo W. A. M. de Jong, Birgitta K. Velthuis, L. Jaap Kappelle, and Jan W. Dankbaar. "Clinical and Imaging Predictors of Recurrent Ischemic Stroke: A Systematic Review and Meta-Analysis." Cerebrovascular Diseases 45, no. 5-6 (2018): 279–87. http://dx.doi.org/10.1159/000490422.

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Background: Predictors of recurrent ischemic stroke are less well known in patients with a recent ischemic stroke than in patients with transient ischemic attack (TIA). We identified clinical and radiological factors for predicting recurrent ischemic stroke in patients with recent ischemic stroke. Methods: A systematic search in PubMed, Embase, Cochrane Library, and CINAHL was performed with the terms “ischemic stroke,” “predictors/determinants,” and “recurrence.” Quality assessment of the articles was performed and the level of evidence was graded for the articles included for the meta-analysis. Pooled risk ratios (RR) and heterogeneity (I2) were calculated using inverse variance random effects models. Results: Ten articles with high-quality results were identified for meta-analysis. Past medical history of stroke or TIA was a predictor of recurrent ischemic stroke (pooled RR 2.5, 95% CI 2.1–3.1). Small vessel strokes were associated with a lower risk of recurrence than large vessel strokes (pooled RR 0.3, 95% CI 0.1–0.7). Patients with stroke of an undetermined cause had a lower risk of recurrence than patients with large artery atherosclerosis (pooled RR 0.5, 95% CI 0.2–1.1). We found no studies using CT or ultrasound for the prediction of recurrent ischemic stroke. The following MRI findings were predictors of recurrent ischemic stroke: multiple lesions (pooled RR 1.7, 95% CI 1.5–2.0), multiple stage lesions (pooled RR 4.1, 95% CI 3.1–5.5), multiple territory lesions (pooled RR 2.9, 95% CI 2.0–4.2), chronic infarcts (pooled RR 1.5, 95% CI 1.2–1.9), and isolated cortical lesions (pooled RR 2.2, 95% CI 1.5–3.2). Conclusions: In patients with a recent ischemic stroke, a history of stroke or TIA and the subtype large artery atherosclerosis are associated with an increased risk of recurrent ischemic stroke. Predictors evaluated with MRI include multiple ischemic changes and isolated cortical lesions. Predictors of recurrent ischemic stroke concerning CT or ultrasound have not been published.
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Gorelick, Philip B. "Prevention of Stroke Recurrence." International Psychogeriatrics 15, S1 (July 2003): 167–71. http://dx.doi.org/10.1017/s1041610203009141.

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Stroke recurrence can be reduced substantially by intervention with the appropriate stroke preventive(s). Control of blood pressure, use of one of the antiplatelet agents aspirin, aspirin plus extended (modified)-release dipyridamole, or clopidogrel, administration of warfarin for patients with atrial fibrillation and high-risk profiles for stroke, and use of carotid endarterectomy in patients with high grades of symptomatic carotid artery stenosis are all proven therapies for prevention of stroke recurrence. Newer therapies to reduce the risk of infection and inflammation promise to further reduce the risk of first and recurrent stroke and are undergoing testing. In this article we review standard and more novel means to prevent stroke recurrence.
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Antic, Ivan, Branislav Petrovic, and Natasa Rancic. "Differences in the outcome of disease between patients diagnosed with 1st and recurrent stroke after two years of monitoring." Medical review 65, no. 1-2 (2012): 23–29. http://dx.doi.org/10.2298/mpns1202023a.

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Introduction. A stroke is the most common neurological disorder, and the most common cause of severe disability. The aim of this study was to establish the incidence and recurrence of the stroke among the population of the Doljevac district, as well as the differences in the outcome of disease between the patients diagnosed with the first and recurrent stroke. Material and Methods. A prospective examination was carried out, and the study included all patients with the first and recurrent stroke in the territory of the Doljevac district (population, 19529) in the period from 2004 to 2008, after two years of monitoring. Results. During the observed period, the total number of the affected people was 380, of whom 182 (47.89%) were males, and 198 (52.10%) were females. The overall standardized incidence rate of the stroke was 270.20, and with recurrences - 42.03. Among the patients with the first stroke, we recorded a higher number of survivals (?2 =3.99; p=0.04) and patients with recurrences in a one-year period (?2 =5.29; p=0.02), as well as in a two-year period (?2 =7.72; p=0.00) since the beginning of the disease. Among the patients with recurrences, we recorded a higher demand for medical help in home healthcare environment (?2 =4.97; p=0.02), and the higher onemonth (?2 =12.09; p=0.00), and one-year lethality (?2 =9.03; p=0.00). Among the patients with recurrences, there were no differences in the diagnosis of the first and recurrent stroke (p>0.05). Conclusion. This study showed that there were no statistical differences in the incidence between the first and recurrent stroke between the sexes (p>0.05). Among the patients with the first stroke, we recorded a higher tendency for survival, and frequent cases of recurrence, and among those with recurrences, the rate of mortality was higher.
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Raghuram, Karthikram, Aditya Durgam, Jennifer Kohlnhofer, and Ayush Singh. "Relationship between stroke recurrence, infarct pattern, and vascular distribution in patients with symptomatic intracranial stenosis." Journal of NeuroInterventional Surgery 10, no. 12 (March 30, 2018): 1161–63. http://dx.doi.org/10.1136/neurintsurg-2017-013735.

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ObjectiveIn view of recent literature suggesting that stroke recurrence and risks related to intervention may be related to plaque physiology/instability, our study sought to discern the pattern of stroke and rates of stoke recurrence as they relate to the anatomy and presentation of the underlying stenosis.MethodsRetrospective chart as well as CT and MR angiographic imaging review of patients in the institutional stroke database was performed, including identification of patient risk factors, medical therapeutic optimization, compliance, serum cholesterol (low density lipoprotein) levels, blood pressure, physical therapy referrals, follow-up clinical status (using the modified Rankin Scales), and rate of recurrent stroke. 39 patients met the inclusion criteria. We evaluated infarct pattern (embolic, adjacent perforator, or watershed) and vascular distribution.ResultsBasilar artery stenosis was most likely to present as a perforator stroke and least likely to recur. Patients discharged with suboptimal medical therapy were twice as likely to have a recurrent stroke. Among patients with optimized medical therapy, no recurrent strokes were seen in patients with an embolic infarct pattern, while a 57% recurrence rate was seen in patients with a watershed infarct pattern.ConclusionsOur results suggest that hemodynamic intracranial vascular stenoses may be less responsive to medical therapy, while stenotic lesions caused by plaque destabilization or in perforator territories may benefit from aggressive medical management with delayed or staged endovascular therapy. Recurrence of stroke may be affected both by vascular territory and by aggressive risk factor control, although the latter remains difficult to evaluate.
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Deveber, Gabrielle, Fenella Jane Kirkham, Kelsey Shannon, Leonardo R. Brandao, Ronald Sträter, Gili Kenet, Hartmut Clausnizer, et al. "Recurrent Stroke: The Role of Thrombophilia in a Large International Pediatric Stroke Population." Blood 132, Supplement 1 (November 29, 2018): 3808. http://dx.doi.org/10.1182/blood-2018-99-118914.

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Abstract OBJECTIVE: Risk factors for arterial ischemic stroke (AIS) in children are multiple and include cardiac disease, vasculopathy, and prothrombotic risk factors (PR). The relevance of these factors to a second AIS event is incompletely understood. METHODS: We conducted a multicenter cohort study to assess the rate of symptomatic stroke recurrence following initial AIS, pooling data on recurrent AIS from the databases held in Canada, Germany, and UK. We followed 894 patients aged 1 month to 18 years (median 6 years) at initial AIS for median 35 months. RESULTS: 160 of 894 patients (17.9%) had recurrence from 1 day to 136 months (median 3.1 months) after first AIS. Recurrence was significantly more common in children with (hazard ratio (HR) 2.5, 95% confidence intervals (CI) 1.92-3.5, p<0.001) compared to children without vasculopathy. After adjusting for vasculopathy, antithrombin deficiency, elevated lipoprotein (a), and the presence of any combined PR were independently associated with recurrence. Recurrence rates calculated per 100 person-years were 10 (95%CI: 3-24) for antithrombin deficiency, 6 (95%CI 4-9) for elevated Lp(a), and 13 (95%CI 7-20) for combined PR. CONCLUSIONS: Identifying children at increased for recurrent AIS events is important in intensifying preventative measures. Among 894 Canadian, English and German pediatric stroke patients, 17.9% experienced recurrent AIS at a median of 3.1 months after the index stroke. The presence of more than one prothrombotic risk factor is associated with AIS recurrence in children Disclosures No relevant conflicts of interest to declare.
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Zhang, Weili, Kai Sun, Jinxing Chen, Yuhua Liao, Qin Qin, Aiqun Ma, Daowen Wang, Zhiming Zhu, Yibo Wang, and Rutai Hui. "High plasma homocysteine levels contribute to the risk of stroke recurrence and all-cause mortality in a large prospective stroke population." Clinical Science 118, no. 3 (October 26, 2009): 187–94. http://dx.doi.org/10.1042/cs20090142.

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Plasma homocysteine concentrations have been associated with the risk of stroke, but its relevance to secondary vascular events and mortality after stroke remains unclear because of inconsistent results from clinical trials. The aim of the present study was to investigate whether plasma homocysteine levels and the MTHFR (methylenetetrahydrofolate reductase) variant C677T contributed to the risk of stroke recurrence and all-cause mortality in a large prospective cohort of stroke patients in a Chinese population. A total of 1823 stroke patients (age, 35–74 years) were recruited during 2000–2001 and prospectively followed-up for a median of 4.5 years. During the follow-up, 347 recurrent strokes and 323 deaths from all-causes were documented. After adjustment for age, gender and other cardiovascular risk factors, a high homocysteine concentration was associated with an increased risk of 1.74-fold for stroke recurrence {RR (relative risk), 1.74 [95% CI (confidence interval), 1.3–2.3]; P&lt;0.0001} and 1.75-fold for all-cause mortality [RR, 1.75 (95% CI, 1.3–2.4); P&lt;0.0001] when highest and lowest categories were compared. Spline regression analyses revealed a threshold level of homocysteine for stroke recurrence. By dichotomizing homocysteine concentrations, the RRs were 1.31 (95% CI, 1.10–1.61; P=0.016) for stroke recurrence and 1.47 (95% CI, 1.15–1.88; P&lt;0.0001) for all-cause mortality in patients with homocysteine levels ≥16 μmol/l relative to those with levels &lt;16 μmol/l. The association of elevated plasma homocysteine concentrations with all-cause mortality was mainly due to an increased risk of cardiovascular deaths. No significant association was found between MTHFR C677T and stroke recurrence or mortality. In conclusion, our findings suggest that elevated homocysteine concentrations can predict the risk of stroke recurrence and mortality in patients with stroke.
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Dissertations / Theses on the topic "Stroke recurrence"

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Jaigobin, Cheryl S. "Survival, stroke recurrence and functional outcome after lacunar stroke." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ58705.pdf.

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Mohan, Keerthi Michelle. "The natural history of stroke recurrence after first-ever stroke." Thesis, King's College London (University of London), 2016. http://kclpure.kcl.ac.uk/portal/en/theses/the-natural-history-of-stroke-recurrence-after-firstever-stroke(530e5d24-437f-43a0-9555-eb45f374e278).html.

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Background - The natural history, predictors and outcomes of stroke recurrence after first-ever stroke have been insufficiently investigated. The available evidence shows great variation and does not provide a consensus of key predictors of stroke recurrence or a critical time-period for stroke recurrence occurring after initial stroke. This thesis uses data collected from the population-based South London Stroke Register to estimate the natural history of stroke recurrence after first-ever stroke. Methods - Data were collected over 12 years from all individuals known to have had an initial and first recurrent stroke from the South London Stroke Register. The cumulative risk and predictors of stroke recurrence up to 12 years after first stroke were identified using survival analyses, taking into account the effect of temporal changes in stroke management. The effect of stroke recurrence on risk of death after first stroke was estimated up to 15 years after initial stroke. A systematic review and meta-analysis of studies of the risk and cumulative risk of stroke recurrence after first stroke was also conducted. Results - The risk of stroke recurrence was estimated to be up to 25% at 12 years after first stroke. Cardiovascular risk factors were found to be important predictors of stroke recurrence, however differences in risk of recurrence were noted between the aetiological subtypes. Stroke recurrence was demonstrated to increase risk of death at all time-points up to 15 years after first stroke. Conclusions – The risk of stroke recurrence is considerable and is associated with increased risk of death up to 15 years after first stroke. Further research is needed to examine the effect of secondary prevention on risk of recurrence. Recurrence in the first year after stroke may also be associated with the biggest increase in risk of death identifying a potentially important time-period for stroke management to be targeted.
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Maniva, Samia Jardelle Costa de Freitas. "Elaboration and validation of educational technology on stroke for prevention of recurrence." Universidade Federal do CearÃ, 2016. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=18306.

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nÃo hÃ
A prevenÃÃo da recorrÃncia do Acidente Vascular Cerebral (AVC) à uma medida fundamental para reduzir novos episÃdios em indivÃduos jà acometidos pela doenÃa. Acredita-se que a construÃÃo e validaÃÃo de uma tecnologia educativa do tipo cartilha sobre AVC seja de grande relevÃncia. O objetivo do estudo foi elaborar e validar uma tecnologia educativa do tipo cartilha sobre AVC para prevenÃÃo da recorrÃncia. O estudo foi realizado em duas etapas. Na primeira etapa, ocorreu a elaboraÃÃo e validaÃÃo de conteÃdo da cartilha. Na elaboraÃÃo da cartilha, os assuntos foram selecionados por meio de uma revisÃo integrativa e avaliados por onze especialistas. Em seguida, realizou-se a validaÃÃo de aparÃncia da cartilha com dez pacientes hospitalizados com AVC. Para anÃlise dos dados, foi utilizado o Ãndice de Validade de ConteÃdo (IVC). Na segunda etapa, conduziu-se um estudo quase-experimental, do tipo antes e depois. A cartilha validada foi aplicada a um grupo de 87 pacientes com AVC. Esta etapa foi desenvolvida na Unidade de AVC do Hospital Geral de Fortaleza (CearÃ), no perÃodo de fevereiro a abril de 2016. Foi utilizado o inquÃrito CAP, elaborado pela pesquisadora e previamente validado, para avaliar o conhecimento, a atitude e prÃtica dos pacientes sobre AVC, antes da implementaÃÃo da cartilha (prÃ-teste), imediatamente apÃs (pÃs-teste imediato) e apÃs quatro semanas (pÃs-teste tardio), via contato telefÃnico. Os dados foram apresentados por meio de tabelas e grÃficos, e discutidos com base na literatura pertinente. Foram calculadas as medidas estatÃsticas mÃdia, mediana e desvio padrÃo das variÃveis: idade, n de anos de estudo, renda, tempo de inÃcio dos sintomas e comparaÃÃo das mÃdias de pontuaÃÃo do CAP nos trÃs momentos. Todos os aspectos Ãticos foram respeitados, conforme a ResoluÃÃo 466/12, do Conselho Nacional de SaÃde. A cartilha educativa intitulada âCartilha do AVC: o que Ã, o que fazer e como prevenirâ, foi constituÃda por sete domÃnios: definiÃÃo da doenÃa, sinais e sintomas, aÃÃo emergencial, tratamento, fatores de risco, recorrÃncia de AVC e medidas preventivas. Na validaÃÃo de conteÃdo, a mÃdia do IVC para cada um dos aspectos avaliativos da cartilha obteve valor superior a 0,85 e a mÃdia global do IVC foi 0,94, indicando excelente grau de concordÃncia entre os especialistas. Com relaÃÃo à aplicaÃÃo da cartilha no grupo de pacientes, a mÃdia de idade dos pacientes foi de 51,6 anos (Â16,1), variando de 19 a 81 anos. A maioria foi composta por mulheres (51,7%), era casada (74,7%) e exerciam atividade laboral (67,8%), com renda mÃdia de um salÃrio mÃnimo. Quanto ao tipo de AVC, 94,% tiveram AVC isquÃmico. Os principais fatores de risco relatados para AVC foram: sedentarismo (86%), hipertensÃo arterial (66,3%) e diabetes mellitus (24,4%). AVC prÃvio ocorreu em 17,3% dos pacientes. No que diz respeito à comparaÃÃo das mÃdias das pontuaÃÃes do CAP, no prÃ-teste, conhecimento foi 3,31 (IC=3,02-3,61); atitude 0,63 (IC=0,43-0,83) e prÃtica 5,12 (IC=4,61-5,62). No pÃs-teste imediato, conhecimento foi 5,95 (IC=5,74-6,16), atitude 1,98 (IC=1,93-2,02) e prÃtica 11,64 (IC=11,49-11,79). No pÃs-teste tardio, conhecimento foi 5,25 (IC=5,02-5,49), atitude 2,00 (IC=2,00-2,00) e prÃtica 9,91 (IC=9,59-10,23). Diante de tais achados, pode-se afirmar que a cartilha educativa promoveu conhecimento, atitude e prÃtica adequada em pacientes sobre AVC, com vistas à prevenÃÃo da recorrÃncia.
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Pennlert, Johanna. "Recurrent stroke : risk factors, predictors and prognosis." Doctoral thesis, Umeå universitet, Medicin, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-127304.

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Background Many risk factors for stroke are well characterized and might, at least to some extent, be similar for first-ever stroke and for recurrent stroke events. However, previous studies have shown heterogeneous results on predictors and rates of stroke recurrence. Patients who survive spontaneous intracerebral hemorrhage (ICH) often have compelling indications for antithrombotic (AT) treatment (antiplatelet (AP) and/or anticoagulant (AC) treatment), but due to controversy of the decision to treat, a large proportion of these patients are untreated. In the absence of evidence from randomized controlled trials (RCTs), there is need for more high- quality observational data on the clinical impact of, and optimal timing of AT in ICH survivors. The aims of this thesis were to assess time trends in stroke recurrence, to determine the factors associated with an increased risk of stroke recurrence – including socioeconomic factors – and to determine to what extent ICH survivors with and without atrial fibrillation (AF) receive AT treatment and to determine the optimal timing (if any) of such treatment.  Methods The population-based Monitoring Trends and Determinants of Cardiovascular Disease (MONICA) stroke incidence register was used to assess the epidemiology and predictors of stroke recurrence after ischemic stroke (IS) and ICH from 1995 to 2008 in northern Sweden. Riksstroke, the Swedish stroke register, linked with the National Patient Register and the Swedish Dispensed Drug Register, made it possible to identify survivors of first-ever ICH from 2005 to 2012 with and without concomitant AF to investigate to what extent these patients were prescribed AP and AC therapy. The optimal timing of initiating treatment following ICH in patients with AF 2005–2012 was described through separate cumulative incidence functions for severe thrombotic and hemorrhagic events and for the combined endpoint “vascular death or non-fatal stroke”. Riksstroke data on first-ever stroke patients from 2001 to 2012 was linked to the Longitudinal Integration Database for Health Insurance and Labour market studies to add information on education and income to investigate the relationship between socioeconomic status and risk of recurrence. Results Comparison between the cohorts of 1995–1998 and 2004–2008 showed declining risk of stroke recurrence (hazard ratio: 0.64, 95% confidence interval (CI): 0.52-0.78) in northern Sweden. Significant factors associated with an increased risk of stroke recurrence were age and diabetes. Following ICH, a majority (62%) of recurrent stroke events were ischemic.  The nationwide Riksstroke study confirmed the declining incidence, and it further concluded that low income, primary school as highest attained level of education, and living alone were associated with a higher risk of recurrence beyond the acute phase. The inverse effects of socioeconomic status on risk of recurrence did not differ between men and women and persisted over the study period. Of Swedish ICH-survivors with AF, 8.5% were prescribed AC and 36.6% AP treatment, within 6 months of ICH. In patients with AF, predictors of AC treatment were less severe ICH, younger age, previous anticoagulation, valvular disease and previous IS. High CHA2DS2-VASc scores did not seem to correlate with AC treatment. We observed both an increasing proportion of AC treatment at time of the initial ICH (8.1% in 2006 compared with 14.6% in 2012) and a secular trend of increasing AC use one year after discharge (8.3% in 2006 versus 17.2% in 2011) (p<0.001 assuming linear trends). In patients with high cardiovascular event risk, AC treatment was associated with a reduced risk of vascular death and non-fatal stroke with no significantly increased risk of severe hemorrhage. The benefit appeared to be greatest when treatment was started 7–8 weeks after ICH. For high-risk women, the total risk of vascular death or stroke recurrence within three years was 17.0% when AC treatment was initiated eight weeks after ICH and 28.6% without any antithrombotic treatment (95% CI for difference: 1.4% to 21.8%). For high-risk men, the corresponding risks were 14.3% vs. 23.6% (95% CI for difference: 0.4% to 18.2%). Conclusion Stroke recurrence is declining in Sweden, but it is still common among stroke survivors and has a severe impact on patient morbidity and mortality. Age, diabetes and low socioeconomic status are predictors of stroke recurrence. Regarding ICH survivors with concomitant AF, physicians face the clinical dilemma of balancing the risks of thrombosis and bleeding. In awaiting evidence from RCTs, our results show that AC treatment in ICH survivors with AF was initiated more frequently over the study period, which seems beneficial, particularly in high-risk patients. The optimal timing of anticoagulation following ICH in AF patients seems to be around 7–8 weeks following the hemorrhage.
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Johansson, Elias. "Carotid stenosis." Doctoral thesis, Umeå universitet, Institutionen för folkhälsa och klinisk medicin, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-46396.

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Carotid stenosis is one of several causes of ischemic stroke and entails a high risk of ischemic stroke recurrence. Removal of a carotid stenosis by carotid endarterectomy results in a risk reduction for ischemic stroke, but the magnitude of risk reduction depends on several factors. If the delay between the last symptom and carotid endarterectomy is less than 2 weeks, the absolute risk reduction is >10%, regardless of age, sex, or if the degree of carotid stenosis is 50–69% or 70–99%. Thus, speed is the key. However, if many patients suffers an ischemic stroke recurrence within the first 2 weeks of the presenting event, an additional benefit is likely be obtained if carotid endarterectomy is performed even earlier than within 2 week after the presenting event. Carotid endarterectomy for asymptomatic carotid stenoses carries a small risk reduction for stroke. Screening for asymptomatic carotid stenosis requires a prevalence of >5% in the examined population, i.e., higher than in the general population; however, directed screening in groups with a prevalence of >5% is beneficial. The aims of this thesis were to investigate the length of the delay to carotid endarterectomy, determine the risk of recurrent stroke before carotid endarterectomy, and determine if a calcification in the area of the carotid arteries seen on dental panoramic radiographs is a valid selection method for directed ultrasound screening to detect asymptomatic carotid stenosis. Consecutive patients with a symptomatic carotid stenosis who underwent a preoperative evaluation aimed at carotid endarterectomy at Umeå Stroke Centre between January 1, 2004–March 31, 2006 (n=275) were collected retrospectively and between August 1, 2007–December 31, 2009 (n=230) prospectively. In addition, 117 consecutive persons, all preliminarily eligible for asymptomatic carotid endarterectomy and with a calcification in the area of the carotid arteries seen on panoramic radiographs, were prospectively examined with carotid ultrasound. The median delay between the presenting event and carotid endarterectomy was 11.7 weeks in the first half year of 2004, dropped to 6.9 weeks in the first quarter year of 2006, and had dropped to 3.6 weeks in the second half year of 2009. The risk of ipsilateral ischemic stroke recurrence was 4.8% within 2 days, 7.9% within 1 week, and 11.2% within 2 weeks of the presenting event. For patients with a stroke or transient ischemic attack as the presenting event, this risk was 6.0% within 2 days, 9.7% within 1 week, and 14.3% within 2 weeks of the presenting event. For the 10 patients with a near-occlusion, the risk of ipsilateral ischemic stroke recurrence was 50% at 4 weeks after the presenting event. Among the 117 persons with a calcification in the area of the carotid arteries seen on panoramic radiographs, eight had a 50–99% carotid stenosis, equalling a prevalence of 6.8% (not statistically significantly over the pre-specified 5% threshold). Among men, the prevalence of 50–99% carotid stenosis was 12.5%, which was statistically significantly over the pre-specified 5% threshold. In conclusion: The delay to carotid endarterectomy was longer than 2 weeks. Additional benefit is likely to be gained by performing carotid endarterectomy within a few days of the presenting event instead of at 2 weeks because many patients suffer a stroke recurrence within a few days; speed is indeed the key. The finding that near-occlusion entails an early high risk of stroke recurrence stands in sharp contrast to previous studies; one possible explaination is that this was a high-risk period missed in previous studies. The incidental finding of a calcification in the area of the carotid arteries on a panoramic radiograph is a valid indication for carotid ultrasound screening in men who are otherwise eligible for asymptomatic carotid endarterectomy.
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Chong, Boon Hor, and 鍾文一. "Risk of ischemic stroke and recurrent hemorrhagic stroke in Chinese population." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B47323450.

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Stroke is a devastating, neurological dysfunction due to brain blood supply disturbance. It is responsible for increasingly high rate of mortality and disability worldwide. This thesis comprises two original studies involving 868 patients at risk of ischemic stroke and/or hemorrhagic stroke. The first study investigated aspirin’s effect among patients with intracranial hemorrhage. Unlike Caucasians which hemorrhagic strokes account for 10-15% of all strokes; in Chinese, intracranial hemorrhages strike up to 35%. After such, anti-platelet agent like aspirin is often avoided for fear of recurrent intracranial hemorrhages, despite compelling indications. However, clinical data is limited. In this single-centered observational study, we included 440 consecutive Chinese patients with a first spontaneous intracranial hemorrhage surviving the first month performed during 1996-2010. 56 patients (12.7%) of these 440 patients were prescribed aspirin after intracranial hemorrhage (312 patient-aspirin years). After a mean follow-up of 62.2 ± 1.8 months, 47 patients had recurrent intracranial hemorrhage(10.7%, 20.6 per 1,000 patient years). Patients prescribed aspirin did not have higher risk of recurrent intracranial hemorrhage compared with those without (22.7 per 1,000 patient-aspirin years vs. 22.4 per 1,000 patient years, p=0.70). Multivariate analysis identified age > 60 years and hypertension as independent predictors for recurrent intracranial hemorrhage. In a subgroup analysis: the incidence of combined vascular events including recurrent intracranial hemorrhage, ischemic stroke, and acute coronary syndrome was statistically lower in patients prescribed aspirin than without (52.4 per 1,000 patient-aspirin years, vs. 112.8 per 1,000 patient-years, p=0.04). Implications of the results: despite having a substantial risk for recurrent intracranial hemorrhage, post-intracranial hemorrhage ones are at risk for thrombotic vascular events and management goal should thus focus on ameliorating overall cardiovascular risk instead of preventing recurrent intracranial hemorrhage. Hence, thrombo-prophylaxis should still be considered. The second study investigated the relation between premature atrial complexes and new-onset atrial fibrillation together with other cardiovascular events. Premature atrial complexes though taken as benign phenomenon, are common in patients with underlying conditions such as coronary heart disease, chronic rheumatic heart disease. While prompt management of atrial fibrillation may prevent ischemic stroke, atrial fibrillation is often unfound until ischemic stroke occurs. In this study, 428 patients without atrial fibrillation but complained of palpitations, dizziness or syncope were recruited. 107 patients with >100 premature atrial complexes/day were defined to have frequent premature atrial complexes. After a mean follow-up of 6.1 ±1.3 years, 31 patients (29%) with frequent premature atrial complexes developed atrial fibrillation compared with 29 patients (9%) with premature atrial complexes?100/day (p<0.01). Cox regression analysis revealed: frequent premature atrial complexes, age>75 years and coronary artery disease were independent predictors. In secondary endpoint (ischemic stroke, congestive heart failure, and death), patients with frequent premature atrial complexes were more at risk than those without (34.5% vs. 19.3%) (Hazard ratio: 1.95, 95% confidence interval: 1.37-3.50, p=0.001). Cox regression analysis showed: age> 75 years, coronary artery disease and frequent premature atrial complexes were independent predictors. These permit early identification of high risks patients of new atrial fibrillation and other events, thus promoting appropriate preventive treatment.
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Medicine
Master
Master of Philosophy
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7

Lilly, Flavius R. W. "Severe Mental Illness among Stroke Survivors| Post-Stroke Non-Psychiatric Hospitalizations, Recurrent Stroke and Mortality Over Five Years." Thesis, University of Maryland, Baltimore County, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3707293.

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BACKGROUND AND PURPOSE: This study sought to examine the association of severe mental illness (SMI) among stroke survivors treated in Veteran Administration (VA) hospitals with medical (non-psychiatric) hospitalizations, recurrent stroke hospitalization and mortality risk over a five year period after the initial stroke. Additionally, this study used administrative data to explored inpatient stroke treatment differences between patients with and without SMI.

METHODS: This retrospective cohort study included 523 veterans who survived an initial stroke hospitalization in a VA medical center during fiscal year 2003. This cohort of stroke survivors was followed from discharge in 2003 through 2008 using administrative data documenting patient demographics, disease co-morbidities, subsequent VA hospital admissions, recurrent stroke admissions, and death. Multivariate Poisson regression with log link functions was used to examine the relationship between SMI status and non-psychiatric hospitalizations after stroke. Cox proportional hazards regression was used to examine the relationship between SMI status and recurrent stroke and post-stroke mortality. The differences in compliance with inpatient stroke treatment guidelines between patients with and without SMI was assessed using logistic regression.

RESULTS: The study cohort of 523 veterans included 100 with SMI comorbidity and 423 without SMI comorbidity. It was found that stroke survivors with SMI do not have significantly increased risk for non-psychiatric hospitalizations, recurrent stroke or mortality at any time period post-stroke after adjustment for covariates. It was also found that there was no significant difference in the delivery of guideline concordant inpatient stroke care between patients with and without SMI.

CONCLUSIONS: The finding that SMI had little impact on the post-stroke outcomes of hospitalization, recurrent stroke and mortality among veterans who receive their care at VA hospitals was surprising. It was hypothesized that SMI would continue to disadvantage individuals even after having survived a stroke. These findings may be partially explained by the highly integrated nature of care for the mentally ill in the VA system, which may equalize disparities associated with SMI post-stroke. This study offers preliminary evidence of this in VA hospital inpatient settings where acute stroke treatment did not significantly vary between patients with and without SMI.

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8

Viitanen, Matti. "Long-term effects of stroke." Doctoral thesis, Umeå universitet, Rehabiliteringsmedicin, 1987. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-100559.

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Stroke, which has an increasing incidence with age, causes an irreversible brain damage which may lead to impairment, disability and decreased life satisfaction or death. Risk factors for death, recurrent stroke and myocardial infarction, were analyzed in 409 stroke patients treated at the Stroke Unit, Department of Medicine, Umeå University Hospital, between Jan. 1, 1978 and Dec. 31, 1982. The causes of death were related with the time of survival. In fully co-operable (n=62) 4-6 year stroke survivors, the occurrence of motor and perceptual impairments, of self-care (ADL) disability and of self-reported decreased life satisfaction due to stroke was determined. The probability of survival was 77% three months after stroke, 69% after one year, and 37% after five years. Multivariate statistical analysis indicated that impairment of consciousness was the most important risk factor for death followed by age, previous cardiac failure, diabetes mellitus, intracerebral hemorrhage and male sex. During the first week, cerebrovascular disease (90%) was the most dominant primary cause of death, from the second to the fourth week pulmonary embolism (30%), bronchopneumonia during the second and third months and cardiac disease (37%) later than three months after stroke. The risk of recurrence was 14% during the first year after stroke and the accumulated risk of stroke recurrence after 5 years was 37% after stroke. The estimated probability of myocardial infarction was 7% at one year and 19% at 5 years. High age and a history of cardiac failure increased the risk of recurrent stroke. The risk of myocardial infarction was associated with high age, angina pectoris and diabetes mellitus. The highest risk of epilepsy was found between 6 and 12 months after stroke. Motor impairment prevailed in 36% of the long-term survivors, perceptual impairments in up to 57% and decreased ADL-capacity in 32%. As regards ecological perception, perceptual function variables were distinctly grouped into low and high level perception which together with motor function explained 71% of the variance of self-care ADL. While levels of global and of domain specific variables of life satisfaction appeared stable in clinically healthy reference populations aged 60 and 80 years, the stroke had produced a decrease in one or more aspects of life satisfaction for 61% of the long-term survivors. Although significantly associated with motor impairments and ADL disability, these changes could not only be attributed to physical problems.

S. 1-48: sammanfattning, s. 49-114: 5 uppsatser


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9

Irewall, Anna-Lotta. "Recurrent events and secondary prevention after acute cerebrovascular disease." Doctoral thesis, Umeå universitet, Medicin, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-130505.

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Background Patients who experience a stroke or transient ischemic attack (TIA) are at high risk of recurrent stroke, but little is known about temporal trends in unselected populations. Reports of low adherence to recommended treatments indicate a need for enhanced secondary preventive follow-up to achieve the full potential of evidence-based treatments. In addition, socioeconomic factors have been associated with poor health outcomes in a variety of contexts. Therefore, it is important to assess the implementation and results of secondary prevention in different socioeconomic groups. Aims The aims of this thesis were to assess temporal trends in ischemic stroke recurrence and evaluate the implementation and results of a nurse-led, telephone-based follow-up program to improve blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) levels after stroke/TIA. Methods In study I, we collected baseline data for unique patients with an ischemic stroke event between 1998 and 2009 (n=196 765) from the Swedish Stroke Register (Riksstroke). Recurrent ischemic stroke events within 1 year were collected from the Swedish National Inpatient Register (IPR) and the cumulative incidence was compared between four time periods using the Kaplan-Meier survival analysis and the logrank test. Implementation (study II) and 1-year results (study III-IV) for the secondary preventive follow-up were studied in the NAILED (Nurse-based Age-independent Intervention to Limit Evolution of Disease) study. Between 1 Jan 2010 and 31 Dec 2013, the baseline characteristics of consecutive patients admitted to Östersund Hospital for acute stroke or TIA were collected prospectively (n=1776). Consenting patients in a condition permitting telephone-based follow-up were randomized to nurse-led, telephone-based follow-up or follow-up according to usual care. Follow-up was cunducted at 1 and 12 months after discharge and the intervention included BP and LDL-C measurements, titration of medication, and lifestyle counseling. In study II, we analyzed factors associated with non-participation in the randomized phase of the NAILED study, including association with education level. In addition, we compared the 1-year prognosis in terms of cumulative survival between participants and non-participants. In study III, we compared differences in BP and LDL-C levels between the intervention and control groups during the first year of follow-up and, in study IV, in relation to level of education (low, ≤10 years; high, >10 years). Results The cumulative 1-year incidence of recurrent ischemic stroke decreased from 15.0% to 12.0%. Among surviving stroke and TIA patients, 53.1% were included for randomization, 35.7% were excluded mainly due to physical or cognitive disability, and 11.2% declined participation in the randomized phase. A low level of education was independently associated with exclusion, as well as the patient’s decision to abstain from randomization. Excluded patients had a more than 12-times higher risk of death within 1 year than patients who were randomized. After 1 year of follow-up, the mean systolic BP, diastolic BP, and LDL-C levels were 3.3 mmHg (95% CI 0.3 to 6.3), 2.3 mmHg (95% CI 0.5 to 4.2), and 0.3 mmol/L (95% CI 0.1 to 0.4) lower in the intervention group than among controls. Among participants with values above the treatment goal at baseline, the differences in systolic BP and LDL-C levels were more pronounced (8.0 mmHg, 95% CI 4.0 to 12.1; 0.6 mmol/L, 95% CI 0.4 to 0.9). In the intervention group, participants with a low level of education achieved similar or larger improvements in BP and LDL-C than participants with a high level of education. In the control group, BP remained unaltered and the LDL-C levels increased among participants with a low level of education. Conclusion The 1-year risk of ischemic stroke recurrence decreased in Sweden between 1998 and 2010. Nurse-led, telephone-based secondary preventive follow-up is feasible in just over half of the survivors of acute stroke and TIA and achieve better than usual care in terms of BP and LDL-C levels, and equality in BP improvements across groups defined by education level. However, a large proportion of stroke survivors are in a general condition precluding this form of follow-up, and their prognosis in terms of 1-year survival is poor. Patients with a low education level are over-represented within this group and among patients declining randomization for secondary preventive follow-up.
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Popara, Nikola. "Využití umělé inteligence k monitorování stavu obráběcího stroje." Master's thesis, Vysoké učení technické v Brně. Fakulta strojního inženýrství, 2021. http://www.nusl.cz/ntk/nusl-444960.

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This thesis is focus on monitoring state of machine parts that are under the most stress. Type of artificial intelligence used in this work is recurrent neural network and its modifications. Chosen type of neural network was used because of the sequential character of used data. This thesis is solving three problems. In first problem algorithm is trying to determine state of mill tool wear using recurrent neural network. Used method for monitoring state is indirect. Second Problem was focused on detecting fault of a bearing and classifying it to specific category. In third problem RNN is used to predict RUL of monitored bearing.
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Books on the topic "Stroke recurrence"

1

Jaigobin, Cheryl S. Survival, stroke recurrence and functional outcome after lacunar stroke. Ottawa: National Library of Canada, 2001.

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2

Cerebrovascular Diseases: Limiting Stroke Recurrence and Consequences. S Karger Pub, 1998.

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3

Leys, Didier, Charlotte Cordonnier, and Valeria Caso. Stroke. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0067.

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Stroke is a major public health issue. Many are treatable in the acute stage, provided patients are admitted soon enough. The overall incidence of stroke in Western countries is approximately 2400 per year per million inhabitants, and 80% are due to cerebral ischaemia. The prevalence is approximately 12 000 per million inhabitants. Stroke is associated with increased long-term mortality, handicap, cognitive and behavioural impairments, recurrence, and an increased risk of other types of vascular events. It is of major interest to take the heterogeneity of stroke into account, because of differences in the acute management, secondary prevention, and outcomes, according to the subtype and cause of stroke. In all types of stroke, early epileptic seizures, delirium, increased intracranial pressure, and non-specific complications are frequent. In ischaemic strokes, specific complications, such as malignant infarcts, spontaneous haemorrhagic transformation, early recurrence, and a new ischaemic event in another vascular territory, are frequent. In haemorrhagic strokes, the major complication is the subsequent increased volume of bleeding. There is strong evidence that stroke patients should be treated in dedicated stroke units; each time 24 patients are treated in a stroke unit, instead of a conventional ward, one death and one dependence are prevented. This effect does not depend on age, severity, and the stroke subtype. For this reason, stroke unit care is the cornerstone of the treatment of stroke, aiming at the detection and management of life-threatening emergencies, stabilization of most physiological parameters, and prevention of early complications. In ischaemic strokes, besides this general management, specific therapies include intravenous recombinant tissue plasminogen activator, given as soon as possible and before 4.5 hours, otherwise aspirin 300 mg, immediately or after 24 hours in case of thrombolysis, and, in a few patients, decompressive surgery. In intracerebral haemorrhages, blood pressure lowering and haemostatic therapy, when needed, are the two targets, but surgery does not seem effective to reduce death and disability.
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Leys, Didier, Charlotte Cordonnier, and Valeria Caso. Stroke. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0067_update_001.

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Stroke is a major public health issue. Many are treatable in the acute stage, provided patients are admitted soon enough. The overall incidence of stroke in Western countries is approximately 2400 per year per million inhabitants, and 80% are due to cerebral ischaemia. The prevalence is approximately 12 000 per million inhabitants. Stroke is associated with increased long-term mortality, handicap, cognitive and behavioural impairments, recurrence, and an increased risk of other types of vascular events. It is of major interest to take the heterogeneity of stroke into account, because of differences in the acute management, secondary prevention, and outcomes, according to the subtype and cause of stroke. In all types of stroke, early epileptic seizures, delirium, increased intracranial pressure, and non-specific complications are frequent. In ischaemic strokes, specific complications, such as malignant infarcts, spontaneous haemorrhagic transformation, early recurrence, and a new ischaemic event in another vascular territory, are frequent. In haemorrhagic strokes, the major complication is the subsequent increased volume of bleeding. There is strong evidence that stroke patients should be treated in dedicated stroke units; each time 24 patients are treated in a stroke unit, instead of a conventional ward, one death and one dependence are prevented. This effect does not depend on age, severity, and the stroke subtype. For this reason, stroke unit care is the cornerstone of the treatment of stroke, aiming at the detection and management of life-threatening emergencies, stabilization of most physiological parameters, and prevention of early complications. In ischaemic strokes, besides this general management, specific therapies include intravenous recombinant tissue plasminogen activator, given as soon as possible and before 4.5 hours, otherwise aspirin 300 mg, immediately or after 24 hours in case of thrombolysis, and, in a few patients, decompressive surgery. In intracerebral haemorrhages, blood pressure lowering and haemostatic therapy, when needed, are the two targets, but surgery does not seem effective to reduce death and disability.
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Leys, Didier, Charlotte Cordonnier, and Valeria Caso. Stroke. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199687039.003.0067_update_002.

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Stroke is a major public health issue. Many are treatable in the acute stage, provided patients are admitted soon enough. The overall incidence of stroke in Western countries is approximately 2400 per year per million inhabitants, and 80% are due to cerebral ischaemia. The prevalence is approximately 12 000 per million inhabitants. Stroke is associated with increased long-term mortality, handicap, cognitive and behavioural impairments, recurrence, and an increased risk of other types of vascular events. It is of major interest to take the heterogeneity of stroke into account, because of differences in the acute management, secondary prevention, and outcomes, according to the subtype and cause of stroke. In all types of stroke, early epileptic seizures, delirium, increased intracranial pressure, and non-specific complications are frequent. In ischaemic strokes, specific complications, such as malignant infarcts, spontaneous haemorrhagic transformation, early recurrence, and a new ischaemic event in another vascular territory, are frequent. In haemorrhagic strokes, the major complication is the subsequent increased volume of bleeding. There is strong evidence that stroke patients should be treated in dedicated stroke units; each time 24 patients are treated in a stroke unit, instead of a conventional ward, one death and one dependence are prevented. This effect does not depend on age, severity, and the stroke subtype. For this reason, stroke unit care is the cornerstone of the treatment of stroke, aiming at the detection and management of life-threatening emergencies, stabilization of most physiological parameters, and prevention of early complications. In ischaemic strokes, besides this general management, specific therapies include intravenous recombinant tissue plasminogen activator, given as soon as possible and before 4.5 hours, mechanical thrombectomy in case of proximal occlusion (middle cerebral artery, intracranial internal carotid artery, basilar artery), on top of thrombolysis in the absence of contraindication or alone otherwise, aspirin 300 mg, immediately or after 24 hours in case of thrombolysis, and, in a few patients, decompressive surgery. In intracerebral haemorrhages, blood pressure lowering and haemostatic therapy, when needed, are the two targets, while surgery does not seem effective to reduce death and disability.
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Chong, Ji Y., and Michael P. Lerario. Can I Go Home Now? Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190495541.003.0027.

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Transient ischemic attack (TIA) is a risk factor for subsequent stroke. A TIA diagnosis should incorporate findings on brain MRI and noninvasive angiography, if available. Some patients with TIA are at high risk of early recurrence. Rapid evaluation and treatment reduce that risk. Some new data suggest that short-term dual antiplatelet therapy may reduce stroke recurrence in patients with TIA or minor stroke.
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Turc, Guillaume, David Calvet, and Jean-Louis Mas. Cardiac aetiology. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198722366.003.0005.

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Cardiac aetiology accounts for approximately 20% of strokes in young adults. Although atrial fibrillation is a leading cause of stroke in the general population, it is uncommon in young adults. In such patients, more diverse causes of ischaemic stroke are observed, including valvular heart diseases, infective endocarditis, Libman–Sacks endocarditis, dilated cardiomyopathies, congenital heart diseases, myocardial infarction, and intracardiac tumours. Patent foramen ovale is commonly observed in young adults with ischaemic stroke, but this association may be incidental in a sizeable proportion of patients. Young adults who are the most likely to have a stroke-related patent foramen ovale are also those with the lowest recurrence risk.
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Naess, Halvor. Long-term prognosis. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198722366.003.0016.

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Knowledge of prognosis is important for patients in the prime of life in order to make informed decisions about treatment, choice of education, and profession. Median first-year mortality after first-ever cerebral infarction among young adults is about 4% while median annual average mortality after the first year is about 1.7%. Likewise, median first-year recurrence rate of cerebral infarction is 2% and thereafter 1.5% per year. Risk factors for recurrent cerebral infarction include hypertension, diabetes mellitus, symptomatic atherosclerosis, and smoking. Recurrent cerebral infarction and mortality are associated with increasing number of traditional risk factors. About 10% of patients develop post-stroke seizures within 6 years of the acute stroke. Almost 90% of patients report good functional outcome (modified Rankin Scale score ≤2) on long-term follow-up, but up to 30–50% of patients do not resume employment. Many patients have cognitive impairment. Fatigue and depression are also common on long-term follow-up.
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Waldo, Albert L. Rate versus rhythm control therapy for atrial fibrillation. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0511.

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Based on data from several clinical trials, either rate control or rhythm control is an acceptable primary therapeutic strategy for patients with atrial fibrillation. However, since atrial fibrillation tends to recur no matter the therapy, rate control should almost always be a part of the treatment. If a rhythm control strategy is selected, it is important to recognize that recurrence of atrial fibrillation is common, but not clinical failure per se. Rather, the frequency and duration of episodes, as well as severity of symptoms during atrial fibrillation episodes should guide treatment decisions. Thus, occasional recurrence of atrial fibrillation despite therapy may well be clinically acceptable. However, for some patients, rhythm control may be the only strategy that is acceptable. In short, for most patients, either a rate or rhythm control strategy should be considered. However, for all patients, there are two main goals of therapy. One is to avoid stroke and/or systemic embolism, and the other is to avoid a tachycardia-induced cardiomyopathy. Also, because of the frequency of atrial fibrillation recurrence despite the treatment strategy selected, patients with stroke risks should receive anticoagulation therapy despite seemingly having achieved stable sinus rhythm. For patients in whom a rate control strategy is selected, a lenient approach to the acceptable ventricular response rate is a resting heart rate of 110 bpm, and probably 90 bpm. The importance of achieving and maintaining sinus rhythm in patients with atrial fibrillation and heart failure remains to be clearly established.
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Gattringer, Thomas, Christian Enzinger, Stefan Ropele, and Franz Fazekas. Vascular imaging (CTA/MRA). Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198722366.003.0008.

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Non-invasive computed tomography angiography (CTA) and magnetic resonance angiography (MRA) constitute an integral part of the diagnostic workup of stroke patients, which—among the various techniques to image the complex cerebrovascular tree—can be conceptually placed between duplex sonography and digital subtraction angiography. CTA and especially MRA can be performed with different techniques and protocols that need to be used according to the clinical questions. In the setting of acute ischaemic stroke with the therapeutic option of endovascular thrombectomy, the rapid and reliable detection of large vessel occlusion has become of paramount importance. Both CTA and MRA can accomplish this and there is no need for contrast material when performing intracranial MRA. Vascular imaging is also essential to identify vessel-related causes of stroke such as large artery atherosclerosis, dissection, and some forms of arteritis mandating specific management or therapeutic intervention to avoid recurrence. Considering these aspects, frequent and targeted use of CTA or MRA is highly encouraged and especially relevant in young patients with stroke.
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Book chapters on the topic "Stroke recurrence"

1

Ueno, Yasushi. "Recurrence of Stroke in Patients with AF Using NOACs." In Treatment of Non-vitamin K Antagonist Oral Anticoagulants, 11–23. Singapore: Springer Singapore, 2016. http://dx.doi.org/10.1007/978-981-10-1878-7_2.

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Han, Xu, Spyridon Bakas, Roland Kwitt, Stephen Aylward, Hamed Akbari, Michel Bilello, Christos Davatzikos, and Marc Niethammer. "Patient-Specific Registration of Pre-operative and Post-recurrence Brain Tumor MRI Scans." In Brainlesion: Glioma, Multiple Sclerosis, Stroke and Traumatic Brain Injuries, 105–14. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-11723-8_10.

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Brown, Nicholas F., and Martin M. Brown. "Recurrent Thunderclap Headaches." In Stroke Medicine, 215–20. London: Springer London, 2015. http://dx.doi.org/10.1007/978-1-4471-6705-1_34.

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Arachchillage, Deepa, and Hannah Cohen. "Recurrent Miscarriages and Neurological Symptoms." In Stroke Medicine, 43–49. London: Springer London, 2015. http://dx.doi.org/10.1007/978-1-4471-6705-1_7.

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Bornstein, N. M., and A. D. Korczyn. "Prevention of Recurrent Stroke." In Prevention of Stroke, 261–68. New York, NY: Springer New York, 1991. http://dx.doi.org/10.1007/978-1-4757-4226-8_21.

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Merwick, Áine, David J. Werring, and Robert Simister. "Recurrent Neurological Symptoms Mistaken as Multiple Sclerosis." In Stroke Medicine, 243–48. London: Springer London, 2015. http://dx.doi.org/10.1007/978-1-4471-6705-1_38.

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Halabi, Cathra, Rene Colorado, and Karl Meisel. "Preventing recurrent stroke and other serious vascular events." In Warlow's Stroke, 745–865. Chichester, UK: John Wiley & Sons, Ltd, 2019. http://dx.doi.org/10.1002/9781118492390.ch17.

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Pedelty, Laura. "A Practical Guide to Recurrent Stroke Prevention." In Hypertension and Stroke, 173–92. Totowa, NJ: Humana Press, 2010. http://dx.doi.org/10.1007/978-1-60761-010-6_11.

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9

Gubitz, Gord. "Acute Stroke Manatement and Prevention of Recurrences." In Evidence-based Neurology: Management of Neurological Disorders, 113–26. Oxford, UK: Blackwell Publishing Ltd, 2007. http://dx.doi.org/10.1002/9780470988350.ch13.

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Linden, Thomas K. A., and Geoffrey A. Donnan. "Recurrent Stroke Prevention: Diuretic and Angiotensin-Converting Enzyme Inhibitors (ACEIs)—The PROGRESS Trial." In Hypertension and Stroke, 215–31. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-29152-9_12.

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Conference papers on the topic "Stroke recurrence"

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Kruchinina, Margarita, Andrey Gromov, Vladimir Generalov, Vladimir Kruchinin, Gennadiy Shuvalov, Oleg Minin, and Igor Minin. "Dielectrophoresis erythrocytes images for predicting stroke recurrence based on analysis of hemorheological parameters." In Saratov Fall Meeting 2018: Optical and Nano-Technologies for Biology and Medicine, edited by Valery V. Tuchin and Elina A. Genina. SPIE, 2019. http://dx.doi.org/10.1117/12.2525121.

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Li, Xiaolan, Jiahong Chen, Shanqiang Gu, Yaoheng Xie, Chun Zhao, and Enze Lu. "Analysis and recurrence of lightning stroke accidents for three gorges 500-kV transmission lines." In 2010 International Conference on Power System Technology - (POWERCON 2010). IEEE, 2010. http://dx.doi.org/10.1109/powercon.2010.5666710.

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Tamura, Toshiyo, Masaki Sekine, Zunyi Tang, Masaki Yoshida, Yoshinori Takeuchi, and Masaharu Imai. "Preliminary study of a new home healthcare monitoring to prevent the recurrence of stroke." In 2015 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC). IEEE, 2015. http://dx.doi.org/10.1109/embc.2015.7319634.

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Li, Xiaohan, Wenbing Chang, Shenghan Zhou, Fajie Wei, and Jingsong Lei. "The Grey Markov Model Modification of Panel Data Prediction for Stroke Recurrence with Health Care Data." In 2018 Annual Reliability and Maintainability Symposium (RAMS). IEEE, 2018. http://dx.doi.org/10.1109/ram.2018.8463014.

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Raghuram, K., J. Kohlnhofer, and A. Durgam. "P-016 Relationship between stroke recurrence, infarct pattern, and vascular distribution in patients with symptomatic intracranial stenosis." In SNIS 14TH, Annual Meeting, July 24–27, 2017, The Broadmoor, Colorado Springs, CO. BMA House, Tavistock Square, London, WC1H 9JR: BMJ Publishing Group Ltd., 2017. http://dx.doi.org/10.1136/neurintsurg-2017-snis.53.

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deVeber, G., F. Kirkham, L. R. Brandao, R. Sträter, G. Kenet, M. Kausch, M. Stoll, et al. "Recurrent Pediatric Stroke: The Role of Thrombophilia in a Large International Pediatric Stroke Population." In 63rd Annual Meeting of the Society of Thrombosis and Haemostasis Research. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1680137.

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deVeber, G., F. Kirkham, L. R. Brandao, R. Sträter, G. Kenet, M. Kausch, M. Stoll, et al. "Recurrent Pediatric Stroke: The Role of Thrombophilia in a Large International Pediatric Stroke Population." In 63rd Annual Meeting of the Society of Thrombosis and Haemostasis Research. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1680209.

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Degtyarenko, Illya, Ivan Deriuga, Andrii Grygoriev, Serhii Polotskyi, Volodymyr Melnyk, Dmytro Zakharchuk, and Olga Radyvonenko. "Hierarchical Recurrent Neural Network for Handwritten Strokes Classification." In ICASSP 2021 - 2021 IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP). IEEE, 2021. http://dx.doi.org/10.1109/icassp39728.2021.9413412.

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Ananda, Ajeng Suci, Esmeralda Contessa Djamal, and Fikri Nugraha. "Post-Stroke Recognition Based on EEG Using PCA and Recurrent Neural Networks." In 2020 3rd International Conference on Computer and Informatics Engineering (IC2IE). IEEE, 2020. http://dx.doi.org/10.1109/ic2ie50715.2020.9274575.

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Guntari, Ella Wahyu, Esmeralda Contessa Djamal, Fikri Nugraha, and Sandi Lesmana Liemanjaya Liem. "Classification of Post-Stroke EEG Signal Using Genetic Algorithm and Recurrent Neural Networks." In 2020 7th International Conference on Electrical Engineering, Computer Sciences and Informatics (EECSI). IEEE, 2020. http://dx.doi.org/10.23919/eecsi50503.2020.9251296.

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Reports on the topic "Stroke recurrence"

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Zhang, Fangfang, Lili Liu, Tian Li, and Zubing Mei. Prognostic value of metabolic syndrome for risk of stroke recurrence and mortality: A comprehensive systematic review with meta-analysis. INPLASY - International Platform of Registered Systematic Review Protocols, April 2020. http://dx.doi.org/10.37766/inplasy2020.4.0183.

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Early aspirin reduces stroke recurrence following warning symptoms. National Institute for Health Research, July 2016. http://dx.doi.org/10.3310/signal-000264.

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