Abstract:
BACKGROUND AND PURPOSE:There is controversy about the optimal patient position for the detection of right-to-left shunt (RLS). The study was performed to investigate which patient position best detects RLS during contrast-enhanced transcranial Doppler. METHODS:We prospectively evaluated consecutive patients with ischemic stroke or TIA referred to our Noninvasive Cerebrovascular Laboratory for suspected paradoxical embolism. The standard protocol for RLS detection recommended by the International Consensus Criteria was followed. Each patient was examined at rest and after Valsalva maneuver in 4 positions: supine, right lateral decubitus, right lateral leaning, and upright sitting, in random order. RLS was graded 0 (no microbubbles [mB] detected), 1 (1-10 mB), 2 (>10 mB but no curtain), and 3 (curtain, shower of mB). Blood pressure, heart rate, and neurological symptoms were monitored. Data were analyzed using SPSS version 17. RESULTS:RLS was detected in at least 1 position in 89 of 240 patients (37.1%; 95% CI, 33.1%-43.3%). The detection of at least 1 mB with normal breathing was lowest in supine position and highest in right lateral decubitus. With Valsalva maneuver, this was highest in upright sitting (20.4% versus 8.3%; P<0.0002). If mB were undetected on upright sitting position, then they may still be detected in other positions. Changes in the position of the body and the injection of agitated saline were well-tolerated. CONCLUSIONS:RLS is best detected in the upright sitting position with Valsalva maneuver. If negative, then other positions may be used. Validation of our findings by other centers may be helpful.
journal_name
Strokejournal_title
Strokeauthors
Agustin SJ,Yumul MP,Kalaw AJ,Teo BC,Eng J,Phua Z,Singh R,Gan RN,Venketasubramanian Ndoi
10.1161/STROKEAHA.110.609875subject
Has Abstractpub_date
2011-08-01 00:00:00pages
2201-5issue
8eissn
0039-2499issn
1524-4628pii
STROKEAHA.110.609875journal_volume
42pub_type
杂志文章相关文献
STROKE文献大全abstract:BACKGROUND AND PURPOSE:Fibrocartilaginous embolism from the nucleus pulposus has been reported as a rare cause of spinal cord ischemia. We were unable to find previous reports of embolism from this source to cerebral arteries. CASE DESCRIPTION:A previously healthy 17-year-old girl fell during a basketball game. Left h...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.24.5.738
更新日期:1993-05-01 00:00:00
abstract::We have evaluated carotid gamma imaging using 111Indium-labelled platelets in the diagnosis of carotid artery disease and measured the accumulation of labelled platelets on endarterectomy specimens. Autologous 111In labelled platelets were injected in 25 patients with TIA. Gamma images were then taken daily and indepe...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.14.5.752
更新日期:1983-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Enlarged perivascular spaces in the brain are common but generally overlooked and of uncertain pathophysiology. They may reflect underlying cerebral small vessel disease. We determined whether enlarged perivascular spaces were associated with lacunar stroke subtype and white matter hyperintensiti...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.109.564914
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Intravenous tissue plasminogen activator (tPA) is an economically worthwhile but underused treatment option for acute ischemic stroke. We sought to identify the extent of tPA use in Canadian medical centers and the potential savings associated with increased use nationally and by province. METHO...
journal_title:Stroke
pub_type: 信件
doi:10.1161/STROKEAHA.106.479477
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Intravenous thrombolysis (IVT) within 4.5 hours from symptom onset improves functional outcome in patients with acute ischemic stroke. Its use in patients with previous stroke within the preceding 3 months is contraindicated because of the assumed higher risk of intracranial hemorrhage. In additi...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.116.013599
更新日期:2016-08-01 00:00:00
abstract::Background and Purpose- Preterm neonates with intraventricular hemorrhage (IVH) are at risk for posthemorrhagic hydrocephalus and poor neurological outcomes. Iron has been implicated in ventriculomegaly, hippocampal injury, and poor outcomes following IVH. We hypothesized that levels of cerebrospinal fluid blood break...
journal_title:Stroke
pub_type: 临床试验,杂志文章
doi:10.1161/STROKEAHA.119.028744
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Previous work has shown that cerebral microembolism detected with transcranial Doppler sonography distal to internal carotid artery stenosis occurs more frequently in recently symptomatic compared with asymptomatic patients. It has remained unclear whether cerebral microembolism also indicates a ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.26.11.2184
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Antiplatelet therapy is currently one of the methods for preventing transient ischemic attacks and cerebral thrombosis. Because antiplatelet agents are generally administered on a long-term basis, patient compliance is an important factor. The purpose of this study was to determine the compliance...
journal_title:Stroke
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.str.25.12.2337
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Mechanical thrombectomy (MT) is the recommended treatment for acute ischemic stroke caused by anterior circulation large vessel occlusion. However, despite a high rate of reperfusion, the clinical response to successful MT remains highly variable in the early time window where optimal imaging sel...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.120.031929
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Patient and radiological characteristics of intracerebral hemorrhage (ICH), surgical treatment, and outcome after ICH are interrelated. Our purpose was to define whether these characteristics or surgical treatment correlate with mortality among young adults. METHODS:We retrospectively reviewed c...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.114.006020
更新日期:2014-08-01 00:00:00
abstract::Background and Purpose- Multifaceted quality improvement interventions of stroke care have been shown to improve hospital personnel adherence to evidence-based performance measures and subsequent stroke outcomes. This study aimed to evaluate the cost-effectiveness of a multifaceted quality improvement intervention for...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.119.027980
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) lower serum cholesterol and decrease the incidence of stroke and cardiovascular disease. There is growing evidence that statins exert some of their beneficial effects independent of cholesterol lowering. Indeed, we...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.32.4.980
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The goal of this study was to determine whether release of endothelium-derived relaxing factor (EDRF) from carotid artery in response to acetylcholine is altered by aging. METHODS:Responses were examined in arteries from Wistar rats 6 to 8 months old (young rats), 24 to 26 months old (old rats),...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.25.12.2457
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We sought to assess outcomes after endovascular treatment/therapy of acute ischemic stroke, overall and by subgroups, and looked for predictors of outcome. METHODS:We used data from a mandatory, population-based registry that includes external monitoring of completeness, which assesses reperfusi...
journal_title:Stroke
pub_type: 杂志文章,多中心研究
doi:10.1161/STROKEAHA.113.003489
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Declining trends in the incidence and mortality of stroke have been observed in Finland since the beginning of the 1980s until 1997. In this study we analyzed the trends in fatal and nonfatal strokes in Finland during 1991-2002. METHODS:The Finnish Hospital Discharge Register was linked to the N...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000152945.28543.4a
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We used a rat model of reversible spinal ischemia to assess the effect of spinal cord temperature on the development of neurological and histopathologic changes after 20 minutes of reversible aortic occlusion. Spinal cord blood flow and CO2 reactivity was tested by using laser Doppler before and ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.25.10.2038
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Some clinical models, like California ABCD and unified ABCD2 scores, are now available to predict the early risk of stroke after a TIA. Despite the transitivity of symptoms, DWI identified an area of acute brain ischemia in almost half of patients. It would be interesting to know how the presence...
journal_title:Stroke
pub_type: 信件
doi:10.1161/STROKEAHA.108.537969
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Patient selection is crucial in the endovascular treatment of acute ischemic stroke patients. Baseline computed tomographic (CT) images, evaluated with the Alberta Stroke Program Early CT Scale (ASPECTS), are considered significant predictors of outcome. In this study, we evaluated CT images and ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.113.001068
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Current guidelines suggest that cardiac arrest (CA) survivors should be ventilated with 100% O(2) after resuscitation. Breathing 100% O(2) may worsen neurological outcome after experimental CA. This study tested the hypothesis that graded reoxygenation, with oximetry guidance, can safely reduce F...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000248455.73785.b1
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The diagnosis of intracranial atherosclerosis requires availability of appropriate imaging techniques. The objective was to evaluate the proportion of European hospitals where imaging techniques necessary to detect intracranial atherosclerosis are available. Method- We randomly selected 886 hospi...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.108.526434
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Cysteine could potentially lower the risk of stroke through antihypertensive and antioxidant effects. Our aim was to evaluate the hypothesis that cysteine intake is inversely associated with stroke incidence. METHODS:We used data from the Swedish Mammography Cohort, a population-based prospectiv...
journal_title:Stroke
pub_type: 临床试验,杂志文章
doi:10.1161/STROKEAHA.114.008022
更新日期:2015-04-01 00:00:00
abstract::Acute cerebral circulatory changes following experimental cerebral hemorrhage were investigated in eight cats. The cerebral hemorrhage was produced in the right basal ganglia by introducing arterial blood via a thin catheter, using the systemic arterial blood pressure of the cat as a driving force. Local cerebral bloo...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.19.8.991
更新日期:1988-08-01 00:00:00
abstract::As indicated by Barnett, Plum and Walton, a definitive clinical trial to resolve the issue of the effectiveness of carotid endarterectomy is clearly needed. A proposal to foster such a trial, through a moratorium on third-party reimbursement other than for randomized patients, has herein been presented. ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.17.6.1335
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The craniospinal epidural spaces can be categorized into 3 different compartments related to their specific drainage role of the bone and central nervous system, the ventral epidural, dorsal epidural, and lateral epidural groups. We propose this new classification system for dural arteriovenous s...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.108.516757
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:To increase the reliability of 99mTc-hexamethyl propyleneamine oxime (HMPAO) single photon emission computed tomography (SPECT) study in the evaluation of hemodynamic change with balloon test occlusion (BTO) of the internal carotid artery, we attempted to clarify the usefulness of additional moni...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.30.2.407
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Discharge ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) codes have been used to identify patients with acute stroke for epidemiological, quality of care, and cost studies. The aim of this study was to determine if the accuracy of the primary ICD-9-CM cod...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.29.8.1602
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The efficacy of neuroprotective approaches in stroke may be influenced by existing comorbidities. Here, we compared the effects of normobaric hyperoxia (NBO) in normotensive versus hypertensive rats subjected to transient focal cerebral ischemia. METHODS:Male Sprague-Dawley and spontaneously hyp...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.118.020626
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The incidence of subarachnoid hemorrhage (SAH) has been investigated in many studies. A recent study in Izumo, Japan, indicates that the incidence of SAH is as high as that in Finland. The purpose of this study was to confirm the high incidence of SAH in Japan. METHODS:The incidence rate of SAH ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/hs0102.101891
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The purpose of this study was to assess the prevalence and characteristics of silent cerebral infarction in a population-based consecutive autopsy series of residents of Hisayama, Kyushu, Japan. METHODS:Autopsy records, cerebral pathological findings, and clinical charts of 966 Hisayama resident...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.26.3.380
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Patent foramen ovale (PFO) may increase the risk of embolic stroke of undetermined source (ESUS). Guidelines suggest anticoagulation may be more effective than antiplatelets in preventing stroke in patients with ESUS and PFO when interventional closure is not performed. METHODS:Patients with ESU...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.120.031237
更新日期:2021-01-28 00:00:00