Dr. Amer Jafar

Previous studies showed that a positive family history of stroke (FHstroke) is an independent risk factor for lacunar stroke

The aim of the present study was to determine whether familial aggregation of stroke was different for lacunar stroke phenotypes

In 157 patients with a first-ever lacunar stroke, a complete first-degree FHstroke was obtained by a standardized questionnaire and additional interview

Fifty-two percent of patients reported a positive FHstroke in at least one of their first-degree relatives

A family history of stroke might be an independent risk factor for the lacunar stroke phenotype with aLACs at younger ages, suggesting a role for genetic factors in this phenotype caused by diffuse vasculopathy

High infection rate after severe stroke may partly relate to brain-induced immunodepression syndrome

Aim:  to investigate the role of autonomic shift in increased susceptibility to infection after acute intracerebral hemorrhage (ICH)

The authors retrospectively analyzed 62 selected patients with acute ICH from a prospective database

Autonomic shift was assessed using the cross-correlational baroreflex sensitivity (BRS)

They identified 36 (58%) patients with infection during the first 5 days of hospital stay

Patients with infections had significantly lower BRS, higher initial NIHSS scores, larger haemorrhages, and more frequently had intraventricular blood extension and underwent invasive procedures

Conclusion: Decreased BRS was independently

associated with infections after ICH Autonomic shift may play an

important role in increased susceptibility to infections after acute brain injury including ICH

This austrian study addresses the value of helicopter transport compared with other means of transportation to a stroke unit and compares their rates of thrombolysis on a nationwide basis

Prospective data collection: 2 stroke units between 2003 and 2009 were used

Results: Of 21 712 ischaemic stroke patients, 905 patients (4.1%) were transported by helicopter

Of these, 752 patients (3.4%) were transported by direct HEMS, and 153 patients (0.7%) were transported by indirect HEMS

Thrombolysis rates were highest for HEMS (24% direct, 29% indirect)

Conclusion: The shortest hospital arrival times and highest thrombolysis rates were seen in ischaemic stroke patients transported by helicopter.

Multiple studies suggest that statin use before acute ischaemic stroke is associated with improved functional outcome

The authors performed a systematic literature search and meta-analysis of studies investigating the association between prestroke statin use and clinical outcome

Results: Meta-analysis of all available data identified an association between prestroke statin use and improved functional outcome

Larger positive effects for small vessel strokes compared with other subtypes

However, evidence of publication bias in the existing literature suggests these findings should be interpreted with caution

BoTULS trial Botulinum toxin is increasingly used to

treat upper limb spasticity due to stroke, but its impact on arm function is unclear

The researchers evaluated botulinum toxin for upper limb spasticity and function poststroke

Three hundred thirty-three patients with stroke with upper limb spasticity and reduced arm function participated in a multicenter randomized controlled trial

The intervention group received botulinum toxin type A injection(s) plus a 4-week therapy program

The control group received the therapy program alone

The primary outcome was upper limb function at 1 month (Action Research Arm Test). Secondary outcomes included measures of impairment, activity limitation, and pain at 1, 3, and 12 months

Results: There was no significant difference in achievement of improved arm function (Action Research Arm Test) at 1 month

Significant differences in favor of the intervention group were seen in muscle tone at 1 month; upper limb strength at 3 months; basic arm functional tasks (hand hygiene, facilitation of dressing) at 1, 3, and 12 months; and pain at 12 months

Botulinum toxin type A is unlikely to be useful for improving active upper limb function (eg, reaching and grasping) in the majority of patients with spasticity after stroke, but it may improve basic upper limb tasks (hand hygiene, facilitation ofdressing) and pain.

Early Prediction of Outcome of Activities of Daily Living After Stroke

Risk and Cumulative Risk of Stroke Recurrence

Translational Stroke Research of the Combination of Thrombolysis and Antioxidant Therapy