Including Distal Motor Function within the NIHSS: Correlation with Motor Arm Function and IV rt-PA Treatment Response

Egelko, Aron; Kirchoff-Torres, Kathryn F.; Ramaswamy, Srinath; Shaftman, Stephanie R.; Zach, Victor; Tanné, David; Gorman, Mark; Levine, Steven R.

doi:10.1016/j.jstrokecerebrovasdis.2021.106046

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…All patients were evaluated by a stroke neurologist on admission for IS, who collected the medical history (including time of symptoms onset to identify wake‐up IS), body mass index (BMI), treatments, neurological impairment severity assessed with the 11‐item NIHSS (from 0, no deficit, to 40; Lyden et al, 2001), and distal upper limb motor function (DMF: 0 = normal–full extension maintained for 5 s; 1 = some movement–any change from full extension within 5 s; and 2 = no movement–no strength at all; Egelko et al, 2021). NIHSS and DMF scores were repeated at day 15 ± 4 (preferably at D15, range D11–D19), and at month 3 after IS.…”

Section: Methodsmentioning

confidence: 99%

Functional recovery after ischemic stroke: Impact of different sleep health parameters

Denis

Jaussent

Guiraud

et al. 2023

Journal of Sleep Research

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SummarySleep disturbances after ischaemic stroke include alterations of sleep architecture, obstructive sleep apnea, restless legs syndrome, daytime sleepiness and insomnia. Our aim was to explore their impacts on functional outcomes at month 3 after stroke, and to assess the benefit of continuous positive airway pressure in patients with severe obstructive sleep apnea. Ninety patients with supra‐tentorial ischaemic stroke underwent clinical screening for sleep disorders and polysomnography at day 15 ± 4 after stroke in a multisite study. Patients with severe obstructive apnea (apnea–hypopnea index ≥ 30 per hr) were randomized into two groups: continuous positive airway pressure‐treated and sham (1:1 ratio). Functional independence was assessed with the Barthel Index at month 3 after stroke in function of apnea–hypopnea index severity and treatment group. Secondary objectives were disability (modified Rankin score) and National Institute of Health Stroke Scale according to apnea–hypopnea index. Sixty‐one patients (71.8 years, 42.6% men) completed the study: 51 (83.6%) had obstructive apnea (21.3% severe apnea), 10 (16.7%) daytime sleepiness, 13 (24.1%) insomnia, 3 (5.7%) depression, and 20 (34.5%) restless legs syndrome. Barthel Index, modified Rankin score and Stroke Scale were similar at baseline and 3 months post‐stroke in the different obstructive sleep apnea groups. Changes at 3 months in those three scores were similar in continuous positive airway pressure versus sham‐continuous positive airway pressure patients. In patients with worse clinical outcomes at month 3, mean nocturnal oxygen saturation was lower whereas there was no association with apnea–hypopnea index. Poorer outcomes at 3 months were also associated with insomnia, restless legs syndrome, depressive symptoms, and decreased total sleep time and rapid eye movement sleep.

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Section: Methodsmentioning

confidence: 99%

Functional recovery after ischemic stroke: Impact of different sleep health parameters

Denis

Jaussent

Guiraud

et al. 2023

Journal of Sleep Research

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Hematoma evacuation based on active strategies versus conservative treatment in the management of moderate basal ganglia hemorrhage: A retrospective study

Zhang

Huang

et al. 2023

Translational Neuroscience

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Objective The internal capsule of the basal ganglia is vulnerable to direct pressure from the hematoma and to secondary damage from toxic products of hemorrhage. Our study evaluated the risk and benefits of active strategies including ultra-early surgery and hematoma evacuation through a transsylvian-transinsular approach for moderate basal ganglia hemorrhage. Methods We retrospectively collected patients with moderate basal ganglia hemorrhage in two hospitals. The conservative group contained 51 patients who had the best medical treatment, and the surgery group contained 36 patients who were treated with hematoma evacuation through a transsylvian-transinsular approach within 6 h from ictus. Motor function of upper and lower limbs recorded with the motor sub-score of NIHSS (m-NIHSS) at the baseline, 7 days, 30 days, and 90 days, the modified Rankin Scale (mRS), and Barthel Index (BI) scores at 30 and 90 days were compared between the two groups. Good recovery was defined as an m-NIHSS of 0–2 and poor recovery as 3–4. Favorable prognosis was defined as an mRS of 0–3 and unfavorable prognosis as 4–5. Results The mean time from ictus to surgery was 250.3 ± 57.3 min. The good recovery proportions of upper and lower limbs in the surgery group were significantly higher than that in the conservative group (p < 0.05) at 7 days after hemorrhage. The good recovery proportion of upper limbs was significantly higher in the surgery group than in the conservative group (p < 0.05) at 3 months after hemorrhage. Living ability using BI scores was significantly higher in the surgery group than the conservative group (p < 0.05) at 3 months after hemorrhage. The favorable prognosis proportion had no statistically significant difference between the two groups at 3 months after hemorrhage. Conclusions Ultra-early hematoma evacuation through a transsylvian-transinsular approach are active strategies for moderate basal ganglia hemorrhage and have potential advantages in improving motor function recovery and daily living. The postoperative rebleeding rate does not increase simultaneously.

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Including Distal Motor Function within the NIHSS: Correlation with Motor Arm Function and IV rt-PA Treatment Response

Cited by 2 publications

References 14 publications

Functional recovery after ischemic stroke: Impact of different sleep health parameters

Functional recovery after ischemic stroke: Impact of different sleep health parameters

Hematoma evacuation based on active strategies versus conservative treatment in the management of moderate basal ganglia hemorrhage: A retrospective study

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