March 2021 Stroke Highlights

HomeStrokeVol. 52, No. 3March 2021 Stroke Highlights Free AccessResearch ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree ArticlePDF/EPUBMarch José Rafael Romero, MD RomeroJosé Romero https://orcid.org/0000-0002-1101-2950 Search for more papers by this author Originally published22 Feb 2021https://doi.org/10.1161/STROKEAHA.121.034246Stroke. 2021;52:771is related toAcute Ischemic and COVID-19Clinical Outcomes Identification of Patients With Persistent Penumbral Profiles Beyond 24 Hours From Last Known WellEndovascular Treatment Acute in ChildrenAcute Coronavirus Disease 2019: An Analysis 27 676 PatientsCoronavirus disease 2019 (COVID-19) may increase risk stroke. Qureshi et al studied the factors, co-morbidities, treatment strategies, outcomes (1) patients with without acute ischemic stroke (AIS) COVID-19 (2) AIS COVID-19. Among a total 8163 confirmed COVID-19, 103 (1.3%) developed AIS; on contrary, among unlikely have 199 (1.0%) had AIS. Factors associated included older age, Black race, hypertension, diabetes, hyperlipidemia, atrial fibrillation, congestive heart failure. were likely poststroke complications including myocardial infarction, cerebral edema, intracerebral hemorrhage, kidney injury, hepatic failure, respiratory less be discharged home (proxy functional outcome) higher in-hospital mortality. In AIS, comparison between showed proportion people but no other significant differences complications, or use (thrombolysis thrombectomy). This study highlights that vascular are at adverse if they concurrent outcome See p 905.Clinical WellIn study, Sarraj evaluated relation persistent penumbral tissue clinico-radiological mismatch beyond hours symptom onset (modified Rankin Scale) 90 days large vessel occlusions. was using index (PPI) >1, defined ratio Tmax >6 seconds infarct volume either brain magnetic resonance imaging (85%) computed tomography (15%). They from DEFUSE 3 trial (Endovascular Therapy Following Imaging Evaluation Stroke), 75 who received thrombectomy 69 best medical therapy. Thirty-two (22.2%) PPI >1 most arm. nonpenumbral pattern (PPI ≤1) younger, baseline volumes, similar National Institutes Health Scale scores >1. ≤1 significantly predicted probability independence; conversely, profile reduction odds independence. Further, correlated clinic-radiological mismatch, is, Score smaller core infarct. suggests there is group patterns hours, outcomes, which benefit revascularization. However, randomized clinical trials needed prove safety late endovascular these patients. 838.Endovascular Children: Experience MR CLEAN RegistryAcute children carries high morbidity mortality, options limited. Van Es report underwent Registry, an ongoing, prospective, multicenter, observational intervention centers Netherlands. Nine 2014 2017 (median age 14 years, range 13 months 16years). All presented hemiparesis, median pediatric Scores (17; interquartile range, 9.5–19.5). involved anterior circulation. Median time 133 minutes (interquartile 115 – 183 minutes), one wakeup Four intravenous alteplase. Most cases performed under general anesthesia, access varied (radial, femoral, cervical). Modified infarction score 2B better achieved 8 after 2 passes, mean procedure 53 minutes. One patient pseudo-aneurysm common femoral artery, treated successfully thrombin injection, periprocedural reported. early neurological recovery hours. At long-term, underlying cardiac major determinant recurrent complications. cardiomyopathy good 6 0–2). view low likelihood controlled carried stroke, prospective registry based studies such as can inform clinicians decisions population. 781. Previous Back top Next FiguresReferencesRelatedDetailsRelated articlesAcute COVID-19Adnan I. Qureshi, al. Stroke. 2021;52:905-912Clinical WellAmrou Sarraj, 2021;52:838-849Endovascular ChildrenAdriaan C.G.M. van Es, 2021;52:781-788 March 2021Vol Issue Article InformationMetrics © American Heart Association, Inc.https://doi.org/10.1161/STROKEAHA.121.034246 publishedFebruary 22, PDF download Advertisement SubjectsCerebrovascular Disease/StrokeCerebrovascular ProceduresIschemic