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DYNAMIC FOLLOW UP OF APHASIC DISORDERS IN PATIENTS WITH ISCHEMIC STROKE IN ACUTE STAGE.
Dora Peychinska, Maya Danovska, Dimitar Chakarov, Virginia Simeonova, Christo Lilovski
Journal of IMAB : Annual Proceeding (Scientific Papers) , 2004, DOI: http://dx.doi.org/10.5272/jimab.2004101.19
Abstract: The dynamic follow up of aphasic disorders in patients with acute ischemic stroke is of great importance because of its prognostic value for their future recovery. The purpose of that clinical study is to compare the type of aphasia with the CT data about the infarction localization and to evaluate the prospective aphasia recovery. In the clinical study were included 37 patients with ischemic stroke and aphasia, theated in II-nd Neurology Clinic, Medical University Pleven. The diagnosis ischemic stroke was confirmed by clinical and CT investigations. Partial and full recovery of sensory aphasia was registered in all the patients with total aphasia, while motor aphasia showed little tendency of reduction in acute ischemic stroke. Aphasic disorders were more severe in cases with ischemic infarctions localized in the specific anatomical regions responsible for the speech function. The dynamic follow up of aphasic disorders has prognostic value for the speech recovery. Better prognosis show sensory and amnestic aphasia. Lesion localization also influences the prognosis.
The Study of Quality of Life in Aphasic Stroke Patients in University- Medical Centers of Hamedan
M. Mazdeh,A. Yaghobi
Qom University of Medical Sciences Journal , 2009,
Abstract: Background and ObjectivesAs clinical improvement of patients surviving stroke is frequently incomplete and is followed by residual neurologic deficit, evaluation of the consequent function of these patients in three respects i.e; physical, social and emotional, which are considered as quality of life is useful in decision making for health care providers. Since few studies have been carried out in this regard, the aim of the present study was to obtain the average life quality score in four levels in aphasic stroke patients and comparing it with the quality of life score of the healthy population which is 5.Methods This study was a descriptive-cross sectional research carried out on 105 aphasic stroke patients referring to medical centers in Hamadan, Iran. Their diagnoses were confirmed by clinical and radiological findings. These patients were eligible for the study and had survived the stroke for at least six months. Sampling was non randomized and goal-oriented. Dependent variables included psychological, communicational, energy and physical status of the patients measured quantitatively. Data were gathered using the SAQOL-39 questionnaire.Results In this study the female population (58.1%) was greater than the male. The greater number of the aphasic patients (42%) was between 71 to 85 years old and the smallest number (6.7%) was between 39 to 50 years old. The greatest average score of life quality in the studied patients was related to the psychological state (2.17), while the smallest was related to the energy state (1.49). Average score of the life quality in the total population of the studied patients was calculated to be (1.88).ConclusionThe findings of the present study can lead to special supportive measures with the aim of improving life quality in aphasic stroke patients. We suggest that life quality of the patient after stroke should be compared to his/her own quality of life before stroke. Because there is no special service for care providers of stroke patients, an international program should be planned so that by reducing stress, they could have a better relation with the patients.Keywords: Life Quality; Stroke; Aphasia.
The Study of Quality of Life in Aphasic Stroke Patients in University- Medical Centers of Hamedan  [cached]
M Mazdeh
Qom University of Medical Sciences Journal , 2012,
Abstract: Background and Objectives As clinical improvement of patients surviving stroke is frequently incomplete and is followed by residual neurologic deficit, evaluation of the consequent function of these patients in three respects i.e; physical, social and emotional, which are considered as quality of life is useful in decision making for health care providers. Since few studies have been carried out in this regard, the aim of the present study was to obtain the average life quality score in four levels in aphasic stroke patients and comparing it with the quality of life score of the healthy population which is 5. Methods This study was a descriptive-cross sectional research carried out on 105 aphasic stroke patients referring to medical centers in Hamadan, Iran. Their diagnoses were confirmed by clinical and radiological findings. These patients were eligible for the study and had survived the stroke for at least six months. Sampling was non randomized and goal-oriented. Dependent variables included psychological, communicational, energy and physical status of the patients measured quantitatively. Data were gathered using the SAQOL-39 questionnaire. Results In this study the female population (58.1%) was greater than the male. The greater number of the aphasic patients (42%) was between 71 to 85 years old and the smallest number (6.7%) was between 39 to 50 years old. The greatest average score of life quality in the studied patients was related to the psychological state (2.17), while the smallest was related to the energy state (1.49). Average score of the life quality in the total population of the studied patients was calculated to be (1.88). Conclusion The findings of the present study can lead to special supportive measures with the aim of improving life quality in aphasic stroke patients. We suggest that life quality of the patient after stroke should be compared to his/her own quality of life before stroke. Because there is no special service for care providers of stroke patients, an international program should be planned so that by reducing stress, they could have a better relation with the patients.
Pain Following Stroke: A Population-Based Follow-Up Study  [PDF]
Henriette Klit, Nanna B. Finnerup, Kim Overvad, Grethe Andersen, Troels S. Jensen
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0027607
Abstract: Background and Purpose Chronic pain is increasingly recognized as a consequence of stroke. This study aimed to describe the prevalence and pain types of new onset chronic pain (“novel pain”) in patients with stroke compared with a randomly selected reference group from the general population and to identify factors associated with pain development in stroke patients. Methods In a population-based follow-up design, development of chronic pain after stroke was assessed by a questionnaire sent to consecutive stroke patients, registered in a Danish national stroke database, two years after their stroke. A randomly selected sex- and age-matched reference group from the same catchment area received a similar questionnaire about development of new types of chronic pain in the same time period. A total of 608 stroke patients and 519 reference subjects were included in the study. Results Development of novel pain was reported by 39.0% of stroke patients and 28.9% of reference subjects (OR 1.57, CI 1.21-2.04), and was associated with low age and depression in a multivariate model. Daily intake of pain medication for novel pain was reported by 15.3% and 9.4% of the stroke and reference population, respectively. Novel headache, shoulder pain, pain from increased muscle stiffness, and other types of novel pain were more common in stroke patients, whereas joint pain was equally common in the two groups. Conclusions Development of chronic pain is more common in stroke patients compared with sex- and age-matched reference subjects. Evaluation of post-stroke pain should be part of stroke follow-up.
Sex Differences in Stroke Recovery  [cached]
Sue-Min Lai, PhD, MS, MBA,Pamela W. Duncan, PhD,Paul Dew, MD, MPH,John Keighley, MS
Preventing Chronic Disease , 2005,
Abstract: Introduction This study examined differences between men and women in the ability to perform basic activities of daily living, instrumental activities of daily living, and higher physical functioning after stroke. The objective of the study was to determine whether sex differences in stroke recovery can be explained by depressive status beyond older age, stroke severity, prestroke physical functioning, and other medical comorbidities. Methods A total of 459 stroke patients were recruited from acute and subacute facilities in an urban midwestern community. These patients were followed prospectively from stroke onset until 6 months poststroke. All study participants were assessed using standardized stroke outcome measures, including the National Institutes of Health Stroke Scale, the Barthel Activities of Daily Living Index, the Lawton Instrumental Activities of Daily Living scale, and the SF-36 Health Survey physical functioning scale. The Geriatric Depression Scale was used to assess depressive status. Each outcome was measured at baseline (within 2 weeks of stroke onset), as well as 1, 3, and 6 months poststroke. Prestroke physical functioning, stroke characteristics, and comorbidities were also assessed at baseline. Results Female patients in the study were older than male patients, with a mean age of 71 years for women vs 69 years for men. Female patients reported lower prestroke physical functioning than their male counterparts. Six months after stroke, women in the study were less likely than the men to achieve a score of ≥95 on the Barthel Activities of Daily Living Index (hazards ratio [HR] = 0.68; 95% confidence interval [CI], 0.52–0.90), carry out eight of nine instrumental activities of daily living without assistance (HR = 0.46; 95% CI, 0.30–0.68), and score ≥90 on the SF-36 Health Survey physical functioning scale (HR = 0.54; 95% CI, 0.28–1.01). When age, prestroke physical functioning, stroke severity, and depressive status at baseline were controlled in the analysis, women in the study continued to be less likely (HR = 0.51; 95% CI, 0.32–0.79) than men in the study to be able to carry out eight of nine instrumental activities of daily living completely without assistance, but there were no observed sex differences in achievement of independence in basic activities of daily living or higher physical functioning. Conclusion Prestroke physical functioning and depressive symptoms are important factors in the investigation of sex differences in stroke recovery. Lower recovery of activities of daily living and physical functioning in women after
Brain regions essential for improved lexical access in an aged aphasic patient: a case report
Marcus Meinzer, Tobias Flaisch, Jonas Obleser, Ramin Assadollahi, Daniela Djundja, Gabriela Barthel, Brigitte Rockstroh
BMC Neurology , 2006, DOI: 10.1186/1471-2377-6-28
Abstract: An 80-year old patient with chronic aphasia (2 years post-onset) was investigated before and after intensive language training using an overt picture naming task. Differential brain activation in the right inferior frontal gyrus for correct word retrieval and errors was found. Improved language performance following therapy was mirrored by increased fronto-thalamic activation while stability in more general measures of attention/concentration and working memory was assured. Three healthy age-matched control subjects did not show behavioral changes or increased activation when tested repeatedly within the same 2-week time interval.The results bear significance in that the changes in brain activation reported can unequivocally be attributed to the short-term training program and a language domain-specific plasticity process. Moreover, it further challenges the claim of a limited recovery potential in chronic aphasia, even at very old age. Delineation of brain regions essential for performance on a single case basis might have major implications for treatment using transcranial magnetic stimulation.Aphasia, the loss of the ability to produce or comprehend language, constitutes a frequent consequence of left hemispheric stroke. Within the aphasic syndrome, one of the most frequent and disturbing syndromes is impaired lexical access (e.g. object naming). Even though patients may succeed in retrieving words, semantic paraphasias (misnaming) and neologisms (meaningless word creations) are frequently observed. Neurophysiological changes accompanying recovery of function in aphasia have remained controversial [1,2] Even though recently two studies used functional magnetic resonance imaging (fMRI) to investigate overt language production in aphasia [3,4] the neural substrate for lexical access and its different types of errors has never been investigated. Furthermore, recent efforts in aphasia treatment [5,6] addressed naming performance by fascilitation or inhibition of brai
Sex-independent neuroprotection with minocycline after experimental thromboembolic stroke
Md Nasrul Hoda, Weiguo Li, Ajmal Ahmad, Safia Ogbi, Marina A Zemskova, Maribeth H Johnson, Adviye Ergul, William D Hill, David C Hess, Irina Y Sazonova
Experimental & Translational Stroke Medicine , 2011, DOI: 10.1186/2040-7378-3-16
Abstract: Five groups of mice were subjected to thromboembolic stroke: adult males, aged males, adult females, aged females, and adult ovariectomized females. They were treated with phosphate saline (vehicle) or minocycline (6 mg/kg) immediately after stroke onset. Behavioral outcomes, infarct volumes and cerebral blood flow were assessed. The effect of minocycline on expression and activity of MMP-9 was analyzed.The model resulted in reproducible infarct in the experimental groups. As expected, adult females were significantly more resistant to cerebral ischemic injury than males. This advantage was abolished by aging and ovariectomy. Minocycline significantly reduced the infarct volume (P < 0.0001) and also improved neurologic score (P < 0.0001) in all groups. Moreover, minocycline treatment significantly reduced mortality at 24 hours post stroke (P = 0.037) for aged mice (25% versus 54%). Stroke up-regulated MMP-9 level in the brain, and acute minocycline treatment reduced its expression in both genders (P < 0.0001).In a thromboembolic stroke model minocycline is neuroprotective irrespective of mouse sex and age.Interest in sex differences during acute stroke is an area of growing interest. A consistent finding in rodent models of cerebral ischemia is that young females have smaller infarct sizes and better outcomes than young male rodents [1]. This female protection is lost after ovariectomy. However, the sex difference in stroke is only present when the brain is reperfused; in permanent occlusion the sex difference vanishes [2]. Moreover, in older rodents, the sex difference seen in younger animals is lost [3]. Reproductively senescent older female and male mice have similar infarct sizes after 2 hours of ischemia and 22 hours of reperfusion [4].The effect of sex on stroke outcome may also be hormone independent [3]. Recent studies suggest the existence of sex-divergent cell death pathways operating during cerebral ischemia [5]. The neuronal nitric oxide (NO)/Poly ADP ri
Comparative analysis of patients with post-stroke epilepsy  [cached]
N. Abdullaeva
Medical and Health Science Journal , 2012,
Abstract: Epilepsy is one of the most common neurological diseases. Increase of epilepsy occurrence in elderly patients was first noted in 1975. Cerebrovascular diseases should be particularly noticed among various causes of the disease. However, most studies have been focused on analysis of hemorrhagic strokes. Meanwhile, the cases of ischemic strokes are of particular interest as they are associated with elderly epilepsy.52 patients with post-stroke epilepsy were observed. Peculiarities of epileptic seizures in patients with post-stroke epilepsy have been shown, and also association between the types of seizures and the time of their development has been revealed. It has been shown that there is a group of patients with seizures - precursors. EEG peculiarities in patients with post-strokeepilepsy have been revealed.The received data of research are necessary for practitioners to improve treatment of cerebrovascular diseases. The patients with seizures, occurring before strokes, are of great interest and it is necessary to pay particular attention to these patients.
POST-STROKE WRITING AND READING DISORDERS  [PDF]
Sinanovi? Osman,Mrkonji? Zamir
SANAMED , 2013,
Abstract: The writing and reading disorders in stroke patients (alexias, agraphias and acalculias) are more frequent than verified in routine exam, not only in the less developed but also in large neurological departments. Alexia is an acquired type of sensory aphasia where damage to the brain causes a patient to lose the ability to read. It is also called word blindness, text blindness orvisual aphasia. Alexia refers to an acquired inability to read caused by brain damage and must be distinguished from dyslexia, a developmental abnormality in which the individual is unable to learn to read, and from illiteracy, which reflects a poor educational back-ground. Most aphasics are also alexic, but alexia may occur in the absence of aphasia and may occasionally be the soledisability resulting from specific brain lesions. There are different classifications of alexias. Traditionally, the alexias are divided into three categories: pure alexia with agraphia, pure alexia without agraphia, and alexia associated with aphasia (“aphasic alexia”). Agraphia is defined as the disruption of previously intact writing skills by brain damage. Writing involves several elements—language processing, spelling, visual perception, visual-spatial orientation for graphic symbols, motor planning, and motor control of writing. A disturbance of any of these processes can impair writing. Agraphia may occur by itself or as association with aphasias, alexia, agnosia and apraxia. Agraphia can also result from “peripheral” involvement of the motor act of writing. Like alexia, agraphia must be distinguished from illiteracy, where writing skills were never developed. Acalculia is a clinical syndrome of acquired deficits in mathematical calculation, either mentally or with paper and pencil. This language disturbances can be classified differently, but there are three principal types of acalculia: acalculia associated with language disturbances, including number paraphasia, number agraphia, or number alexia; acalculia secondary to visual-spatial dysfunction with malalignment of numbers and columns, and a primary anarithmetria entailing disruption of the computation process.
Overview of Post-Stroke Epilepsy
Wadi Bnouhanna, Amal Satté, Jamal Mounach, Hamid Ouhabi
Open Access Library Journal (OALib Journal) , 2019, DOI: 10.4236/oalib.1105705
Abstract:
Stroke is the most common cause of seizures, symptomatic epilepsy, and status epilepticus in elderly. Symptomatic stroke-related seizures symptoms are dependent on lesions topography. All types of focal seizures can be observed. Many clinical studies make a distinction between early (within 7 to 14 days of stroke onset) and late (beyond 14 days of stroke onset) seizures based on presumed physiopathological differences. The diagnosis of a seizure during the acute phase of a stroke can be difficult in the absence of a witness when there are disorders of vigilance and speech. The use of antiepileptic drugs is discussed in all cases. New antiepileptic drugs appear to be most appropriate. The aim of this study is to present an overview of the epidemiological, clinical and therapeutic features of vascular epilepsy based on meta-analyses and the more recently published expert recommendations.
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