No abstract

Background: Intravenous thrombolysis is the standard medical treatment for acute ischemic stroke (AIS) within 4.5 hours of symptom onset, and symptomatic hemorrhagic transformation (sHT) is the most feared complication of this treatment. Objective: To describe the prevalence, risk factors, treatment and outcome of sHT. Design and setting: This is a retrospective cross-sectional study in a quaternary care hospital in Sao Paulo, Brazil. Methods: We reviewed 90 records of patients with AIS submitted to thrombolysis from March 2018 to February 2020. Evaluation of brain imaging after thrombolysis and the treatment initiated after detection of hemorrhage were made. Results: The overall prevalence of HT was 18.9% (n = 17, mean age 69.4±14.6 years, 58.8% males) and 8.9% (n = 8) of sHT. The most prevalent comorbidities were renal impairment (82%), hypertension (76.4%), diabetes mellitus (35.2%), atrial fibrillation (35.2%) and smoking (35.2%). The median baseline NIHSS score was 17. The most prevalent radiological classification of post-thrombolysis HT was class 2 (41.1%) from the Heidelberg Bleeding Classification. Cryoprecipitate and tranexamic acid were administered in 11.8% (n = 2). The mortality rate for HT was 35.3% (n = 6). Antiplatelet or anticoagulant therapy was initiated after a mean of 24.6 days from HT diagnosis and there was no stroke recurrence at 90 days. Conclusion: We showed a prevalence of sHT and related risk factors aligned with other studies, but with high mortality rates, despite being a stroke service. The late initiation of antiplatelets or anticoagulants did not lead to stroke recurrence at 90 days.

Introduction: Stroke is the leading cause of disability worldwide, not only due to motor impairment, but to many sequelae in other domains. Fatigue is one of the most impacting symptoms in the quality of life in post stroke patients, with estimated prevalence around 30%. Objectives and methods: We present a cross-sectional study that aimed to determine the prevalence of fatigue in patients with ischemic stroke followed in the neurovascular outpatient clinic of a tertiary hospital in São Paulo, Brazil, using the Fatigue Assessment Scale (FAS) questionnaire. It can range from 0-50 points, proportional to symptom intensity; scores equal or over 24 points indicate fatigue in such individuals. Casuistics and results: One hundred and fifty seven questionnaires were analyzed and classified according to the FAS. Mean age was 58 years, 74 (47.13%) individuals were men and median FAS score was 21 points (interquartile range: 18–29). Of the interviewees, 64 individuals (40.76%) were classified as having fatigue by the established cut-off; in this subgroup, mean age was 55 years and 28 (43.75%) were men. Discussion and conclusion: In this study, around 40% of post-stroke patients have fatigue, indicating a high prevalence in our population. Fatigue has a high impact on the quality of life of patients, also worsening in functionality and mortality, due to lesser participation in rehabilitation and physical activities. Thus, the health professional dealing with post-stroke patients must be aware and prepared to help patients in coping with fatigue.

Introduction: Stroke is characterized by the acute onset of one or more neurologic deficits that persist for at least 24 hours, and is the result of a vascular disorder in a defined territory, being the leading cause of disability. Late complications, such as sexual dysfunction, have a direct impact on psychological and emotional aspects and directly affect the quality of life of these patients. Objectives and methods: Cross-sectional study that aimed to determine the prevalence of sexual dysfunction in patients with ischemic stroke followed in the neurovascular outpatient clinic of a tertiary hospital in São Paulo, Brazil, using the Female Sexual Quotient (FSQ) questionnaire. The FSQ can range from 0-100 points. Higher values indicate better sexual performance/satisfaction and a score of 60 points or less was considered as having sexual dysfunction. Casuistics and results: Sixty-five questionnaires were analyzed and classified according to the FSQ score. Mean age was 52 years and median FSQ score was 54 points. Of the interviewees, 30.7% had their sexual performance classified as poor-null, 13.85% of patients had poor-unfavorable sexual performance, 15.38% as unfavorable-regular. Regular-good and good-great sexual performance were found in 21.54% and 18.46%, respectively. Discussion: In this study, only 40% of post-stroke women have regular-good and good-great sexual performance. The impact of the stroke on the sexual life of these patients is high, because most of the interviewees had sexual dysfunction according to FSQ. Conclusion: The health professional must be aware of the non-motor sequelae caused by the stroke and be prepared to help these patients in coping with sexual dysfunctions.

Introduction: Stroke is the leading cause of disability worldwide. Late complications, such as sexual dysfunction, have a direct impact on psychological and emotional aspects and directly affect the quality of life of these patients. Objectives and methods: We present a cross-sectional study that aimed to determine the prevalence of sexual dysfunction in patients with ischemic stroke followed in the neurovascular outpatient clinic of a tertiary hospital in São Paulo, Brazil, using the Male Sexual Quotient (MSQ) questionnaire. The MSQ can range from 0-100 points. Higher values indicate better sexual performance/satisfaction and a score of 60 points or less was considered as having sexual dysfunction. Casuistics and results: Fifty eight questionnaires were analyzed and classified according to the MSQ score. Mean age was 60 years and median MSQ score was 64 points. Of the interviewees, 24.14% had their sexual performance classified as poor-null, 17.24% of patients had poorunfavorable sexual performance, 6.90% as unfavorable-regular; regulargood and good-great sexual performance were equally found in 25.86% of the subjects. Discussion and conclusion: In this study, almost half of post-stroke men have sexual dysfunction according to MSQ, indicating a high impact of such a condition in the quality of life of our patients due to its prevalence. Thus, the health professional dealing with post-stroke patients must be aware and prepared to help patients in coping with sexual dysfunctions.