Seasonal Variations in Neurological Severity and Outcomes of Ischemic Stroke　― 5-Year Single-Center Observational Study ―

Toyoda, Kazunori; Koga, Masatoshi; Yamagami, Hiroshi; Yokota, Chiaki; Sato, Shigeo; Inoue, Matsuhisa; Endo, Kenji; Fujinami, Jun; Ihara, Masafumi; Nagatsuka, Kazuyuki; Minematsu, Kazuo

doi:10.1253/circj.cj-17-1310

Cited by 22 publications

(18 citation statements)

References 40 publications

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“…Some studies have reported that ischemic stroke occurrence was significantly higher during spring and autumn than in summer [4,5]. However, another study stated that there was a fairly even distribution of ischemic stroke over all 4 seasons [6] and a recent meta-analysis showed very little seasonal variation [7]. Also, our analysis of variance of the monthly number of ischemic stroke between 2015 and 2019 was not significant.…”

Section: What Could We Hypothesize For This Observation?contrasting

confidence: 72%

The Baffling Case of Ischemic Stroke Disappearance from the Casualty Department in the COVID-19 Era

et al. 2020

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Section: What Could We Hypothesize For This Observation?contrasting

confidence: 72%

The Baffling Case of Ischemic Stroke Disappearance from the Casualty Department in the COVID-19 Era

et al. 2020

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“…Some studies report that ischaemic stroke events are significantly higher during spring and autumn than in summer 17,18 and, in our case, the drop in stroke admissions has occurred during the beginning of spring. However, another study stated that there was a fairly even distribution of ischaemic stroke over all four seasons 19 and a recent meta-analysis showed very little seasonal variation 20 .…”

Section: Accepted Articlementioning

confidence: 99%

“…Since the first reported case in early December 2019, severe acute respiratory coronavirus 2 (SARS-CoV-2) infection, known as Coronavirus Disease 2019 (COVID- 19), has become pandemic so rapidly that healthcare systems are overwhelmed [5][6][7] . In Spain, by April 19th,195,944 cases and 20,453 deaths have been confirmed 8 .…”

Section: Introductionmentioning

confidence: 99%

Ischaemic stroke in the time of coronavirus disease 2019

Meza

Gil

Saldaña

et al. 2020

Euro J of Neurology

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Background and purposeStroke assistance is facing changes and new challenges since COVID‐19 became pandemic. A variation on the patient influx might be one of the greater concerns, due to fewer people coming to emergency departments or coming too late. However, no data quantifying this have been published until now. The aim was to analyse the impact of the COVID‐19 epidemic outbreak on hospital stroke admissions and their characteristics in our region.MethodsThe data of every patient admitted to any hospital of our healthcare system with a diagnosis of ischaemic stroke between 30 December 2019 and 19 April 2020 were reviewed. Demographic and clinical data were recorded and compared between periods before and after the setting of the state of emergency secondary to the COVID‐19 outbreak.ResultsIn total, 354 patients with ischaemic stroke were admitted in our study period. There was a weekly average of 27.5 cases before the setting of the state of emergency against 12 afterwards (P < 0.001). This drop in stroke cases occurred progressively from week 11, persisting in time despite the decrease in confirmed cases of COVID‐19. No differences in the proportion of intravenous thrombolysis (21.1% vs. 21.5%, P = 0.935) or endovascular therapy (12.4% vs. 15.2%, P = 0.510) were found, nor in other demographic or clinical characteristics except for median onset‐to‐door time (102 vs. 183 min, P = 0.015).ConclusionsThis observational study offers the perspective of a whole region in one of the countries more heavily stricken by the SARS‐CoV‐2 epidemic and shows that the decrease of stroke events, since the beginning of the COVID‐19 outbreak, happened globally and without any specific patient distribution.

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“…Finally, among those patients, 135 patients (acute ischemic stroke, n = 118; TIA, n = 17) who underwent MPRAGE for the evaluation of the aortic arch and carotid plaques were included in this retrospective observational study. Patient characteristics including past medical history and stroke risk factors were collected using a database in our stroke center (the National Cerebral and Cardiovascular Center stroke registry; Clinical Trial.gov: NCT02251665) [32,33].…”

Section: Study Populationmentioning

confidence: 99%

Associations of High Intensities on Magnetization-Prepared Rapid Acquisition with Gradient Echo with Aortic Complicated Lesions in Ischemic Stroke Patients

et al. 2019

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Background: Aortic complicated lesions (ACLs) are key parameters for evaluating aortic embolic sources in embolic stroke, and are usually diagnosed using transesophageal echocardiography (TEE). However, alternative methods for diagnosing ACLs have not been well established. We investigated associations between high-intensity areas on T1-weighted imaging (T1WI) with magnetization-prepared rapid acquisition with gradient echo (MPRAGE) and ACLs on TEE among ischemic stroke patients. Methods: Participants comprised 135 patients (mean age, 71 years; 35 women) with ischemic stroke or transient ischemic attack who underwent TEE for evaluation of embolic sources and plaque imaging using MPRAGE for evaluation of aortic or carotid plaques. Aortic plaque with signal intensity ≥200% of sternocleidomastoid intensity on MPRAGE was categorized as “high intensity”. ACLs on TEE were defined by focal increases in intima-media thickness (IMT) ≥4.0 mm or the presence of ulcerated or mobile plaques. Results: Fifty-six patients (42%) showed high-intensity areas on MPRAGE at the aortic arch. Aortic maximum IMT was significantly higher in patients with high intensities than in those without (p < 0.001). Incidences of ACLs (66 vs. 20%, p < 0.001) or ulcerated or mobile plaques (30 vs. 6%, p < 0.001) were significantly higher in patients with high intensities than in patients without. Multivariable logistic regression analysis showed that high intensities on MPRAGE were independently associated with the presence of ACLs (OR 5.72; 95% CI 2.38–13.70) and ulcerated or mobile plaques (OR 4.18; 95% CI 1.29–13.50). Conclusions: High intensities on T1WI with MPRAGE in the aortic arch were significantly associated with the presence of ACLs. An evaluation of the aortic arch using MPRAGE may be useful for predicting ACLs.

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Seasonal Variations in Neurological Severity and Outcomes of Ischemic Stroke　― 5-Year Single-Center Observational Study ―

Cited by 22 publications

References 40 publications

The Baffling Case of Ischemic Stroke Disappearance from the Casualty Department in the COVID-19 Era

The Baffling Case of Ischemic Stroke Disappearance from the Casualty Department in the COVID-19 Era

Ischaemic stroke in the time of coronavirus disease 2019

Associations of High Intensities on Magnetization-Prepared Rapid Acquisition with Gradient Echo with Aortic Complicated Lesions in Ischemic Stroke Patients

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Seasonal Variations in Neurological Severity and Outcomes of Ischemic Stroke ― 5-Year Single-Center Observational Study ―

Cited by 22 publications

References 40 publications

The Baffling Case of Ischemic Stroke Disappearance from the Casualty Department in the COVID-19 Era

The Baffling Case of Ischemic Stroke Disappearance from the Casualty Department in the COVID-19 Era

Ischaemic stroke in the time of coronavirus disease 2019

Associations of High Intensities on Magnetization-Prepared Rapid Acquisition with Gradient Echo with Aortic Complicated Lesions in Ischemic Stroke Patients

Contact Info

Product

Resources

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Seasonal Variations in Neurological Severity and Outcomes of Ischemic Stroke　― 5-Year Single-Center Observational Study ―