Stroke Laterality Bias in the Management of Acute Ischemic Stroke

McCluskey, Gavin; Wade, Carrie; McKee, Jacqueline; McCarron, Peter; McVerry, Ferghal; McCarron, Mark O.

doi:10.1016/j.jstrokecerebrovasdis.2016.07.019

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…Pooled data of Indian studies 9 revealed the range of ischaemic stroke and haemorrhagic stroke was 60 to 80% and 20 to 30% respectively. In the series of McCluskey et al, 10 large vessel involvement was noticed in 41% and small vessel (lacunar) in 18%; in contrast, it was 75.3 and 8.4% respectively in our study.…”

Section: Discussioncontrasting

confidence: 73%

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An Analysis of Laterality in Acute Arterial Stroke and Its Associations

Kumar¹,

T²,

S³

et al. 2017

jemds

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Section: Discussioncontrasting

confidence: 73%

“…16,17 Some studies did not reveal any difference in the laterality with regard to the occurrence of stroke and 10-year survival. 10,17 The distribution of intracerebral haemorrhage (ICH) in the present study was compared with another study from India and USA. The details are shown in table 4.…”

Section: Discussionmentioning

confidence: 93%

An Analysis of Laterality in Acute Arterial Stroke and Its Associations

Kumar¹,

T²,

S³

et al. 2017

jemds

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“…Second, effects of stroke laterality were not considered for the group level analysis. Stroke laterality was reported to bias the disease characterization of IS, although the overall 10-year survival rate does not differ between IS in the left vs. right hemisphere (48). Third, patients' rs-fMRI data was collected within 2 weeks after the disease onset, during which the interaction of the functional impairment and remodeling may not have fully developed at the time of neuroimaging.…”

Section: Discussionmentioning

confidence: 99%

Ischemic Stroke in Pontine and Corona Radiata: Location Specific Impairment of Neural Network Investigated With Resting State fMRI

Jiang

Cai

et al. 2019

Front. Neurol.

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Objective: This study aims to investigate location-specific functional remodeling following ischemic stroke in pons and corona radiata. Methods: This study was approved by the local Institutional Review Board. Written consent was obtained from each of the participants prior to the MRI examination. Thirty six subjects with first ever acute ischemic stroke in pons (PS, n = 15, aged 62.8 ± 11.01 years) or corona radiata (CRS, n = 21, aged 59.33 ± 13.84 years) as well as 30 age and sex matched healthy controls (HC, n = 30, aged 60 ± 6.43 years) were examined with resting state functional magnetic resonance imaging (rs-fMRI). Regional homogeneity (ReHo) and degree centrality (DC) were calculated using a voxel-based approach. Intergroup differences in ReHo and DC were explored using a permutation test with a threshold-free cluster enhancement (PT TFCE, number of permutations = 1,000, family-wise error rate (FWER) < 0.05). Results: ReHo and DC alterations were identified in distributed anatomies for both PS and CRS groups. DC mainly increased in the bilateral anterior and posterior cingulate cortex, the inferior frontal-orbital gyrus, and decreased in the bilateral cuneus, calcarine, and the precuneus, while ReHo mainly decreased in the precentral and the postcentral gyri, inferior parietal lobules, precuneus, posterior cingulate cortex, and the superior occipital gyrus. PS and CRS groups were not significantly different in ReHo or DC (FWER > 0.05). Conclusions: Focal ischemic stroke in pons or corona radiata leads to extensive alterations in the functional network centrality. IS-induced network remodeling is more anatomy-specific than pathway-specific, which may underpin the clinicotopographical profiles during the disease dynamic. Approaches targeting neural pathway and functional connectivity may shed light on a better characterization and management innovation of ischemic stroke.

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“…U p to 80% of survivors of right brain stroke are not diagnosed with cognitive disorders of spatial cognition or awareness 1,2 during routine acute stroke care, and thus, they cannot receive a plan for personalized cognitive treatment. Worse, right brain stroke itself is underdiagnosed, so survivors of right brain stroke are at risk of undertreatment or incorrect treatment [3][4][5] because of the difficulty in identifying the cognitive hallmarks of right brain disorders during routine care.…”

Section: Introductionmentioning

confidence: 99%

Spatial Neglect and Anosognosia After Right Brain Stroke

Barrett¹

2021

CONTINUUM: Lifelong Learning in Neurology

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PURPOSE OF REVIEW Up to 80% of survivors of right brain stroke leave acute care without being diagnosed with a major invisible disability. Studies indicate that a generic cognitive neurologic evaluation does not reliably detect spatial neglect, nor does it identify unawareness of deficit after right brain stroke; this article reviews the symptoms, clinical presentation, and management of these two cognitive disorders occurring after right brain stroke. RECENT FINDINGS Stroke and occupational therapy practice guidelines stress a quality standard for spatial neglect assessment and treatment to reduce adverse outcomes for patients, their families, and society. Neurologists may attribute poor outcomes associated with spatial neglect to stroke severity. However, people with spatial neglect are half as likely to return to home and community, have one-third the community mobility, and require 3 times as much caregiver supervision compared with similar stroke survivors. Multiple randomized trials support a feasible first-line rehabilitation approach for spatial neglect: prism adaptation therapy; more than 20 studies reported that this treatment improves daily life independence. Evidence-based treatment of anosognosia is not as developed; however, treatment for this problem is also available. SUMMARY This article guides neurologists’ assessment of right brain cognitive disorders and describes how to efficiently assemble and direct a treatment team to address spatial neglect and unawareness of deficit.

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Stroke Laterality Bias in the Management of Acute Ischemic Stroke

Cited by 6 publications

References 21 publications

An Analysis of Laterality in Acute Arterial Stroke and Its Associations

An Analysis of Laterality in Acute Arterial Stroke and Its Associations

Ischemic Stroke in Pontine and Corona Radiata: Location Specific Impairment of Neural Network Investigated With Resting State fMRI

Spatial Neglect and Anosognosia After Right Brain Stroke

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