1.Cerebral Edema in Patients with severe Hemispheric Syndrome: Incidence, Risk Factors, and Outcomes—Data from SITS-ISTR
Irene ESCUDERO-MARTÍNEZ ; Magnus THORÉN ; Peter RINGLEB ; Ana Paiva NUNES ; Manuel CAPPELLARI ; Viiu-Marika RAND ; Piotr SOBOLEWSKI ; Jose EGIDO ; Danilo TONI ; Shih-Yin CHEN ; Nicole TSAO ; Niaz AHMED
Journal of Stroke 2023;25(1):101-110
Background:
and Purpose Cerebral edema (CED) in ischemic stroke can worsen prognosis and about 70% of patients who develop severe CED die if treated conservatively. We aimed to describe incidence, risk factors and outcomes of CED in patients with extensive ischemia.
Methods:
Oservational study based on Safe Implementation of Treatments in Stroke-International Stroke Treatment Registry (2003–2019). Severe hemispheric syndrome (SHS) at baseline and persistent SHS (pSHS) at 24 hours were defined as National Institutes of Health Stroke Score (NIHSS) >15. Outcomes were moderate/severe CED detected by neuroimaging, functional independence (modified Rankin Scale 0–2) and death at 90 days.
Results:
Patients (n=8,560) presented with SHS and developed pSHS at 24 hours; 82.2% received intravenous thrombolysis (IVT), 10.5% IVT+thrombectomy, and 7.3% thrombectomy alone. Median age was 77 and NIHSS 21. Of 7,949 patients with CED data, 3,780 (47.6%) had any CED and 2,297 (28.9%) moderate/severe CED. In the multivariable analysis, age <50 years (relative risk [RR], 1.56), signs of acute infarct (RR, 1.29), hyperdense artery sign (RR, 1.39), blood glucose >128.5 mg/dL (RR, 1.21), and decreased level of consciousness (RR, 1.14) were associated with moderate/severe CED (for all P<0.05). Patients with moderate/severe CED had lower odds to achieve functional Independence (adjusted odds ratio [aOR], 0.35; 95% confidence interval [CI], 0.23 to 0.55) and higher odds of death at 90 days (aOR, 2.54; 95% CI, 2.14 to 3.02).
Conclusions
In patients with extensive ischemia, the most important predictors for moderate/ severe CED were age <50, high blood glucose, signs of acute infarct, hyperdense artery on baseline scans, and decreased level of consciousness. CED was associated with worse functional outcome and a higher risk of death at 3 months.
2.Mediterranean Diet and Physical Activity Protect from Silent Brain Infarcts in a Cohort of Patients with Atrial Fibrillation
Irene ESCUDERO-MARTÍNEZ ; Fernando MANCHA ; Angela VEGA-SALVATIERRA ; María Irene AYUSO ; Rafael F OCETE ; Pilar ALGABA ; Antonio LÓPEZ-RUEDA ; Pilar PIÑERO ; Elena FAJARDO ; José Román FERNÁNDEZ-ENGO ; Eva María MARTÍN-SÁNCHEZ ; Alejandro GALVAO-CARMONA ; Elena ZAPATA-ARRIAZA ; Lucía LEBRATO ; Blanca PARDO-GALIANA ; Juan Antonio CABEZAS ; Alejandro GONZÁLEZ ; Francisco MONICHE ; Joan MONTANER
Journal of Stroke 2019;21(3):353-355
No abstract available.
Atrial Fibrillation
;
Brain
;
Cohort Studies
;
Diet, Mediterranean
;
Humans
;
Motor Activity
3.Clinical Outcomes of Mechanical Thrombectomy in Stroke Tandem Lesions According to Intracranial Occlusion Location
Elena ZAPATA-ARRIAZA ; Asier de ALBÓNIGA-CHINDURZA ; Joaquin ORTEGA-QUINTANILLA ; Irene ESCUDERO-MARTÍNEZ ; Francisco MONICHE ; Manuel MEDINA-RODRÍGUEZ ; Blanca PARDO-GALIANA ; Juan Antonio Cabezas RODRÍGUEZ ; Lucía Lebrato HERNÁNDEZ ; Leire AINZ ; Soledad PÉREZ-SÁNCHEZ ; Ana DOMÍNGUEZ-MAYORAL ; Ana BARRAGÁN ; Aurelio CAYUELA ; Joan MONTANER ; Alejandro González GARCÍA
Journal of Stroke 2021;23(1):124-127
4.Chest Computed Tomography Findings and Validation of Clinical Criteria of Stroke Associated Pneumonia
Elena ZAPATA-ARRIAZA ; Pilar SERRANO-GOTARREDONA ; Silvia NAVARRO-HERRERO ; Francisco MONICHE ; Blanca PARDO-GALIANA ; Esther PALLISA ; Angela VEGA-SALVATIERRA ; Fernando MANCHA ; Irene ESCUDERO-MARTÍNEZ ; Alejandro BUSTAMANTE ; Joan MONTANER
Journal of Stroke 2019;21(2):217-219
5.Sex Differences by Hospital-Level in Performance and Outcomes of Endovascular Treatment for Acute Ischemic Stroke
Soledad PÉREZ-SÁNCHEZ ; Ana BARRAGÁN-PRIETO ; Joaquín ORTEGA-QUINTANILLA ; Ana DOMÍNGUEZ-MAYORAL ; Miguel Ángel GAMERO-GARCÍA ; Elena ZAPATA-ARRIAZA ; Reyes de TORRES-CHACÓN ; Asier de ALBÓNIGA-CHINDURZA ; Montserrat ZAPATA-HIDALGO ; Francisco MONICHE ; Irene ESCUDERO-MARTÍNEZ ; Pablo BAENA ; Juan Antonio CABEZAS ; Juan Miguel OROPESA-RUIZ ; Gema SANZ-FERNÁNDEZ ; Alejandro GONZÁLEZ ; Joan MONTANER
Journal of Stroke 2020;22(2):258-261
6.The Value of Transcranial Doppler Sonography in Hyperperfusion Syndrome after Carotid Artery Stenting: A Nationwide Prospective Study
Francisco MONICHE ; Irene ESCUDERO-MARTÍNEZ ; Fernando MANCHA ; Alejandro TOMASELLO ; Marc RIBÓ ; Fernando DELGADO-ACOSTA ; Juán José OCHOA ; Joaquín GIL ; Rosario GIL ; Montserrat GONZÁLEZ-DELGADO ; Eduardo MURIAS ; Alain LUNA ; Alberto GIL ; Sonia MOSTEIRO ; María Dolores FERNÁNDEZ-COUTO ; Luis Fernández de ALARCÓN ; José M. RAMÍREZ-MORENO ; Joaquín ZAMARRO ; Guillermo PARRILLA ; José L. CANIEGO ; Gustavo ZAPATA-WAINBERG ; Andrés GONZÁLEZ-MANDLY ; José A. de las HERAS ; Luis LÓPEZ-MESONERO ; Joaquín ORTEGA ; Juan F. ARENILLAS ; Ernesto GARCÍA ; Pedro P. ALCÁZAR ; Elena ZAPATA-ARRIAZA ; Asier de ALBÓNIGA-CHINDURZA ; Juan Antonio CABEZAS ; Pilar ALGABA ; Aurelio CAYUELA ; Joan MONTANER ; Alejandro González GARCÍA
Journal of Stroke 2020;22(2):254-257