View clinical trials related to Cerebrovascular Stroke.
Filter by:To evaluate the effect of different risk factors on carotid arteries via ultrasonography parameters.
In ischemic stroke, the recanalization rate after intravenous thrombolysis has been estimated to be less than 50% in patients with proximal intracranial artery occlusion; this rate is greater than 80% after endovascular thrombectomy. Thromboelastometry is a method of analysis of coagulation and fibrinolysis in whole blood. The main objective of this study is to evaluate whether the parameters obtained by thromboelastometry are predictive of revascularization at arteriography during mechanical thrombectomy, after treatment with rt-PA thrombolysis.
Deficits in upper limb (UL) functional recovery persist in a large proportion of stroke survivors. Understanding how to obtain the best possible UL recovery is a major scientific, clinical and patient priority. We propose that UL motor recovery may be improved by training that focuses on remediating an individual's specific motor impairment. Our approach is based on evidence that deficits in the control of muscle activation thresholds (spatial thresholds) of the elbow in stroke underlie impairments such as disordered movement and spasticity. Our novel training program focuses on improving the individual's active elbow control range using error augmentation (EA) feedback. Since training intensity and lesion load are key factors in motor recovery that lack guidelines, we will also investigate effects of exercise dose and corticospinal tract (CST) injury on UL recovery. In this multicenter, double-blind, parallel-group, randomized controlled trial (RCT), patients with stroke will participate in an individualized intensive technology-assisted reaching training program, based on error augmentation (EA), in order to improve voluntary elbow function. They will practice robot-assisted reaching in a virtual reality (VR) game setting. We will identify if intensive training with feedback aimed at expanding the range of spatial threshold (ST) control at the elbow (experimental group) is better than intensive training with general feedback about task success (control group). We will also determine the patient-specific optimal therapy dose by comparing kinematic and clinical outcomes after 3, 6 and 9 weeks of intensive training, and again at 4 weeks after training to determine carry-over effects. We will quantify the severity of the participant's motor deficit, as the amount of cortico spinal tract (CST) injury due to the stroke (%CST injury) and relate training gains to their %CST injury. Results of this pragmatic trial will provide essential information for optimizing individualized post-stroke training programs and help determine optimal patient-specific training dosing to improve motor recovery in people with different levels of stroke severity. This type of research involving personalized, impairment-based feedback and dose-effective training has the potential to significantly improve rehabilitation for a greater number of post-stroke individuals and improve the health and quality of life of Canadians.
Cerebral microbleed (CMB) refers to small, round dark-signal lesions detected by T2*-weighted or gradient-echo (GRE) magnetic resonance imaging (MRI) ..CMBs were introduced to stroke physicians in the late 1990s and early 2000s after development of MRI techniques sensitive to paramagnetic effects The clinical significance of CMBs has been actively investigated, especially in the stroke field and more recently in studies on cognitive impairment, vascular dementia and later developement of cerebral hge ..Histological investigation has shown that CMBs are tiny foci containing hemosiderin-laden macrophages and abnormal microvessels . Clinical cases with frank symptoms caused by CMBs are uncommon, Because CMBs are manifestations of focal extravascular leakage of blood components, however, investigators have suggested that accumulation of CMBs reflects a bleeding-prone status in individuals with an elevated risk of cerebral hemorrhage. Clinical studies have found strong associations between CMBs and chronic hypertension and low cholesterol levels and between the proximity and volume of CMBs and those of subsequent intracerebral hemorrhage (ICH) . studies have found that CMBs are linked to subsequent hemorrhagic stroke in stroke survivors,and suggested that CMBs are related to antithrombotic-related hemorrhage.
The investigators are performing a study to determine whether changes in blood flow occur in the neck and back of the brain following a series of head positions and a manipulation of the upper neck. Each participant will be asked to undergo a series of MRI's to evaluate whether there are any changes in blood flow resulting from any of the head positions or manipulation. The study will be conducted over a period of 1 day and each participant can anticipate the testing to take approximately 120 minutes.