Academic literature on the topic 'Aphasia and stroke care'
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Journal articles on the topic "Aphasia and stroke care"
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Musser, Benjamin, Joanne Wilkinson, Thomas Gilbert, and Barbara G. Bokhour. "Changes in Identity after Aphasic Stroke: Implications for Primary Care." International Journal of Family Medicine 2015 (January 21, 2015): 1–8. http://dx.doi.org/10.1155/2015/970345.
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Background. Stroke survivors with aphasia experience difficulty associated with their communication disorder. While much has been written about aphasia’s impacts on partners/family, we lack data regarding the psychosocial adjustment of aphasic stroke survivors, with a paucity of data from the patients themselves. Methods. Qualitative study of lived experiences of individuals with poststroke aphasia. Each of the stroke survivors with aphasia completed 3-4 semistructured interviews. In most cases, patients’ partners jointly participated in interviews, which were transcribed and analyzed using techniques derived from grounded theory. Results. 12 patients were interviewed, with the total of 45 interviews over 18 months. Themes included poststroke changes in patients’ relationships and identities, which were altered across several domains including occupational identity, relationship and family roles, and social identity. While all these domains were impacted by aphasia, the impact varied over time. Conclusion. Despite the challenges of interviewing individuals with aphasia, we explored aphasia’s impacts on how individuals experience their identity and develop new identities months and years after stroke. This data has important implications for primary care of patients with aphasia, including the importance of the long-term primary care relationship in supporting psychosocial adjustment to life after aphasic stroke.
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STAN, Adina, Stefan STRILCIUC, Nicoleta GHERGHEL, Angela COZMA, Alexander CRISTIAN, Silvina ILUT, Alina BLESNEAG, et al. "Aphasia after acute ischemic stroke: epidemiology and impact on tertiary care resources." Balneo and PRM Research Journal, Vol.12, no.4 (December 14, 2021): 376–80. http://dx.doi.org/10.12680/balneo.2021.465.
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Introduction. This study aimed to reveal the disease burden of aphasia after acute ischemic stroke (AIS) at the national level and investigate the impact of aphasia on tertiary care resources and patient outcomes. We aimed to investigate the length of stay (LOS) and discharge modified Rankin Scale (mRS) score in aphasic, acute ischemic stroke (AIS) patients in order to estimate aphasia-related disease burden at a national level. Material and method. The local database from the Cluj-Napoca Emergency County Hospital (CNECH), the second largest stroke center in Romania was used to export demographics, baseline clinical and laboratory data, inpatient length of stay (LOS), NIH Stroke Scale (NIHSS), and discharge modified Rankin Scale (mRS) score data for all AIS patients admitted during March 2019. Results and discussions. Of 92 patients included in the study, 30 (32.6 %) had aphasia on admission. In a marginally significant unadjusted hierarchical multiple regression model, individuals with aphasia had a LOS of 1.86 days longer than stroke survivors without aphasia. In an adjusted version of the model, the NIHSS score at baseline was a significant predictor for LOS. In addition, the presence of aphasia was associated with a 1.49 increase in the mean mRS score. Aphasia was a marginally significant predictor for increased LOS. Presence of aphasia was more likely to produce a poor functional outcome. Conclusions. Considering an estimated impact of approximately EUR 3 million on direct medical expenditure annually, future policymaking efforts should improve prevention of stroke and improved access to post-stroke aphasia care in Romania. Keywords: aphasia; acute ischemic stroke; length of stay; disability, outcome,
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Whelan, K., M. Haarstad, B. Feldbruegge, A. Jacobi, C. Mayo, T. Hautz, C. Heyer, B. Graham, and G. Hunter. "P.092 Successful implementation of a supported conversation program on an acute stroke unit." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 48, s3 (November 2021): S45—S46. http://dx.doi.org/10.1017/cjn.2021.370.
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Background: Aphasia is a life alerting deficit that affects up to 40% of people living with stroke. Barriers to communication ultimately impacts the care aphasic patients receive, as well as functional recovery. The Canadian Stroke Best Practice Recommendations suggest early and frequent language interventions to improve patients with aphasia quality of life, mood, and social outcomes. Methods: A supported conversation (SC) program (colloquially named The Aphasia Club) was implemented on the Acute Stroke Unit (ASU). The program included aphasia awareness and assessment training, as well as creation of an aphasia tool kit and discipline specific aphasia-friendly resources. Staff were encouraged to complete a 1-hour independent course on SC through the Aphasia Institute. Speech and language pathologists (SLP) offered an additional 30-minute in-person teaching session with interdisciplinary practice professionals. Following SLP assessment, personalized communication profiles were created for patients with aphasia to help staff understand the most useful strategies for communication. Results: More then 50 interprofessional staff members took SC training. Staff reported increased levels of knowledge and confidence when communicating with aphasic patients. Conclusions: A supported communication program was successfully implemented on an ASU. Planning appropriate communication interventions can assist interdisciplinary professionals in their ability to support patients through their stroke journey.
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Gunawan, Pricilla Yani, and Kalista Ardelia Iswara. "Correlation Between Aphasia in Stroke Patients and Severe Depression of Family Members as Primary Caregivers." Medicinus 8, no. 3 (June 2, 2021): 94. http://dx.doi.org/10.19166/med.v8i3.3765.
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<p><strong>Background and Objective: </strong>Stroke is a disease with an increasing annual prevalence. One of the most frequent clinical manifestation seen in stroke patients is aphasia which greatly affects the patient’s ability to communicate. The burden and the pressure of taking care of the patient placed on the family members often results in psychological impacts such as depression. We intend to know the association between aphasia in stroke patients with severe depression on family members. </p><p><strong>Methodology:</strong> This was a cross sectional study, using an unpaired categorical comparative analysis. Inclusion criteria were family members of patients with and without aphasia. Patients and caregivers who gave their consent verbally were guided to fill in the Hamilton Depression Rating Scale questionnaire. The association between aphasia status and the depression scale was analyzed using Chi-Square.</p><p><strong>Results: </strong>Out of 54 respondents included in the study, there were 25 caregivers (46,3%) taking care stroke patients without aphasia, and 29 caregivers (53,7) taking care stroke patients with aphasia. As much as35 (64.8%) were categorized as normal- moderate level of depression and 19 (35.2%) categorized as major depression. From those with major depression, 14 (73.7%) were found in the aphasic group and 5 were in the non-aphasia group. Chi-Square analysis shows a significant correlation [P=0.03; OR=3.73 (1.1-12.7)] between aphasia in stroke patients and severe depression of the caregivers.</p><p><strong>Conclusion: </strong>There is a significant association between aphasia in stroke patients and the incidence of severe depression on their caregivers.</p>
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Febryanto, Dwi, Retnaningsih, and Fitria Handayani. "Assessment Of Afasia in Stroke Patients: Case Study." Journal Of Nursing Practice 3, no. 2 (April 29, 2020): 210–19. http://dx.doi.org/10.30994/jnp.v3i2.88.
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Introduction: Aphasia is understood as difficulty in understanding or producing language caused by disorders involving the brain hemispheres. Early assessment of aphasia is very important to prevent the emergence of telegraphic speech styles, improve welfare, independence, social participation, quality of life, reduce length of stay and care costs, but there is little literature on this subject, especially in stroke patients. Purpose: This study is to provide an overview of the assessment of aphasia in stroke patients. Methods: The design of a case study involving 6 participants and data collection was carried out by conducting an assessment using the Language Aphasia Screening Test (LAST) instrument which was monitored for 3 days, including monitoring errors for naming images, monitoring mismatches repeating words and sentences, monitoring spontaneous pronunciation, monitoring image comprehension, monitoring comprehension of verbal instructions.Results: A total of 6 ischemic stroke patients were found wrong in repeating words and sentences. Conclusion: In aphasic stroke patients all language modalities are impaired, ranging from spontaneous speech, repetition, naming, language comprehension, reading and writing
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Godecke, Erin, Elizabeth A. Armstrong, Tapan Rai, Sandy Middleton, Natalie Ciccone, Anne Whitworth, Miranda Rose, et al. "A randomized controlled trial of very early rehabilitation in speech after stroke." International Journal of Stroke 11, no. 5 (May 5, 2016): 586–92. http://dx.doi.org/10.1177/1747493016641116.
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Rationale The efficacy of rehabilitation therapy for aphasia caused by stroke is uncertain. Aims and hypothesis The Very Early Rehabilitation of Speech (VERSE) trial aims to determine if intensive prescribed aphasia therapy (VERSE) is more effective and cost saving than non-prescribed, intensive (usual care-plus) and non-intensive usual care (UC) therapy when started within 15 days of stroke onset and continued daily over four weeks. We hypothesize that aphasia therapy when started very early after stroke and delivered daily could enhance recovery of communication compared with UC. Sample size estimates A total of 246 participants (82 per arm) will provide 80% power to detect a 4.4% improvement on aphasia quotient between VERSE and UC plus at a significance level of α = 0.05. Setting Acute-care hospitals and accompanying rehabilitation services throughout Australia, 2014–2017. Design Three-arm, prospective, randomized, parallel group, open-label, blinded endpoint assessment (PROBE) trial. Participants Acute stroke in previous 14 days and aphasia diagnosed by aphasia quotient (AQ) of the Western Aphasia Battery (WAB). Randomization Computer-generated blocked randomization procedure stratified by aphasia severity according to Western Aphasia Battery, to one of three arms. Intervention All participants receive UC—usual ward-based aphasia therapy. Arm 1: UC—no additional therapy; Arm 2: UC-plus usual ward-based therapy; Arm 3: VERSE therapy—a prescribed and structured aphasia therapy program. Arms 2 and 3 receive a total of 20 additional sessions (45–60 min, provided daily) of aphasia therapy. The additional intervention must be provided before day 50 post stroke. Study outcome measures The aphasia quotient of Western Aphasia Battery at 12 weeks post stroke. Secondary outcomes include discourse measures, the Stroke and Aphasia Quality of Life Scale-39 and the Aphasia Depression Rating Scale at 12 and 26 weeks. Economic evaluation Incremental cost-effectiveness ratios at 26 weeks will be reported. Discussion This trial is designed to test whether the intensive and prescribed VERSE intervention is effective in promoting maximum recovery and preventing costly health complications in a vulnerable population of survivors of stroke. It will also provide novel, prospective, aphasia specific cost-effectiveness data to guide future policy development for this population.
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Bahia, Mariana Mendes, and Regina Yu Shon Chun. "Quality of life in aphasia: differences between fluent and non-fluent aphasic Augmentative and Alternative Communication users." Audiology - Communication Research 19, no. 4 (December 2014): 352–59. http://dx.doi.org/10.1590/s2317-64312014000300001353.
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Purpose To investigate and to compare quality of life (QOL) in fluent and non-fluent aphasics. Methods This is a prospective, quantitative, and transversal study. We included 11 stroke patients with aphasia (five non-fluent aphasics augmentative and alternative communication users and six fluent aphasics). Data was gathered from the Stroke Specific Quality of Life Scale (SS-QOL), a structure interview, and The Modified Rankin Scale. Results The non-fluent aphasics presented poorer Rankin and quality of life than the fluent aphasics. The major difference occurred in the fields of language and upper extremity function. The three most affected domains in non-fluent aphasics were language, social roles, and thinking, whereas in the fluent aphasics were personality, social roles, and thinking. All the subjects referred a worse quality of life after stroke. The domains of language and self-care were identified as the most affected after stroke. Conclusion This study demonstrated that, in general, non-fluent aphasics have lower quality of life than fluent aphasics. However, this difference is not homogeneous among the several quality of life domains. Additionally, this research evidences a relationship between aphasia severity and individual functionality, implying impairment in quality of life, especially for non-fluent aphasics.
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Macrae, Margaret, and Jacinta M. Douglas. "Communication Outcome 12 Months Following Left-Hemisphere Stroke in the Elderly." Brain Impairment 9, no. 2 (September 1, 2008): 170–78. http://dx.doi.org/10.1375/brim.9.2.170.
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AbstractWith increasing life expectancy and the changing age structure of the population, the health sector is experiencing increased demands on services associated with age-related diseases including stroke and Alzheimer's disease. The communication needs of older Australians in these disease groups need to be understood to enable adequate provision of speech pathology services. In this project we set out to make a preliminary investigation of 12-month communication outcome and discharge destination of aphasic stroke survivors over age 65 at onset of first ever in a lifetime stroke (FELS). The recruitment timeframe was a 6-month period of stroke admissions to a large metropolitan health network. Nearly 70% of stroke admissions were aged 65 years and over and 34% were ascertained retrospectively from medical records as having aphasia. Within this group, there was a 20% mortality rate. Sixteen left-hemisphere stroke survivors with aphasia were followed up at 12 months. More than half were living in residential care. Excluding the impact of recurrent stroke, 12-month reassessment of language demonstrated substantial improvement could occur in the old-very old stroke survivor. These findings highlight the need to develop systematic review and follow-up speech pathology services that operate effectively in residential care environments.
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Shankar, Shyam, Ishan Malhotra, Pavel Gozenput, Mangalore Amith Shenoy, Pavan Irukulla, Roman Bernstein, and Yizhak Kupfer. "1991: NOMINAL APHASIA: UTI, NOT STROKE?" Critical Care Medicine 44, no. 12 (December 2016): 573. http://dx.doi.org/10.1097/01.ccm.0000510663.98093.e9.
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Rose, Miranda L., David Copland, Lyndsey Nickels, Leanne Togher, Marcus Meinzer, Tapan Rai, Dominique A. Cadilhac, et al. "Constraint-induced or multi-modal personalized aphasia rehabilitation (COMPARE): A randomized controlled trial for stroke-related chronic aphasia." International Journal of Stroke 14, no. 9 (September 7, 2019): 972–76. http://dx.doi.org/10.1177/1747493019870401.
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Rationale The comparative efficacy and cost-effectiveness of constraint-induced and multi-modality aphasia therapy in chronic stroke are unknown. Aims and hypotheses In the COMPARE trial, we aim to determine whether Multi-Modal Aphasia Treatment (M-MAT) and Constraint-Induced Aphasia Therapy Plus (CIAT-Plus) are superior to usual care (UC) for chronic post-stroke aphasia. Primary hypothesis: CIAT-Plus and M-MAT will reduce aphasia severity (Western Aphasia Battery-Revised Aphasia Quotient (WAB-R-AQ)) compared with UC: CIAT-Plus superior for moderate aphasia; M-MAT superior for mild and severe aphasia. Sample size estimates A total of 216 participants (72 per arm) will provide 90% power to detect a 5-point difference on the WAB-R-AQ between CIAT-Plus or M-MAT and UC at α = 0.05. Methods and design Prospective, randomized, parallel group, open-label, assessor blinded trial. Participants: Stroke >6 months; aphasia severity categorized using WAB-R-AQ. Computer-generated blocked and stratified randomization by aphasia severity (mild, moderate, and severe), to 3 arms: CIAT-Plus, M-MAT (both 30 h therapy over two weeks); UC (self-reported usual community care). Study outcomes WAB-R-AQ immediately post-intervention. Secondary outcomes: WAB-R-AQ at 12-week follow-up; naming scores, discourse measures, Communicative Effectiveness Index, Scenario Test, and Stroke and Aphasia Quality of Life Scale-39 g immediately and at 12 weeks post-intervention; incremental cost-effectiveness ratios compared with UC at 12 weeks. Discussion This trial will determine whether CIAT-Plus and M-MAT are superior and more cost-effective than UC in chronic aphasia. Participant subgroups with the greatest response to CIAT-Plus and M-MAT will be described.
Dissertations / Theses on the topic "Aphasia and stroke care"
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Snook, Katherine Dorothy Ms. "Telephone-based Script Training and Generalization for Aphasia." The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1372865259.
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Dahné, Ylva, and Emma Thorin. "Sjuksköterskan och patienter med strokeinduceradafasi – En litteraturöversikt om kommunikation ochpersoncentrering." Thesis, Högskolan Dalarna, Omvårdnad, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:du-25249.
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Bakgrund: Stroke är ett samlingsbegrepp för hjärninfarkter och hjärnblödningar. Stroke ger ofta livslånga men, såsom afasi. Afasi innebär en reducerad förmåga att förstå talat/skrivet språk och/eller en reducerad förmåga att uttrycka sig adekvat. För att en god och personcentrerad vård ska kunna erbjudas patienter med stroke så är en fungerande kommunikation en förutsättning. Syfte: Syftet är att beskriva faktorer som påverkar personcentrerad vård och kommunikation mellan sjuksköterskan och patienter som drabbats av strokeinducerad afasi. Metod: Studien är en litteraturöversikt. Studien är baserad på 15 vetenskapliga artiklar som lästs och analyserats och där gemensamma teman identifierats. Resultat: Resultatet visade på ett antal strategier som främjade eller försvårade en god kommunikation mellan sjuksköterskan och patienter som drabbats av strokeinducerad afasi. Dessa strategier berörde sju områden: Verbal kommunikation, Icke verbal kommunikation, Att se patienten som en kompetent och unik individ, Uppmärksamhet och engagemang, Tidsaspekten vid kommunikation med afasidrabbade, Den omgivande miljöns betydelse för kommunikationen samt Personalens utbildning och kompetens. Konklusion: Det finns inget standardsvar på hur kommunikationen ska gå till, varje individ är unik och varje situation kräver sin unika lösning. Dock finns det ett antal aspekter och metoder som är betydelsefulla och användbara vid kommunikation med afasidrabbade. Dessa används i olika utsträckning inom vården.Background: Stroke is a collective term for cerebral infarction and cerebral hemorrhage. Stroke often causes lifelong detrimental effects, such as aphasia. Aphasia means a reduced ability to understand spoken/written language and/or a reduced ability to express oneself adequately. To enable a good and person-centred care for the patients, an effective communication is a prerequisite. Aim: The aim of this study is to describe the factors that influence the person-centred care and communication between the nurse and patients affected by stroke induced aphasia. Method: The study is a literature review on bachelor level. The study is based on 15 scientific articles that have been red and analyzed and where common themes have been identified. Result: The results revealed a number of strategies that promoted and hindered good communication between the nurse and people affected by stroke induced aphasia. These strategies concern seven areas: Verbal communication, Nonverbal communication, Seeing the patient as a competent and unique individual, Attention and involvement, The time aspect of communication with patients with aphasia, The importance of the surrounding environment for communication and The personnel's education and skills . Conclusion: There is no standard answer to how communication shall be achieved, each individual is unique and every situation requires a different solution. However, there are a number of aspects and methods that are important and useful when communicating with aphasic people. These are used to different degrees in health care.
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Kjellberg, Katarina, and Linnéa Öhrström. "Livet för personer med afasi och deras närstående efter stroke : Personer med afasi och deras närståendes skattningar på COAST respektive Carer COAST i relation till en språklig bedömning med testet A-ning." Thesis, Uppsala universitet, Logopedi, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-312952.
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ABSTRACT Stroke can result in aphasia which is an acquired language disorder. It affects both the person with aphasia and the relatives. Previous studies have shown that people with aphasia consider themselves to have fewer difficulties with communication in comparison to their relatives’ opinions. The relatives rate the difficulties as less severe in comparison to the speech and language pathologists. The scales Communication Outcome after Stroke (COAST) and Carer Communication Outcome after Stroke (Carer COAST) can be used to investigate the experiences of the people with aphasia and their relatives regarding the language and communication ability of people with aphasia and the quality of life for both groups. By using COAST and Carer COAST this study aimed to investigate the experiences of people with aphasia and their relatives and to compare their experiences to the assessment of language. This study also aimed to start a validation of COAST and Carer COAST on a Swedish population. A qualitative and a quantitative analysis were used. Twenty people with aphasia and nineteen relatives were participating. The ratings between people with aphasia, their relatives and the speech and language pathologist did not differ a lot even though the relatives rated the difficulties as most severe. The quality of life was negatively affected for almost all participants. This study provided deeper insight in the different experiences which can be crucial in the clinical practice. The validation of COAST and Carer COAST can contribute to an extended use of the scales clinically and in research. Keywords: aphasia, stroke, relative, experiences, speech and language pathology, Communication Outcome after Stroke, Carer Communication Outcome after Stroke SAMMANFATTNING Afasi är en förvärvad språkstörning som kan uppkomma efter stroke och påverkar både personen som fått afasi och de närstående. Enligt tidigare studier anser personer med afasi att de har mindre kommunikationssvårigheter än vad de närstående upplever. De närstående upplever i sin tur svårigheterna som mindre än vad logopeder bedömer. Skattningsformulären Communication Outcome after Stroke (COAST) och Carer Communication Outcome after Stroke (Carer COAST) kan användas för att undersöka upplevelserna hos personer med afasi och deras närstående avseende den språkliga och kommunikativa förmågan hos personen med afasi samt livskvaliteten hos båda parter. Studien syftade till att med COAST och Carer COAST studera upplevelserna hos personer med afasi och deras närstående samt hur dessa förhöll sig till en språklig bedömning. Ytterligare ett syfte var att påbörja validering av COAST och Carer COAST på en svensk population. En kvalitativ och en kvantitativ analys gjordes. Tjugo personer med afasi och nitton närstående deltog. Det var inga större skillnader mellan skattningarna av deltagarna med afasi och deras närstående. Skattningarna stämde även till stor del överens med den språkliga bedömningen även om de närstående överlag skattade svårigheterna som störst. Livskvaliteten var negativt påverkad för de flesta deltagarna. Studiens resultat ökar insikten om de olika upplevelserna vilket kan vara av betydelse i den kliniska verksamheten. Valideringen av COAST och Carer COAST kan innebära att skattningsskalorna i större utsträckning kan användas kliniskt och inom forskning. Nyckelord: afasi, stroke, närstående, upplevelser, logopedi, Communication Outcome after Stroke, Carer Communication Outcome after Stroke
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Laska, Ann Charlotte. "Aphasia in acute stroke /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-195-1/.
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Kontou, Eirini. "Depression and aphasia after stroke." Thesis, University of Nottingham, 2010. http://eprints.nottingham.ac.uk/12841/.
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Background: Post-stroke depression (PSD) is a common phenomenon and has a negative impact on rehabilitation, recovery and quality of life. About one third of stroke patients suffer communication problems, including aphasia, which is a condition that mainly affects their ability in understanding and/or producing language. The frequency of depressive symptoms in post-stroke aphasia has been difficult to determine as most studies have excluded stroke patients with aphasia due to methodological limitations. As a result, depression remains often under-diagnosed and untreated in these patients. Objectives: The purpose of this thesis was 1) to develop and validate a revised version of the Visual Analogue Mood Scales (YAMS), and 2) to identify factors which may be associated with low mood in stroke patients with aphasia. Method: The items Happy and Energetic of the VAMS were reversed for a more consistent format. All participants completed a questionnaire including the revised version of the VAMS (VAMS-R), the Hospital & Anxiety Depression Scale (BADS), but also four key items of the VAMS-R which were repeated with and without verbal descriptors to assess their content and test-rest reliability. Aphasic stroke patients were recruited both from hospital and community settings and completed assessments at recruitment and at six months follow up. Participants were assessed on measures of communication, cognition, mood, activities of daily living, and disability associated with living with aphasia. Carers also completed assessments of caregiving strain and satisfaction with care at six months follow up. Results: The VAMS-R showed good evidence of validity and reliability in a community sample of 50 older adults and in 71 stroke patients with aphasia. In the main study, 132 aphasic stroke patients were invited to take part, 71 consented and completed baseline assessments and 63 were followed up at six months. Most participants (n=47) were recruited in the community, 38 were men, mean age was 70 years old and the mean time post-stroke was 15 months. Almost half of the aphasic stroke patients recruited had low mood at baseline (55%) and at follow up (44%) based either on their self-report or the observer-rated mood scores. Physical impairment, demographic and medical information, ADL and leisure activities were not shown to be significant predictors of depression. Communication impairment was significantly related to low mood, but was not predictive of self report mood outcomes at both end points. Disability and emotional consequences living with aphasia were predictive of low mood and accounted for 37% of the variance in self-report mood scores at recruitment and for 48% of the variance at follow up. Baseline language battery scores and follow up Carer Strain Index scores were predictive of the observer-rated mood scores at follow up. Conclusions: The VAMS-R, VASES and SADQ-21 could be used to screen for symptoms of low mood in aphasic stroke patients who cannot complete conventional mood assessments that rely on verbal communication. The main factors found to predict low mood in stroke patients with aphasia were disability associated with living with aphasia, carer strain and communication impairment. The factors identified are amenable to psychological intervention and future research should address interventions for the management of post-stroke depression in aphasia. The need to include people with aphasia in future post-stroke depression research is also highlighted.
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Beeson, Pelagie Maritz. "Memory impairment associated with stroke and aphasia." Diss., The University of Arizona, 1990. http://hdl.handle.net/10150/185167.
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Brain structures in the perisylvian region that are critical for language also subserve verbal memory processes. Researchers have documented a reduction in verbal memory span in individuals with perisylvian stroke resulting in aphasia, but scant data are available regarding the integrity of long-term memory in such individuals. Whereas dissociated memory processes have been documented in nonaphasic populations, characteristic patterns of short- versus long-term memory have not typically been associated with specific lesion sites in aphasic individuals. The purpose of this study was to examine memory abilities of aphasic individuals in relation to site of neurological lesion resulting from cerebrovascular accident. Fourteen individuals with stroke and aphasia and fourteen demographically matched control subjects were given selected tests of short-term memory (STM) and long-term memory (LTM). The stroke patients represented two distinct groups with regard to site of neurological lesion: seven with anterior lesions, seven with posterior lesions. STM was assessed with Digits Forward and Tapping Forward subtests from the Wechsler Memory Scale-Revised (Wechsler, 1988). Verbal LTM was assessed using two multitrial free recall paradigms. One paradigm required free recall of a word list presented aurally with selective reminding of unrecalled items. The other required free and cued recall of a word list presented with guided semantic encoding. Stroke patients were impaired relative to normal control subjects on tests of verbal memory, with greater impairment of LTM associated with anterior lesions and greater impairment of STM associated with posterior lesions. Individuals with anterior lesions were deficient in the enactment of successful LTM encoding and retrieval strategies. The posterior aphasia group was most impaired for digit span, a task dependent upon subvocal rehearsal. There were no group differences on a test of visual short-term memory. Verbal memory performance did not correlate highly with language ability, and did not appear to be simply a consequence of language impairment. The memory impairments observed in aphasic stroke patients were interpreted as working memory impairments with distinct manifestations dependent upon lesion site.
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Ford, Emma Jane. "Quality of life after stroke and aphasia : stroke survivors' and spouses' perspectives." Thesis, Staffordshire University, 2014. http://eprints.staffs.ac.uk/1997/.
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Having previously worked in research teams investigating the impact of stroke and aphasia upon individuals and spending two years working therapeutically with people with low mood and post-stroke aphasia, a passion for aiding this client group to achieve a good quality of life was developed. Furthermore, completing this work highlighted the paucity of good quality research including this population, despite having learned from personal experience that it was feasible to do so, given that the appropriate adaptations and considerations were made to accommodate communication difficulties. Subsequently, a need for further research regarding quality of life post-stroke and aphasia was acknowledged. An initial review of the existing literature regarding quality of life post-stroke and aphasia was conducted, to determine what was already known, and what remained to be found. The studies identified for review were subjected to evaluation. The outcome of the review suggested that quality of life was a complex, multifaceted concept, impacted by a number of factors, but that it was not possible to determine for certain what factors were important in achieving a good quality of life, primarily due to the methodological limitations of the studies forming the evidence base. Chiefly, the data collection methods used were seemingly inappropriate for people with communication difficulties. Thus it was proposed that the more aphasia friendly, Q methodology approach was utilised to gather the views of people with post-stroke aphasia about what factors were important to achieve a good quality of life. Six aphasic stroke survivors and five spouses completed a Q sort task, in which they were required to rank a number of statements depicting different factors related to quality of life, in terms of personal importance. Spouses did this task from the perspective of the stroke survivor. Ultimately, two factors were identified: ‘returning to the pre-stroke self’ which represented the stroke survivors of working age, and ‘life beyond stroke, what’s important now?’ which reflected the views of the older, retired participants. The two factors were considered in relation to Erikson’s (1968) psychosocial stages of development model and in terms of stroke recovery models (Holbrook, Quality of Life After Stroke and Aphasia 1982; Kirkevold, 2002). Significant, strong and positive pair-wise correlations between the Q sort outcomes of the stroke survivors’ and their respective spouses’ suggested that spouses could reliably report the stroke survivors’ views regarding quality of life. The importance of the findings in relation to the work of a clinical psychologist was subsequently considered.
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Griffith, Julie. "Post-Stroke Language Remediation Through Constraint-Induced Aphasia Therapy." University of Cincinnati / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1415615475.
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Bethel, Susannah. "Functional magnetic resonance imaging of recovery from post-stroke aphasia." Thesis, University of Nottingham, 2009. http://eprints.nottingham.ac.uk/12635/.
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This thesis presents the design, development and application of a novel overt picture-naming paradigm through a series of exploratory behavioural and imaging experiments. The paradigm is subsequently used in a functional magnetic resonance imaging study of recovery from post-stroke aphasia. The possibility of comparing correct and error naming responses in aphasic patients and unimpaired subjects induced to make errors was investigated and successfully trialled. This research improves on techniques currently favoured in imaging studies to explore the processes involved in functional recovery in a more analytical way. The novel study design provides a new way to interrogate processing involved in the production of aphasic responses. The intentions of this project were to drive the research field of post-stroke aphasia recovery forward by suggesting and applying new methods of using functional imaging to investigate the current pertinent research questions. In addition to this, it was aimed that data collected from participants who have an aphasic deficit, and those with a healthy language system, would be analysed to provide evidence of how a stroke damaged brain may recover functional language. It was hypothesised that results from aphasic patients would show that successful language performance is associated with cortical activation of the patients' normal left hemispheric language areas, around their lesion site. Conversely, the hypotheses state that production of linguistic errors would correlate with an increase in activation in areas of the right hemisphere homologous to the left lateralised fronto-temporal language production network. It was thought that further investigation of successful and unsuccessful language performance in unimpaired speakers would echo this finding. The current debate in this research field centres on the role of the undamaged hemisphere in successful recovery. Five chronic stage aphasics were tested using the developed continuous scanning, event-related paradigm and their correct and error naming trials were compared. Results indicate that recruitment of cortical areas homologous to the stroke lesion can support successful language processing. This is contrary to the theory that disinhibition of non-dominant language areas may contribute to the production of aphasic errors. An investigation of forced errors in unimpaired speakers was also conducted to provide comparisons with the aphasic patient group. Imaging results showed that the naming-to-deadline paradigm used may provide a useful baseline for the normal processes involved in the monitoring and control of task performance.
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DeMarco, Andrew Tesla, and Andrew Tesla DeMarco. "Neural Substrates of Phonological Processing in Chronic Aphasia from Stroke." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/622976.
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Deficits in phonology are among the most common and persistent impairments in aphasia after left hemisphere stroke, and can have significant functional consequences for spoken and written language. While many individuals make considerable gains through physiological restitution and in response to treatment, the neural substrates supporting phonological performance in the face of damage to critical language regions is poorly understood. To address this issue, we used BOLD fMRI to measure regional brain activation in a case series of individuals with aphasia after left MCA stroke during a phonological task. The results of this study support the idea that damage to even a portion of the phonological network results in impaired phonological processing. We found that individuals with left perisylvian damage tend to rely on the residual left-hemisphere language network, and typically recruit regions associated with domain-general cognitive processing which fall outside of the left-hemisphere language network. However, recruitment of these regions did not necessarily enhance phonological processing. Rather, more successful phonological processing outside the scanner was associated with recruitment of a language region in right posterior middle temporal gyrus and a region in left occipital pole. More successful phonological processing inside the scanner was associated with additional recruitment of the left supramarginal gyrus within the healthy control network, engagement of bilateral intraparietal sulcus from the multi-demand network, and up-regulation of the right-hemisphere network of regions homotopic to the left-hemisphere language network seen in the healthy control group. These findings emphasize the contributions of residual components of the left-hemisphere language network, engagement of a non-linguistic domain-general multi-demand network, and the participation of the non-dominant right-hemisphere language network in successful phonological processing in chronic aphasia after stroke.
Books on the topic "Aphasia and stroke care"
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1955-, Pfalzgraf Beth, ed. Pathways: Moving beyond stroke and aphasia. Detroit: Wayne State University Press, 1990.
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1956-, Byng Sally, Gilpin Sue, and Ireland Chris, eds. Talking about aphasia: Living with loss of language after stroke. Buckingham: Open University Press, 1997.
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Stroke diary: A primer for aphasia therapy. Charleston, SC?]: Thomas G. Broussard, 2015.
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Mozeiko, Jennifer L., and Deborah S. Yost, eds. Caring For a Loved One with Aphasia After Stroke. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-11767-1.
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Burton Hospitals NHS Trust. Department of General Medicine and Care of the Elderly. Audit of stroke care. Burton upon Trent: The Trust, 2001.
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Farhad, Huwez, and Good Dawn, eds. Stroke care: A practical manual. 2nd ed. Oxford: Oxford University Press, 2010.
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Alway, David, and John Walden Cole, eds. Stroke Essentials for Primary Care. Totowa, NJ: Humana Press, 2009. http://dx.doi.org/10.1007/978-1-59745-433-9.
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Heart and Stroke Foundation of Ontario. Coordinated Stroke Strategy. Best practice guidelines for stroke care: A resource for implementing optimal stroke care. Toronto: Heart and Stroke Foundation of Ontario, 2003.
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Parr, Susie. Living with severe aphasia: The experience of communication impairment after stroke. Brighton: Pavilion Publishing, 2004.
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Underwood, Helen. I need help: A stroke patient's plea : understanding simplified medical terminology and anatomy with emphasis on stroke (cerebrovascular accident of CVA) : including symptoms and concrete suggestions for patients and caregivers. Nevada City, CA: Blue Dolphin Pub., 1991.
Find full textBook chapters on the topic "Aphasia and stroke care"
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Berthier, Marcelo L., Guadalupe Dávila, Natalia García-Casares, and Ignacio Moreno-Torres. "Post-stroke Aphasia." In The Behavioral Consequences of Stroke, 95–117. New York, NY: Springer New York, 2013. http://dx.doi.org/10.1007/978-1-4614-7672-6_6.
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Kobata, Hitoshi. "Stroke." In Neurocritical Care, 111–28. Singapore: Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-13-7272-8_10.
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Theisler, Charles. "Stroke." In Adjuvant Medical Care, 322–24. New York: CRC Press, 2022. http://dx.doi.org/10.1201/b22898-316.
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Zielinski, Brandon A., and Denise Morita. "Stroke." In Pediatric Critical Care Medicine, 589–99. London: Springer London, 2014. http://dx.doi.org/10.1007/978-1-4471-6356-5_36.
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Ferbert, Andreas, Michael S. Pessin, Klaus Rieke, and Werner Hacke. "Vertebrobasilar Stroke, Cerebellar Stroke, and Basilar Occlusion." In Neurocritical Care, 596–606. Berlin, Heidelberg: Springer Berlin Heidelberg, 1994. http://dx.doi.org/10.1007/978-3-642-87602-8_53.
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Smith, Peter, and David Colin-Thomé. "Stroke." In Guide to the Primary Care Guidelines, 167–72. 4th ed. London: CRC Press, 2022. http://dx.doi.org/10.1201/9781909368903-22.
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Alway, David. "Identifying Stroke and Stroke Type." In Stroke Essentials for Primary Care, 1–8. Totowa, NJ: Humana Press, 2008. http://dx.doi.org/10.1007/978-1-59745-433-9_1.
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Oliveira-Filho, Jamary, and Walter J. Koroshetz. "Ischemic Stroke." In Surgical Intensive Care Medicine, 219–41. Boston, MA: Springer US, 2001. http://dx.doi.org/10.1007/978-1-4757-6645-5_14.
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Oliveira-Filho, Jamary, and Walter J. Koroshetz. "Hemorrhagic Stroke." In Surgical Intensive Care Medicine, 243–58. Boston, MA: Springer US, 2001. http://dx.doi.org/10.1007/978-1-4757-6645-5_15.
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Ardelt, Agnieszka A. "Ischemic Stroke." In Handbook of Neurocritical Care, 123–40. Totowa, NJ: Humana Press, 2004. http://dx.doi.org/10.1007/978-1-59259-772-7_8.
Full textConference papers on the topic "Aphasia and stroke care"
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Brooks, Joseph Bruno Bidin, and Fábio César Prosdócimi. "Bilingual aphasia after stroke. Case report." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.187.
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Context: With the largest number of bilingual individuals in the world, there is a growing need for understanding and studying language in different populations. In cases of bilingual aphasia, patterns of language recovery can vary. Parallel, or simultaneous, recovery in both languages is the most common type of language recovery, followed by differential recovery, where there is an improvement in one language compared to another. This case report was approved by the Ethics Committee of Universidade Metropolitana de Santos. Case Report: The present case refers to a male patient, 52 years old, righthanded, born in Arkansas-United States of America and resident for 20 years in the city of Santos, São Paulo. The patient is bilingual fluent in English and Portuguese and had a sudden deficit in strength and sensitivity in the right hemibody, associated with language disorders. Imaging exams showed a hemorrhagic lesion in the topography of the left lenticular nucleus. In the neurological evaluation, hemiparesis and proportioned and complete hemiparesis were shown on the right. In the language assessment, he presented an important impairment of fluency, compression and repetition in the Portuguese language and relative preservation, with slight dysfunction in fluency in the English language. Conclusions: Symptomatic treatment was instituted and after 12 months he had partial improvement of motor symptoms and complete aphasia.
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Santos, João Vitor Ribeiro dos, Mariana Spitz, and Ana Carolina Andorinho. "Stroke secondary to thrombotic microangiopathy." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.300.
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Introduction: Thrombotic thrombocytopenic purpura (TTP) is a hematological disease resulting from the ADAMTS 13 plasmatic protein deficit. It can be congenital or sporadic, and is usually autoimmune. Pathological platelet adhesion occurs, leading to microthrombi in capillary and arterial circulation, microangiopathic anemia and ischemia. The clinical picture includes thrombocytopenia, renal dysfunction, fluctuating neurological symptoms, microangiopathic hemolytic anemia, and fever. Methods: Case report of a 51-year-old male hypertensive patient, diagnosed with idiopathic thrombocytopenic purpura (ITP) 10 years ago and submitted to splenectomy 5 years ago, who developed acute cholecystitis. He underwent urgent colecistectomy, and on the fourth postoperative day presented sudden space and time disorientation, transcortical motor aphasia and right faciobrachial paresis, with ipsilateral Babinski and Hoffman signs. Results: Brain CT showed left frontoparietal hypodensity. During hospitalization, there was worsening of renal function, increased LDH, and thrombocytopenia. Hematoscopy identified signs of intravascular hemolysis (erythrocyte fragmentation, reticulocytosis, helmet erythrocytes). Direct Coombs was negative. There was no history of heparin use. TTP was diagnosed, and fresh frozen plasma and prednisone 1mg/kg were prescribed. There was resolution of thrombotic microangiopathy, with subsequent increase of platelet levels, decreased LDH and improved hematoscopy. Conclusions: This case illustrates a rare cause of stroke and an unusual association of two hematological conditions: ITP and TTP. The treatment of TTP consists of replacement of deficient ADAMTS13 protein through plasmapheresis or fresh frozen plasma. The use of immunosuppressants is also associated, initially with glucocorticoids, followed by rituximab or splenectomy in order to prevent recurrences.
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Silva, Bruno Custódio, Vivianne Amanda do Nascimento, Maria Isabelle Nakano Vieira, Guilherme Rocha Spiller, and Celso David Lago. "Medium cerebral artery thrombosis – radiological fing: hyperdense MCA sign – case report." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.244.
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Introduction: Vascular diseases are the leading cause of death in the world. Although major advances in neuroimaging and stroke treatment have contributed to a decrease in mortality, strokes occupy second place in the list. Case report: A 75-year-old man is admitted to emergency with an altered neurological examination: right hemiplegia, Broca’s aphasia and dysphagia. Conscience was preserved. Computed tomography (CT) was performed, which showed the radiological finding of hyperdense MCA sign, confirming the diagnosis of ischemic stroke with involvement of the left middle cerebral artery branch. The treatment, in this case, was outside the criteria for thrombolytics. Discussion: Irrigation of the brain is done by Willis polygon. One of the essential branches is the medium cerebral artery (MCA), the most important termination of the internal carotid arteries, responsible for blood supply of the dorsolateral hemifacial of both cerebral hemispheres, irrigating the frontal, parietal and temporal lobes. The imaging exam in suspected cases of stroke focuses on confirming its diagnosis and etiology, location of the lesion, extent of ischemic evolution, therapeutic treatment and prognosis. CT is the main modality of neuroimaging for stroke and an important radiological finding is the hyperdense artery sign, which is more common in MCA and demonstrates an evolving or impending infarction and is secondary to a plunger housed in this vessel. Therefore, it is an important early tomographic sign of ischemic stroke found on non-contrast blood CT. Conclusion: Ischemic stroke is the most common etiology among strokes. The diagnosis must be based mainly on anamnesis and image exam, such as a CT scan. The CT performed helps to guide treatment, prognosis and clinical evolution. Finally, the recognition of the hyperdense MCA sign, found in the first 6 hours, is also extremely helpful for stroke classification.
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Santos, Leonardo Daniel Reis, Omar Pereira de Almeida Neto, Michelle Franco Macedo de Lima, and Nathália Varano. "Left atrial myxoma and transient ischemic attacks: case report." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.205.
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Context: Cardiac tumors are rare and myxomas are the most prevalent between them. Although histologically benign, they may cause severe effects given their intracardiac location. Unspecific symptoms compromise the diagnosis, leading to complications such as changes in the cerebral vascular dynamics. Case report following the CARE guidelines. Case report: A 62-year-old woman was admitted to a high complexity hospital in Minas Gerais, with history of unstable angina, aphasia, right hemiparesis, dysarthria, claiming precordialgia with strong intensity. Complained hyporexia and weight loss during the last month. Medical history of 7 transient ischemic attacks (TIA) in the last two years. Physical examination with no abnormalities. Chest x-ray and transesophageal echocardiogram showed bilateral neovascularization and 4.9 x 2.9 cm dimension mass in the left atrium. Coronary angiography revealed proximal calcification and atherosclerotic plaque occluding 40% of the flux in the middle third of the anterior descending artery, pointing to the coexistence of coronary disease and left atrial myxoma. The occurrence of a TIA was determined and the prescription of an anticoagulant to avoid future embolic events. A surgical approach was necessary. Biopsy concluded myxoid and hyaline-rich stroma tumor, evident vascular system, star-shaped cells isolated or forming small groups, confirming myxoma diagnosis. After a ten-day hospitalization, the patient was clinically stable, and was discharged after health education. Conclusion: Cardiac tumors such as myxomas lead to important cerebral vascular consequences, so that the clinical investigation is essential to the differential diagnosis between a stroke and the TIA, to provide adequate treatment and disease prevention.
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Ferreira, Isadora Santos, Mauricio Elias Nunes da Silva, Liz Barros Rebouças, Rafael Bernhart Carra, Rene de Araújo Gleizer, and Rafaela Almeida Alquéres. "Management challenge of basilar artery occlusion in SUS: Case report." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.151.
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Context: Stroke caused by basilar artery occlusion is rare, corresponding to 1% of strokes. There is no consensus in the literature on the ideal management of this disease at acute phase. However, mechanical thrombectomy may be a viable treatment option. Case report: 68-year-old female, with no comorbidities, admitted to a secondary hospital 14h after headache, dizziness, vomiting and difficulty walking. She was disoriented, with severe dysarthria and dysphonia, horizontal and vertical ophthalmoparesis and pronation of the right upper limb (NIHSS: 4). Cranial tomography was normal and cranial angiotomography showed a basilar artery thrombosis. Patient was out of the window for intravenous thrombolysis and our hospital did not have another possibility of treatment. Due to high morbidity and mortality, also the possibility of neurological deterioration, medical contact was made with a tertiary hospital with hemodynamic service. During patient transference, she evolved with decreased level of consciousness, aphasia and tetraparesis (NIHSS: 18). Upon arrival at the hospital, a thrombectomy was performed due to an important clinical-radiological mismatch, 19 hours within symptoms onset and 3 hours after neurological worsening. After discharge, patient walked with assistance and physical examination showed a significant improvement in neurological deficits (NIHSS: 6). Conclusions: This case demonstrates the importance of engaging Brazil’s public health system in the management of acute ischemic stroke, especially in challenging cases such as basilar artery occlusion. This patient was the first admitted to our hospital to perform a thrombectomy after effective transference for a tertiary hospital and staff engagement of both hospitals.
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Gramasco, Hendrick Henrique Fernandes, Maria Clara Foloni, Rebeca Aranha Barbosa Sousa, Yasmim Nadime José Frigo, Mateus Felipe dos Santos, Guilherme Drumond Jardini Anastácio, Stella de Angelis Trivellato, et al. "Chemical thrombolysis with extended 15-hour window in a patient undergoing perfusion CT scan with Rapid CT protocol: a case report." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.516.
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Context: Recently, with the advance of neuroimaging modalities, the windows of reperfusion therapy in patients with acute stroke have been reviewed and extended, especially for mechanical thrombectomy. Case report: 81 year old patient, previously hypertensive and dyslipidemic, fully functional (modified Rankin scale = 0), admitted to the emergency room of a tertiary hospital with global aphasia, right hemiparesis, right homonymous hemianopsia and severe hypoesthesia of the right upper limb, scoring 26 on the NIHSS, with report of having contacted family members for the last time 15 hours before admission. She was treated according to the institution’s acute stroke protocol, and underwent non-contrast brain computed tomography (CT), perfusion CT with Rapid CT protocol and cerebral artery + neck angio-CT, which ruled out bleeding and showed an ASPECTS of 8, an estimated ischemic core volume of 17 mL, and an area with hypoperfusion of 118 mL (perfusional mismatch of 101 mL), besides occlusion of the M1 segment of the left middle cerebral artery. Thus, she was submitted to chemical thrombolysis, with a decrease in NIHSS score to 15 and evolving without complications upon hospitalization. Conclusions: In patients with uncertain ictus, the use of advanced neuroimaging modalities, such as perfusion tomography with Rapid CT protocol, may assist in the indication of reperfusion therapies safely.
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Teixeira, Davi Vargas Freitas, Arthur da Veiga Kalil Coelho, Camila Alves Pereira, Luciana Zelante Ambiel Magalhães, Marcele Schettini, and Sônia Maria Cesar de Azevedo Silva. "Bilateral anterior cerebral infarction associated with anatomical variation in a patient with COVID-19: a case report." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.338.
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Context: Cardiovascular diseases are the main cause of death in Brazil. Amongst them, cerebrovascular disease is the second greater cause of death and the first in disability. Despite its overall high incidence, initial presentation with bilateral anterior circulation involvement is rare. The association between COVID-19 and stroke is still unclear, nethertheless, a prothrombotic state has been consistently described. Case report: A 80-years-old male, with past medical history of atrial fibrillation in regular use of apixaban, treated for severe COVID-19 Pneumonia for 13 days of hospitalization, was admitted seven days after discharge, presenting loss of consciousness followed by a not witnessed fall. At first evaluation the patient was somnolent, eye opening to tactile stimulation, motor aphasia, right central facial palsy and crural predominant double hemiparesis. Tomography study revealed bilateral hypoattenuation at superior frontal and cingulate girus. Angiotomography identified a hipoplasic A1 segment of anterior cerebral artery. Addtional findings included segmental pulmonary embolism and aorta intraluminal thrombus. The patient evolved to mutism and worsening level of consciousness, followed by death after several clinical complications. Conclusions: Anatomical variants of anterior circulatian are common although tipically assintomatic. When related to cerebrovascular disease, cardioembolic event is frequently accountable. This case exhibits an unusual stroke presentation during COVID-19 convalescence period among other thrombotic events despite anticoagulant therapy. Therefore, reinforces literature findings that SARS- CoV-2 infection and stroke simultaneously increase mortality and highlights that more physiolopathology knowlegde regarding this association is required, as well as efficiency trials of oral anticoagulants in these scenarios.
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Rolindo, Saullo José Silva, Isabela Louise Caldeira Silva, Samuel Campos Silva, and Denise Sisterolli Diniz. "Vasculitis of the central nervous system secondary to amiopathic dermatomyositis: A case report." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.661.
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Context: Dermatomyositis (DM) is an idiopathic inflammatory myopathy, characterized by proximal skeletal muscle weakness, associated with a variety of characteristic skin manifestations. A form called Amiopathic Dermatomyositis (AD) is a condition that patients have cutaneous findings characteristic of DM without weakness and/or normal muscle enzymes. In turn, central nervous system (CNS) vasculitis refers to a wide spectrum of diseases that result in inflammation and destruction of the blood vessels of the brain, spinal cord and meninges. Case report: Female, 54 years old, reports for 3 months a progressive myalgia, paraparesis and edema in the proximal region of the lower limbs, evolving in the last weeks with erythematous and itchy lesions on the trunk (in shawl), feet and hands, with subsequent peeling of these (mechanic’s hands). During diagnostic investigation she presented epileptic seizures with behavioral arrest, right hemiparesis and motor aphasia. It evolved with a new stroke in the left frontoparietal region. Bilateral angiography showed points of constriction of segments of the middle cerebral artery bilaterally, compatible with CNS vasculitis. Therefore, with the exclusion of other secondary causes of arteritis, associated with the marker of positive inflammatory myopathy (Anti-Jo1) and CPK within the serum levels of normality, the diagnosis of the stroke secondary to AD was closed. Conclusions: Both CNS vasculitis and AD are rare conditions, characteristically diagnoses of exclusion, deserving to be remembered in clinical cases with singular manifestations, as reported in this case.
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Wang, Yuan, Roozbeh Behroozmand, Lorelei Phillip Johnson, and Julius Fridriksson. "Topology Highlights Neural Deficits of Post-Stroke Aphasia Patients." In 2020 IEEE 17th International Symposium on Biomedical Imaging (ISBI). IEEE, 2020. http://dx.doi.org/10.1109/isbi45749.2020.9098734.
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Mustafaoglu, Rustem, Abdurrahim Yildiz, and Ayşe Nur Bardak. "Does Speech Disorder (Aphasia) Affect Respiratory Muscle Strength in Stroke?" In ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.pa3699.
Full textReports on the topic "Aphasia and stroke care"
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Chen, Luyao, Qin Ye, and Zude Zhu. Treatment of post-stroke aphasia and its induced reorganization of language networks: a systematic review and meta-analysis study. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, April 2022. http://dx.doi.org/10.37766/inplasy2022.4.0097.
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Liang, Pengpeng, Yufei Li, Yanan Feng, Guoliang Yin, suwen Chen, Xiangyi Liu, and Fengxia Zhang. Effects of Acupuncture-Related Therapies in the Rehabilitation of Patients with Post-Stroke Aphasia―A Network Meta-Analysis of Randomized Controlled Trials. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, September 2022. http://dx.doi.org/10.37766/inplasy2022.9.0024.
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Duncan, Pamela, Cheryl Bushnell, Sara Jones, Anna Johnson, Mysha Sissine, Sabina Geshell, Matthew Psioda, et al. Comparing a Care Program and Usual Care to Help Patients Transition Home from the Hospital after a Stroke -- The COMPASS Study. Patient-Centered Outcomes Research Institute® (PCORI), April 2022. http://dx.doi.org/10.25302/03.2022.pcs.140314532.
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Cheng, Xiaorong, Shunqin Mao, Yibao Zhang, Xiaoyun Peng, Rui Ma, Yingcun Bao, Qun Li, et al. Early physical rehabilitation vs standard care for intracerebral hemorrhage stroke: a protocol for systematic review. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, November 2020. http://dx.doi.org/10.37766/inplasy2020.11.0068.
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Mawson, Susan, Ali Ali, Mandy Higginbottom, Steven Ariss, Joanna Blackburn, Joseph Langley, Chris Redford, et al. Circle of Care for Home: Community Stroke Services Sheffield. Project Report, Part 1: January 2021. Sheffield Hallam University, 2021. http://dx.doi.org/10.7190/circle-care-home-2020-2021.
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Goodwin, Simon. IMPROVE-Stroke: IMproving the PRevention Of Vascular Events after Stroke or TIA – a randomised controlled pilot trial of nurse independent prescriber-led care pathway-based risk factor management. National Institute for Health and Care Research (NIHR), March 2022. http://dx.doi.org/10.3310/nihropenres.1115183.1.
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Krhutová, Lenka, Petr Šaloun, Kamila Vondroušová, Marcela Dabrowská, Zdeněk Velart, David Andrešič, and Miroslav Paulíček. Výzkum a vývoj podpůrných sítí a informačních systémů pro neformální pečující o osoby po cévních mozkových příhodách. Ostravská univerzita, 2021. http://dx.doi.org/10.15452/vsouhrntacr.2021.
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The summary research report describes and summarizes the goals, course and results of the TAČR–VISNEP project. The aim of the experimental development project was to create an information system (IS) for informal carers (ICs) for a person after stroke using modern information technologies in the technical and non-technical spheres of research. IS will allow users to obtain relevant, timely and interconnected information on support networks to prevent their possible social isolation and exclusion, physical and psychological exhaustion, health disorders and other risk factors in their difficult life situation. The purpose of IS is to contribute to improved awareness of ICs support systems across other long-term care providers, in particular public administration, general practitioners etc. The intent of the project was to create and verify a pilot model of IS in Moravian-Silesian Region, which can subsequently be applied in other regions and / or other target ICs groups. The presented results of the project are based on data obtained by research procedures of qualitative and quantitative methodology in the process of agile software development.
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Totten, Annette, Dana M. Womack, Marian S. McDonagh, Cynthia Davis-O’Reilly, Jessica C. Griffin, Ian Blazina, Sara Grusing, and Nancy Elder. Improving Rural Health Through Telehealth-Guided Provider-to-Provider Communication. Agency for Healthcare Research and Quality, December 2022. http://dx.doi.org/10.23970/ahrqepccer254.
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Objectives. To assess the use, effectiveness, and implementation of telehealth-supported provider-to-provider communication and collaboration for the provision of healthcare services to rural populations and to inform a scientific workshop convened by the National Institutes of Health Office of Disease Prevention on October 12–14, 2021. Data sources. We conducted a comprehensive literature search of Ovid MEDLINE®, CINAHL®, Embase®, and Cochrane CENTRAL. We searched for articles published from January 1, 2015, to October 12, 2021, to identify data on use of rural provider-to-provider telehealth (Key Question 1) and the same databases for articles published January 1, 2010, to October 12, 2021, for studies of effectiveness and implementation (Key Questions 2 and 3) and to identify methodological weaknesses in the research (Key Question 4). Additional sources were identified through reference lists, stakeholder suggestions, and responses to a Federal Register notice. Review methods. Our methods followed the Agency for Healthcare Research and Quality Methods Guide (available at https://effectivehealthcare.ahrq.gov/topics/cer-methods-guide/overview) and the PRISMA reporting guidelines. We used predefined criteria and dual review of abstracts and full-text articles to identify research results on (1) regional or national use, (2) effectiveness, (3) barriers and facilitators to implementation, and (4) methodological weakness in studies of provider-to-provider telehealth for rural populations. We assessed the risk of bias of the effectiveness studies using criteria specific to the different study designs and evaluated strength of evidence (SOE) for studies of similar telehealth interventions with similar outcomes. We categorized barriers and facilitators to implementation using the Consolidated Framework for Implementation Research (CFIR) and summarized methodological weaknesses of studies. Results. We included 166 studies reported in 179 publications. Studies on the degree of uptake of provider-to-provider telehealth were limited to specific clinical uses (pharmacy, psychiatry, emergency care, and stroke management) in seven studies using national or regional surveys and claims data. They reported variability across States and regions, but increasing uptake over time. Ninety-seven studies (20 trials and 77 observational studies) evaluated the effectiveness of provider-to-provider telehealth in rural settings, finding that there may be similar rates of transfers and lengths of stay with telehealth for inpatient consultations; similar mortality rates for remote intensive care unit care; similar clinical outcomes and transfer rates for neonates; improvements in medication adherence and treatment response in outpatient care for depression; improvements in some clinical monitoring measures for diabetes with endocrinology or pharmacy outpatient consultations; similar mortality or time to treatment when used to support emergency assessment and management of stroke, heart attack, or chest pain at rural hospitals; and similar rates of appropriate versus inappropriate transfers of critical care and trauma patients with specialist telehealth consultations for rural emergency departments (SOE: low). Studies of telehealth for education and mentoring of rural healthcare providers may result in intended changes in provider behavior and increases in provider knowledge, confidence, and self-efficacy (SOE: low). Patient outcomes were not frequently reported for telehealth provider education, but two studies reported improvement (SOE: low). Evidence for telehealth interventions for other clinical uses and outcomes was insufficient. We identified 67 program evaluations and qualitative studies that identified barriers and facilitators to rural provider-to-provider telehealth. Success was linked to well-functioning technology; sufficient resources, including time, staff, leadership, and equipment; and adequate payment or reimbursement. Some considerations may be unique to implementation of provider-to-provider telehealth in rural areas. These include the need for consultants to better understand the rural context; regional initiatives that pool resources among rural organizations that may not be able to support telehealth individually; and programs that can support care for infrequent as well as frequent clinical situations in rural practices. An assessment of methodological weaknesses found that studies were limited by less rigorous study designs, small sample sizes, and lack of analyses that address risks for bias. A key weakness was that studies did not assess or attempt to adjust for the risk that temporal changes may impact the results in studies that compared outcomes before and after telehealth implementation. Conclusions. While the evidence base is limited, what is available suggests that telehealth supporting provider-to-provider communications and collaboration may be beneficial. Telehealth studies report better patient outcomes in some clinical scenarios (e.g., outpatient care for depression or diabetes, education/mentoring) where telehealth interventions increase access to expertise and high-quality care. In other applications (e.g., inpatient care, emergency care), telehealth results in patient outcomes that are similar to usual care, which may be interpreted as a benefit when the purpose of telehealth is to make equivalent services available locally to rural residents. Most barriers to implementation are common to practice change efforts. Methodological weaknesses stem from weaker study designs, such as before-after studies, and small numbers of participants. The rapid increase in the use of telehealth in response to the Coronavirus disease 2019 (COVID-19) pandemic is likely to produce more data and offer opportunities for more rigorous studies.
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Newman-Toker, David E., Susan M. Peterson, Shervin Badihian, Ahmed Hassoon, Najlla Nassery, Donna Parizadeh, Lisa M. Wilson, et al. Diagnostic Errors in the Emergency Department: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), December 2022. http://dx.doi.org/10.23970/ahrqepccer258.
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Objectives. Diagnostic errors are a known patient safety concern across all clinical settings, including the emergency department (ED). We conducted a systematic review to determine the most frequent diseases and clinical presentations associated with diagnostic errors (and resulting harms) in the ED, measure error and harm frequency, as well as assess causal factors. Methods. We searched PubMed®, Cumulative Index to Nursing and Allied Health Literature (CINAHL®), and Embase® from January 2000 through September 2021. We included research studies and targeted grey literature reporting diagnostic errors or misdiagnosis-related harms in EDs in the United States or other developed countries with ED care deemed comparable by a technical expert panel. We applied standard definitions for diagnostic errors, misdiagnosis-related harms (adverse events), and serious harms (permanent disability or death). Preventability was determined by original study authors or differences in harms across groups. Two reviewers independently screened search results for eligibility; serially extracted data regarding common diseases, error/harm rates, and causes/risk factors; and independently assessed risk of bias of included studies. We synthesized results for each question and extrapolated U.S. estimates. We present 95 percent confidence intervals (CIs) or plausible range (PR) bounds, as appropriate. Results. We identified 19,127 citations and included 279 studies. The top 15 clinical conditions associated with serious misdiagnosis-related harms (accounting for 68% [95% CI 66 to 71] of serious harms) were (1) stroke, (2) myocardial infarction, (3) aortic aneurysm and dissection, (4) spinal cord compression and injury, (5) venous thromboembolism, (6/7 – tie) meningitis and encephalitis, (6/7 – tie) sepsis, (8) lung cancer, (9) traumatic brain injury and traumatic intracranial hemorrhage, (10) arterial thromboembolism, (11) spinal and intracranial abscess, (12) cardiac arrhythmia, (13) pneumonia, (14) gastrointestinal perforation and rupture, and (15) intestinal obstruction. Average disease-specific error rates ranged from 1.5 percent (myocardial infarction) to 56 percent (spinal abscess), with additional variation by clinical presentation (e.g., missed stroke average 17%, but 4% for weakness and 40% for dizziness/vertigo). There was also wide, superimposed variation by hospital (e.g., missed myocardial infarction 0% to 29% across hospitals within a single study). An estimated 5.7 percent (95% CI 4.4 to 7.1) of all ED visits had at least one diagnostic error. Estimated preventable adverse event rates were as follows: any harm severity (2.0%, 95% CI 1.0 to 3.6), any serious harms (0.3%, PR 0.1 to 0.7), and deaths (0.2%, PR 0.1 to 0.4). While most disease-specific error rates derived from mainly U.S.-based studies, overall error and harm rates were derived from three prospective studies conducted outside the United States (in Canada, Spain, and Switzerland, with combined n=1,758). If overall rates are generalizable to all U.S. ED visits (130 million, 95% CI 116 to 144), this would translate to 7.4 million (PR 5.1 to 10.2) ED diagnostic errors annually; 2.6 million (PR 1.1 to 5.2) diagnostic adverse events with preventable harms; and 371,000 (PR 142,000 to 909,000) serious misdiagnosis-related harms, including more than 100,000 permanent, high-severity disabilities and 250,000 deaths. Although errors were often multifactorial, 89 percent (95% CI 88 to 90) of diagnostic error malpractice claims involved failures of clinical decision-making or judgment, regardless of the underlying disease present. Key process failures were errors in diagnostic assessment, test ordering, and test interpretation. Most often these were attributed to inadequate knowledge, skills, or reasoning, particularly in “atypical” or otherwise subtle case presentations. Limitations included use of malpractice claims and incident reports for distribution of diseases leading to serious harms, reliance on a small number of non-U.S. studies for overall (disease-agnostic) diagnostic error and harm rates, and methodologic variability across studies in measuring disease-specific rates, determining preventability, and assessing causal factors. Conclusions. Although estimated ED error rates are low (and comparable to those found in other clinical settings), the number of patients potentially impacted is large. Not all diagnostic errors or harms are preventable, but wide variability in diagnostic error rates across diseases, symptoms, and hospitals suggests improvement is possible. With 130 million U.S. ED visits, estimated rates for diagnostic error (5.7%), misdiagnosis-related harms (2.0%), and serious misdiagnosis-related harms (0.3%) could translate to more than 7 million errors, 2.5 million harms, and 350,000 patients suffering potentially preventable permanent disability or death. Over two-thirds of serious harms are attributable to just 15 diseases and linked to cognitive errors, particularly in cases with “atypical” manifestations. Scalable solutions to enhance bedside diagnostic processes are needed, and these should target the most commonly misdiagnosed clinical presentations of key diseases causing serious harms. New studies should confirm overall rates are representative of current U.S.-based ED practice and focus on identified evidence gaps (errors among common diseases with lower-severity harms, pediatric ED errors and harms, dynamic systems factors such as overcrowding, and false positives). Policy changes to consider based on this review include: (1) standardizing measurement and research results reporting to maximize comparability of measures of diagnostic error and misdiagnosis-related harms; (2) creating a National Diagnostic Performance Dashboard to track performance; and (3) using multiple policy levers (e.g., research funding, public accountability, payment reforms) to facilitate the rapid development and deployment of solutions to address this critically important patient safety concern.
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Computerised speech and language therapy can help people with aphasia find words following a stroke. National Institute for Health Research, January 2020. http://dx.doi.org/10.3310/signal-000864.
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