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Cooray, Vernon, Marcos Rubinstein, and Farhad Rachidi. "A Self-Consistent Return Stroke Model That Includes the Effect of the Ground Conductivity at the Strike Point." Atmosphere 13, no. 4 (April 6, 2022): 593. http://dx.doi.org/10.3390/atmos13040593.
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A current generation type return stroke model which can take into account the possible modifications of the return stroke properties by the soil conductivity at the strike point of the lightning flash is introduced. The model is also capable of incorporating the reflection of the current at the ground end of the return stroke channel. In this paper, this return stroke model is used to investigate (a) the effect of the ground conductivity at the strike point on the source electromagnetic fields generated by return strokes and (b) the effect of current reflection at ground level on the electromagnetic field generated by return strokes. The source electromagnetic fields are the electromagnetic fields generated by lightning flashes calculated in such a way that they are not distorted by propagation effects. The results obtained show that the ground conductivity at the strike point does not significantly influence the return stroke current peak or the radiation field peak for ground conductivities higher than about 0.001 S/m. However, strike points with very poor conductivities (lower than 0.001 S/m) would result in a decrease of the peak electric field. In contrast to the peak values of the lightning current and the electric field, the peak values of the time derivatives of the lightning current and electric field are significantly reduced when the strike point of the lightning flash is located over a finitely conducting ground. The inclusion of the current reflection at ground level influences significantly the saturation of the close electric fields. The current reflection also gives rise to residual electric fields, a difference in the field levels generated by the dart leader and the return stroke. The residual field decreases as the fraction of the reflected current decreases.
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Wu, Qing, Guan Jun Qian, Bin Hu, Song Huang, Xian He Dou, and Hao Wei Pei. "A New Trip Fault of Transmission Line Caused by Lightning Striking to Ground Wire and Conductor Simultaneously." Applied Mechanics and Materials 701-702 (December 2014): 1187–93. http://dx.doi.org/10.4028/www.scientific.net/amm.701-702.1187.
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Lightning strokes are the main cause for the trip fault of transmission line with a rated voltage of 110 kV and above. The counterattack trip and the shielding failure trip were thought to be the two kinds of fault type caused by lightning strokes. According to the development process of the two fault types, a few effective lightning protection methods are proposed. However, there is no relative report about the case that the ground wire and the conductor are stricken simultaneously. Therefore, no specific protection method is presented. In this paper, the possibility of the both stroke is analyzed, according the the mechanism of lightning stroke and the characteristics of lightning strokes. Then, a series of simulation test were designed and carried out. The observation results recorded by high-speed camera indicate that the downward leader could strike grounded wire and conductor simultaneously. At last, based on the intelligent monitoring system of transmission line, the traveling wave current of a lightning stroke was recorded. And after comparing the current with the simulation results by ATP/EMTP, the stroke was thought to be a both stroke. The photos in the fault point indicate that there are discharge points both on the grounded wire and conductor. And this field data clarified that the trip fault was caused by both stroke. A new lightning stroke fault was presented and verified in this paper, this report will supply important reference for lightning protection of transmission line.
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Poelman, Dieter R., Wolfgang Schulz, Stephane Pedeboy, Dustin Hill, Marcelo Saba, Hugh Hunt, Lukas Schwalt, et al. "Global ground strike point characteristics in negative downward lightning flashes – Part 1: Observations." Natural Hazards and Earth System Sciences 21, no. 6 (June 18, 2021): 1909–19. http://dx.doi.org/10.5194/nhess-21-1909-2021.
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Abstract. Information about lightning properties is important in order to advance the current understanding of lightning, whereby the characteristics of ground strike points (GSPs) are in particular helpful to improving the risk estimation for lightning protection. Lightning properties of a total of 1174 negative downward lightning flashes are analyzed. The high-speed video recordings are taken in different regions, including Austria, Brazil, South Africa and the USA, and are analyzed in terms of flash multiplicity, duration, interstroke intervals and ground strike point properties. According to our knowledge this is the first simultaneous analysis of GSP properties in different regions of the world applying a common methodology. Although the results vary among the data sets, the analysis reveals that a third of the flashes are single-stroke events, while the overall mean number of strokes per flash equals 3.67. From the video imagery an average of 1.56 GSPs per flash is derived, with about 60 % of the multiple-stroke flashes striking the ground in more than one place. It follows that a ground contact point is struck 2.35 times on average. Multiple-stroke flashes last on average 371 ms, whereas the geometric mean (GM) interstroke interval value preceding strokes producing a new GSP is about 18 % greater than the GM value preceding subsequent strokes following a pre-existing lightning channel. In addition, a positive correlation between the duration and multiplicity of the flash is presented. The characteristics of the subset of flashes exhibiting multiple GSPs is further examined. It follows that strokes with a stroke order of 2 create a new GSP in 60 % of the cases, while this percentage quickly drops for higher-order strokes. Further, the possibility of forming a new lightning channel to ground in terms of the number of strokes that conditioned the previous lightning channel shows that approximately 88 % developed after the occurrence of only one stroke. Investigating the time intervals in the other 12 % of the cases when two or more strokes re-used the previous lightning channel showed that the average interstroke time interval preceding a new lightning channel is found to be more than twice the time difference between strokes that follow the previous lightning channel.
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Somasundaran, Abhilash, Hashik Mohammed, Jayaraj Kezhukatt, Alvin Treasa George, and S. Narayanan Potty. "Accuracy of Siriraj stroke scale in the diagnosis of stroke subtypes among stroke patients." International Journal of Research in Medical Sciences 5, no. 3 (February 20, 2017): 1084. http://dx.doi.org/10.18203/2320-6012.ijrms20170666.
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Background: Early detection of intracranial blood is essential for the rational use of anti hemostatic drugs in stroke patients. CT scan is quite expensive as well as it is not easily available especially in the rural areas. Clinical stroke scores were developed to overcome these limitations. Aim of present study is to identify the stroke subtype using Siriraj stroke scoring and thus asses its accuracy by comparing with CT scan reports.Methods: A cross sectional study was conducted in a tertiary centre that evaluated 464 patients admitted with a diagnosis of stroke. Siriraj Stroke score was calculated for each patient and a CT scan of brain was also taken. The results of diagnosis made by Siriraj stroke scoring were compiled and compared with the diagnosis obtained by CT Scan.Results: Of the total 464 patients, the incidence of hemorrhagic stroke was 27.8% and ischemic stroke was 72.2%, as per the CT scan reports, while the Siriraj stroke score diagnosed 16.8% patients to have hemorrhagic stroke and 74.6% to have ischemic stroke and no definite diagnosis was made in rest of the patients (8.6%). The sensitivity of the scoring was found to be 59.2% in diagnosing hemorrhagic stroke and 95.5% in ischemic stroke.Conclusions: Our study has shown that siriraj stroke scoring has a high degree of accuracy in detecting both types of strokes, with roughly 80% of both hemorrhagic and ischemic strokes being correctly identified. However there is a low sensitivity in diagnosing hemorrhagic strokes and higher sensitivity in diagnosing ischemic strokes.
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Plamondon, Réjean, Christian O'Reilly, and Claudéric Ouellet-Plamondon. "Strokes against stroke—strokes for strides." Pattern Recognition 47, no. 3 (March 2014): 929–44. http://dx.doi.org/10.1016/j.patcog.2013.05.004.
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Poelman, Dieter R., Wolfgang Schulz, Stephane Pedeboy, Leandro Z. S. Campos, Michihiro Matsui, Dustin Hill, Marcelo Saba, and Hugh Hunt. "Global ground strike point characteristics in negative downward lightning flashes – Part 2: Algorithm validation." Natural Hazards and Earth System Sciences 21, no. 6 (June 18, 2021): 1921–33. http://dx.doi.org/10.5194/nhess-21-1921-2021.
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Abstract. At present the lightning flash density is a key input parameter for assessing the risk of occurrence of a lightning strike in a particular region of interest. Since it is known that flashes tend to have more than one ground termination point on average, the use of ground strike point densities as opposed to flash densities is more appropriate. Lightning location systems (LLSs) do not directly provide ground strike point densities. However, ingesting their observations into an algorithm that groups strokes into respective ground strike points results in the sought-after density value. The aim of this study is to assess the ability of three distinct ground strike point algorithms to correctly determine the observed ground-truth strike points. The output of the algorithms is tested against a large set of ground-truth observations taken from different regions around the world, including Austria, Brazil, France, Spain, South Africa and the United States of America. These observations are linked to the observations made by a local LLS in order to retrieve the necessary parameters of each lightning discharge, which serve as input for the algorithms. Median values of the separation distance between the first stroke in the flash and subsequent ground strike points are found to vary between 1.3 and 2.75 km. It follows that all three of the algorithms perform well, with success rates of up to about 90 % to retrieve the correct type of the strokes in the flash, i.e., whether the stroke creates a new termination point or follows a pre-existing channel. The most important factor that influences the algorithms' performance is the accuracy by which the strokes are located by the LLS. Additionally, it is shown that the strokes' peak current plays an important role, whereby strokes with a larger absolute peak current have a higher probability of being correctly classified compared to the weaker strokes.
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Natteru, P., M. R. Mohebbi, P. George, D. Wisco, J. Gebel, and C. R. Newey. "Variables That Best Differentiate In-Patient Acute Stroke from Stroke-Mimics with Acute Neurological Deficits." Stroke Research and Treatment 2016 (2016): 1–6. http://dx.doi.org/10.1155/2016/4393127.
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Introduction. Strokes and stroke-mimics have been extensively studied in the emergency department setting. Although in-hospital strokes are less studied in comparison to strokes in the emergency department, they are a source of significant direct and indirect costs. Differentiating in-hospital strokes from stroke-mimics is important. Thus, our study aimed to identify variables that can differentiate in-hospital strokes from stroke-mimics. Methods. We present here a retrospective analysis of 93 patients over a one-year period (2009 to 2010), who were evaluated for a concern of in-hospital strokes. Results. About two-thirds (57) of these patients were determined to have a stroke, and the remaining (36) were stroke-mimics. Patients with in-hospital strokes were more likely to be obese (p=0.03), have been admitted to the cardiology service (p=0.01), have atrial fibrillation (p=0.03), have a weak hand or hemiparesis (p=0.03), and have a prior history of stroke (p=0.05), whereas, when the consults were called for “altered mental status” but no other deficits (p<0.0001), it is likely a stroke-mimic. Conclusion. This study demonstrates that in-hospital strokes are a common occurrence, and knowing the variables can aid in their timely diagnosis and treatment.
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Meretoja, Atte, Monica Acciarresi, Rufus O. Akinyemi, Bruce Campbell, Dar Dowlatshahi, Coralie English, Nils Henninger, et al. "Stroke doctors: Who are we? A World Stroke Organization survey." International Journal of Stroke 12, no. 8 (March 28, 2017): 858–68. http://dx.doi.org/10.1177/1747493017701150.
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Background Specialist training provides skilled workforce for service delivery. Stroke medicine has evolved rapidly in the past years. No prior information exists on background or training of stroke doctors globally. Aims To describe the specialties that represent stroke doctors, their training requirements, and the scientific organizations ensuring continuous medical education. Methods The World Stroke Organization conducted an expert survey between June and November 2014 using e-mailed questionnaires. All Organization for Economic Co-operation and Development countries with >1 million population and other countries with >50 million population were included ( n = 49, total 5.6 billion inhabitants, 85% of global strokes). Two stroke experts from each selected country were surveyed, discrepancies resolved, and further information on identified stroke-specific curricula sought. Results We received responses from 48 (98%) countries. Of ischemic stroke patients, 64% were reportedly treated by neurologists, ranging from 5% in Ireland to 95% in the Netherlands. Per thousand annual strokes there were average six neurologists, ranging from 0.3 in Ethiopia to 33 in Israel. Of intracerebral hemorrhage patients, 29% were reportedly treated by neurosurgeons, ranging from 5% in Sweden to 79% in Japan, with three neurosurgeons per thousand strokes, ranging from 0.1 in Ethiopia to 24 in South Korea. Most countries had a stroke society (86%) while only 10 (21%) had a degree or subspecialty for stroke medicine. Conclusions Stroke doctor numbers, background specialties, and opportunities to specialize in stroke vary across the globe. Most countries have a scientific society to pursue advancement of stroke medicine, but few have stroke curricula.
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Giri, R., S. P. Chimouriya, and B. R. Ghimire. "Application of Absorption Spectra to Study Order of Sequence in Intersecting Printed and Pen Strokes." Journal of Nepal Physical Society 8, no. 3 (December 30, 2022): 1–8. http://dx.doi.org/10.3126/jnphyssoc.v8i3.50696.
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This work is performed to establish chronological order in crossing strokes between printed stroke and pen strokes. Nine different types of pens including cello maxriter pen (black and blue), pilot pen (red and black), cello pointec pen (black and blue) and cello techno tip pen (red, black and blue) are used to produce pen strokes and for printed stroke Canon LBP 3300 printer is used. In the case of printed stroke, only black color stroke is applied. As a result, samples of both homogeneous and heterogeneous intersecting strokes are prepared. This work is based on the assumption that nature and peak characteristics of absorption spectra from crossing stroke should be similar to that of second stroke. Here, absorption spectra is generated by Video Spectral Comparator-6000 by using light of wavelength ranging from 400 nm to 1000 nm. From this experiment, it is found to be possible to find chronological order for heterogeneous crossing strokes (crossing stroke of different colors) only if printed stroke is over pen stroke. It means, only if print is done over writing strokes from red and blue pen, then order of sequence of writing can be determined whereas in other cases it is not possible.
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Li, Meng, Yahan Yu, Yi Yang, Guanghao Ren, and Jian Wang. "Stroke Extraction of Chinese Character Based on Deep Structure Deformable Image Registration." Proceedings of the AAAI Conference on Artificial Intelligence 37, no. 1 (June 26, 2023): 1360–67. http://dx.doi.org/10.1609/aaai.v37i1.25220.
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Stroke extraction of Chinese characters plays an important role in the field of character recognition and generation. The most existing character stroke extraction methods focus on image morphological features. These methods usually lead to errors of cross strokes extraction and stroke matching due to rarely using stroke semantics and prior information. In this paper, we propose a deep learning-based character stroke extraction method that takes semantic features and prior information of strokes into consideration. This method consists of three parts: image registration-based stroke registration that establishes the rough registration of the reference strokes and the target as prior information; image semantic segmentation-based stroke segmentation that preliminarily separates target strokes into seven categories; and high-precision extraction of single strokes. In the stroke registration, we propose a structure deformable image registration network to achieve structure-deformable transformation while maintaining the stable morphology of single strokes for character images with complex structures. In order to verify the effectiveness of the method, we construct two datasets respectively for calligraphy characters and regular handwriting characters. The experimental results show that our method strongly outperforms the baselines. Code is available at https://github.com/MengLi-l1/StrokeExtraction.
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Abdel Mawla, Tamer, Osama Momtaz, Mohamed Abdel Gayed, and Gomaa Abdelrazek. "Left Atrial Appendage Function Assessment by Tissue Doppler Transesophageal Echocardiography in Acute Ischemic Stroke Patients." Open Access Macedonian Journal of Medical Sciences 9, B (September 7, 2021): 858–64. http://dx.doi.org/10.3889/oamjms.2021.5842.
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Background: Strokes due to Cardioembolic causes are the most severe in ischemic stroke subtypes. LAA flow patterns and function could be assessed accurately by TEE. The study aimed to present the importance of Transesophageal echocardiography in the assessment of LAA function and its relation to cardioembolic stroke. Methods: 120 patients were enrolled in the study and were subdivided into 3 subgroups, each group included 40 patients. Group A; patients had a stroke with normal sinus rhythm, Group B; patients had a stroke with atrial fibrillation, and Group C; normal control subjects. The study participants were evaluated by medical history, physical examination, standard 12-leads electrocardiogram, a transesophageal echocardiographic detailed evaluation of the LAA, and brain CT and/or MRI for patients with stroke. Results: both stroke patients with AF and sinus rhythm had significantly higher LAA mean orifice diameter and higher LAA length than control patients, significantly lower mean LAA medial wall tissue Doppler upward and downward motion velocities than control patients and that patients with stroke and AF had significantly lower mean LAA pulsed wave emptying and filling velocities than both patients with stroke and sinus rhythm and control patients. Presence of LAA thrombi, spontaneous echo contrast, and stroke recurrence were higher in stroked AF patients than stroke patients with sinus rhythm. Conclusion: increased LAA orifice diameter, LAA length, and reduced filling and emptying velocities and upward and downward motion velocities of the medial wall of LAA as detected by TEE are associated with stroke and cardio embolization.
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Abd. Herman Syah Thalib, Ricky. Z, Rusli Abdullah, Nur Aliza Aszahra, and Ainun Ainun. "Pencegahan dan Tatalaksana Stroke di Wilayah Puskesmas Maccini Sawah." Jurnal Pengabdian Masyarakat Nusantara 2, no. 4 (December 30, 2020): 12–18. http://dx.doi.org/10.57214/pengabmas.v2i4.444.
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Stroke is a non-communicable disease that still has the highest death rate in the world. Even though stroke is not transmitted from one sufferer to another through contact, prevention must still be improved. Lifestyle and socioeconomics are thought to be one of the biggest factors that cause strokes. This activity aims to prevent and manage stroke by increasing knowledge in detecting signs and symptoms of stroke, preventing recurrent strokes and changing lifestyle modification behavior. Community service activity methods include health education, health checks to identify risk factors for hypertension/stroke, empowering families to recognize signs and symptoms of stroke, controlling stroke risk factors and lifestyle modification. The results of the activity showed that the majority of respondents had had one stroke (60%), the majority of families had sufficient knowledge (60%) about preventing recurrent strokes, the majority of respondents had a low risk (50%). Increased knowledge of patients and families in detecting signs of preventing stroke risk factors is targeted at changing behavior and improving healthy lifestyles to prevent recurrent strokes.
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Mahdi, Jasia, Alicia Bach, Alyssa Smith, Stuart Tomko, Melanie Fields, Jennifer Griffith, Stephanie Morris, et al. "IMMU-07. “STROKE MIMICS” ARE NOT BENIGN IN IMMUNOCOMPROMISED CHILDREN." Neuro-Oncology 23, Supplement_1 (June 1, 2021): i28. http://dx.doi.org/10.1093/neuonc/noab090.115.
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Abstract Objective To determine the clinical variances between strokes and stroke mimics in a pediatric immunocompromised population that consists of children with central nervous system (CNS) and non-CNS malignancies and a history of solid organ transplantation. Methods We performed a retrospective cohort analysis of stroke alert activations in patients with high-grade gliomas, low-grade gliomas, atypical teratoid rhabdoid tumors, rare CNS tumors, B-cell acute lymphoblastic leukemia, T-cell acute lymphoblastic leukemia, osteosarcoma, and solid organ transplants at St. Louis Children’s Hospital between February 2013 and September 2019. We categorized final diagnoses as strokes or stroke mimics. We classified diagnoses as a neurologic emergency if the diagnosis necessitated changes in management. Results Out of 217 stroke alerts, 31 alerts occurred for 28 patients meeting inclusion criteria. All final diagnoses constituted neurologic emergencies, including: stroke (39%), chemotherapy-related neurotoxicity (29%), tumor progression (19%), and seizures/posterior reversible encephalopathy syndrome (13%). Patients meeting inclusion criteria with strokes and stroke mimics presented similarly, with the exception of altered mental status, which was more prevalent in patients with strokes than stroke mimics (p = 0.03). One child received hyperacute thrombectomy for stroke. Only 58% of children with stroke mimics had complete resolution of their presenting neurologic symptoms. Children with strokes and stroke mimics had similar mortality incidences of 33% and 37%, respectively. Conclusions Although all acute neurologic changes in immunocompromised children are not strokes, stroke mimics in this population are neither benign nor self-limited and carry long-term neurologic morbidity and mortality. This study highlights the utility of an acute stroke evaluation infrastructure and the need for acute and long-term neurology involvement in the care of these patients.
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Masotti, Luca, Rinaldo Innocenti, Stefano Spolveri, Irene Chiti, Grazia Panigada, Cristiana Seravalle, Giancarlo Landini, et al. "Stroke prevention in atrial fibrillation: findings from Tuscan FADOI Stroke Registry." Italian Journal of Medicine 9, no. 2 (May 8, 2015): 134. http://dx.doi.org/10.4081/itjm.2014.450.
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Despite vitamin K antagonists (VKAs) are considered the first choice treatment for stroke prevention in atrial fibrillation (AF), literature shows their underuse in this context. Since data about VKAs use prior and after acute stroke lack, the aim of this study was to focus on management of anticoagulation with VKAs in this context. Data were retrieved from Tuscan FADOI Stroke Registry, an online data bank aimed to report on characteristics of stroke patients consecutively admitted in Internal Medicine wards in 2010 and 2011. In this period 819 patients with mean age 76.5±12.3 years were enrolled. Data on etiology were available for 715 of them (88.1%), 87% being ischemic and 13% hemorrhagic strokes. AF was present in 238 patients (33%), 165 (69.3%) having a known AF before hospitalization, whereas 73 patients (31.7%) received a new diagnosis of AF. A percentage of 89% of strokes in patients with known AF were ischemic and 11% hemorrhagic. A percentage of 86.7% of patients with known AF had a CHADS<sub>2</sub> ≥2, but only 28.3% were on VKAs before hospitalization. A percentage of 78.8% of patients treated with VKAs before stroke had an international normalized ratio (INR) ≤2.0; 68.7% of patients with VKAs-related hemorrhagic strokes had INR ≤3.0. Combined endpoint mortality or severe disability in patients with ischemic stroke associated with AF was present in 47%, while it was present in 19.30% and 19.20% of atherothrombotic and lacunar strokes, respectively. At hospital discharge, VKAs were prescribed in 25.9% of AF related ischemic stroke patients. AF related strokes are burdened by severe outcome but VKAs are dramatically underused in patients with AF, even in higher risk patients. Efforts to improve anticoagulation in this stroke subtype are warranted.
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HSIEH, CHEN-CHUNG, and HSI-JIAN LEE. "A PROBABILISTIC STROKE-BASED VITERBI ALGORITHM FOR HANDWRITTEN CHINESE CHARACTERS RECOGNITION." International Journal of Pattern Recognition and Artificial Intelligence 07, no. 02 (April 1993): 329–52. http://dx.doi.org/10.1142/s0218001493000170.
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This paper proposes a probabilistic approach to recognize handwritten Chinese characters. According to the stroke writing sequence, strokes and interleaved stroke relations are built manually as a 1-D string, called an on-line model, to describe a Chinese character. In an input character, strokes are first extracted by a tree searching method. The recognition problem is then formulated as an optimization matching problem in a multistage directed graph, where the number of stages is the length of the modelled stroke sequence. Nodes in a stage represent extracted strokes that have the same stroke type as defined in the on-line model and the link between two neighboring nodes corresponds to the relationship between the two extracted strokes. The probability that the extracted stroke belongs to the predefined stroke type is calculated from the stroke line segments, and the transition probability between two extracted strokes is the degree of satisfaction of the relationship defined in the on-line model. The Viterbi algorithm, which can handle stroke insertion, deletion, splitting, and merging, is applied to recover the sequence of strokes consisting of the unknown character. The similarity is defined to be the product of stroke probabilities and stroke transition probabilities in the stroke sequence. The unknown character is matched with all modelled characters and is recognized as the one with the highest similarity. Experiments with 540 characters uniformly selected from the database CCL/HCCR1 (250 variations/class) are conducted, and the recognition rate is about 92.8%, which proves the feasibility of the proposed recognition system.
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Salehi Omran, Setareh, Salama Chaker, Mackenzie P. Lerario, Alexander E. Merkler, Babak B. Navi, and Hooman Kamel. "Relationship between Lambl’s excrescences and embolic strokes of undetermined source." European Stroke Journal 5, no. 2 (January 21, 2020): 169–73. http://dx.doi.org/10.1177/2396987319901201.
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Introduction About one-fourth of ischaemic strokes are classified as embolic strokes of undetermined source. Lambl’s excrescences are commonly seen on cardiac valves, and data are limited on whether they may be a source of embolization. We examined the relationship between Lambl’s excrescences and embolic stroke of undetermined source. Patients and Methods We performed a case-control study of patients in the Cornell AcutE Stroke Academic Registry. Stroke aetiologies were adjudicated using the Trial of Org 10172 in Acute Stroke Treatment and embolic stroke of undetermined source criteria. We included patients with acute ischaemic stroke between 2011 and 2016 who underwent transthoracic or transoesophageal echocardiography within six months of hospitalisation. Cases were embolic stroke of undetermined source patients and controls were patients with an identified, non-cardioembolic stroke aetiology (i.e. small- or large-vessel strokes). Multiple logistic regression was used to evaluate the association between Lambl’s excrescences and embolic stroke of undetermined source after adjustment for demographics, comorbidities and mode of echocardiography. Results A total of 923 patients met the criteria for this analysis, including 530 with embolic stroke of undetermined source and 393 with small- or large-vessel strokes. Lambl’s excrescences were identified in 47 (8.9%) patients with embolic stroke of undetermined source and 11 (2.8%) patients with small- or large-artery strokes, but the majority (54/58) of Lambl’s excrescences were visualised on transoesophageal echocardiogram and embolic stroke of undetermined source patients were more likely to undergo transoesophageal echocardiogram. After adjustment for demographics, comorbidities and mode of echocardiography, we found no association between the presence of Lambl’s excrescences and embolic stroke of undetermined source (odds ratio 0.9; 95% confidence interval 0.4–2.3). Conclusion We found no association between Lambl’s excrescences and embolic stroke of undetermined source. These results do not support the hypothesis that Lambl’s excrescences are an occult cause of embolic stroke of undetermined source.
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Bulwa, Zachary, and Michael Chen. "Stroke Center Designations, Neurointerventionalist Demand, and the Finances of Stroke Thrombectomy in the United States." Neurology 97, no. 20 Supplement 2 (November 16, 2021): S17—S24. http://dx.doi.org/10.1212/wnl.0000000000012780.
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Purpose of the ReviewThis article aims to provide an update on the designation of stroke centers, neurointerventionalist demand, and cost-effectiveness of stroke thrombectomy in the United States.Recent FindingsThere are now more than 1,660 stroke centers certified by national accrediting bodies in the United States, 306 of which are designated as thrombectomy-capable or comprehensive stroke centers. Considering the amount of nationally certified centers and the number of patients with acute stroke eligible for thrombectomy, each center would be responsible for 64 to 104 thrombectomies per year. As a result, there is a growing demand placed on neurointerventionalists, who have the ability to alter the trajectory of large vessel occlusive strokes. Numbers needed to achieve functional independence after stroke thrombectomy at 90 days range from 3.2 to 7.4 patients in the early time window and 2.8 to 3.6 patients in the extended time window in appropriately selected candidates. With the low number needed to treat, in a variety of valued-based calculations and cost-effectiveness analyses, stroke thrombectomy has proved to be both clinically effective and cost-effective.SummaryAdvancements in the early recognition and treatment of stroke have been paralleled by a remodeling of health care systems to ensure best practices in a timely manner. Stroke center–accrediting bodies provide oversight to safeguard these standards. As successful trial data from high volume centers transform into real-world experience, we must continue to re-evaluate cost-effectiveness, strike a balance between sufficient case volumes to maintain clinical excellence vs the burden and burnout associated with call responsibilities, and improve access to care for all.
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Teitelbaum, Jeanne S., Rüdiger von Kummer, Knut Gjesdal, Arni Kristinsson, Georg Gahn, and Gregory W. Albers. "Effect of Ximelagatran and Warfarin on Stroke Subtypes in Atrial Fibrillation." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 35, no. 2 (May 2008): 160–65. http://dx.doi.org/10.1017/s031716710000857x.
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ABSTRACTBackground and Purpose:The most common stroke subtype among atrial fibrillation (AF) patients not receiving anticoagulants is cardioembolic. In the SPORTIF III and V trials, the oral direct thrombin inhibitor ximelagatran was as effective as warfarin in reducing the risk of stroke in patients with nonvalvular AF. We assessed any differential effect of warfarin versus ximelagatran on the risk and outcome of cardioembolic and noncardioembolic stroke.Methods:7329 patients with AF and ≥1 risk factors for stroke were randomized to treatment with warfarin (target international normalized ratio 2.0-3.0) or fixed-dose ximelagatran. Strokes were classified into specific subtypes. Therapeutic effect of warfarin and ximelagatran, adverse events, and stroke outcomes were assessed according to stroke subtype.Results:The annual stroke rate was low for both cardioembolic (ximelagatran, 0.39%; warfarin, 0.47%) and noncardioembolic stroke (ximelagatran, 0.57%; warfarin, 0.37%). In ischemic strokes, 33.9% (ximelagatran) and 34.3% (warfarin) had strokes of presumed cardioembolic origin. When fatal stroke, disabling stroke, myocardial infarction, and death from any cause were combined as poor outcome, patients with cardioembolic strokes had the highest rate of poor outcome (40%) but this was non- significant.Conclusions:In SPORTIF III and V the efficacy of warfarin and ximelagatran were similar for prevention of cardioembolic and noncardioembolic strokes. Overall outcome tended to be worse following cardioembolic stroke. Ximelagatran has been withdrawn from the market due to hepatic side effects, but similar compounds are presently being studied.
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Feigin, Valery L., Michael Brainin, Bo Norrving, Sheila Martins, Ralph L. Sacco, Werner Hacke, Marc Fisher, Jeyaraj Pandian, and Patrice Lindsay. "World Stroke Organization (WSO): Global Stroke Fact Sheet 2022." International Journal of Stroke 17, no. 1 (January 2022): 18–29. http://dx.doi.org/10.1177/17474930211065917.
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Stroke remains the second-leading cause of death and the third-leading cause of death and disability combined (as expressed by disability-adjusted life-years lost – DALYs) in the world. The estimated global cost of stroke is over US$721 billion (0.66% of the global GDP). From 1990 to 2019, the burden (in terms of the absolute number of cases) increased substantially (70.0% increase in incident strokes, 43.0% deaths from stroke, 102.0% prevalent strokes, and 143.0% DALYs), with the bulk of the global stroke burden (86.0% of deaths and 89.0% of DALYs) residing in lower-income and lower-middle-income countries (LMIC). This World Stroke Organisation (WSO) Global Stroke Fact Sheet 2022 provides the most updated information that can be used to inform communication with all internal and external stakeholders; all statistics have been reviewed and approved for use by the WSO Executive Committee as well as leaders from the Global Burden of Disease research group.
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The Lancet Neurology. "Time to strike out stroke." Lancet Neurology 2, no. 4 (April 2003): 199. http://dx.doi.org/10.1016/s1474-4422(03)00362-4.
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Sivagnanam, G. "An oil to strike stroke." Journal of Pharmacology and Pharmacotherapeutics 2, no. 4 (2011): 310. http://dx.doi.org/10.4103/0976-500x.85935.
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Xin, Yong, and Ruimin LYU. "Experimental Measurement and Markov Chain Modelling of Stroke Order Intuition." Journal of Physics: Conference Series 2289, no. 1 (June 1, 2022): 012015. http://dx.doi.org/10.1088/1742-6596/2289/1/012015.
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Abstract As a feature of Chinese characters, stroke order plays an important role in Chinese character education, Chinese character recognition and handwriting identification. However, in recent years, the research on stroke order is limited to elaboration and supplementation of existing stroke order and stroke order rules. There is no special research that focuses on the principle behind stroke order. To quantify the internal regularity of stroke order, we start with the stroke order intuition in the actual writing. Because stroke order has individual differences, we select a group of students with small differences as testers. In this paper, we design an algorithm to generate random strokes and collect the timing data during testers copying strokes. After pre-processing the collected data, a Markov chain is introduced to model stroke order intuition, which can divide the stroke sequences into three states. And then we classify them into three situations according to the stroke distribution. Next, we compare them with some well-known stroke order rules. The results show that the probability distribution of strokes in different situations is not always consistent with the empirical rules, as well as the relations between them.
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Aaron, Sanjith, Prabhakar A. T., Vivek Mathew, Lakshmanan Jeyaseelan, Kenneth Benjamin, K. P. P. Abhilash, Shaikh Atif Iqbal Ahmed, and Aditya V. Nair. "Acute Stroke Mimics: Etiological Spectrum and Efficacy of FAST, BE FAST, and the ROSIER Scores." Journal of Stroke Medicine 3, no. 2 (December 2020): 151–58. http://dx.doi.org/10.1177/2516608520973520.
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Background and Purpose: Stroke mimics constitute a good number of patients referred as acute strokes within the window period for acute therapies. Proper triaging can avoid unnecessary imaging and even thrombolytic therapies in these patients. This study looked at the etiological spectrum of acute stroke mimics presenting within the 4.5 hours therapeutic window. We also evaluated the FAST, BE FAST, and the ROSIER tools in picking true strokes. Methods: Prospective study conducted over a 2-year period. Results: Acute stroke mimics constituted 328/1635 (20%) of referrals for acute stroke after screening by the neurology stroke team. Focal and generalized seizures with transient weakness and peripheral vertigo were the commonest acute stroke mimics; followed by metabolic causes and psychiatric disorders. Females were more in the stroke mimic group ( P = .02). Ischemic heart disease and atherosclerotic risk factors (except diabetes mellitus) were significantly higher among true strokes. In total, 4 (1.2%) of the stroke mimics were treated with IV thrombolysis. Diagnostic accuracy for different stroke differentiating tools are as follows: FAST (sensitivity 85.9%, specificity 52.8%, odds 6.8), BE FAST (sensitivity 97.0%, specificity 31.4%, odds 14.9), and ROSIER scale (sensitivity 85.7%, specificity 59.4%, odds 8.7%). Conclusions: Acute stroke mimics can constitute up to 20% of cases evaluated as acute strokes by neurology stroke teams. None of the triaging tools appear to have enough accuracy. A proper history and clinical examination should be given priority over fixed protocols whenever acute stroke mimic are suspected especially before administering acute costly interventions. Auditing stroke mimics is important to improve acute stroke pathways.
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Hasibuan, Hijriyah Putri Tarmizi, and Isra Thristy. "Comparison of Tryglicerides Levels and Total Cholesterol in Ischemic Stroke and Haemorrhagic Stroke Patients." Muhammadiyah Medical Journal 1, no. 2 (November 16, 2020): 49. http://dx.doi.org/10.24853/mmj.1.2.49-56.
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Background: Stroke is the second largest cause of death in the world. Stroke is classified based on its etiology as ischemic stroke and hemorrhagic stroke. Most large-scale studies on the risk of total cholesterol and triglyceride levels in stroke are not distinguished between ischemic and hemorrhagic strokes. Purposes: The purpose of this study was to determine the comparison of triglyceride and total cholesterol levels in ischemic stroke patients with hemorrhagic stroke. Method: Descriptive analytic study using medical records of patients at Medan Haji General Hospital in 2018-2019. The number of ischemic stroke patients is 28 patients and hemorrhagic stroke 28 patients with a total sample of 56 patients. Results: In ischemic stroke patients, the average value of triglyceride levels was 144.75 mg/dL and the average value of total cholesterol was 250.93 mg/dL. In hemorrhagic stroke patients, the average value of triglyceride levels is 126.93 mg/dL and the average total cholesterol level is 174.25 mg/dL. Conclusion: From this study we found a significant difference in total cholesterol between ischemic and hemorrhagic strokes. No significant difference was found in triglycerides between ischemic and hemorrhagic strokes.
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Hasibuan, Hijriyah Putri Tarmizi, and Isra Thristy. "Comparison of Tryglicerides Levels and Total Cholesterol in Ischemic Stroke and Haemorrhagic Stroke Patients." Muhammadiyah Medical Journal 1, no. 2 (November 16, 2020): 7. http://dx.doi.org/10.24853/mmj.1.2.7-14.
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Background: Stroke is the second largest cause of death in the world. Stroke is classified based on its etiology as ischemic stroke and hemorrhagic stroke. Most large-scale studies on the risk of total cholesterol and triglyceride levels in stroke are not distinguished between ischemic and hemorrhagic strokes. Purposes: The purpose of this study was to determine the comparison of triglyceride and total cholesterol levels in ischemic stroke patients with hemorrhagic stroke. Method: Descriptive analytic study using medical records of patients at Medan Haji General Hospital in 2018-2019. The number of ischemic stroke patients is 28 patients and hemorrhagic stroke 28 patients with a total sample of 56 patients. Results: In ischemic stroke patients, the average value of triglyceride levels was 144.75 mg/dL and the average value of total cholesterol was 250.93 mg/dL. In hemorrhagic stroke patients, the average value of triglyceride levels is 126.93 mg/dL and the average total cholesterol level is 174.25 mg/dL. Conclusion: From this study we found a significant difference in total cholesterol between ischemic and hemorrhagic strokes. No significant difference was found in triglycerides between ischemic and hemorrhagic strokes.
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Boling, Bryan, and Katie Keinath. "Acute Ischemic Stroke." AACN Advanced Critical Care 29, no. 2 (June 15, 2018): 152–62. http://dx.doi.org/10.4037/aacnacc2018483.
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Acute ischemic stroke is a major cause of mortality and morbidity in the United States and worldwide. Despite the development of specialized stroke centers, mortality and morbidity as a result of acute ischemic strokes can and do happen anywhere. These strokes are emergency situations requiring immediate intervention. This article covers the fundamentals of care involved in treating patients with acute ischemic stroke, including essentials for the initial evaluation, basic neuroimaging, reperfusion therapies, critical care management, and palliative care, as well as current controversies. National guidelines and current research are presented, along with recommendations for implementation.
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Dutta, Dipankar, Emily Bowen, and Chris Foy. "Four-Year Follow-Up of Transient Ischemic Attacks, Strokes, and Mimics." Stroke 46, no. 5 (May 2015): 1227–32. http://dx.doi.org/10.1161/strokeaha.114.008632.
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Background and Purpose— There is limited information on outcomes from rapid access transient ischemic attack (TIA) clinics. We present 4-year outcomes of TIAs, strokes, and mimics from a UK TIA clinic database. Methods— All patients referred between April 2010 and May 2012 were retrospectively identified and outcomes determined. End points were stroke, myocardial infarction, any vascular event (TIA, stroke, or myocardial infarction), and all-cause death. Data were analyzed by survival analysis. Results— Of 1067 patients, 31.6% were TIAs, 18% strokes, and 50.4% mimics. Median assessment time was 4.5 days from onset and follow-up was for 34.9 months. Subsequent strokes occurred in 7.1% of patients with TIA, 10.9% of patients with stroke, and 2.0% of mimics at the end of follow-up. Stroke risk at 90 days was 1.3% for patients diagnosed as TIA or stroke. Compared with mimics, hazard ratios for subsequent stroke were 3.88 (1.90–7.91) for TIA and 5.84 (2.81–12.11) for stroke. Hazard ratio for any subsequent vascular event was 2.91 (1.97–4.30) for TIA and 2.83 (1.81–4.41) for stroke. Hazard ratio for death was 1.68 (1.10–2.56) for TIA and 2.19 (1.38–3.46) for stroke. Conclusions— Our results show a lower 90-day stroke incidence after TIA or minor stroke than in earlier studies, suggesting that rapid access daily TIA clinics may be having a significant effect on reducing strokes.
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Englyst, Nicola A., Gill Horsfield, Joseph Kwan, and Christopher D. Byrne. "Aspirin Resistance is More Common in Lacunar Strokes than Embolic Strokes and is Related to Stroke Severity." Journal of Cerebral Blood Flow & Metabolism 28, no. 6 (March 5, 2008): 1196–203. http://dx.doi.org/10.1038/jcbfm.2008.9.
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The aim of this study was to investigate the relationship between aspirin resistance, ischaemic stroke subtype, stroke severity, and inflammatory cytokines. Aspirin resistance was assessed by thrombelastography in 45 people with ischaemic stroke and 25 controls. Plasma interleukin (IL)-6 was measured. Stroke severity was assessed using the modified Rankin scale and National Institute of Health Stroke Score within 72 h of stroke. Aspirin resistance was more common in the stroke than the control group (67% versus 40%, P=0.028), and within the stroke group the aspirin-resistant group had a higher Rankin score (4.0 versus 2.0, P=0.013). Aspirin resistance was greater in lacunar than embolic strokes (platelet activation 79% versus 59%, P=0.020). The stroke aspirin-resistant group had higher levels of IL-6 than the stroke aspirin-sensitive group (2.4±1 versus 1.8±0.9 ng/mL, P=0.037). Using multivariate analysis, we examined the interrelationships between aspirin resistance, IL-6, and stroke severity. These analyses showed that IL-6 was independently associated with stroke severity as the outcome ( B=3.738, P=0.036), and aspirin resistance was independently associated with IL-6 ( B=0.765, P=0.005) as the outcome. In conclusion, aspirin resistance is related to stroke severity and aspirin resistance is more common in lacunar strokes than embolic strokes.
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McNutt, Michelle K., Cedar Slovacek, David Rosenbaum, Hari Kishan Reddy Indupuru, Xu Zhang, Bryan A. Cotton, John Harvin, Charles E. Wade, Sean I. Savitz, and Lillian S. Kao. "Different strokes: differences in the characteristics and outcomes of BCVI and non-BCVI strokes in trauma patients." Trauma Surgery & Acute Care Open 5, no. 1 (September 2020): e000457. http://dx.doi.org/10.1136/tsaco-2020-000457.
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BackgroundAlthough strokes are rare in trauma patients, they are associated with worse functional and cognitive outcomes and decreased mobility. Blunt cerebrovascular injury (BCVI)–related strokes and mortality have decreased, likely due to refined screening and treatment algorithms in trauma literature; however, there is a paucity of research addressing non-BCVI strokes in trauma. The purpose of this study is to evaluate the incidence, etiology, and risk factors of stroke in our trauma population in order to identify preventive strategies.MethodsThis study was a retrospective review of all adult trauma patients admitted to a level 1 trauma hospital who suffered a stroke during trauma admission from 2010 to 2017. Data were collected from the prospectively maintained trauma and stroke databases. Stroke etiology was determined by a vascular neurologist.ResultsOf the 43 674 adult trauma patients admitted during the study period, 99 (0.2%) were diagnosed with a stroke during the index admission. Twenty-one (21%) strokes were due to BCVI. Seventy-eight (79%) strokes were due to non-BCVI etiologies. Patients with non-BCVI strokes were older, less severely injured, and had more medical comorbidities compared with patients with a BCVI stroke. While patients with a BCVI stroke were more likely to suffer multiple traumatic injuries from MVC (76% vs 28%, p<0.001), non-BCVI strokes had more isolated extremity injuries from fall mechanism (55% vs 10%, p<0.001). Over the study period, the age and incidence of stroke and BCVI (p<0.001) increased. However, the rate of BCVI strokes decreased while the rate of non-BCVI strokes increased.DiscussionThe incidence of stroke has increased despite aggressive screening and treatment of BCVI. This increase is primarily due to non-BCVI strokes which are associated with advanced age and medical comorbidities after low mechanism traumatic injury. Medical optimization of comorbid conditions during trauma hospitalization will become increasingly important for stroke prevention as the population ages.Level of evidence: Level III
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Boodt, Nikki, Kars C. J. Compagne, Bruna G. Dutra, Noor Samuels, Manon L. Tolhuisen, Heitor C. B. R. Alves, Manon Kappelhof, et al. "Stroke Etiology and Thrombus Computed Tomography Characteristics in Patients With Acute Ischemic Stroke." Stroke 51, no. 6 (June 2020): 1727–35. http://dx.doi.org/10.1161/strokeaha.119.027749.
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Background and Purpose— If a relationship between stroke etiology and thrombus computed tomography characteristics exists, assessing these characteristics in clinical practice could serve as a useful additional diagnostic tool for the identification of stroke subtype. Our purpose was to study the association of stroke etiology and thrombus computed tomography characteristics in patients with acute ischemic stroke due to a large vessel occlusion. Methods— For 1429 consecutive patients enrolled in the MR CLEAN Registry, we determined stroke cause as defined by the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria. The association of stroke etiology with the hyperdense artery sign, clot burden score, and thrombus location was estimated with univariable and multivariable binary and ordinal logistic regression. Additionally, for 367 patients with available thin-section imaging, we assessed the association of stroke etiology with absolute and relative thrombus attenuation, distance from internal carotid artery-terminus to thrombus, thrombus length, and thrombus attenuation increase with univariable and multivariable linear regression. Results— Compared with cardioembolic strokes, noncardioembolic strokes were associated with presence of hyperdense artery sign (odds ratio, 2.2 [95% CI, 1.6–3.0]), lower clot burden score (common odds ratio, 0.4 [95% CI, 0.3–0.6]), shift towards a more proximal thrombus location (common odds ratio, 0.2 [95% CI, 0.2–0.3]), higher absolute thrombus attenuation (β, 3.6 [95% CI, 0.9–6.4]), decrease in distance from the ICA-terminus (β, −5.7 [95% CI, −8.3 to −3.0]), and longer thrombi (β, 8.6 [95% CI, 6.5−10.7]), based on univariable analysis. Thrombus characteristics of strokes with undetermined cause were similar to those of cardioembolic strokes. Conclusions— Thrombus computed tomography characteristics of cardioembolic stroke are distinct from those of noncardioembolic stroke. Additionally, our study supports the general hypothesis that many cryptogenic strokes have a cardioembolic cause. Further research should focus on the use of thrombus computed tomography characteristics as a diagnostic tool for stroke cause in clinical practice.
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Maciąg, Anna, Michał Mazurek, Ewa Jędrzejczyk-Patej, and Beata Średniawa. "Embolic stroke of undetermined source (ESUS) – current state of knowledge." In a good rythm 3, no. 60 (December 30, 2021): 13–17. http://dx.doi.org/10.5604/01.3001.0015.7296.
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Ischemic strokes account for over 80% of strokes. However, the cause of about 25% of them remains undetermined. This kind of ischemic stroke is termed cryptogenic (CS, cryptogenic stroke). In most cases, cryptogenic stroke has an embolic origin, which is marked by worse prognosis compared to strokes of another origin. Therefore, the term Embolic Stroke of Undetermined Source (ESUS) was separated from the group of CS in 2014. Cryptogenic stroke, in the broad sense, is a complex case, which presents a challenge to both cardiologists and neurologists. We described the steps, which are essential to take in patients, who have undergone ESUS.
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Nawab, Kalsoom, Anwar Ul Haq, Mehmood Akhtar Khattak, Hina Gul, Naheed Khan, and Irsa Shoaib. "A Systematic Review of Magnetic Resonance Imaging for the Diagnosis of Stroke." Pakistan Journal of Medical and Health Sciences 17, no. 3 (June 8, 2023): 764–65. http://dx.doi.org/10.53350/pjmhs2023173764.
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Background: With the advancement of magnetic resonance imaging (MRI), a non-invasive imaging technique, ischemic and hemorrhagic stroke diagnostic accuracy has increased significantly. The intricate resolution of MRI enables better visualisation of the structure of the brain and vulnerable regions to ischemia. As a result, the detection of hypoperfused areas is now more accurate. Additionally, MRI makes it possible to see hematomas in the brain, revealing hemorrhagic strokes brought on by burst arteries. MRI has become an essential tool in the fight against strokes because to its crucial role in evaluating damage caused by strokes. Purpose: The purpose of this article is to examine the advantages and disadvantages of utilising MRI scans to identify strokes. The use of MRI technology to identify brain injury and differentiate between strokes caused by blood flow and haemorrhage will be highlighted. When it comes to stroke therapy and prognosis, MRI might potentially affect the advice given by doctors. Methods: The Department of Radiology at KTH Hospital Peshawar thoroughly investigated the possibility of MRI for stroke diagnosis between March 2016 and March 2017. We searched the PubMed and EMBASE archives for papers about the use of MRI in stroke patient investigations in order to assemble the most information possible. We only chose studies that have a main concentration on MRI imaging and stroke patients. Results: Twenty-nine research publications examined the efficiency of MRI with an emphasis on stroke diagnosis. Twenty-four of them examined ischemic stroke diagnosis, while the remaining five concentrated on hemorrhagic stroke diagnosis. Findings showed that MRI was very accurate, with a sensitivity and specificity of up to 97% for ischemic stroke detection. MRI shown success in the diagnosis of hemorrhagic stroke, with a sensitivity and specificity of up to [100%]. Conclusions: MRI is a crucial tool for the diagnosis and treatment of stroke. Because of the great accuracy and sensitivity of this imaging method, both ischemic and hemorrhagic strokes may be identified. It also carefully evaluates the effects of a stroke on the brain. The early and successful diagnosis and treatment of stroke depend heavily on the use of MRI. Keywords: diagnosis, ischemic stroke, hemorrhagic stroke, and magnetic resonance imaging
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Wang, Shuxia, Shouxia Wang, Weiping He, and Shengfeng Qin. "Tolerance Zone-Based Grouping Method for Online Multiple Overtracing Freehand Sketches." Mathematical Problems in Engineering 2020 (April 14, 2020): 1–12. http://dx.doi.org/10.1155/2020/7393846.
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Multiple overtracing strokes are common drawing behaviors in freehand sketching; that is, additional strokes are often drawn repeatedly over the existing ones to add more details. This paper proposes a method based on stroke-tolerance zones to group multiple overtraced strokes which are drawn to express a 2D primitive, aiming to convert online freehand sketches into 2D line drawings, which is a base for further 3D reconstruction. Firstly, after the user inputs a new stroke, a tolerance zone around the stroke is constructed by reference to its polygonal approximation points obtained from the stroke preprocessing. Then, the input strokes are divided into stroke groups, each representing a primitive through the stroke grouping process based on the overtraced ratio of two strokes. At last, each stroke group is fitted into one or more 2D geometric primitives including line segments, polylines, ellipses, and arcs. The proposed method groups two strokes together based on their screen-space proximity directly instead of classifying and fitting them firstly, so that it can group strokes of arbitrary shapes. A sketch-recognition prototype system has been implemented to test the effectiveness of the proposed method. The results showed that the proposed method could support online multiple overtracing freehand sketching with no limitation on drawing sequence, but it only deals with strokes with relatively high overtraced ratio.
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Davern, Recie, Helena Hobbs, Hannah Murugan, and Paul Cotter. "306 The Changing Face of Stroke in the DOAC Era." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.196.
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Abstract Background Patients prescribed oral anticoagulants (OAC) for atrial fibrillation (AF) can still present with stroke. The mechanism for stroke in these patients can be due to multiple factors including subtherapeutic dosing and non-compliance. With the increasing use of direct-acting OACs (DOACs) in favour of warfarin, it is unclear if the incidence of stroke in those already taking OAC has reduced. Methods Data was extracted from our unit’s stroke registry, a prospectively maintained database, for patients who presented with stroke while receiving OAC for AF from 2013 to 2017. Type of OAC, type of stroke, OAC dosing at time of event including non-compliance, stroke management and outcome were recorded. Results 67 patients were included for analysis, with 55 ischaemic and 12 haemorrhagic strokes. 52 patients were receiving warfarin at the time of their stroke vs. 15 receiving DOACs. 33/55 (60%) of ischaemic strokes occurred in patients taking warfarin with a sub-therapeutic INR. In 3/55 (5%) of ischaemic strokes, the OAC was held for a procedure while in 6/55 cases (11%) the OAC had been stopped for another reasons e.g. bleeding. 5/55 (7%) were due to non-compliance. 1 ischaemic stroke was due to under-dosing of a DOAC (dabigatran). 16 strokes were recorded in 2013 for patients prescribed OAC vs. 3 in 2017. Overall the number of ischaemic strokes due to subtherapeutic OAC decreased from 14 in 2013 to 1 in 2017 (p value 0.06). Conclusion The majority of strokes occurring in anticoagulated patients are related to warfarin use. We observed an almost significant reduction in the proportion of ischaemic strokes due to under-dosing of OAC over the study period. Warfarin continues to be recommended as the first line anticoagulant for stroke prevention in atrial fibrillation by the HSE Medicines Management Programme, a decision which we would argue warrants review.
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Masina, Marco, Annalena Cicognani, Carla Lofiego, Simona Malservisi, Riccardo Parlangeli, and Alessandro Lombardi. "Embolic stroke of undetermined source: a retrospective analysis from an Italian Stroke Unit." Italian Journal of Medicine 10, no. 3 (September 30, 2016): 202. http://dx.doi.org/10.4081/itjm.2016.690.
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The new clinical construct of embolic stroke of undetermined source (ESUS) suggests that many cryptogenic strokes are related to minor-risk covert embolic cardiac sources or to embolus from non-occlusive plaques in the aortic arch or in the cerebral arteries. The authors analyzed the prevalence of ESUS in a real-life condition in Italy and compared the recurrence rates in cryptogenic strokes, cardioembolic strokes, and ESUS. The authors retrospectively reassessed according to ESUS criteria 391 consecutive admissions in a stroke unit where extensive diagnostic search was routinely performed. Recurrences in each stroke type within a 3-year follow-up period (mean time: 25.44 months - standard deviation: 9.42) were also compared. The prevalence of ESUS in the aforementioned cohort was 10.5%. All ESUS patients received antiplatelet agents. Warfarin was prescribed in 56.9% of cardioembolic strokes. The recurrence rate in ESUS patients was 4.4% per year, slightly higher than in cardioembolic strokes (3.5%) and significantly higher than in cryptogenic non-ESUS (1.2%) (P<0.0001). This is the first description of a cohort of ESUS patients in an Italian stroke unit. Patients with ESUS have a significantly higher risk of recurrence than in those with non-ESUS cryptogenic strokes, and slightly higher than in those with cardioembolic strokes. Results support the hypothesis of a more extensive diagnostic evaluation in cryptogenic strokes and the feasibility of such approach.
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Xie, Shifan, Yik Roy Hwang, and Revin Thomas. "Hyperacute management of ischemic strokes, a British perspective." AIMS Medical Science 10, no. 2 (2023): 107–17. http://dx.doi.org/10.3934/medsci.2023009.
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<abstract> <p>Stroke is a common disease that has a high rate of mortality and morbidity. The World Stroke Organization states that there are over 12.2 million strokes a year, with 1 in 4 people over the age of 25 predicted to have a stroke in their lifetime. The British data shows that there are around 150,000 stroke related admissions every year in the UK, with strokes occurring at an increasing earlier age. Strokes are generally classified as ischemic or hemorrhagic, with approximately 83% of all patients presenting with an ischemic stroke. The aim of this article is to provide an overview of the acute management of ischemic stroke in our center—a secondary care specialist hospital in the Northeast of England, with approximately 1000 stroke admissions a year.</p> </abstract>
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Kotlęga, Dariusz, Barbara Peda, Tomasz Trochanowski, Monika Gołąb-Janowska, Sylwester Ciećwież, and Przemysław Nowacki. "STROKE MIMICS: A PSYCHOGENIC STROKE PATIENT TREATED WITH ALTEPLASE." Acta Neuropsychologica 17, no. 1 (February 12, 2019): 97–102. http://dx.doi.org/10.5604/01.3001.0013.1852.
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For rtPA treatment to be effective it should be initiated within the first 4.5 hours following the onset of a stroke. Such a short therapeutic window demands a rapid diagnosis and decision making on the part of the physician. There are patients with stroke-like symptoms and an initial diagnosis of a stroke, but who are finally diagnosed as suffering from another condition. According to the subject literature, stroke mimics are diagnosed in about 1.4 – 3.5% of patients initially diagnosed as having had an ischemic stroke. Psychogenic strokes (conversion disorders) may be found in as many as 8.2% of stroke patients. Proper diagnosis is especially important in patients eligible for thrombolytic treatment when there is usually not enough time to establish the diagnosis of a stroke mimic, especially one of psychogenic origin. A patient with an initial diagnosis of an ischemic stroke who was treated with intravenous alteplase infusion. The previous two ischemic strokes treated in the same manner had been diagnosed one and two years earlier. In all hospitalizations no rtPA treatment complications had been observed. In our patient a proper neuropsychological examination was performed and a conversion disorder diagnosed. We would like to underline the importance of cooperation between the neuropsychologist and neurology physician within clinical practice.
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Chen, Shuo, Ravinder-Jeet Singh, Noreen Kamal, and Michael D. Hill. "Improving care for acute in-hospital ischemic strokes—A narrative review." International Journal of Stroke 13, no. 9 (July 17, 2018): 905–12. http://dx.doi.org/10.1177/1747493018790029.
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In-hospital strokes, that is new strokes occurring among hospitalized patients, account for 6.5–15% of all strokes. Compared to community-onset stroke patients, in-hospital stroke patients tend to have worse functional and mortality outcomes. This review addresses the characteristics of acute in-hospital ischemic strokes, reasons these patients have worse outcomes compared to community-onset stroke patients, and future steps to improve outcomes.
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Svetlin Gvardjančič, Polona. "Praksa ocenjevanja znanja pri tujem jeziku stroke v slovenskem visokošolskem prostoru." Journal for Foreign Languages 10, no. 1 (December 28, 2018): 255–72. http://dx.doi.org/10.4312/vestnik.10.255-272.
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Zanimanje za ocenjevanje znanja se je v zadnjih desetletjih povečalo, tako na področju terciarnega izobraževanja kot na področju tujih jezikov stroke. V teoretičnem delu smo osvetlili razloge za ta premik in opozorili na ključne teme, ki zanimajo raziskovalce na omenjenem področju. Z raziskavo smo opravili posnetek stanja pri ocenjevanju znanja tujega jezika stroke na visokošolskih ustanovah v Sloveniji. Rezultati potrjujejo osrednjo vlogo učitelja tujega jezika stroke pri vseh opravilih, ki zadevajo ocenjevanje znanja: odločanje o načinih, priprava testov in podelitev ocene. Praksa ocenjevanja znanja kaže na to, da učitelji v ocenjevanje znanja pozorno vključujejo teme, ki so relevantne za stroko, katere jezik predavajo, v izvedbenem delu pa sledijo trendom v pedagoški stroki, kar se odraža v uporabi različnih oblik ocenjevanja. Kljub temu, da se jim zdi primerno, da sami odločajo o ocenjevanju znanja, pa si želijo več sodelovanja in izmenjave izkušenj s kolegi.
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Khan, Muhammad D., Zeeshan Chaughtai, Shaheryar Qazi, Sobaan Taj, Henna Pervaiz, Khurram Irshad, Syed Muhammad A. Bukhari, Sheikh Afraz, and Muhammad T. Kamran. "Types and clinical presentation of stroke." International Journal of Research in Medical Sciences 8, no. 5 (April 27, 2020): 1784. http://dx.doi.org/10.18203/2320-6012.ijrms20201927.
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Background: Stroke is one of the leading causes of mortality and morbidity worldwide. In this study, authors worked on clinical presentation and types of stroke. The two main types of strokes are ischemic and haemorrhagic. Brain infarction is caused by decrease blood flow due to either narrowing of artery or complete obstruction to blood flow owing to embolism. While haemorrhage is caused by rupture of artery or aneurysms leading to accumulation of blood in the brain parenchyma.Methods: Cross sectional study of group of patients in Nishtar hospital Multan, Pakistan who presented with variety of neurological symptoms who were subsequently diagnosed as non-traumatic stroke. All patients were subjected to a detailed history and thorough clinical examination and investigations after obtaining informed consent.Results: Of 122 patient, 66 patients were male and 56 were female. Ischemic stroke was more common: present in 76 patients as compared to 46 patients with hemorrhagic stroke. Hypertension was present in 40.9% of ischemic stroke and 27.8% of hemorrhagic strokes. Most of the patients (67.2%) had altered sensorium at presentation followed by hemiplegia in 39.3 % of patients.Conclusions: Prevalence of ischemic strokes is higher than that of haemorrhagic stroke. Hypertension is associated with both types of these strokes. Moreover, hyperglycaemia and high blood pressure are common in early phase of stroke. Vomiting in stroke favors haemorrhagic stroke.
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Fauzi, Lailla Affianti, Wara Kushartanti, Novita Intan Arovah, Fauzi, Regina Maria, and Adliah Anwar. "Investigating the relationship between physical activity and depression level with stroke recurrences: An observational cross-sectional study." Fizjoterapia Polska 24, no. 3 (August 30, 2024): 210–15. http://dx.doi.org/10.56984/8zg020akkk.
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Background. The complex relationship between physical health and mental well-being, especially for those who have undergone a stroke, is increasingly acknowledged. It is crucial to include interventions that emphasize physical activity as a crucial element in successful stroke rehabilitation and preventing subsequent strokes. This research aimed to evaluate the relationship between physical activity and depression levels with stroke recurrences. Method. This cross-sectional investigation enrolled 60 patients aged between 30 and 85 years, all receiving outpatient stroke treatment in a hospital in Indonesia. Stroke recurrence was defined as experiencing a second stroke within three months after the initial stroke. Among the total participants, 12 had experienced recurrent strokes, while 48 had not. Data on physical activity and depression levels were gathered using the IPAQ short form and PHQ-9 instruments. Simple logistic regression was conducted to assess the association between physical activity and depression levels with stroke recurrence, adjusting for age and sex. Result. Patients with higher physical activity levels were less likely to experience recurrent strokes (OR = 0.534, 95% CI 0.201; 1.422), p = 0.027. In contrast, patients with higher depression levels were more likely to experience recurrent strokes (OR = 2.055, 95% CI 1.115; 3.787), p = 0.021. Conclusion. The study highlights low physical activity and high depression as influential factors in increasing stroke recurrence, underscoring the need to promote physical activity and mental health support in stroke rehabilitation.
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Andersen, Klaus Kaae, Anne Julie Tybjerg, Alejandro Daniel Babore, and Tom Skyhøj Olsen. "Occult primary brain cancers manifesting in the aftermath of ischaemic and haemorrhagic stroke." European Stroke Journal 5, no. 3 (April 15, 2020): 237–44. http://dx.doi.org/10.1177/2396987320920101.
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Introduction Symptoms of occult brain cancer may mimic stroke. Misdiagnosis may lead to improper treatment and delayed diagnosis. We characterised strokes associated with occult primary brain cancer and determined risk that ischaemic and haemorrhagic strokes are associated with occult primary brain cancer. Patients and methods All patients with incident stroke in Denmark 2003–2015 were identified through the Danish Stroke Registry (n = 85,893) and matched 1:10 on age and sex to the Danish background population without a stroke history (n = 858,740). This cohort was linked to the Danish Cancer Registry and prevalence of occult primary brain cancer defined as the event of previously unknown primary brain cancer during a one-year follow-up was estimated. We used Cox regression models to study risk of occult primary brain cancer in comparison to the background population. Results Of 77,484 patients with ischaemic strokes, 39 (1 in 2000) were associated with primary brain cancer; of 8409 with haemorrhagic strokes, it was 126 (1 in 66). In the background cohort, 205 (1 in 4000) had occult primary brain cancer. The multivariate stroke risk factor analysis showed that patients with occult primary brain cancer differed significantly from those without occult primary brain cancer indicating they might have stroke mimics rather than true strokes. Discussion and conclusions: Strokes associated with occult primary brain cancer tend to be stroke mimics rather than true strokes. Primary brain cancer is rare in patients with ischaemic stroke (1 in 2000); risk that misdiagnosis results in maltreatment is, therefore, very low. Occult primary brain cancers are mainly found among patients with haemorrhagic stroke; they are not uncommon (1 in 66) and should always be kept in mind.
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Ullah, Imran, Bakth Jamal, Fawad Ali, Hanif Ur Rehman, Zia Ullah, and Said Ali. "Comparison of the CNN and RNN Approaches with Respect to Brain Tumor using MRI Image Datasets." Scholars Journal of Applied Medical Sciences 10, no. 3 (March 31, 2022): 398–404. http://dx.doi.org/10.36347/sjams.2022.v10i03.022.
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Introduction: Heart disease and cancer are the top two killers in the world, but strokes are the third most common cause of death worldwide. Furthermore, one-third of stroke victims are left with long-term disabilities. An Ischemic-strokes account for 80% of all strokes, while hemorrhagic strokes account for 20% of all strokes. Aim of this study: The main aim of this study is comparing the haemorrhagic and ischemic stroke patients – analysis of mortality, clinical development and relationship between stroke variables. Research Methodology: The design of this research is descriptive and exploratory. The current study included 100 patients with an acknowledged stroke incidence (57 men and 43 women). The difference of statistics between infarct and haemorrhage on the demographic & clinical variables was discovered through the use of univariate and Multivariate analysis. Data analysis: The data have been analyzed on a total of 100 patients based on the two types of strokes using various statistical tools on clinical and demographic variables. Conclusion: It is concluded that in comparison to ischemic stroke, hemorrhagic stroke affected a younger age group. Stroke patients with a history of hypertension had a statistically insignificant link between their hypertensive history and the occurrence of the disease, according to the univariate analysis.
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Shehata, Mishkat. "Prevention of stroke in primary care." InnovAiT: Education and inspiration for general practice 12, no. 5 (March 21, 2019): 252–57. http://dx.doi.org/10.1177/1755738019829780.
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Stroke is a clinical syndrome that is characterised by rapidly developing signs of global or focal disturbance of cerebral function and lasting for more than 24 hours. Stroke is the leading cause of adult disability in the UK and a major cause of morbidity and mortality worldwide. Half of strokes occur in patients over 70 years in age. Strokes and the associated disability have a major socioeconomic impact, and prevention of stroke is an important challenge for primary care. Important modifiable risk factors for stroke have been identified. This article briefly outlines the types of stroke that occur, before detailing how GPs and other health professionals can prevent strokes by lifestyle modification and pharmacotherapy.
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fitria candradewi, susan, and Shinta Dewi Nur Rahmah. "ANALISIS HUBUNGAN TERAPI ANTIHIPERTENSI SEBAGAI PENCEGAHAN SEKUNDER TERHADAP KEJADIAN SERANGAN ULANG STROKE ISKEMIK PADA PASIEN STROKE ISKEMIK." Jurnal Insan Farmasi Indonesia 5, no. 1 (May 29, 2022): 1–8. http://dx.doi.org/10.36387/jifi.v5i1.923.
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Individuals who survive a first ischemic stroke are at high risk for recurrent stroke. This study aims to analyze the relationship between antihypertensives on the incidence of ischemic stroke recurrence in ischemic stroke patients. Type of research is analytic observational with a retrospective cohort approach. The research sample was taken using purposive sampling technique. The research sample was patients who had an ischemic stroke at PKU Muhammadiyah Hospital Yogyakarta in 2018. There were 201 samples that met the inclusion criteria. Consisting of 135 treatment groups and 66 patients as the control group. In the treatment group, 110 patients did not have recurrent strokes and 25 patients had recurrent strokes. In the control group there were 58 patients who did not have recurrent strokes and 8 patients had recurrent strokes. Statistical analysis showed an RR value of 0.927 (95% CI: 0.822-1.046) and p-value of 0.344. The conclusion from the results of this study is that there is no relationship between the administration of antihypertensive therapy with the incidence of ischemic stroke recurrence in ischemic stroke patients at PKU Muhammadiyah Hospital Yogyakarta.
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Alrabghi, Lujain, Raghad Alnemari, Rawan Aloteebi, Hamad Alshammari, Mustafa Ayyad, Mohammed Al Ibrahim, Mohsen Alotayfi, Turki Bugshan, Abdullah Alfaifi, and Hussain Aljuwayd. "Stroke types and management." International Journal Of Community Medicine And Public Health 5, no. 9 (August 24, 2018): 3715. http://dx.doi.org/10.18203/2394-6040.ijcmph20183439.
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Strokes are a leading cause of morbidity and mortality across the world, in fact the third leading cause after heart diseases and cancer. Additionally, among the survivors of stroke, one-third suffers from permanent disabilities. Strokes can be classified broadly as ischemic and hemorrhagic, which account for 80% and 20% of total respectively. The prognosis of cerebrovascular accidents depends on quick diagnosis of the type, followed by appropriate and fast management. We conducted this review using a comprehensive search of MEDLINE, PubMed and EMBASE, from January 1982 to March 2017. The following search terms were used: stroke, cerebrovascular accidents, ischemic stroke, hemorrhagic stroke, stroke types, management of stroke, rehabilitation, CVA prevention. The most critical part about approaching a stroke patient is to identify the type of stroke, whether hemorrhagic or ischemic, as each type requires a different guideline of management. Also, time is the key in preserving neuronal function and preventing further damage. At the same time, the general population must be educated about methods of preventing stroke by making positive lifestyle changes.
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Hastuti, Riani Dwi, Andar Setyawan, Indah Ari Handayani, and Putri Nabila Khalisha. "Incidence of Stroke Cases at Blambangan General Hospital of Banyuwangi in January-December 2022: A Descriptive Study." AKSONA 4, no. 1 (January 31, 2024): 9–13. http://dx.doi.org/10.20473/aksona.v4i1.47492.
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Highlight: The majority of stroke cases at Blambangan General Hospital in Banyuwangi are ischemic strokes. The age group that experienced the most strokes was >40 years. The gender that experienced the most strokes was female. ABSTRACT Introduction: Stroke is a leading cause of morbidity in Indonesia. It significantly contributes to the overall burden of disease and places a substantial impact on the health of the population in Indonesia. Objective: The purpose of this study was to show the incidence of stroke cases in the Blambangan General Hospital in Banyuwangi. Understanding the prevalence of strokes at this particular hospital is critical for identifying patterns, improving patient care, and taking preventive actions to deal with this important health issue. Methods: This study used a retrospective cross-sectional sampling method to look at all 342 inpatient stroke cases that were treated in the neurology department of Blambangan General Hospital in Banyuwangi in 2022. All of their data was collected and analyzed. Results: Most cases of stroke in this study were ischemic strokes, with a total of 212 cases (62.0% of all cases). The age group that experienced the most strokes was over 40 years old (96.2%) and female (56.4%). More than half of stroke patients had hypertension, and 80.1% had diabetes mellitus. Conclusion: This study found that ischemic stroke survivors, mostly female and aged over 40, were frequently associated with diabetes mellitus and hypertension. These findings provide insights into the frequency of these stroke types within the examined population.
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Bernick, Charles B., Lewis H. Kuller, Will T. Longstreth, Corinne Dulberg, Teri A. Manolio, Norman J. Beauchamp, and Thomas R. Price. "Silent Brain MRI Infarcts and Subsequent Stroke Type In the Cardiovascular health Study." Stroke 32, suppl_1 (January 2001): 363. http://dx.doi.org/10.1161/str.32.suppl_1.363-d.
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P136 Objective: Silent infarcts seen on cranial MRI scans are a risk factor for subsequent clinical stroke in the elderly. This study examines the type of clinical strokes seen in those with silent infarcts. Methods: Cranial MRI examination was completed on 3324 Cardiovascular Health Study (CHS) participants aged 65+ who were without a prior history of clinical stroke. Incident strokes were identified over an average follow-up of 4 years and classified as hemorrhagic or ischemic. Ischemic strokes were further subdivided into lacunar, cardioembolic, atherosclerotic or other/unknown. Results: Silent MRI infarcts >3mm were found in approximately 28% (n=923). Of these, 7% (n=67) subsequently had a clinically evident stroke. The characteristics of the silent MRI infarcts in those who sustained an incident stroke were as folows: 56 had only subcortical infarcts, of which 55 were <20mm; 4 had only cortical infarcts; and 7 had both cortical and subcortical infarcts. Of those with only subcortical silent MRI infarcts, 16% (n=9) went on to a hemorrhagic stroke and 84% (n=47) sustained an ischemic stroke. The ischemic strokes were subtyped as 12 cardioembolic, 3 lacunar, 2 atherosclerotic and 30 unknown/other. Considering only those with cortical silent infarcts, either alone or in combination with subcortical infarcts, there was 1 hemorrhagic stroke and 10 ischemic strokes. Half of the ischemic strokes were cardioembolic and half were unknown type. Conclusion: Elderly individuals with silent subcortical infarcts who go onto subsequent stroke may be at risk not only for lacunar infarcts but also cardioembolic or hemorrhagic strokes.
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Kate, Mahesh Pundlik, Deepti Arora, Shweta Jain Verma, PN Sylaja, Vishnu Renjith, Meenakshi Sharma, and Jeyaraj Durai Pandian. "Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India (SPRINT INDIA) study protocol." International Journal of Stroke 15, no. 1 (December 18, 2019): 109–15. http://dx.doi.org/10.1177/1747493019895653.
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Rationale Recurrent stroke, cardiovascular morbidity, and mortality are important causes of poor outcome in patients with index stroke. Despite the availability of best medical management recurrent stroke occur in up to 15–20% of patients with stroke in India. Education for stroke prevention could be a strategy to prevent recurrent strokes. Hypothesis We hypothesize that a structured semi-interactive stroke prevention package can reduce the risk of recurrent strokes, acute coronary artery syndrome, and death in patients with sub-acute stroke at the end of one year. Design Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in INDIA (SPRINT INDIA) is a multi-center stroke trial involving 25 centers under the Indian Stroke Clinical Trial Network. Patients with first ever sub-acute stroke within two days to three months of onset, age 18–85 years, mRS <5, showing recent stroke in imaging are included. Participants or caregivers able to read and complete tasks suggested in a stroke prevention workbook and have a cellular device for receiving short message service and watching videos. A total of 5830 stroke patients speaking 11 different languages are being randomized to intervention or control arm. Patients in the intervention arm are receiving a stroke prevention workbook, regular educational short messages, and videos. All patients in the control arm are receiving standard of care management. Summary Structured semi-interactive stroke prevention package may reduce the risk of recurrent strokes, acute coronary artery syndrome, and death in patients with sub-acute stroke. Trial registration This trial is registered with clinicaltrials.gov (NCT03228979) and CTRI (Clinical Trial Registry India; CTRI/2017/09/009600).
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Ghimire, Bal Ram, Roshan Giri, and Shanker Prasad Chimouriya. "STUDY OF CHRONOLOGICAL ORDER IN INTERSECTING PRINTED AND PEN STROKES WITH THE HELP OF CHROMATICITY DIAGRAM." Acta Scientifica Malaysia 6, no. 2 (2022): 38–42. http://dx.doi.org/10.26480/asm.02.2022.38.42.
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Writing cross stroke examination is one of the difficult and challenging problem in forensic document examination. In this work, we tried to find sequence of order in crossing printed and pen strokes. The study mainly deals with application of chromaticity diagram generated by Video Spectral Comparator (VSC)-6000. Chromaticity co-ordinates are generated from three different points of first, second and cross strokes. When two strokes cross each other, then surface on point of intersection corresponds to second stroke. So, we have started this work with the assumption that chromaticity co-ordinate (x,y) of the crossing stroke should be similar to that of second stroke. We perform our experiment in both homogeneous and heterogeneous crossing strokes. We repeat the same experiment five times by preparing different samples each time to establish more valid conclusion but we get positive and conclusive results only in the case of heterogeneous crossing strokes where printed stroke is above the pen strokes.