Susan Lewis #strokeart2014

My name is Susan Lewis and I was born in Manchester UK. I had a stroke at the age of 62 in 2009. My left side was affected, I was unable to walk or use my left hand and I am a left handed person. Eventually I regained the use of my limbs but I still have some weakness. I started to draw and paint bookmarks with my daughter just to see if I could manage to create something small. I found this to be very relaxing and therapeutic. I decided to find an Art Class and joined one in April 2014. I have now painted two landscape watercolour pictures for the first time in my life and I hope to carry on painting because I love to paint and I have also met some lovely people at the class. I now have new friends and a wonderful hobby which I hope will continue for the future.

Moshe Shoham #strokeart2014

Moshe Shoham (69), born in Argentina and immigrated to Israel in 1965. A member of Kibbutz Afik where he fulfilled many senior administrative roles. Worked in hotel management and specializes in economics of food and nutrition. Suffered a stroke 9 years ago. Took the leadership role in establishing a club of Neeman for stroke survivors and their caregivers in the many isolated settlements around the Sea of Galilee. “As a result of my stroke, I partially lost my third dimensional sight, in addition to left side hemiplegia. Consequently I have chosen to create largely abstract works in painting and ceramics. In that way I am able to give expression to movement and sharpness of colours.” Presenting works from 2013-14 Digital paintings and Ceramic sculpture Photos by Gal Lapid/Moran Grosz

Jessica Thåström #strokeart2014

I suffered a stroke at 16, brought on by contraceptive pills. It caused all disabilities associated with stroke, except aphasia, such as; hemiparesis, sensory disturbances, visual field loss, chronic fatigue, attention disorder and Neglect. I lost insterest in life, became suicidal and could not see a future. I suffered from depression and PTSD due to the time I spent in the hospital. It took six years to find my way back to my art, and found my own techinques and motifs. My art is stroke related; how it feels to live with the effects of stroke, to literally feel like half a body and how it feels to live with this fatigue. I will never recover fully, but I have found quality of life through art and writing my biography. I will soon be 23 years old and I have gone from being a shy and timid girl – STROKE – to being hateful and depressed with no visions for the future, to speaking publicly about my experiences and finding my own voice. I feel as though I was meant to suffer all the effects except for aphasia; I was born to speak. To tell of the flipside of stroke.

Paul Edgerton #strokeart2014

Hi I'm a stroke survivor from Stockport and I turned to art when I became ill with Angina, then I had my strokes and my art work has gone bigger and better, It helps me to relax and it takes away all the pressure and anxiety that builds up when you've had a stroke. I started drawing first then moved on to water colours, now I'm doing large canvas's with acrylics. It's great fun.

#strokeart2014 M. Shoham

Art work from stroke survivors will be on display at WSC 2014 in Istanbul.

#strokeart2014 Anita Hamers - Dijkstra

My name is Anita Hamers - Dijkstra, I'm 47 years old, born in Hoogwoud and I live in Spanbroek in the Netherlands.

I am a member of the Dutch Association stroke support organization.

After my education of four years ‘Painting and Exhibitor’ at the Nimeto in Utrecht  I worked two years as Exhibitor. In 1988, twenty-six years ago at the age of 21 years, I've had my stroke.
Since this time I had to paint left, which was pretty difficult in the beginning. Fortunately, my inspiration was not lost. Now I paint again since 1992 it has helped me in my recovery, and it will continue to help me in the future. Life has regained value by being able to paint.
In 1995 I married, our son was born in May 1997. The birth of my son has influenced my paintings at that time. I painted subjects that had to do with "children."
My motivation I get again and again the challenge to combine my fantasy thoughts with my feelings this 'combination' than is reflected in my paintings.

My technique is partly determined by the subject to paint on a fantasy - "unnatural" way to approach. The subjects of my paintings are created by combining today experiences with my colorful imagination.

Women films herself having a stroke!

Women films herself having a stroke!

Canadian women Stacey Yepes filmed herself having a stroke to prove to doctors that she wasn't 'just' suffering stress. The evidence shows that we all need to take the signs of stroke much more seriously.  

The identification of acute stroke: an analysis of emergency calls

Referral and triage of patients with transient ischemic attacks to an acute access clinic: risk stratification in an Australian setting

Dementia, stroke, and vascular risk factors; a review


Guidelines from around the world:

Guidelines Australia

ACC/AHA Joint Guidelines

Guidelines Canada

Diagnosis and initial management of acute stroke and transient ischaemic attack (TIA)

National Clinical Guidelines UK

Hemicraniectomy for malignant middle cerebral artery infarction: Current status and future directions

Hemicraniectomy for malignant middle cerebral artery infarction: Current status and future directions

Keywords:

• decompressive surgery;
• hemicraniectomy;
• malignant;
• middle cerebral artery infarction;
• space-occupying

Malignant middle cerebral artery infarction is a life-threatening sub-type of ischemic stroke that may only be survived at the expense of permanent disability. Decompressive hemicraniectomy is an effective surgical therapy to reduce mortality and improve functional outcome without promoting most severe disability. Evidence derives from three European randomized controlled trials in patients up to 60 years. The recently finished DEcompressive Surgery for the Treatment of malignant INfarction of the middle cerebral arterY – II trial gives now high-level evidence for the effectiveness of decompressive hemicraniectomy in patients older than 60 years. Nevertheless, pressing issues persist that need to be answered in future clinical trials, e.g. the acceptable degree of disability in survivors of malignant middle cerebral artery infarction, the importance of aphasia, and the best timing for decompressive hemicraniectomy. This review provides an overview of the current diagnosis and treatment of malignant middle cerebral artery infarction with a focus on decompressive hemicraniectomy and outlines future perspectives.

Click here to review article new to IJS online Early View

Prevalence of stroke and coexistent conditions: disparities between indigenous and nonindigenous Western Australians

Keywords:

• Australia;
• comorbidity;
• epidemiology;
• indigenous;
• linked data;
• prevalence;
• stroke

Background

Worldwide, the prevalence of stroke is poorly described in indigenous populations, despite high stroke burden. This paper reports the average point prevalence of hospitalized stroke and coexistent conditions (2007–2011) in indigenous and nonindigenous people in Western Australia, the largest and most sparsely populated Australian jurisdiction.

Methods

Using state-wide linked hospital and mortality data, indigenous and nonindigenous prevalent stroke cases (aged 25–84 years) were identified after reviewing stroke admissions over a fixed 20-year look-back period. Prevalent cases were those alive at midyear of each study year. The 2007–2011 period prevalence was a weighted average of annual prevalence. Histories of 11 comorbidities were identified using the 20-year look-back period.

Results

Indigenous cases comprised 5% of the average 13 591 annual prevalent cases. Indigenous patients were more likely to be younger, female, and have unknown stroke type. Indigenous prevalence was higher at every age. The age-standardized prevalence in indigenous men (33·7 per 1000; 95% confidence interval 31·9–35·4) was 3.7 times greater than in nonindigenous men (9·1 per 1000; 95% confidence interval 9·0–9·2). The corresponding estimates for women were 27·1 per 1000 (25·7–28·4) and 6·1 per 1000 (6·0–6·2) (ratio = 4·4). The percentage with selected comorbid conditions was substantially higher for indigenous patients.

Conclusions

The high stroke prevalence in indigenous Western Australians, coupled with clinical complexity from comorbid conditions, requires access to culturally appropriate medical, rehabilitation, and logistical support. Intensified primary and secondary prevention is needed to reduce the impact of stroke on indigenous people.

New to IJS online Early View

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Statistical analysis plan for the ‘Efficacy of Nitric Oxide in Stroke’ (ENOS) trial

Statistical analysis plan for the ‘Efficacy of Nitric Oxide in Stroke’ (ENOS) trial

High blood pressure is common during the acute phase of stroke and is associated with a poor outcome. However, the management of high blood pressure remains unclear. The ‘Efficacy of Nitric Oxide in Stroke’ trial tested whether transdermal glyceryl trinitrate, a nitric oxide donor that lowers blood pressure, is safe and effective in improving outcome after acute stroke. Efficacy of Nitric Oxide in Stroke is an international multicenter, prospective, randomized, single-blind, blinded endpoint trial, with funding from the UK Medical Research Council. Patients with acute ischemic stroke or intracerebral hemorrhage and systolic blood pressure 140–220 mmHg were randomized to glyceryl trinitrate or no glyceryl trinitrate and, where relevant, to continue or stop prestroke antihypertensive therapy. The primary outcome is shift in modified Rankin Scale at three-months. Patients or relatives gave written informed (proxy) consent, and all sites had research ethics approval. Analyses will be done by intention to treat. This paper and attachment describe the trial's statistical analysis plan, developed prior to unblinding of date. The statistical analysis plan contains design and methods for analyses, and unpopulated tables and figures for the two primary publications and some secondary publications. The database will be locked in late February 2014 in preparation for presentation of the results in May 2014. The data from the trial will improve the precision of the estimates of the overall treatment effects (efficacy and safety) of results from completed trials of blood pressure management in acute stroke, and provide the first large-scale randomized evidence on transdermal glyceryl trinitrate, and of continuing (vs. stopping) prestroke antihypertensive medications, in acute stroke.

Keywords: acute stroke trial;

blood pressure;

glyceryl trinitrate;

intracerebral hemorrhage;

ischemic stroke;

statistical analysis plan

ENOS http://clinicaltrials.gov/show/NCT00989716

1. Philip M. W. Bath, 
2. Aimee Houlton, 
3. Lisa Woodhouse, 
4. Nikola Sprigg, 
5. Joanna Wardlaw,
6. Stuart Pocock and
7. on behalf of the ENOS Trialists