Cerebral Vascular Accident (CVA)/Stroke
Conditions
Keywords
Ischemic Stroke, Haemorrhagic Stroke, Cerebral Vascular Disease
Brief summary
This study aims to contribute to the identification of factors that may be predictive of cognitive function and to provide data on cerebral hemodynamic in ischemic and haemorrhagic stroke. This study will prospectively study cerebral autoregulation, neurovascular coupling and microembolic signs in cerebrovascular patients with ischemic and haemorrhagic stroke and its relationship with cognitive function and functional recovery
Interventions
DIAGNOSTIC_TESTCerebral Autoregulation (CAR)
Cerebral Autoregulation (CAR) is the mechanism capable of maintaining cerebral blood flow constant despite fluctuations in blood pressure. The evaluation of dynamic CAR (dCAR) with spontaneous blood pressure variations allows it to be applied in acute and non-collaborating patients
DIAGNOSTIC_TESTNeurovascular coupling (NVC)
Neurovascular coupling (NVC) is the relationship between neural activity and cerebral blood flow, allowing this activity to be evaluated in spatiotemporal terms .
DIAGNOSTIC_TESTMicroembolic signals (MES)
Microembolic signals (MES)
DIAGNOSTIC_TESTMontreal Cognitive Assessment (MoCA)
Montreal Cognitive Assessment (MoCA)
DIAGNOSTIC_TESTInformant Questionnaire on Cognitive Decline in the Elderly (IQCODE)
Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE)
DIAGNOSTIC_TESTInstrumental Activities of Daily Living Scale (IADL)
Instrumental Activities of Daily Living Scale (IADL)
DIAGNOSTIC_TESTModified Rankin Scale for Neurologic Disability (mRS)
Modified Rankin Scale for Neurologic Disability (mRS)
Sponsors
Hospital de Sao Joao, Porto
RISE Study Group
Universidade do Porto
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Minimum age limit: 18 years * Patients with intracerebral haemorrhages; Patients with ischemic stroke of atherosclerotic, cardioembolic and embolic etiology from an unknown source; * Previous mRS equal or more than 4; * National Institutes of Health Stroke Scale (NIHSS)≤20 at admission; * IQCODE final score<3.0
Exclusion criteria
* History of dementia or other central nervous system disease associated with cognitive impairment; * Absence of adequate temporal bone window for Transcranial Doppler monitoring; * Patients with a large cerebral infarct (greater than on third of the middle cerebral artery territory) or a strategic infarct (paramedian thalamus, medial frontal cortex, or hippocampus) evaluated in the 24 hours-CT; * Average life expectancy less than 1 year for a different cause of cardiovascular disease; * Patients with intracranial vascular malformation, intracranial venous thrombosis, head trauma or tumour and haemorrhagic transformation within an infarct; * Serious kidney and systemic diseases; * Active cancer patients;
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Functional status | 3±1 months after onset; 12±1 months after onset | The modified Rankin Scale (mRS): 0 - None; 1- No significant disability despite symptoms: able to carry out all usual duties and activities; 2 - Slight disability: unable to carry out all previous activities, but able to look after own affairs without assistance; 3 - Moderate disability: requiring some help, but able to walk without assistance; 4 - Moderately severe disability: unable to walk without assistance, unable to attend to needs without assistance; 5 - Severe disability: bed-ridden, incontinent, and requiring constant nursing care and attention; 6 - Dead |
| Cognitive status | 12±1 months after onset | Cognitive status at 12 months of follow-up will be calculated based in 7-scale cognitive score operationalized from Montreal Cognitive Assessment (MoCA) together with modified Rankin Scale (mRS): 1. \- Sub-category Normal: No evidence of cognitive impairment; 2. \- Sub-category Minor Single: Scores are reduced by more than 1 point in only one cognitive domain of MoCA test; 3. \- Sub-category Minor Multi: Scores are reduced by more than 1 point in more than one cognitive domain of MoCA test; 4. \- Sub-category Major Mild: Cognitive impairments (MoCA test 20-25) and minimal functional problems (mRS less than 3); 5. \- Sub-category Major Moderate: More severe cognitive impairments (MoCA test 14-19) and more limiting function (mRS=3 or 4); 6. \- Sub-category Major Severe: Severest cognitive impairments (MoCA less than 14) and most limited function or Moderately severe/severe disability (mRS more than 4); 7. \- Sub-category Death. |
Countries
Portugal
Outcome results
None listed