1. Dr. Amer Jafar

2.  Previous studies showed that a positive family history of stroke (FHstroke) is an independent risk factor for lacunar stroke  The aim of the present study was to determine whether familial aggregation of stroke was different for lacunar stroke phenotypes

3.  In 157 patients with a first-ever lacunar stroke, a complete first-degree FHstroke was obtained by a standardized questionnaire and additional interview  Fifty-two percent of patients reported a positive FHstroke in at least one of their first-degree relatives  A family history of stroke might be an independent risk factor for the lacunar stroke phenotype with aLACs at younger ages, suggesting a role for genetic factors in this phenotype caused by diffuse vasculopathy

4.  High infection rate after severe stroke may partly relate to brain-induced immunodepression syndrome  Aim: to investigate the role of autonomic shift in increased susceptibility to infection after acute intracerebral hemorrhage (ICH)  The authors retrospectively analyzed 62 selected patients with acute ICH from a prospective database  Autonomic shift was assessed using the cross-correlational baroreflex sensitivity (BRS)

5.  They identified 36 (58%) patients with infection during the first 5 days of hospital stay  Patients with infections had significantly lower BRS, higher initial NIHSS scores, larger haemorrhages, and more frequently had intraventricular blood extension and underwent invasive procedures

6.  Conclusion:  Decreased BRS was independently associated with infections after ICH  Autonomic shift may play an important role in increased susceptibility to infections after acute brain injury including ICH

7.  This austrian study addresses the value of helicopter transport compared with other means of transportation to a stroke unit and compares their rates of thrombolysis on a nationwide basis  Prospective data collection: 2 stroke units between 2003 and 2009 were used  Results: Of 21 712 ischaemic stroke patients, 905 patients (4.1%) were transported by helicopter

8.  Of these, 752 patients (3.4%) were transported by direct HEMS, and 153 patients (0.7%) were transported by indirect HEMS  Thrombolysis rates were highest for HEMS (24% direct, 29% indirect)  Conclusion: The shortest hospital arrival times and highest thrombolysis rates were seen in ischaemic stroke patients transported by helicopter.

9.  Multiple studies suggest that statin use before acute ischaemic stroke is associated with improved functional outcome  The authors performed a systematic literature search and meta-analysis of studies investigating the association between prestroke statin use and clinical outcome  Results: Meta-analysis of all available data identified an association between prestroke statin use and improved functional outcome

10.  Larger positive effects for small vessel strokes compared with other subtypes  However, evidence of publication bias in the existing literature suggests these findings should be interpreted with caution

11.  BoTULS trial  Botulinum toxin is increasingly used to treat upper limb spasticity due to stroke, but its impact on arm function is unclear  The researchers evaluated botulinum toxin for upper limb spasticity and function poststroke  Three hundred thirty-three patients with stroke with upper limb spasticity and reduced arm function participated in a multicenter randomized controlled trial

12.  The intervention group received botulinum toxin type A injection(s) plus a 4-week therapy program  The control group received the therapy program alone  The primary outcome was upper limb function at 1 month (Action Research Arm Test). Secondary outcomes included measures of impairment, activity limitation, and pain at 1, 3, and 12 months

13.  Results: There was no significant difference in achievement of improved arm function (Action Research Arm Test) at 1 month  Significant differences in favor of the intervention group were seen in muscle tone at 1 month; upper limb strength at 3 months; basic arm functional tasks (hand hygiene, facilitation of dressing) at 1, 3, and 12 months; and pain at 12 months

14.  Botulinum toxin type A is unlikely to be useful for improving active upper limb function (eg, reaching and grasping) in the majority of patients with spasticity after stroke, but it may improve basic upper limb tasks (hand hygiene, facilitation ofdressing) and pain.

15.  Early Prediction of Outcome of Activities of Daily Living After Stroke  Risk and Cumulative Risk of Stroke Recurrence  Translational Stroke Research of the Combination of Thrombolysis and Antioxidant Therapy