Journal of Thai Stroke Society

Editorial

นภาศรี ชัยสินอนันต์กุล — 2024-08-12

Stroke news

วรุตม์ สุทธิคนึง — 2024-08-12

Public Relations

สุรีรัตน์ สุวัชรังกูร — 2024-08-12

Message from President of Thai Stroke Society

เจษฎา อุดมมงคล — 2024-08-12

Embolic Stroke in a Patient with Marantic Endocarditis: A Case Report

Pattarapol Kanjanapipatkul — 2024-08-12

Non-bacterial thrombotic endocarditis (NBTE) is an unusual valvular heart disease which may occur in patients with underlying malignancies or systemic autoimmune diseases. “Marantic endocarditis” is named specifically for the cardiac vegetation pertaining to malignancies. It can cause embolus propagation to distal organs, occluding blood vessels that nourish these organs. Symptoms can vary based on the affected ischemic sites; for instance, focal neurological deficits as a consequence of cerebral vessel occlusion.
Herein, we described a 64-year-old woman with an advanced stage of adenocarcinoma of the lung presenting with two episodes of left hemiparesis within a week. Brain MRI showed restricted diffusion in multiple vascular territories of the brain, along with severe stenosis of the M2 segment of the right middle cerebral artery. Transesophageal echocardiography revealed vegetations on the mitral and tricuspid leaflets. A series of blood cultures showed no organism. Thrombophilic test indicated a dramatic increase in D-dimer level. She was diagnosed with embolic stroke related to marantic endocarditis and treated with parenteral anticoagulants. She was discharged from the hospital with modified Rankin Scale of 4. The prognosis of NBTE with distal embolism depends on the malignancy stage and the severity of the embolic strokes.

Predictive factors of functional outcome after endovascular thrombectomy in patients with acute ischemic stroke

Punnaphat Chramnanpho — 2024-08-12

Background: Functional recovery plays a crucial role in helping patients to their normal or nearly normal state after treatment and enabling them to resume their daily activities.

Objectives: This study aimed to investigate the process of functional recovery following endovascular thrombectomy and identify predictive factors which associated with the recovery process.

Methods: A purposive sample comprising of 79 patients who underwent endovascular thrombectomy was included in this study. Descriptive statistics and stepwise multiple regression analyses were employed to analyze the collected data.

Results: Functional recovery of post-thrombectomy patients were at severe dependency level. Their median ± IQR of Bathel index was 36.5±31.5. The combination of stroke severity and disability level explained 65 percent of the variabilities in predicting functional recovery (R2 = 0.65, p = 0.05)

Conclusion: These findings provide valuable insights into the nursing care of acute ischemic stroke patients undergoing endovascular thrombectomy and emphasizing continuity of stroke care.

Factors predicting stroke prevention behaviours among patients with uncontrolled hypertension in nonthaburi province

Amorn Mueangkaew Mueangkaew — 2024-08-12

This cross-sectional survey research was to study factors predicting stroke prevention behavior among patients with uncontrolled high blood pressure. The sample consisted of patients with uncontrolled high blood pressure who received services at the subdistrict health promoting hospital in Mueang Nonthaburi District Nonthaburi Province aged between 30 - 79 years, 275 people. Data were collected using interviews and descriptive statistics chi-square statistics fisher statistics and bivariate logistic regression analysis revealed that factors related to behavior to prevent stroke include female, aged 50 years and over, patients with no medical conditions other than high blood pressure. Knowledge about prevention of stroke perceived risk of stroke. Perceived severity of stroke knowledge about stroke prevention that patients can practice and social support and can predict 48.5% of stroke prevention behaviors. Therefore, public health agencies should encourage patients with high blood pressure to have knowledge about perception of stroke risk factor, burden and severity of the disease. Including guidelines for preventing stroke that can be practiced. So that patients can take care of themselves and effectively prevent stroke.

Cancer-Associated Arterial Thrombosis: An Updated Investigation of Cancer-Associated Ischemic Stroke

Waratchaya Walailaksanaporn — 2024-08-12

The recognition of cancer-associated ischemic stroke is increasing, shedding light on the previously overlooked problem of cancer-associated ESUS and its impact on late-stage cancer diagnoses. There is growing acknowledgment of the hypercoagulable state in cancer patients with ischemic stroke, with the risk of stroke significantly rising in the year preceding a cancer diagnosis, reaching its peak just before diagnosis. Several cancer types, with lung cancer being the most prevalent, are linked to cancer-associated ischemic stroke. The complex pathophysiology of this condition involves malignancy-related intravascular hypercoagulability, characterized by non-bacterial thrombotic endocarditis (NBTE) and paradoxical embolization as key mechanisms. The diagnostic work-up for stroke patients with cancer should include a standard etiological assessment, supplemented by an occult cancer detection protocol that encompasses various blood tests (especially D-dimer), imaging techniques, and Thoraco-Abdominal-Pelvic Computed Tomography (CT). Ongoing research explores the potential addition of FDG PET/CT to conventional cancer screening. Furthermore, a recent study investigating cancer-associated strokes introduced a machine learning-based prediction model utilizing immunohistochemically stained thrombi obtained during thrombectomy.