Observational studyBrain and behavior2025
STAND: Ultrasound of Cerebral Blood Flow During First Verticalization in Acute Stroke-A Prospective Case-Control Study.
Observational study in Brain and behavior, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04180826 (Impact of Verticalization on Intracranial Hemodynamics Assessed by Continuous Transcranial Doppler Monitoring at the Acute Phase of Ischemic Stroke), which is not on this map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Impact of Verticalization on Intracranial Hemodynamics Assessed by Continuous Transcranial Doppler Monitoring at the Acute Phase of Ischemic Stroke
Who cites it
1 citing paper in PubMed.
- STAND: Ultrasound of Cerebral Blood Flow During First Verticalization in Acute Stroke-A Prospective Case-Control Study.Brain and behavior · 2025Observational
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeThe optimal timing for mobilizing patients during the acute phase of ischemic stroke remains unclear. Prior research has produced conflicting results, often neglecting the impact of upstream arterial stenosis on cerebral blood flow. This study aimed to determine whether early transition to a seated position in the acute phase of ischemic stroke influences intracranial hemodynamics, particularly in patients with significant carotid stenosis.
methodsIn a prospective, bi-centric, 1:1 case-control observational study (NCT04180826), we continuously and non-invasively monitored cerebral and systemic hemodynamics during the first authorized transition from supine to a sitting position in patients with ischemic stroke of the carotid territory. Cases were defined as those with homolateral carotid stenosis >50% by NASCET criteria. The primary outcome was a >10% reduction in mean flow velocity (MFV) in the homolateral middle cerebral artery (MCA).
resultsOf 42 screened patients, 36 were included (19 controls, 17 cases). A significant (>10%) MFV drop occurred in 9/17 cases (53%) versus 1/19 controls (5%; p = 0.012). Notably, cases with an MFV drop showed no compensatory systemic response (no rise in blood pressure or heart rate). Multivariate analysis revealed that a shorter time from stroke onset to sitting (coefficient = -2.793, p = 0.016) and being a case (coefficient = -6.283, p = 0.004) independently predicted an MFV decrease >10%. Additional factors associated with significant MFV decline in cases included the absence of a blood pressure increase after verticalization, lower hemoglobin (p = 0.007), and higher BNP levels (p = 0.024).
conclusionsEarly sitting in the acute phase of ischemic stroke is more frequently associated with marked MFV reductions in patients with carotid stenosis, potentially due to impaired systemic hemodynamic adaptation. These findings underscore the importance of individualized mobilization strategies based on vascular and systemic factors.
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