Economic and Societal Aspects of Stroke Management

Stroke is a major health burden worldwide with attendant mortality, morbidity, and cost. In 2010, there were approximately 16.9 million strokes and an estimated 33 million stroke survivors worldwide. Also, in the United States, stroke is the third leading cause of death, with ischemic stroke resulting in 8% 30-day mortality (20% for hemorrhagic stroke). The staggering economic cost of the disease is driven largely by disability and long term care. Efforts in stroke healthcare delivery are focusing on performance, efficiency and value to better serve the consumer.
Source: Neuroimaging Clinics - Category: Radiology Authors: Source Type: research

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Conclusion: The burden of disease was higher in the population with disabilities than that in the general population. Cardiovascular diseases and cancer had a higher burden of disease than did other diseases in the population with disabilities; thus, overall, non-communicable diseases have a higher burden of disease than communicable diseases or injuries in the population with disabilities than in the general population. PMID: 30636948 [PubMed - in process]
Source: Journal of Korean Medical Science - Category: Biomedical Science Tags: J Korean Med Sci Source Type: research
Non-traumatic intracerebral hemorrhage (ICH) is associated with a significant global burden of disease, and despite being proportionally less frequent than ischemic stroke, in 2010 it was associated with greater worldwide disability-adjusted life years lost. The focus of outcome assessment after ICH has been mortality in most studies, because of the high early case fatality which reaches 40% in some population-based studies. The most robust and consistent predictors of early mortality include age, severity of neurological impairment, hemorrhage volume and antithrombotic therapy at the time of the event.
Source: Journal of the Neurological Sciences - Category: Neurology Authors: Tags: Review Article Source Type: research
5'-AMP-activated protein kinase (AMPK), a member of the serine/threonine (Ser/Thr) kinase group, is universally distributed in various cells and organs. It is a significant endogenous defensive molecule that responds to harmful stimuli, such as cerebral ischemia, cerebral hemorrhage, and, neurodegenerative diseases (NDD). Cerebral ischemia, which results from insufficient blood flow or the blockage of blood vessels, is a major cause of ischemic stroke. Ischemic stroke has received increased attention due to its '3H' effects, namely high mortality, high morbidity, and high disability. Numerous studies have revealed that act...
Source: Theranostics - Category: Molecular Biology Authors: Tags: Review Source Type: research
​BY GREGORY TAYLOR, DO, &MATTHEW WARPINSKI, DOA 35-year-old man with a history of uncontrolled hypertension and medical noncompliance was brought to the emergency department by EMS complaining of a headache. The family said the patient was watching football and developed an acute headache after he stood up screaming in excitement.His family said he had not taken his blood pressure medication for years. He was afebrile, his blood pressure was 245/129 mm Hg, his respiratory rate was 18 bpm, his heart rate was 68 bpm, and he weighed 340 pounds. The patient was obtunded with a Glasgow Coma Scale score of 4 and was subseq...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Publication date: December 2018Source: The Lancet Neurology, Volume 17, Issue 12Author(s): Audrey M Thiebaut, Maxime Gauberti, Carine Ali, Sara Martinez De Lizarrondo, Denis Vivien, Manuel Yepes, Benoit D RousselSummaryAlthough recent technical advances in thrombectomy have revolutionised acute stroke treatment, prevalence of disability and death related to stroke remain high. Therefore, plasminogen activators—eukaryotic, bacterial, or engineered forms that can promote fibrinolysis by converting plasminogen into active plasmin and facilitate clot breakdown—are still commonly used in the acute treatment of ischa...
Source: The Lancet Neurology - Category: Neurology Source Type: research
ConclusionThe Mindframe Capture LP is a  technically effective thrombectomy device for the treatment of isolated M2 occlusions. The lower profile of the device is advantageous when targeting peripheral intracranial occlusions.
Source: Clinical Neuroradiology - Category: Neurology Source Type: research
Publication date: Available online 22 October 2018Source: Neurología (English Edition)Author(s): C. Avellaneda-Gómez, A. Rodríguez Campello, E. Giralt Steinhauer, A. Gómez González, M. Serra Martínez, P. de Ceballos Cerrajería, A. Zabalza de Torres, E. Cuadrado-Godia, A. Ois Santiago, J. Jiménez-Conde, J. RoquerAbstractIntroductionA considerable percentage of events initially diagnosed as ischaemic stroke have non-cerebrovascular causes; these are called stroke mimics (SM). Currently available evidence about these events is heterogeneous and comes from studies with sm...
Source: Neurologia - Category: Neurology Source Type: research
This article addresses ethical concerns pertinent to each phase. First, we discuss ethical issues regarding consent for thrombolysis and endovascular treatment for acute ischemic stroke, including a review of considerations regarding the provision of acute stroke treatment advice over the telephone. Next, we discuss capacity for consent and prognostication after ischemic stroke and intracranial hemorrhage, with a focus on the problems of the self-fulfilling prophecy. Finally, we discuss residual disability and patients' return to driving. Consideration of these ethical dimensions of cerebrovascular disease will assist neur...
Source: Seminars in Neurology - Category: Neurology Authors: Tags: Review Article Source Type: research
Although the growing use of continuous-flow left ventricular assist devices (LVADs) has improved the survival and quality of life of patients with stage D heart failure, ischemic and hemorrhagic cerebrovascular accidents remain one of the most-feared complications of this therapy and a significant source of disability, morbidity, and mortality. In this article, the authors aim to summarize the current data regarding the incidence/prevalence of both ischemic and hemorrhagic stroke in patients with continuous-flow LVADs, compare axial and centrifugal devices, and discuss the major risk factors for neurologic events that have been identified.
Source: Cardiology Clinics - Category: Cardiology Authors: Source Type: research
AbstractBackgroundTenecteplase (TNK-tPA) is a promising third-generation plasminogen activator, because of its greater fibrin specificity and longer half-life than alteplase. There is a paucity of studies on intravenous thrombolysis using TNK-tPA in developing countries. The present study has been undertaken to compare the efficacy and safety of TNK-tPA with alteplase.MethodsTwo studies were conducted. Study I was an open-label, randomized study in which two doses of TNK-tPA (0.1 and 0.2  mg/kg) were compared. Study II was an open-label study in which TNK-tPA 0.2 mg/kg bolus was compared with historical controls....
Source: American Journal of Cardiovascular Drugs - Category: Cardiology Source Type: research
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