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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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
Publication date: October 2018Source: The Lancet Neurology, Volume 17, Issue 10Author(s): Luis San Román, Bijoy K Menon, Jordi Blasco, María Hernández-Pérez, Antoni Dávalos, Charles B L M Majoie, Bruce C V Campbell, Francis Guillemin, Hester Lingsma, René Anxionnat, Jonathan Epstein, Jeffrey L Saver, Henk Marquering, John H Wong, Demetrius Lopes, Gernot Reimann, Hubert Desal, Diederik W J Dippel, Shelagh Coutts, Richard du Mesnil de RochemontSummaryBackgroundEvidence regarding whether imaging can be used effectively to select patients for endovascular thrombectomy (EVT) is scarce. ...
Source: The Lancet Neurology - Category: Neurology Source Type: research
CONCLUSIONS: Post stroke spasticity is more common in persons with hemorrhagic stroke, severe paresis and lower functional abilities. The most incidence of spasticity happens in the first month after stroke. PMID: 30129501 [PubMed - as supplied by publisher]
Source: Journal of the National Medical Association - Category: General Medicine Tags: J Natl Med Assoc Source Type: research
Stroke remains a leading cause of human disability. Important gains have been realized in the setting of acute ischemic stroke, where thrombolytic and catheter-based reperfusion therapies can substantially improve long-term behavioral outcomes. However, most patients with a new stroke are not eligible for such therapies because of delays in diagnosis or hemorrhagic etiology, for example, and many who are treated nonetheless have substantial long-term disability. Additional classes of poststroke therapy are needed.
Source: JAMA Neurology - Category: Neurology Source Type: research
Conclusionhaemorrhagic CVA constitutes a larger percentage of stroke subtypes on this side of the globe effecting poor to lower middle class. Proper strategy to prevent and treat haemorrhagic CVA in this part of the world is the need of the hour.
Source: Clinical Epidemiology and Global Health - Category: Epidemiology Source Type: research
ConclusionsThe factors relating to a worse functional outcome were symptomatic hemorrhage transformation, lack of recanalization and complications during EVT. The factors relating to mortality were symptomatic hemorrhage and hydrocephalus. Distal flow was achieve in most cases with a low complication rate. Half of the patients presented functional independence one year after the stroke.ResumenObjetivoEstudiar los resultados y las complicaciones del tratamiento endovascular (TEV) en pacientes con ictus isquémico agudo ingresados en una unidad de cuidados intensivos (UCI). Analizar los factores que podrían infl...
Source: Medicina Intensiva - Category: Intensive Care Source Type: research
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