Variations in Acute Hospital Stroke Care and Factors Influencing Adherence to Quality Indicators in 6 European Audits Brief Reports

Conclusions— Detected variations in performance of acute stroke services were found. Differences in adherence to quality indicators might indicate population subgroups with specific needs for improving care delivery.
Source: Stroke - Category: Neurology Authors: Tags: Health policy and outcome research, Emergency treatment of Stroke, Other Stroke Treatment - Medical Brief Reports Source Type: research

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AbstractPurpose of reviewIt has become evident that strict time-based criteria are not optimal in selecting patients for acute stroke intervention, leaving the majority of patients untreated due to missing universal time-based criteria. We discuss the pathophysiologic basis for a shift of focus from time to the imaging evidence of salvageable tissue, as well as clinical and imaging tools.Recent findingsThere is strong evidence for the benefit of thrombectomy in patients with a sustained salvageable tissue presenting within 24  h. Although evidence of benefit is limited in patients presenting longer than 24 h, tho...
Source: Current Treatment Options in Neurology - Category: Neurology Source Type: research
The role of intravenous thrombolytic therapy in the management of acute ischemic stroke is well established, and faster administration of intravenous tissue plasminogen activator (tPA) has been associated with better short-term outcomes in clinical practice.
Source: JAMA - Category: General Medicine Source Type: research
This study assesses the current practices of physicians in Lebanon routinely involved in ischemic stroke (IS) management. We conducted a prospective observational study of patients hospitalized at 8 different Lebanese hospitals in the period August 1, 2015 to July 31, 2016, with a diagnosis of acute stroke. Baseline characteristics and data on diagnostic studies, as well as treatments received during hospitalization and at discharge, were collected and analyzed. Two hundred and three strokes/transient ischemic attacks (TIAs) were recorded but only 173 patients (85%) with ischemic events were included in the study. The pati...
Source: Functional Neurology - Category: Neurology Tags: Funct Neurol Source Type: research
Pre-hospital delay was a critical factor affecting stroke patients receiving intravenous thrombolytic therapy. The aim of this study was to explore the factors associated with pre-hospital delay and thrombolysis in China.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
Future Neurology, Ahead of Print.
Source: Future Neurology - Category: Neurology Authors: Source Type: research
Specific clinical risk factors may contribute to improving or worsening neurological functions in acute ischemic stroke (AIS) patients pre-treated with a combined cholesterol reducer and recombinant tissue pla...
Source: Lipids in Health and Disease - Category: Lipidology Authors: Tags: Research Source Type: research
This study aimed to assess the relationship between baseline SBP and outcome. Materials and Methods: Studies that evaluated the association between the baseline SBP and the outcome of patients undergoing thrombolytic therapy were sought. Data were extracted according to a predefined data extraction form and then analyzed by STATA 12.0 software. The primary endpoint was the occurrence of good outcomes measured by a modified Rankin Scale score at 3 months, while the secondary endpoint was the occurrence of intracranial hemorrhage and death. Results: Eleven studies involving a total of 33,263 patients were included. Poo...
Source: The Neurologist - Category: Neurology Tags: Original Articles Source Type: research
We administered intravenous thrombolytic therapy to a 51-year-old female patient with a 101-min stroke onset. The patient was unconscious during the manifestation of symptoms. Computed tomography angiography examination of the intracranial artery at the time of admission suggested that the left middle cerebral artery was occluded. The patient regained consciousness after the intravenous thrombolytic treatment was administered. On an urgent cerebral angiography, it was revealed that the recanalization of the left middle cerebral artery was successful.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Case Report Source Type: research
ConclusionFurther integrated processes are required to maximise patient benefit from thrombolysis. Expansion of community education to incorporate less common symptoms and provision of alert pagers for patients may provide further reduction in thrombolysis times.
Source: Journal of Neurology - Category: Neurology Source Type: research
Spinal epidural hematoma (SEH) after acupuncture is rare and may present with acute or subacute onset and varied symptoms, making it difficult to diagnose. This condition can mimic acute stroke, so it is vital to establish a clear diagnosis before considering thrombolytic therapy, which could be disastrous if applied inappropriately.
Source: The Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Selected Topics: Neurological Emergencies Source Type: research
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