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Good outcome after intravenous thrombolysis for acute stroke in a patient under treatment with dabigatran
We describe an unusual case of treatment IV rt-PA for acute ischemic stroke in a patient receiving dabigatran for AF.
Source: The American Journal of Emergency Medicine - April 18, 2014 Category: Emergency Medicine Authors: Cátia Diogo, Josiana Duarte, Sofia Sobral, Paula Pestana, Hipólito Nzwalo, Henrique Rita, José Sousa e Costa Tags: Case Report Source Type: research

Ischemic Stroke Differential Diagnose: Spontaneous Spinal Epidural Hematoma can be fatal
Spontaneous Spinal Epidural Hematoma (SSEH) is rarely seen, it is the important reason for the spinal cord compression. Patients generally visit the doctor due to the acute pain in the neck and interscapular area. The male patient 58years old was admitted to the emergency service of our hospital with the sudden onset neck pain and followed by rapidly right hemiparesis He arrived at our hospital 120minutes after the onset of her symptoms with suspected acute stroke. We assessed for acute stroke performed clinical examinations necessary for intravenous thrombolytic treatment with alteplase, No abnormality was observed in his...
Source: The American Journal of Emergency Medicine - January 21, 2015 Category: Emergency Medicine Authors: Huseyin Buyukgol, M. Kemal Ilik, Faik Ilik Source Type: research

Pre-procedure Change in Arterial Occlusion in Acute Ischemic Stroke Patients undergoing Endovascular Treatment by CT Angiography
The American Heart Association/American Stroke Association guidelines strongly recommend a noninvasive intracranial vascular study such as CT angiogram in acute stroke patient if endovascular treatment is contemplated.
Source: The American Journal of Emergency Medicine - February 4, 2015 Category: Emergency Medicine Authors: Adnan I. Qureshi, Mushtaq H. Qureshi, Farhan Siddiq, Daraspreet Kainth, Ameer E. Hassan, Alberto Maud Tags: Original Contribution Source Type: research

Preprocedure change in arterial occlusion in acute ischemic stroke patients undergoing endovascular treatment by computed tomographic angiography
The American Heart Association/American Stroke Association guidelines strongly recommend a noninvasive intracranial vascular study such as computed tomographic (CT) angiogram in acute stroke patient if endovascular treatment is contemplated.
Source: The American Journal of Emergency Medicine - February 4, 2015 Category: Emergency Medicine Authors: Adnan I. Qureshi, Mushtaq H. Qureshi, Farhan Siddiq, Daraspreet Kainth, Ameer E. Hassan, Alberto Maud Tags: Original Contribution Source Type: research

Is it dangerous to treat acute ischemic stroke by thrombolytic therapy in patients with comorbid intracranial aneurysms
The safety of cerebral ischemic stroke patients with comorbid intracranial aneurysms treated by thrombolysis is still an unsolved mystery. We aimed to perform a secondary analysis and review to provide evidence on whether stroke patients with intracranial aneurysms have worse outcomes following thrombolysis.
Source: The American Journal of Emergency Medicine - December 16, 2015 Category: Emergency Medicine Authors: Jiayue Ding, Jie Han, Zhe Jing, Yue Jiang Source Type: research

Stroke Prevention for Patients with Atrial Fibrillation: Values and Preferences of Canadian Emergency Medicine Trainees
Atrial Fibrillation (AF) is the most common serious cardiac arrhythmia and it is associated with a five-fold increase in the risk of ischemic stroke[1–3]. This risk can be reduced by up to 64% with oral anticoagulation (OAC)[4]. Many patients are first diagnosed with atrial fibrillation (AF) in the context of visit to the emergency department (ED) and AF can account for 1% or more of ED visits[5–7]. Clinical risk stratification for stroke and bleeding and subsequent prescription of OAC are the cornerstones of management of AF.
Source: The American Journal of Emergency Medicine - May 12, 2016 Category: Emergency Medicine Authors: William F. McIntyre, Zardasht Oqab, Payam Yazdan-Ashoori, Kieran L. Quinn, Erik M. van Oosten, Wilma M. Hopman, Adrian Baranchuk Tags: Correspondence Source Type: research

Stroke prevention for patients with atrial fibrillation: values and preferences of Canadian emergency medicine trainees
Atrial fibrillation (AF) is the most common serious cardiac arrhythmia, and it is associated with a 5-fold increase in the risk of ischemic stroke [1 –3] . This risk can be reduced by up to 64% with oral anticoagulation (OAC) [4] . Many patients are first diagnosed with AF in the context of visit to the emergency department (ED), and AF can account for 1% or more of ED visits [5–7] . Clinical risk stratification for stroke and bleeding and subsequent prescription of OAC are the cornerstones of management of AF.
Source: The American Journal of Emergency Medicine - May 12, 2016 Category: Emergency Medicine Authors: William F. McIntyre, Zardasht Oqab, Payam Yazdan-Ashoori, Kieran L. Quinn, Erik M. van Oosten, Wilma M. Hopman, Adrian Baranchuk Tags: Correspondence Source Type: research

Favorable outcome of blood urea nitrogen/creatinine-based hydration therapy 3 months after acute ischemic stroke
Dehydration is associated with acute ischemic stroke. However, the relationship between hydration therapy given during acute ischemic stroke and clinical outcomes remains unclear.
Source: The American Journal of Emergency Medicine - September 16, 2016 Category: Emergency Medicine Authors: Jen Lin Chung, Tsung Yang Jen, Chu Huang Yen, Hsiung Tsai Yuan, Ming Hsueh Lee, Meng Lee, Ting Hsiao Cheng, Kuang Yu Hsiao, Leng Chieh Lin Tags: Brief Report Source Type: research

Favorable outcome of blood urea nitrogen/creatinine –based hydration therapy 3 months after acute ischemic stroke
Dehydration is associated with acute ischemic stroke. However, the relationship between hydration therapy given during acute ischemic stroke and clinical outcomes remains unclear.
Source: The American Journal of Emergency Medicine - September 16, 2016 Category: Emergency Medicine Authors: Chung Jen Lin, Jen Tsung Yang, Yen Chu Huang, Yuan Hsiung Tsai, Ming Hsueh Lee, Meng Lee, Cheng Ting Hsiao, Kuang Yu Hsiao, Leng Chieh Lin Tags: Brief Report Source Type: research

Can we imagine a survival chain also for ischemic stroke?
I read with great interest the article about the University of Amiens experience in the management of acute stroke [1] and the concept of “door-to-needle” time, so similar to the best known “door-to-balloon” one. During my recent training period in an excellent Stroke Unit, I've directly experienced a quite brand new concept, brought by mechanical thrombectomy, the “door-to-reperfusion” time. We know from meta-analysis dat a that for every 9-minute delay in reperfusion, 1 of every 100 treated patients had a worse disability outcome (+1 point on MrS scale) [2].
Source: The American Journal of Emergency Medicine - May 29, 2017 Category: Emergency Medicine Authors: Aurora Vecchiato Source Type: research

The impact of intravenous alteplase on long-term patient survival: The Georgia Coverdell acute stroke registry's experience
This study assessed the impact of thrombolytic treatment by alteplase on 1-year mortality and readmission among acute ischemic stroke patients.
Source: The American Journal of Emergency Medicine - July 31, 2017 Category: Emergency Medicine Authors: Moges S. Ido, Michael R. Frankel, Ike S. Okosun, Richard B. Rothenberg Source Type: research

Hemodynamic characteristics of suspected stroke in the emergency department
The objective of this study was to identify baseline hemodynamic characteristics of emergency department (ED) patients with suspected acute stroke.
Source: The American Journal of Emergency Medicine - August 7, 2017 Category: Emergency Medicine Authors: Joseph B. Miller, Richard M. Nowak, Brian P. Reed, Salvatore DiSomma, Prabath Nanayakkara, Michele Moyer, Scott Millis, Harish Kinni, Phillip Levy Source Type: research

The impact of IV alteplase on long-term patient survival: The Georgia Coverdell acute stroke registry's experience
This study assessed the impact of thrombolytic treatment by alteplase on 1-year mortality and readmission among acute ischemic stroke patients.
Source: The American Journal of Emergency Medicine - July 31, 2017 Category: Emergency Medicine Authors: Moges S. Ido, Michael R. Frankel, Ike S. Okosun, Richard B. Rothenberg Tags: Original Contribution Source Type: research

How should we treat patients who wake up with a stroke? A review of recent advances in management of acute ischemic stroke
Acute ischemic strokes account for 85% of all strokes and are the fifth leading cause of mortality in the United States. About one in five of all ischemic strokes occur during sleep and are not noticed until the patient wakes up with neurological deficits. There is growing evidence to support that a significantly higher number of stroke patients could benefit from more aggressive care, especially those patients who wake up with strokes. There is increasing research to support a physiologically-based approach based on advanced imaging rather than simply a time-based determination of whether or not a patient would benefit from reperfusion.
Source: The American Journal of Emergency Medicine - February 21, 2019 Category: Emergency Medicine Authors: Danielle Biggs, Michael E. Silverman, Frank Chen, Brian Walsh, Peter Wynne Source Type: research

Impact of CT scanner location on door to imaging time for emergency department stroke evaluation
Stroke is a potentially serious condition commonly diagnosed in the ED. Time to diagnosis can be crucial to maximizing outcome in a majority of ischemic stroke cases amenable to thrombolytic therapy.
Source: The American Journal of Emergency Medicine - August 13, 2019 Category: Emergency Medicine Authors: William Bonadio Source Type: research

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