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The Impact of Comprehensive Stroke Care Capacity on the Hospital Volume of Stroke Interventions: A Nationwide Study in Japan: J-ASPECT Study
We examined the effect of hospital characteristics, having a t-PA protocol, and the number of fulfilled CSC items (total CSC score) on the hospital volume of t-PA infusion, removal of intracerebral hemorrhage, and coiling and clipping of intracranial aneurysms performed in 2009.Results: Approximately 55% of hospitals responded to the survey. Facilities with t-PA protocols (85%) had a significantly higher likelihood of having 23 CSC items, for example, personnel (eg, neurosurgeons: 97.3% versus 66.1% and neurologists: 51.3% versus 27.7%), diagnostic (eg, digital cerebral angiography: 87.4% versus 43.2%), specific expertise...
Source: Journal of Stroke and Cerebrovascular Diseases - October 7, 2013 Category: Neurology Authors: Koji Iihara, Kunihiro Nishimura, Akiko Kada, Jyoji Nakagawara, Kazunori Toyoda, Kuniaki Ogasawara, Junichi Ono, Yoshiaki Shiokawa, Toru Aruga, Shigeru Miyachi, Izumi Nagata, Shinya Matsuda, Koichi B. Ishikawa, Akifumi Suzuki, Hisae Mori, Fumiaki Nakamura, Tags: Original Articles Source Type: research

Recurrent stroke in a patient with vitamin B12 deficiency and MTHFR mutation
We report an unusual case of recurrent stroke in a patient with vitamin B12 deficiency who was also homozygous for the methylene tetrahydrofolate reductase (MTHFR) gene mutation. The patient was a 35-year-old male vegetarian with no known medical history who initially presented with global aphasia, slurred speech, right facial weakness, and right-sided hemiplegia and was found to have a stroke (NIH Stroke Scale score of 25). At that time a CT scan of the head ruled out intracranial hemorrhage and a CT angiogram of the head and neck was done. The patient was found to have occlusion of the M1 segment of the left middle cereb...
Source: Neurology Clinical Practice - February 12, 2017 Category: Neurology Authors: Zacharia, G., Shani, D., Ortiz, R. A. Tags: Stroke in young adults, Stroke prevention, Hematologic, All Cerebrovascular disease/Stroke Case Source Type: research

Unlabeled amphetamine isomer in sports supplement “probably” caused hemorrhagic stroke
3.5 out of 5 stars Hemorrhagic Stroke Probably Caused by Exercise Combined With a Sports Supplement Containing β-Methylphenylethylamine (BMPEA): A Case Report. Cohen P et al. Ann Intern Med 2015 May 12 [Epub ahead of print] Reference Last month, the FDA sent letters to 5 companies that manufacture so-called “dietary” or “sports” supplements, warning them that their products were mislabeled because they contained an unlisted ingredient. That ingredient, β-methylphenylethylamine (BMPEA), is an isomer of amphetamine. Although the effects of BMPEA in humans have not been well studied, it has been ...
Source: The Poison Review - May 22, 2015 Category: Toxicology Authors: Leon Tags: Medical amphetamine beta-methylphenylethylamine BMPEA dietary supplement hemorrhagic stroke sports supplement Source Type: news

The disappearing thrombus: An uncommon cause of ischemic stroke
A 46-year-old woman presented with 2 episodes of transient left-sided paresis and hypoesthesia lasting 30 minutes. The emergency department initiated a stroke code due to reoccurrence of symptoms. Workup revealed a platelet count of 1,141,000, and CT angiography showed a large pedunculated thrombus within the right internal carotid artery (figure 1). She underwent emergent plateletpheresis without an anticoagulant (unfractionated heparin, low molecular weight heparin). This was not started at the time of initial presentation because of increased bleeding risk in patients with either reactive or essential thrombocythemia.1 ...
Source: Nature Clinical Practice - December 8, 2014 Category: Neurology Authors: Lerner, D. P., Graffagnino, C. Tags: Stroke in young adults, All Imaging, Embolism, Infarction Cases Source Type: research

E-021 Pathophysiology, stroke types, collateral formation and aneurysms in moyamoya disease/moya moya syndrome
ConclusionsMMD is presented most commonly with ischemic stroke in the pediatric age group and with hemorrhagic stroke in the adult age group. MMD-associated intracranial aneurysms frequently occur in patients presenting with hemorrhagic unilateral MMD and are associated with an extremely high rate of rupture. Long-standing hemodynamic stress might contribute to the formation of an aneurysm.Disclosures S. Ahmad: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Ahmad, S. Tags: Electronic poster abstracts Source Type: research

Update on Neurocritical Care of Stroke
AbstractPurpose of ReviewThis review will highlight the recent advancements in acute ischemic stroke diagnosis and treatment, with special attention to new features and recommendations of stroke care in the neurocritical care unit.Recent FindingsNew studies suggest that pre-hospital treatment of stroke with mobile stroke units and telestroke technology may lead to earlier stroke therapy with intravenous tissue plasminogen activator (tPA), and recent studies show tPA can be given in previously contraindicated situations. More rapid automated CT perfusion and angiography may demonstrate a vascular penumbra for neuroendovascu...
Source: Current Cardiology Reports - June 23, 2017 Category: Cardiology Source Type: research

I Never Thought Stroke Would Happen to Me
by Myra Wilson, Stroke Survivor On November 3, 2014, I was in nursing school working as a student nurse at a hospital in Seattle. My first sign that something was not quite right was when I was walking through the nursing station and both of my eyes went blurry. I could still see color but I couldn't see letters. It was blurry for about 30 seconds before clearing up again. I was going to lunch and went to give a report to another nurse. The nurse noticed while I was speaking that I slurred my speech. I didn't notice my speech was slurred at all. It was at that time that I experienced a sudden sharp pain on the right s...
Source: Healthy Living - The Huffington Post - May 13, 2016 Category: Consumer Health News Source Type: news

E-057 Process Improvement in Door-to-Groin Puncture Times at a Comprehensive Stroke Center Shows a Trend Towards Reduced Mortality at 90 Days
ConclusionOur systematic process improvement initiative significantly reduced door-to-groin puncture times and showed a trend towards reduced mortality at 90 days. A multidisciplinary approach and ensuring hospital system investment are key to an effective process.DisclosuresY. Kayan: 2; C; Medtronic, Penumbra. J. Delgado Almandoz: 2; C; Medtronic, Penumbra. M. Young: None. J. Fease: None. J. Scholz: None. A. Milner: None. T. Hehr: None. M. Mulder: None. P. Roohani: None. R. Tarrel: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Kayan, Y., Delgado Almandoz, J., Young, M., Fease, J., Scholz, J., Milner, A., Hehr, T., Mulder, M., Roohani, P., Tarrel, R. Tags: Electronic poster abstracts Source Type: research

Intravenous thrombolysis in SLE-related stroke: a case report and literature review
AbstractPatients with systemic lupus erythematosus (SLE) bear an increased risk of ischemic stroke. However, evidences for treating acute stroke due to artery thrombosis in SLE patients are extremely limited. A 45-year-old woman experienced sudden left hemiplegia. She was transported to the emergency department of our hospital 2  hours after the initial symptom. According to the medical records, the patient was diagnosed with SLE at the age of 28. CT scanned 150 min after the initial symptom showed no evidence of acute changes or hemorrhage. Magnetic resonance angiography (MRA) revealed occlusion of the right proximal mi...
Source: Neurological Sciences - November 7, 2017 Category: Neurology Source Type: research

Isolated Cortical Vein Thrombosis Associated with Prothrombin Gene Mutation
We report a 47-year-old female patient who had a frontal hemorrhage with headache associated with contralateral hemiparesis and hemisensory deficit on presentation. This hemorrhagic stroke was localized in a nonarterial territory, and it was caused by ipsilateral and isolated thrombosis of the vein of Labbe found on catheter angiogram that demonstrated a filling defect of the vein of Labbe at its connection with the transverse sinus. There were no filling defects in the superficial middle cerebral veins. Our patient had a family history of cardiovascular disease, stroke, and factor V Leiden mutation and cigarette smoking a...
Source: Journal of Stroke and Cerebrovascular Diseases - July 8, 2013 Category: Neurology Authors: Elias A. Giraldo, Rohan Arora, Robert A. Koenigsberg Tags: Case Reports Source Type: research

E-030 clinical and angiographic outcomes in endovascular treatment of tandem vessel occlusions in acute ischemic stroke
ConclusionEndovascular treatment of tandem arterial occlusions in acute ischemic stroke is feasible, safe, and yields excellent angiographic and good clinical outcomesDisclosuresM. Grigoryan: None. D. Haussen: None. A. Lima: None. J. Grossberg: None. A. Anderson: None. S. Belagaje: None. F. Nahab: None. M. Frankel: None. R. Nogueira: 2; C; Covidien, Steering Committee for the SWIFT and SWIFT Prime Trials and Core Lab for the STAR Trial, Stryker, PI for the TREVO-2 and DAWN Trials, Penumbra, Executive Committee for the 3D Separator Trial.
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Grigoryan, M., Haussen, D., Lima, A., Grossberg, J., Anderson, A., Belagaje, S., Nahab, F., Frankel, M., Nogueira, R. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

Metronidazole Induced Encephalopathy Mimicking an Acute Ischemic Stroke Event.
We report a rare case of MIE mimicking an acute ischemic stroke, and hypothesize the relationship between the findings of CTP and that of MRI based on the anatomical connection of the dentate nucleus and the cerebral hemisphere. PMID: 30078820 [PubMed - as supplied by publisher]
Source: Neurologia Medico-Chirurgica - August 7, 2018 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research

P005/44 Using the pEGASUS-stent with antithrombogenic properties and single antiplatelet therapy in a case of thrombectomy
IntroductionRescue stenting is used more and more in stroke cases with large-vessel-occlusion or medium-vessel-occlusion refractory to mechanical thrombectomy. The pEGASUS-stent(Phenox) represents a device which is equipped with a hydrophilic polymer coating(HPC) with antithrombogenic properties. The coating allows for implantation under single antiplatelet therapy, thus possibly reducing the risk of bleeding in acute stroke cases.Case HistoryA 79-year-old woman was rushed to emergency room due to left-sided hemiparesis and National-Institutes-of-Health-Stroke-Scale(NIHSS) of 14. Computed-tomography-image showed an occlusi...
Source: Journal of NeuroInterventional Surgery - August 21, 2023 Category: Neurosurgery Authors: Krug, N., Schulze-Zachau, V., Ntoulias, N., Psychogios, M. Tags: 4.3 CASE PROPOSAL - Acute ischemic stroke Source Type: research

ASPECT Score and Its Application to Vasospasm in Aneurysmal Subarachnoid Haemorrhage: a Case –Control Study
AbstractDelayed cerebral ischaemia (DCI) is a significant complication of aneurysmal subarachnoid haemorrhage (aSAH) and is strongly associated with poorer outcome. The Alberta Stroke Program Early Computer Tomography (ASPECT) score is an established scoring tool, used in acute ischaemic stroke, to quantify early ischaemic changes on CT head scans. We aim to identify if ASPECT scoring correlates with functional outcome in DCI following aSAH. Retrospective case –control study. Inclusion criteria: admission to the Department of Neurosurgery at Leeds Teaching Hospitals NHS Trust (a tertiary neurosurgical centre in the Unite...
Source: Translational Stroke Research - August 9, 2022 Category: Neurology Source Type: research

Is Achondroplasia Linked to Stroke? (P6.265)
CONCLUSIONS:This case shows an interesting correlation between achondroplasia and carney complex related myxomas that has not been described in literature before. Achondroplasia is an autosomal dominant mutation in FGFR3 gene on chromosome 4P. Mutaions in carney complex are also described to be autosomal dominant mostly involving chromosome 17q23-q24 . There has been no clear pathogenesis described pertaining this correlation yet but more genetics have to be explored.Study Supported by:Disclosure: Dr. Kaur has nothing to disclose. Dr. Mittal has nothing to disclose. Dr. Hosley has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Kaur, H., Mittal, S., Hosley, C. Tags: Cerebrovascular Disease and Interventional Neurology: Case Reports Source Type: research

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