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Specialty: Emergency Medicine
Condition: Hemorrhagic Stroke

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Total 233 results found since Jan 2013.

Subarachnoid hemorrhage in the emergency department
ConclusionSubarachnoid hemorrhages are frequently misdiagnosed; therefore, we believe it is imperative to address the diagnosis and initiation of early management in the emergency medicine department to minimize poor outcomes in the future.
Source: International Journal of Emergency Medicine - May 12, 2021 Category: Emergency Medicine Source Type: research

Evolution Over Time of Ventilatory Management and Outcome of Patients With Neurologic Disease*
OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologi...
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Intraplaque CTA characteristics as predictors of symptomatology: a semiautomated volumetric analysis
ConclusionHigher volumes of intraplaque IPH, LRNC, matrix, and degree of arterial stenosis are associated with ipsilateral neurologic symptoms. Greater intraplaque proportions of LRNC are also associated with ipsilateral ischemic manifestations, suggesting that larger relative composition of lipids may be particularly predictive of symptomatology.
Source: Emergency Radiology - October 6, 2021 Category: Emergency Medicine Source Type: research

Various effects of nutritional status on clinical outcomes after intracerebral hemorrhage
AbstractAlthough the assessment of nutrition is essential for stroke patients, detailed associations between nutritional status at admission, subsequent complications, and clinical outcomes in patients with acute intracerebral hemorrhage (ICH) are unclear. We aimed to elucidate these associations using the Controlling Nutritional Status (CONUT) score. Consecutive patients with acute ICH were investigated. Nutritional status was evaluated using the CONUT score, calculated from the serum albumin level, lymphocyte count, and total cholesterol level. Subsequent complications, such as hemorrhage expansion (HE) during the acute ...
Source: Internal and Emergency Medicine - December 1, 2021 Category: Emergency Medicine Source Type: research

Recognizing Vaccine-Induced Immune Thrombotic Thrombocytopenia
CONCLUSIONS: Vaccine-induced immune thrombotic thrombocytopenia is a serious complication of vaccination that is not feasible to anticipate or prevent. When the patient presents with sustained headache, neurologic symptoms/signs, abdominal pain, dyspnea, or limb pain/swelling beginning 5–30 days post vaccination, platelet count and d-dimer must be measured, and imaging for thrombosis performed. Confirmation of vaccine-induced immune thrombotic thrombocytopenia diagnosis should be ordered (platelet factor 4/polyanion enzyme-linked immunosorbent assay; platelet factor 4–enhanced platelet activation testing) as treatm...
Source: Critical Care Medicine - December 20, 2021 Category: Emergency Medicine Tags: Online Review Article Source Type: research

ALM Fluid Therapy Shifts Sympathetic Hyperactivity to Parasympathetic Dominance in the Rat Model of Non-Compressible Hemorrhagic Shock
Excessive sympathetic outflow following trauma can lead to cardiac dysfunction, inflammation, coagulopathy, and poor outcomes. We previously reported that buprenorphine analgesia decreased survival after hemorrhagic trauma. Our aim is to examine the underlying mechanisms of mortality in a non-compressible hemorrhage rat model resuscitated with saline or adenosine, lidocaine, magnesium (ALM). Anesthetized adult male Sprague-Dawley rats were randomly assigned to Saline control group or ALM therapy group (both n = 10). Hemorrhage was induced by 50% liver resection. After 15 min, 0.7 mL/kg 3% NaCl ± ALM intravenou...
Source: Shock - January 21, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Early Treatment With a Single Dose of Mesenchymal Stem Cell Derived Extracellular Vesicles Modulates the Brain Transcriptome to Create Neuroprotective Changes in a Porcine Model of Traumatic Brain Injury and Hemorrhagic Shock
Conclusions: In a porcine model of TBI + HS, EV treatment was associated with an attenuation of cerebral inflammatory networks and a promotion of neurogenesis and neuroplasticity. These transcriptomic changes could explain the observed neuroprotective and neurorestorative properties associated with EV treatment.
Source: Shock - January 21, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Characteristics and Outcomes of Pediatric Patients With a Ventricular Assist Device Presenting to the Emergency Department
Conclusions Among subjects in a single outpatient pediatric VAD program presenting to the ED, the most common complaints were abdominal pain/vomiting, fever, and headache. The most common adverse events were major infection and right heart failure. Subjects had a high rate of ED utilization and hospital admission.
Source: Pediatric Emergency Care - February 1, 2022 Category: Emergency Medicine Tags: Original Research Article Source Type: research

Leukocyte and its Subtypes as Predictors of Short-Term Outcome in Cardiogenic Shock Complicating Acute Myocardial Infarction: A Cohort Study
Background: Patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI) are at high risk of death. Inflammation is involved in both CS and AMI, and our present study aimed to investigate the changes of leukocyte and its subtypes as well as their prognostic value in patients with CS complicating AMI. Methods: Data of 217 consecutive patients with CS complicating AMI were analyzed. The primary endpoint was 30-day all-cause mortality. The secondary endpoint was the composite events of major adverse cardiovascular events (MACE) including 30-day all-cause mortality, ventricular tachycardia/ven...
Source: Shock - March 1, 2022 Category: Emergency Medicine Tags: Clinical Aspects Source Type: research

MRI of Cerebrovascular Injury Associated With COVID-19 and Non-COVID-19 Acute Respiratory Distress Syndrome: A Matched Case-Control Study
CONCLUSIONS: In a case-control study of selected ARDS patients with brain MRI, the frequencies of ischemic and hemorrhagic cerebrovascular injuries were similar between COVID-19 versus non-COVID-19 ARDS patients. However, the MRI pattern of disseminated hemorrhagic leukoencephalopathy was unique to the COVID-19 ARDS patients in this cohort.
Source: Critical Care Medicine - October 20, 2022 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Protect That Neck! Management of Blunt and Penetrating Neck Trauma
Blunt and penetrating vascular injuries to the neck represent a significant burden of mortality and disability among trauma patients. Blunt cerebrovascular injury can present with signs of stroke either immediately or in a delayed fashion. Most injuries are detected with computed tomography angiogram and managed by antiplatelet agents or unfractionated heparin. In contrast, for patients presenting with penetrating neck injuries, assessment for hard signs of vascular and aerodigestive injury should be done and prompt emergent surgical consultation if present. Overall management priorities for penetrating neck injuries focus...
Source: Emergency Medicine Clinics of North America - November 22, 2022 Category: Emergency Medicine Authors: Matt Piaseczny, Julie La, Tim Chaplin, Chris Evans Source Type: research

Diagnostic accuracy of the physical exam in emergency department patients with acute vertigo or dizziness: Systematic review and meta-analysis for GRACE-3
CONCLUSION: Most neurological exam findings have low sensitivity and high specificity for a central cause in patients with acute vertigo or dizziness. In acute vestibular syndrome (monophasic, continuous, persistent dizziness), HINTS and HINTS+ have high sensitivity when performed by trained clinicians.PMID:36453134 | DOI:10.1111/acem.14630
Source: Accident and Emergency Nursing - December 1, 2022 Category: Emergency Medicine Authors: Vishal Paresh Shah Lucas Oliveira J E Silva Wigdan Farah Mohamed O Seisa Abdalla Kara Balla April Christensen Magdoleen Farah Bashar Hasan Fernanda Bellolio M Hassan Murad Source Type: research

Intermittent thoracic resuscitative endovascular balloon occlusion of the aorta improves renal function compared to 60  min continuous application after porcine class III hemorrhage
ConclusioniREBOA was survivable, did not cause rebleeding, decreased the total ischemic time and increased the renal blood flow, urine output and decreased renal ischemic injury compared to cREBOA. Intermittent reperfusions during REBOA may be preferred to be continuous, complete occlusion in prolonged application to improve renal function.
Source: European Journal of Trauma and Emergency Surgery - December 5, 2022 Category: Emergency Medicine Source Type: research