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Specialty: Emergency Medicine
Condition: Stroke

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Total 1739 results found since Jan 2013.

The efficacy and safety of high-dose statins in acute phase of ischemic stroke and transient ischemic attack: a systematic review
AbstractInconsistent findings in the studies have been observed concerning the higher dose of statins use in the acute phase of ischemic stroke and transient ischemic attack (TIA). Therefore, we performed a systematic review to assess this issue. A computerized literature search in PubMed, Cochrane Library databases, and EMBASE for randomized controlled trials (RCTs) was conducted. The efficacy outcome indicators were National Institutes of Health Stroke Scale (NIHSS) score, infarct volume, and recurrence of stroke; the safety outcome indicators were intracranial hemorrhage events, cardiovascular and cerebrovascular events...
Source: Internal and Emergency Medicine - March 15, 2017 Category: Emergency Medicine Source Type: research

PreHospital Ambulance Stroke Test - pilot study of a novel stroke test
There is a need for a prehospital stroke test that in addition to high sensitivity for stroke, also is able to communicate stroke severity similar to the National Institute of Health Stroke Scale (NIHSS).
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - April 11, 2017 Category: Emergency Medicine Authors: Gunnar Andsberg, Magnus Esbj örnsson, Arne Olofsson, Arne Lindgren, Bo Norrving and Mia von Euler Source Type: research

Presentation of Acute Childhood Stroke in a Tertiary Pediatric Emergency Department
Conclusions The spectrum of stroke in a developing country was similar to published series from developed countries in terms of final diagnosis, risk factors, and delay to ED presentation, neuroimaging, and long-term neurodeficits. No tropical diseases were identified as risk factors.
Source: Pediatric Emergency Care - August 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

American Heart Association/American Stroke Association Deletes Sections from 2018 Stroke Guidelines
The updated American Heart Association (AHA)/American Stroke Association (ASA) Guidelines for the Early Management of Patients with Acute Ischemic Stroke were published in January 2018.1 The purpose of the guidelines is to provide an up-to-date, comprehensive set of recommendations for clinicians caring for adult patients with acute arterial ischemic stroke in a single document. The guidelines detail new and updated recommendations that reflect and incorporate the most recent literature in the evaluation and management of acute ischemic stroke. Some sections of the latest guidelines have sparked debate in the medical commu...
Source: Western Journal of Emergency Medicine - October 22, 2018 Category: Emergency Medicine Source Type: research

Barriers to Prompt Presentation to Emergency Departments in Colorado after Onset of Stroke Symptoms
Introduction: Despite significant morbidity and mortality from stroke, patient delays to emergency department (ED) presentation following the onset of stroke symptoms are one of the main contraindications to treatment for acute ischemic stroke (AIS). Our objective was to identify patient and environmental factors associated with delayed presentations to the ED after onset of stroke symptoms.  Methods: This was a pre-planned secondary analysis of data from a multicenter, retrospective observational study at three hospitals in Colorado. We included consecutive adult patients if they were admitted to the hospital from the ED...
Source: Western Journal of Emergency Medicine - December 5, 2018 Category: Emergency Medicine Source Type: research

Lacunar stroke syndromes as predictors of lacunar and non-lacunar infarcts on neuroimaging: a hospital-based study
AbstractLacunar syndromes are usually caused by small ischemic lesions called lacunar infarcts. However, non-lacunar infarcts account for about 20% of lacunar syndromes. The aim of this study was to identify clinical predictors of lacunar syndromes led by non-lacunar infarcts. The following single centre, observational study was conducted on an analysis of the “Perugia hospital-based Stroke Registry” database enrolling consecutive patients admitted with ischemic stroke during the period 2010–2017. We evaluated patient risk factors and clinical features linked to stroke syndrome (lacunar/non-lacunar) and to cerebral i...
Source: Internal and Emergency Medicine - September 17, 2019 Category: Emergency Medicine Source Type: research

Challenges Related to the Implementation of an EMS-Administered, Large Vessel Occlusion Stroke Score
This study examines the integration of a modified Rapid Arterial oCcclusion Evaluation (mRACE) score into an existing stroke treatment protocol.Methods: We performed a retrospective review of EMS and hospital charts of patients transported to a single comprehensive stroke center. Adult patients with an EMS provider impression of “stroke/TIA,” “CVA,” or “neurological problem” were included for analysis. EMS protocols mandated the use of the Cincinnati Prehospital Stroke Score (CPSS). The novel protocol authorized the use of the mRACE score to identify candidates for triage directly...
Source: Western Journal of Emergency Medicine - October 21, 2019 Category: Emergency Medicine Source Type: research

Multiple Administrations of Intravenous Thrombolytic Therapy to a Stroke Mimic
Patients who present emergently with focal neurological deficits concerning for acute ischemic stroke can be extremely challenging to diagnose and treat. Unnecessary administration of thrombolytics to potential stroke patients whose symptoms are not caused by an acute ischemic stroke —stroke mimics—may result in patient harm, although the overall risk of hemorrhagic complications among stroke mimics is low.
Source: The Journal of Emergency Medicine - December 1, 2019 Category: Emergency Medicine Authors: Ava L. Liberman, Daniel Antoniello, Steven Tversky, Michael G. Fara, Cen Zhang, Lindsey Gurin, Sara K. Rostanski Tags: Clinical Communications: Adult Source Type: research

Intravenous Thrombolysis at 3.5 Hours From Onset of Pediatric Acute Ischemic Stroke
We report the case of a 14-year-old girl who presented with right-sided weakness and ataxia, loss of sensation, and altered mental status. Magnetic resonance imaging with diffusion-weighted imaging showed an acute lesion in the distribution of the left posterior cerebral artery, and magnetic resonance angiogram demonstrated occlusion of the third branch of the left posterior cerebral artery. With parental consent, clinicians decided to infuse an adult dose of weight-adjusted intravenous alteplase at 3.5 hours from onset of symptoms, with subsequent improvement in National Institutes of Health Stroke Scale score from 11 to ...
Source: Pediatric Emergency Care - January 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Outcomes of reperfusion therapy for acute ischaemic stroke in patients aged 90 years or older: a retrospective study
AbstractThe benefits and risks of acute reperfusion therapy (RT) in acute ischaemic stroke (AIS) remain uncertain in older patients, especially in nonagenarians. We aimed to assess the impact of RT in this population. Single-center retrospective cohort study comparing patients  ≥ 90 years old admitted to a Stroke Unit (2008–2018) with AIS, submitted or not to RT [intravenous thrombolysis(IVT), mechanical thrombectomy(MT) or both]. Baseline characteristics, in-hospital complications and 3-month outcomes were compared. The primary outcome was 3-month “favorable o utcome”, defined as modified Rankin Scale score 0...
Source: Internal and Emergency Medicine - April 3, 2020 Category: Emergency Medicine Source Type: research

Management of acute ischemic stroke in patients with COVID-19 infection: Insights from an international panel
A corona virus (SARS-CoV-2) has infected 986,776 persons as of April 2nd, 2020 over a period of 4  months. There is a possibility that Coronavirus Disease 2019 (COVID-19) infection increases the risk of stroke similar to other respiratory tract infections [1]. Approximately 5% of hospitalized patients with COVID-19 infection suffer from stroke with over 80% of them being ischemic stroke [2]. T he reported mortality is 39% in patient with stroke [2] and COVID-19 infection which is much higher than the mortality observed in patients with stroke without COVID-19 infection [3].
Source: The American Journal of Emergency Medicine - May 9, 2020 Category: Emergency Medicine Authors: Adnan I. Qureshi, Foad Abd-Allah, Fahmi Alsenani, Emrah Aytac, Afshin Borhani-Haghighi, Alfonso Ciccone, Camilo R. Gomez, Erdem Gurkas, Chung Y. Hsu, Vishal Jani, Liqun Jiao, Adam Kobayashi, Jun Lee, Jahanzeb Liaqat, Mikael Mazighi, Rajsrinivas Parthasara Source Type: research

Impact of Emergency Department Crowding on Delays in Acute Stroke Care
Introduction:Delays in identification and treatment of acute stroke contribute to significant morbidity and mortality. Multiple clinical factors have been associated with delays in acute stroke care. We aimed to determine the relationship between emergency department (ED) crowding and the delivery of timely emergency stroke care.Methods:We used prospectively collected data from our institutional Get with the Guidelines-Stroke registry to identify consecutive acute ischemic stroke patients presenting to our urban academic ED from July 2016 –August 2018. We used capacity logs to determine the degree of ED crowding at the t...
Source: Western Journal of Emergency Medicine - July 8, 2020 Category: Emergency Medicine Source Type: research

Request of hospital care dropped for TIA but remained stable for stroke during COVID-19 pandemic at a large Italian university hospital
AbstractReduced incidence of stroke during COVID-19 pandemic was sometimes  reported. While decrease in stroke incidence and fear of patients to go to the hospitals were sometimes invoked to explain this decrease, reduction in urban pollution was also hypothesized as a possible cause. We investigated statistically the incidence of ischemic and hemorrhagic stroke, and of transient ischemic attacks, at a large Italian tertiary stroke center during the pandemic. We analyzed statistically the number of transient ischemic attacks (TIA), ischemic strokes (IS) and hemorrhagic strokes (HS) between March 8 and May 2, 2020, the pe...
Source: Internal and Emergency Medicine - October 15, 2020 Category: Emergency Medicine Source Type: research

Effect of off-hour versus work-hour thrombolysis for acute ischemic stroke on emergency department patients’ outcome: a retrospective study
Conclusions In this study, there were no significant differences in mortality and functional outcomes at 3 months between patients who underwent off-hour or work-hour thrombolysis in the emergency department.
Source: European Journal of Emergency Medicine - March 10, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

Inhalation of 2% Hydrogen Improves Survival Rate and Attenuates Shedding of Vascular Endothelial Glycocalyx in Rats with Heat Stroke
Heat stroke is characterized by excessive oxidative stress and inflammatory responses, both of which are implicated in vascular endothelial glycocalyx shedding and heat-stroke mortality. Although molecular hydrogen has antioxidation and anti-inflammatory potency, its effect on the vascular endothelial glycocalyx in heat stroke has not been examined. Therefore, the aim of this study was to investigate the influence of hydrogen inhalation on the survival and thickness of the vascular endothelial glycocalyx of rats subjected to heat stroke. Altogether, 98 Wistar rats were assigned to the experiments. A heat-controlled chamber...
Source: Shock - September 23, 2021 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research