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Specialty: Emergency Medicine
Condition: Stroke

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Total 1739 results found since Jan 2013.

Field Validation of the Los Angeles Motor Scale as a Tool for Paramedic Assessment of Stroke Severity
Prior stroke research has confirmed that early, therapeutic intervention is crucial to improve outcomes in acute cerebrovascular disease (ACVD) including both acute ischemic stroke and intracerebral hemorrhage. Neurological deficit status in the field is crucial to hospital pre-arrival notification, routing to stroke centers, and for initiation of experimental, pre-hospital treatment interventions. The Los Angeles Motor Scale (LAMS) is a 3-item, 0- to 10-point motor stroke-deficit scale developed for prehospital and emergency department (ED) use.
Source: The Journal of Emergency Medicine - May 1, 2017 Category: Emergency Medicine Authors: Katherine C. Wurlitzer Tags: Abstract Source Type: research

Predictive Factors of Functional Prognosis of Stroke in the Emergency Department
Stroke is a common cause of disability. A wide variety of factors influence stroke prognosis. Identifying factors predicting functional decline is necessary in order to improve quality of life. Emergency physicians are often asked to predict outcomes after stroke by the patient and his family. The aim of our study was to identify predictive factors of early functional decline in stroke patients.
Source: The Journal of Emergency Medicine - September 1, 2017 Category: Emergency Medicine Authors: H. Ghazali, I. Chermiti, M. Kallel, S. Mahdhoui, I. Henane, N. El Hani, A. Azouzi, S. Souissi Tags: MEMC Abstract Source Type: research

Feasibility and Safety of Intravascular Temperature Management for Severe Heat Stroke: A Prospective Multicenter Pilot Study
This study evaluated the efficacies of conventional treatment with or without intravascular temperature management for severe heat stroke. Design: Prospective multicenter study. Setting: Critical care and emergency medical centers at 10 tertiary hospitals. Patients: Patients with severe heat stroke hospitalized during two summers. Interventions: Conventional cooling with or without intravascular temperature management. Measurements and Main Results: Cooling efficacy, Sequential Organ Failure Assessment score, occurrence rate of serious adverse events, and prognosis based on the modified Rankin Scale and Cere...
Source: Critical Care Medicine - June 16, 2018 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Fast Protocol for Treating Acute Ischemic Stroke by Emergency Physicians
ConclusionImplementation of a stroke protocol with emergency physician–directed acute care decreased both door-to-needle time and onset-to-treatment time without increasing the rate of symptomatic intracerebral hemorrhage.
Source: Annals of Emergency Medicine - September 18, 2018 Category: Emergency Medicine Source Type: research

Targeted Temperature Management at 33°C or 36°C Produces Equivalent Neuroprotective Effects in the Middle Cerebral Artery Occlusion Rat Model of Ischemic Stroke
Targeted temperature management (TTM, 32°C to 36°C) is one of the most successful achievements in modern resuscitation medicine. It has become standard treatment for survivors of sudden cardiac arrest to minimize secondary brain damage. TTM at 36°C is just as effective as TTM at 33°C and is actually preferred because it reduces adverse TTM-associated effects. TTM also likely has direct neuroprotective effects in ischemic brains in danger of stroke. It remains unclear, however, whether higher temperature TTM is equally effective in protecting the brain from the effects of stroke. Here, we asked whether TTM at 36°C is a...
Source: Shock - November 14, 2018 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

A Case of Lenticulostriate Stroke Due to Minor Closed Head Injury in a 2-Year-Old Child: Role of Mineralizing Angiopathy
Conclusions Some infants can present with the onset of stroke-like symptoms after minor head injuries. Presence of linear calcifications of the basal ganglia noticed on brain computed tomography in many of these patients suggests that mineralizing angiopathy may be a predisposing factor for lenticulostriate stroke after minor closed head injury in infants. Brain magnetic resonance imaging to further delineate possible cerebral infarction is indicated.
Source: Pediatric Emergency Care - December 1, 2018 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Access to acute care resources in various income settings to treat new-onset stroke: A survey of acute care providers
ConclusionThe striking finding from this study was that there was essentially very little difference between the responses between LMIC and HIC respondents with a few notable exceptions. The findings also propose a universal lack of adherence to the 2013 AHA/ASA stroke management guideline by both groups, in contrast to the good reported knowledge thereof. Carefully planned qualitative research is needed to identify the barriers to achieving the 2013 AHA/ACA recommendations.
Source: African Journal of Emergency Medicine - January 20, 2019 Category: Emergency Medicine Source Type: research

The authors respond: Studying prehospital supplemental oxygen in acute stroke
We appreciate the opportunity to respond to this letter and thank you to the author for taking time to raise these important issues regarding the potential role of prehospital supplemental oxygen (sO2) for stroke. This is an area that needs additional – including prospective – studies to better understand the potential benefits and harms of sO2 for acute stroke. In this retrospective cohort study, the Get with the Guidelines-Stroke (GWTG-S) database was used to identify adult acute stroke patients who presented to an academic Comprehensive St roke Center via EMS between January 1, 2013 and December 31, 2017.
Source: The American Journal of Emergency Medicine - February 26, 2020 Category: Emergency Medicine Source Type: research

A rapid response-type doctor car system shortened time to intravenous thrombolytic therapy for patients with ischemic stroke: an observational study at a single emergency center in Japan
ConclusionIn this study, patients with ischemic stroke in RRC group received intravenous thrombolytic therapy in a shorter time compared to the group that received usual care.
Source: International Journal of Emergency Medicine - June 25, 2020 Category: Emergency Medicine Source Type: research

Acute Kidney Injury in Acute Ischemic Stroke Patients in Clinical Trials
Objectives: Acute ischemic stroke patients are at risk of acute kidney injury due to volume depletion, contrast exposure, and preexisting comorbid diseases. We determined the occurrence rate and identified predictors associated with acute kidney injury in acute ischemic stroke patients. Setting: Multiple specialized ICUs within academic medical centers. Design: Post hoc analysis of pooled data from prospective randomized clinical trials. Patients: Acute ischemic stroke patients recruited within 3 hours or within 5 hours of symptom onset. Interventions: IV recombinant tissue plasminogen activator, endovascular...
Source: Critical Care Medicine - August 21, 2020 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Detailed severity assessment of Cincinnati Prehospital Stroke Scale to detect large vessel occlusion in acute ischemic stroke
Selecting stroke patients with large vessel occlusion (LVO) based on prehospital stroke scales could provide a faster triage and transportation to a comprehensive stroke centre resulting a favourable outcome. ...
Source: BMC Emergency Medicine - August 24, 2020 Category: Emergency Medicine Authors: Gabor Tarkanyi, Peter Csecsei, Istvan Szegedi, Evelin Feher, Adam Annus, Tihamer Molnar and Laszlo Szapary Tags: Research article Source Type: research

Novel Treatments for Transient Ischemic Attack and Acute Ischemic Stroke
The treatment of acute ischemic stroke is one of the most rapidly evolving areas in medicine. Like all ischemic vascular emergencies, the priority is reperfusion before irreversible infarction. The central nervous system is sensitive to brief periods of hypoperfusion, making stroke a golden hour diagnosis. Although the phrase “time is brain” is relevant today, emerging treatment strategies use more specific markers for consideration of reperfusion than time alone. Innovations in early stroke detection and individualized patient selection for reperfusion therapies have equipped the emergency medicine clinician with mo r...
Source: Emergency Medicine Clinics of North America - November 4, 2020 Category: Emergency Medicine Authors: Matthew S. Siket, Rhonda Cadena Source Type: research

Thrombolysis with alteplase 3 –4.5 hours after acute ischaemic stroke: trial reanalysis adjusted for baseline imbalances
In patients presenting to the emergency department with acute stroke, previous evidence from the Third European Cooperative Acute Stroke Study (ECASS III) recommended alteplase treatment within 3 to 4.5 hours of symptoms onset. Factors taken into consideration in the original report include time to treatment, history of smoking or hypertension, and an adjusted National Institute of Health Stroke Scale (NIHSS) score. However, it is unclear if accounting for history of stroke and baseline differences in NIHSS score on arrival may alter outcomes in patients given alteplase.
Source: The Journal of Emergency Medicine - October 1, 2020 Category: Emergency Medicine Authors: Anne Kathryn Watson, Amanda Young Tags: Abstract Source Type: research

Squamous Cell Carcinoma of the Neck: An Unlikely Stroke Mimic
Stroke mimics are noncerebrovascular conditions that present with classical stroke symptoms. They account for up to 30% of stroke presentations in the emergency department (ED). Emergency physicians are faced with a diagnostic dilemma —rapid treatment of stroke, a leading cause or mortality and morbidity in the United States, or ruling out the ever-growing list of conditions that mimic strokes.
Source: The Journal of Emergency Medicine - October 14, 2021 Category: Emergency Medicine Authors: Vera Obinwanne, Laura Bauler, Dylan Bergeon, Timothy Trichler Source Type: research

Tenecteplase vs. alteplase for acute ischemic stroke: a systematic review
ConclusionsThe available evidence suggests that tenecteplase appears to be a better thrombolytic agent for acute ischemic stroke when compared to alteplase.
Source: International Journal of Emergency Medicine - January 4, 2022 Category: Emergency Medicine Source Type: research