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Specialty: Emergency Medicine
Condition: Stroke

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Total 1739 results found since Jan 2013.

Nonconvulsive status epilepticus masquerading as stroke
This case describes a patient with multiple stroke risk factors—including prior stroke—who presented to the emergency department with symptoms suggestive of stroke and who received a rapid stroke work up but was later found to be in nonconvulsive status epilepticus (NCSE). This case report highlights the challenge and importance of making an accurate diagnosis in NCSE, and we have included teaching points to help clinicians understand the clinical manifestations and diagnosis of NCSE as well as how it may impact a patient's prognosis.
Source: The American Journal of Emergency Medicine - August 28, 2014 Category: Emergency Medicine Authors: Christopher Kennel, Andreas Michas-Martin, Brian D. Berman, Sharon Poisson Tags: Case Report Source Type: research

Factors associated with delayed evaluation of patients with potential stroke in US EDs
The American Heart Association/American Stroke Association guidelines recommend all patients presenting to emergency departments (EDs) with a potential stroke be seen within 10 minutes of arrival, although this may not be achieved in all patients. We sought to identify factors associated with delayed evaluation of ED patients with potential stroke.
Source: The American Journal of Emergency Medicine - August 26, 2014 Category: Emergency Medicine Authors: Jonathan Taylor, Ken Uchino, M. Shazam Hussain, Jestin N. Carlson Tags: Original Contribution Source Type: research

Stroke Incidence and Mortality Trends in us Communities, 1987 to 2011
Stroke is the fourth leading cause of death in the United States and is a major cause of morbidity among adults. Overall, there has been a decrease in stroke incidence in several countries, however, sex- and race-specific data have been inconsistent. In the United States, age-adjusted mortality after stroke has declined by 37% from 1999 to 2009. This decreased mortality was most apparent in white men and least apparent in black men.
Source: The Journal of Emergency Medicine - October 27, 2014 Category: Emergency Medicine Authors: Andrea Stember Tags: Abstract Source Type: research

Diagnostic value of plasma Signal Peptide-Cub-Egf domain-containing protein-1 (SCUBE-1) in an experimental model of acute ischemic stroke
Considering the critical role of early action in management of stroke, there is still a need for a biomarker that would reliably assist in the early diagnosis and patient selection for tissue plasminogen activator (t-PA) therapy, which has provided a considerable success in terms of mortality and morbidity of patients with stroke. This is particularly important if this novel biochemical marker that could give rapid results, specific for brain damage and that can be used in the emergency setting for early diagnosis and differentiation from other conditions that mimics some stroke findings [1,2].
Source: The American Journal of Emergency Medicine - December 2, 2014 Category: Emergency Medicine Authors: Turkmen Suha, Eryigit Umut, Karaca Yunus, Mentese Ahmet, Uzun Sumer Aysegul, Yulug Esin, Aksut Nurhak, Gazioglu Sibel, Gunduz Abdulkadir Tags: Original Contribution Source Type: research

Hospital Variation in Thrombolysis Times Among Patients With Acute Ischemic Stroke: The Contributions of Door-To-Imaging Time And Imaging-To-Needle Time
Prompt administration of intravenous tissue plasminogen activator (TPA) can substantially reduce disability associated with acute ischemic stroke. Practice guidelines recommend administration of TPA within 60 min of hospital arrival for acute ischemic stroke. Despite these guidelines, unfortunately, times until TPA treatment in acute ischemic stroke remain suboptimal.
Source: The Journal of Emergency Medicine - January 24, 2015 Category: Emergency Medicine Authors: Bartholomew Paull Tags: Abstract Source Type: research

Effects of Golden Hour Thrombolysis: A Prehospital Acute Neurological Treatment and Optimization of Medical Care in Stroke (PHANTOM-S) Substudy
The effectiveness of intravenous thrombolysis for acute ischemic stroke is thought to be highest when given during the first hour from onset of symptoms, termed the “golden hour.” In this post hoc analysis of data from the Prehospital Acute Neurological Treatment and Optimization of Medical Care in Stroke (PHANTOM-S) trial, researchers studied the effect of a specialized stroke ambulance (STEMO) on rates of golden hour thrombolysis, 7- and 90-day mortality, secondary intracerebral hemorrhage, and discharge home.
Source: The Journal of Emergency Medicine - May 1, 2015 Category: Emergency Medicine Authors: Taylor Burkholder Tags: Abstract Source Type: research

Safety of Intravenous Thrombolysis in Stroke Mimics: Prospective 5-Year Study and Comprehensive Meta-Analysis
With more emphasis now being placed on reducing door-to-needle times and time to intravenous thrombolysis (IVT) administration in acute ischemic stroke (AIS), there is growing concern about the safety of inadvertently giving IVT to patients with stroke mimics (SMs). The aim of this study was to determine the safety of IVT in SMs. This was a prospective study of consecutive patients treated with IVT at a tertiary care stroke center in Memphis, TN from 2009 to 2013. Initial diagnosis of AIS was compared to discharge diagnosis to identify patients who presented as SMs.
Source: The Journal of Emergency Medicine - June 19, 2015 Category: Emergency Medicine Authors: Andrea Stember Tags: Abstract Source Type: research

Risk factors for medical complications of acute hemorrhagic stroke
Conclusions Our study has assessed that hypertension followed by diabetes mellitus are the major risk factors for medical complications of hemorrhagic stroke. Female mortality rate was more when compared to males.\
Source: Journal of Acute Disease - August 4, 2015 Category: Emergency Medicine Source Type: research

Cerebral oximetry with cerebral blood volume index in detecting pediatric stroke in a pediatric ED
Despite pediatric stroke awareness and pediatric stroke activation systems, recognition and imaging delays along with activation inconsistency still occur. Reliable objective pediatric stroke detection tools are needed to improve detection and activations. Regional cerebral oxygen saturation (rcso2) with cerebral blood volume index (CBVI) can detect abnormal cerebral physiology.
Source: The American Journal of Emergency Medicine - July 22, 2015 Category: Emergency Medicine Authors: Thomas J. Abramo, Z. Leah Harris, Mark Meredith, Kristen Crossman, Rawle Seupaul, Abby Williams, Sheila McMorrow, Jennifer Dindo, Angela Gordon, Maria Melguizo-Castro, Zhuopei Hu, Todd Nick Tags: Original Contribution Source Type: research

Marked regional variation in acute stroke treatment among medicare beneficiaries
The administration of intravenous tissue-type plasminogen activator (tPA) and intra-arterial treatment (IAT) for the treatment of acute ischemic stroke is an ongoing field of debate and optimization in the medical literature. With acute ischemic stroke being a significant cause of morbidity and mortality, especially for the elderly population, the optimal treatment of stroke is an ongoing concern.
Source: The Journal of Emergency Medicine - November 1, 2015 Category: Emergency Medicine Authors: Angela Wright Tags: Abstract Source Type: research

Are all stroke patients eligible for fast alteplase treatment? An analysis of unavoidable delays.
CONCLUSIONS: Up to 31% of patients have delays due to medical or eligibility-related causes that may be legitimate reasons for providing alteplase later than the benchmark time of 60 minutes. This article is protected by copyright. All rights reserved. PMID: 26824684 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - January 29, 2016 Category: Emergency Medicine Authors: Choi PM, Desai JA, Kashyap D, Stephenson C, Kamal N, Vogt S, Bohm V, Suddes M, Bugbee E, Hill MD, Demchuk AM, Smith EE Tags: Acad Emerg Med Source Type: research

A case of stroke during cardiac catheterisation: It's not common, but it is a double whammy!
We report a case of a 57-year-old lady with acute myocardial infarction who developed stroke on the cardiac catheterisation table. The case illustrates the need for a protocol of care, vigilant cardiologist and staff who can recognise the symptoms and signs as well as good collaborative efforts between the cardiology, neurology and, at times, the interventional radiology teams.
Source: Journal of Acute Disease - April 1, 2016 Category: Emergency Medicine Source Type: research

No space left for intravenous thrombolysis in acute stroke: CONS
Abstract Recent successful clinical trials of endovascular thrombectomy for large artery ischaemic stroke have established the value of this treatment modality as an adjunct to intravenous thrombolysis, not as an alternative: thrombectomy delivery was undertaken in the context of highly efficient networks for acute thrombolysis delivery and the great majority of patients received IV thrombolytic drug treatment. Even for the minority of acute stroke patients for whom thrombectomy is potentially relevant, access will be limited by geography and service infrastructure. Developments in intravenous thrombolysis in the ...
Source: Internal and Emergency Medicine - April 14, 2016 Category: Emergency Medicine Source Type: research

Endovascular Therapy Is Effective and Safe for Patients With Severe Ischemic Stroke
Recent studies, including the Interventional Management of Stroke III (IMS III) and Multicenter Randomized Clinical Trial of Endovascular Therapy for Acute Ischemic Stroke in the Netherlands (MR CLEAN), attempted to evaluate the efficacy of intravenous tissue-type plasminogen activator (tPA) treatment alone for acute ischemic stroke versus endovascular therapy after intravenous tPA.
Source: The Journal of Emergency Medicine - April 30, 2016 Category: Emergency Medicine Authors: Jennifer Zhan Source Type: research

Excellance, Inc. Announces Attendance at the 2016 International Mobile Stroke Summit
Excellance Inc, manufacturer of high quality custom ambulances and emergency vehicles, today announced their presence at the 2016 International Mobile Stroke Summit. The event will be held at the InterContinental Hotel and Conference Center in Cleveland, OH from May 20-21, 2016. Excellance, Inc. will have a booth at the event to educate attendees on their Mobile Stroke Treatment Unit (MSTU) designed specifically to cut down the time that it takes to diagnose and treat patients. The Cleveland Clinic purchased their first MSTU from Excellance using telemedicine. The MSTU from Excellance has new on-board technology that inc...
Source: JEMS Operations - May 13, 2016 Category: Emergency Medicine Tags: Industry News Ambulances & Vehicle Ops Source Type: news