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Drug: Activase
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Total 37 results found since Jan 2013.

Clinical Utility of Electronic Alberta Stroke Program Early Computed Tomography Score Software in the ENCHANTED Trial Database Clinical Sciences
Background and Purpose—Clinical utility of electronic Alberta Stroke Program Early CT Score (e-ASPECTS), an automated system for quantifying signs of infarction, was evaluated in a large database of thrombolyzed patients with acute ischemic stroke.Methods—All baseline noncontrast computed tomographic scans of patients with anterior circulation acute ischemic stroke who participated in the alteplase dose arm of the randomized controlled trial ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study) were reviewed; poor quality and large (>6 mm) slice thickness were excluded. Included scans had e-ASPECTS...
Source: Stroke - May 25, 2018 Category: Neurology Authors: Simon Nagel, Xia Wang, Cheryl Carcel, Thompson Robinson, Richard I. Lindley, John Chalmers, Craig S. Anderson Tags: Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

Improving Door-to-Needle Times for Acute Ischemic Stroke: Effect of Rapid Patient Registration, Moving Directly to Computed Tomography, and Giving Alteplase at the Computed Tomography Scanner Original Articles
Conclusions— Taking the patient to CT on the emergency medical services stretcher, registering the patient as unknown, STAT stroke protocol, and administering alteplase in CT are associated with lower DTN time.
Source: Circulation: Cardiovascular Quality and Outcomes - January 16, 2017 Category: Cardiology Authors: Kamal, N., Holodinsky, J. K., Stephenson, C., Kashayp, D., Demchuk, A. M., Hill, M. D., Vilneff, R. L., Bugbee, E., Zerna, C., Newcommon, N., Lang, E., Knox, D., Smith, E. E. Tags: Quality and Outcomes, Ischemic Stroke Original Articles Source Type: research

Protocol for the perfusion and angiography imaging sub‐study of the Third International Stroke Trial (IST‐3) of alteplase treatment within six‐hours of acute ischemic stroke
RationaleIntravenous thrombolysis with recombinant tissue Plasminogen Activator improves outcomes in patients treated early after stroke but at the risk of causing intracranial hemorrhage. Restricting recombinant tissue Plasminogen Activator use to patients with evidence of still salvageable tissue, or with definite arterial occlusion, might help reduce risk, increase benefit and identify patients for treatment at late time windows. AimsTo determine if perfusion or angiographic imaging with computed tomography or magnetic resonance help identify patients who are more likely to benefit from recombinant tissue Plasminogen Ac...
Source: International Journal of Stroke - January 22, 2013 Category: Neurology Authors: Joanna M. Wardlaw, Rudiger Kummer, Trevor Carpenter, Mark Parsons, Richard I. Lindley, Geoff Cohen, Veronica Murray, Adam Kobayashi, Andre Peeters, Francesca Chappell, Peter A. G. Sandercock Tags: Protocols 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

Intra-Arterial Therapy and Post-Treatment Infarct Volumes: Insights From the ESCAPE Randomized Controlled Trial Clinical Sciences
Conclusions— These results support the primary results of the ESCAPE trial and show that the biological underpinning of the success of endovascular therapy is a reduction in infarct volume. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01778335.
Source: Stroke - February 22, 2016 Category: Neurology Authors: Al-Ajlan, F. S., Goyal, M., Demchuk, A. M., Minhas, P., Sabiq, F., Assis, Z., Willinsky, R., Montanera, W. J., Rempel, J. L., Shuaib, A., Thornton, J., Williams, D., Roy, D., Poppe, A. Y., Jovin, T. G., Sapkota, B. L., Baxter, B. W., Krings, T., Silver, F Tags: Imaging, Quality and Outcomes, Ischemic Stroke Clinical Sciences Source Type: research

Predicting Stroke Outcome Using Clinical- versus Imaging-based Scoring System
Several models to predict outcome in ischemic stroke patients receiving intravenous (i.v.) alteplase can be divided into clinical-based and imaging-based systems. Alberta Stroke Program Early Computed Tomography (CT) Score (ASPECTS) and Dense cerebral artery sign/early infarct signs on admission CT scan, prestroke modified Rankin Scale (mRS) score, Age, Glucose level at baseline, Onset-to-treatment time, and baseline National Institutes of Health Stroke Scale score (DRAGON) are typical imaging- and clinical-based scoring systems, respectively.
Source: Journal of Stroke and Cerebrovascular Diseases - January 6, 2015 Category: Neurology Authors: Joon Hyun Baek, Kitae Kim, Yeong-Bae Lee, Kee-Hyung Park, Hyeon-Mi Park, Dong-Jin Shin, Young Hee Sung, Dong Hoon Shin, Oh Young Bang Source Type: research

Tenecteplase in ischemic stroke offers improved recanalization: Analysis of 2 trials
Conclusions: Tenecteplase may offer greater recanalization efficacy compared to alteplase, possibly exaggerated in patients with complete vessel occlusions on baseline CTA.
Source: Neurology - July 3, 2017 Category: Neurology Authors: Bivard, A., Huang, X., Levi, C. R., Spratt, N., Campbell, B. C. V., Cheripelli, B. K., Kalladka, D., Moreton, F. C., Ford, I., Bladin, C. F., Davis, S. M., Donnan, G. A., Muir, K. W., Parsons, M. W. Tags: CT, MRI, All Cerebrovascular disease/Stroke, Infarction ARTICLE Source Type: research

Stroke Care: A Balanced Approach to the tPA Debate
In conclusion, alteplase is the only treatment available for acute ischemic stroke that is effective in some patients. In order to improve tPA effectiveness and minimize risks, patients with symptoms suggestive of an AIS should get rapid assessment and treatment with tPA after careful review of the contraindications. Given that smaller strokes can still be associated with considerable long term neurological morbidity, treatment should still be considered in those patients after weighing the risks and benefits and in consultation with the patient and family. Advanced age should also not be a limiting factor. Although the NI...
Source: EPMonthly.com - December 31, 2016 Category: Emergency Medicine Authors: Logan Plaster Tags: Uncategorized Source Type: news

Frequency of Hemorrhage on Follow Up Imaging in Stroke Patients Treated With rt-PA Depending on Clinical Course
Conclusions: Frequency of hemorrhagic transformation in Routine follow-up brain imaging and consecutive changes in therapeutic management were different depending on clinical course measured by NHISS score. Introduction Brain imaging 24–36 h after systemic thrombolysis for acute ischemic stroke is recommended in American Stroke Association and European Stroke Organization guidelines (1, 2). Brain imaging is performed to detect secondary bleeding or hemorrhagic transformation in order to adapt medical stroke prevention if necessary. Guideline recommendations are based on the results of the first study on rt-PA...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Influence of Sex on Stroke Prognosis: A Demographic, Clinical, and Molecular Analysis
Conclusion Our data suggest that women who suffer from IS present with a poorer functional outcome than men at 3-months, regardless of other preclinical and clinical factors during the acute phase. These relationships seem to be mediated by atrial dysfunction and inflammation. The inflammatory response is slightly higher in women; however, there are no sex differences in their functional behavior. There is a probable relationship between the molecular marker of atrial dysfunction NT-proBNP and worse functional outcome in women, and the connection seems to be more important in cardioembolic stroke patients. In patients wi...
Source: Frontiers in Neurology - April 16, 2019 Category: Neurology Source Type: research

Lori’s Stroke Required Help From Doctors An Hour Away. Telemedicine Provided It.
Editor’s note: Our previous stories this American Stroke Month featured warning signs heeded and missed. Today we shift gears to showcase a textbook response to a stroke, including the crucial role of telestroke, a way for experts at another facility to help care for a patient via a webcam-type connection. The CHRONIC Care Act, which includes a provision to require Medicare to cover telestroke, will be discussed Tuesday during a hearing of the Senate Finance Committee. Lori Hoopingarner savored her occasional weekend getaway. Between running her financial advising company, raising a 10-year-old daughter and 6-year-old s...
Source: Healthy Living - The Huffington Post - May 15, 2017 Category: Consumer Health News Source Type: news

Memphis Mobile Stroke Unit Saves Lives
A year after a mobile stroke unit hit the streets of Memphis, officials say it is saving lives by cutting the time it takes to treat stroke patients. The University of Tennessee Health Science Center began using the 14-ton ambulance last year as part of a three-year controlled study. The unit has a CT scanner that can X-ray images of the brain, and is equipped to provide early fluids to stroke patients and dye blood vessels to determine the type of stroke the patient has had. "The emergency room on average takes 40 to 50 minutes to do the things we do in 13 to 14 minutes," said Dr.Andrei Alexandrov, UTHSC neurolo...
Source: JEMS: Journal of Emergency Medical Services News - June 10, 2017 Category: Emergency Medicine Authors: Olivia Peterkin, The Commercial Appeal Tags: News Mobile Integrated Healthcare Source Type: news

Management of Acute Ischemic Stroke-Specific Focus on Anesthetic Management for Mechanical Thrombectomy.
Abstract Acute ischemic stroke is a neurological emergency with a high likelihood of morbidity, mortality, and long-term disability. Modern stroke care involves multidisciplinary management by neurologists, radiologists, neurosurgeons, and anesthesiologists. Current American Heart Association/American Stroke Association (AHA/ASA) guidelines recommend thrombolytic therapy with intravenous (IV) alteplase within the first 3-4.5 hours of initial stroke symptoms and endovascular mechanical thrombectomy within the first 16-24 hours depending on specific inclusion criteria. The anesthesia and critical care provider may b...
Source: Anesthesia and Analgesia - July 6, 2020 Category: Anesthesiology Authors: Businger J, Fort AC, Vlisides PE, Cobas M, Akca O Tags: Anesth Analg Source Type: research

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