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Specialty: Neurology
Source: Der Nervenarzt

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Total 213 results found since Jan 2013.

Diabetes and the central nervous system.
Abstract Diabetes increases the risk of stroke by a factor of 2-4. For primary and secondary stroke prevention, strict glycemic control alone was not superior to standard treatment. However, the risk of stroke in patients with diabetes could be reduced by multimodal risk interventions during the last 20 years by about 50%. Increased glucose levels (poststroke hyperglycemia (PSH)) which indicate a worse prognosis develop in 50% of stroke patients. The potentially beneficial effect of strict glycemic control in PSH by i. v. insulin was neutralized by negative effects of an increased rate of hypoglycemic episode...
Source: Der Nervenarzt - April 12, 2017 Category: Neurology Authors: Erbguth F Tags: Nervenarzt Source Type: research

Guideline conform diagnostics for dysphagia : A  representative survey of speech therapists at certified stroke units in Germany.
CONCLUSION: The implementation of a detailed and differentiated anamnesis, standardized screening, and a clinical swallowing examination with testing of different food consistencies suggests a high quality of the dysphagia diagnostics at stroke units in Germany. The increasing availability of technical instruments, especially fiber endoscopy, substantiates this view. PMID: 28382486 [PubMed - as supplied by publisher]
Source: Der Nervenarzt - April 5, 2017 Category: Neurology Authors: Flader CM, Rosendahl C, Günther T Tags: Nervenarzt Source Type: research

Availability of mechanical thrombectomy for acute stroke : Analysis of the health care reality in Germany.
CONCLUSION: Due to a narrow net of certified stroke units with nationwide availability of STL, excellent structural conditions for treatment of acute stroke patients are already established in Germany. With regard to the nationwide availability of MT, there is still a need for optimization. Despite the increasing number of hospitals providing MT as an emergency procedure, a trend toward large intervention centers with supraregional catchment areas can be observed. PMID: 28382485 [PubMed - as supplied by publisher]
Source: Der Nervenarzt - April 5, 2017 Category: Neurology Authors: Krogias C, Bartig D, Kitzrow M, Brassel F, Busch EW, Nolden-Koch M, Reimann G, Weimar C, Weber R, Eyding J Tags: Nervenarzt Source Type: research

Medical care of patients with spasticity following stroke : Evaluation of the treatment situation in Germany with focus on the use of botulinum toxin.
DISCUSSION: Due to a response rate of 37% for the postal survey a selection bias cannot be excluded. Although botulinum toxin is recommended in the national treatment guidelines, many neurologists do not use botulinum toxin. The reasons can be seen from the barriers described. PMID: 28289789 [PubMed - as supplied by publisher]
Source: Der Nervenarzt - March 12, 2017 Category: Neurology Authors: Kerkemeyer L, Lux G, Walendzik A, Wasem J, Neumann A Tags: Nervenarzt Source Type: research

Direct oral anticoagulants and acute stroke : Insights into translational research studies.
Abstract In recent years a considerable number of translational research studies on intracerebral hemorrhage and ischemic stroke have been published, which are characterized by a particular proximity to practical clinical questions. Animal research has provided insights into the pathophysiological processes and therapy effects, which have so far only been insufficiently investigated in clinical studies. This includes the effectiveness of a rapid reversal of anticoagulation in cases of anticoagulation-associated intracerebral hemorrhage and the safety of thrombolytic treatment in ischemic stroke occurring during...
Source: Der Nervenarzt - February 9, 2017 Category: Neurology Authors: Foerch C, Schäfer JH, Pfeilschifter W, Bohmann F Tags: Nervenarzt Source Type: research

Juvenile stroke - what is important?
Abstract Stroke in young adults is a diagnostic and therapeutic challenge for all persons involved. Approximately 15% of ischemic strokes occur in young adults. Lack of awareness of the symptoms in emergency departments often results in delayed diagnosis and access to specific therapeutic options, such as revascularization. The causes are often heterogeneous and necessitate specific investigations. The etiology of juvenile stroke includes drug abuse, vasculitis and arteriopathies, such as reversible vasoconstriction syndrome and posterior reversible encephalopathy syndrome, although the prevalence of classical va...
Source: Der Nervenarzt - February 9, 2017 Category: Neurology Authors: Fischer M, Eckert B, Röther J Tags: Nervenarzt Source Type: research

Home-based telerehabilitation after stroke.
Abstract The use of modern information and telecommunication technologies enables telerehabilitation of neurological deficits in the domestic environment. The current state of studies on rehabilitative teletherapy for improvement of motor function and mobility deficits due to stroke is reviewed. Two neurolinguistic proof of concept studies investigating the efficacy of online interactive telespeech therapy are reported, which compared virtual screen to screen interactive telerehabilitation of aphasia after stroke and dysarthrophonia in Parkinson's disease to conventional face to face rehabilitation. The results of...
Source: Der Nervenarzt - January 17, 2017 Category: Neurology Authors: Keidel M, Vauth F, Richter J, Hoffmann B, Soda H, Griewing B, Scibor M Tags: Nervenarzt Source Type: research

Telemedical prenotification in acute stroke treatment : Experiences from the Stroke Angel initiative from 2004 until the present.
CONCLUSION: Telemedicine is applicable in the preclinical care of acute stroke and, thanks to the computer-based data collection, leads to an increase in process transparency, which helps to improve the internal clinical processes in and around a stroke unit. PMID: 28084499 [PubMed - as supplied by publisher]
Source: Der Nervenarzt - January 12, 2017 Category: Neurology Authors: Soda H, Ziegler V, Shammas L, Griewing B, Kippnich U, Keidel M, Rashid A Tags: Nervenarzt Source Type: research

Telemedicine: Comprehensive coverage and quality - Not a contradiction : Practical experience from the stroke network with telemedicine in northern Bavaria (STENO).
Abstract Telemedicine is widely used in the field of stroke treatment. Following the pioneering and implementation phase, the quality of the whole stroke treatment process needs to be ensured in telemedically connected hospitals. This is particular important for telestroke hospitals without neurological expertise and can be achieved by integrating telemedicine into the stroke unit concept and stroke networks. The Stroke Network with Telemedicine in Northern Bavaria (STENO) provides an example of how quality management can be practically implemented. The implementation of STENO has established a network-wide quali...
Source: Der Nervenarzt - January 11, 2017 Category: Neurology Authors: Breuer L, Erbguth F, Oschmann P, Schwab S Tags: Nervenarzt Source Type: research

Mission (im)possible : Setting up a  neurological center 12,000 km away with telemedicine.
CONCLUSION: The project has shown that it is possible to convey specialized neurological knowledge over large distances to provide significant benefits for patients and caregivers. PMID: 28083684 [PubMed - as supplied by publisher]
Source: Der Nervenarzt - January 11, 2017 Category: Neurology Authors: Meyding-Lamadé U, Craemer EM, Lamadé EK, Bassa B, Enk K, Ilsen H, Jacobi C, Jost V, Lorenz MW, Mohs C, Schwark C, Zimmerlein B, Gottschalk T, Hacke W, Kress B Tags: Nervenarzt Source Type: research

Management of dysphagia in acute stroke : A  prospective study for validation of current recommendations.
CONCLUSION: Clinical screening alone is not sufficient to identify patients at risk for aspiration pneumonia. The FEES should be used at a low threshold in cases of severe stroke and minor clinical abnormalities, especially concerning isolated dysarthria and cough after swallowing water; therefore, current recommendations should be correspondingly modified. PMID: 28074215 [PubMed - as supplied by publisher]
Source: Der Nervenarzt - January 9, 2017 Category: Neurology Authors: Lindner-Pfleghar B, Neugebauer H, Stösser S, Kassubek J, Ludolph A, Dziewas R, Prosiegel M, Riecker A Tags: Nervenarzt Source Type: research

New aspects of neurorehabilitation: motor and language.
Abstract Advancements in medical care over the last decades have contributed to a continuous decline in immediate post-stroke mortality. The flipside of this development is that patients surviving the initial stroke are forced to live with sometimes extreme functional motor and/or language limitations for the remaining life span. The following overview presents evidence-based neurorehabilitative interventions to promote motor and language recovery in the acute and chronic post-stroke stages. Therapeutic approaches comprise intensive training, neuropharmacological drugs and non-invasive brain stimulation technique...
Source: Der Nervenarzt - November 16, 2016 Category: Neurology Authors: Liepert J, Breitenstein C Tags: Nervenarzt Source Type: research

Tracer diagnosis stroke.
PMID: 27798734 [PubMed - as supplied by publisher]
Source: Der Nervenarzt - October 30, 2016 Category: Neurology Authors: Röther J, Dichgans M, Bohn A, Fischer M, Kehrberger E, Moecke H, Prückner S, Trentzsch H, Urban B, Marung H Tags: Nervenarzt Source Type: research

Posttraumatic stress disorder : Trigger and consequence of vascular diseases.
Abstract Posttraumatic stress disorder (PTSD) was previously thought to be a psychological reaction precipitated by exposure to war, sexual and physical violence; however, PTSD is also prevalent after life-threatening medical events, such as stroke and myocardial infarction. After such events PTSD is often underdiagnosed despite the fact that it is clearly associated with adverse clinical outcomes including recurrence of cardiac events and increased mortality. Moreover, PTSD increases the risk of vascular events. This review summarizes the bidirectional relationship between PTSD and vascular diseases and outlines...
Source: Der Nervenarzt - October 16, 2016 Category: Neurology Authors: Schöner J, Kronenberg G, Heinz A, Endres M, Gertz K Tags: Nervenarzt Source Type: research

Aphasia: evidence-based therapy approaches.
Abstract Speech and language therapy is essential in the rehabilitation of aphasic disorders following a stroke. Due to the predicted increase of aphasia and limited resources within the healthcare system, the development of efficient and sustainable treatment methods is of exceptional importance. The effectiveness of both traditional and innovative approaches needs to be evaluated against the standards of evidence-based medicine. Class I evidence has been established for high-intensity speech and language therapy in subacute and chronic stages of aphasia. Innovative training-based approaches have so far only bee...
Source: Der Nervenarzt - September 19, 2016 Category: Neurology Authors: Darkow R, Flöel A Tags: Nervenarzt Source Type: research