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COVID-19 presenting as stroke.
CONCLUSIONS: Timely assessment and hyperacute treatment is the key to minimize mortality and morbidity of patients with acute stroke. Stroke teams should be wary of the fact that COVID-19 patients can present with cerebrovascular accidents and dawn appropriate personal protective equipment in every suspected patient. Further studies are urgently needed for a comprehensive understanding of the neurological pathology of COVID-19 and its effects on the nervous system. PMID: 32360439 [PubMed - as supplied by publisher]
Source: Brain, Behavior, and Immunity - April 27, 2020 Category: Neurology Authors: Avula A, Nalleballe K, Narula N, Sapozhnikov S, Dandu V, Toom S, Glaser A, Elsayegh D Tags: Brain Behav Immun Source Type: research

Emergency room diagnoses of psychogenic nonepileptic seizures with psychogenic status and functional (psychogenic) symptoms: Whopping
Publication date: March 2020Source: Epilepsy & Behavior, Volume 104, Part AAuthor(s): Helene Kholi, Laurent VercueilAbstractCollecting 130 electronic medical records and diagnoses from emergency room stays of eleven patients with confirmed psychogenic nonepileptic seizure (PNES) over a 17-year period (2001–2018), 48 different diagnostic terms were retrieved. This emphasized the need for a consensual terminology encompassing not only PNES but also all functional transient (paroxysmal) events, including episodes of motor or sensory deficits, and cognitive symptoms. Rather than defining what it is not (PNES, stroke mimicksâ...
Source: Epilepsy and Behavior - January 24, 2020 Category: Neurology Source Type: research

Emergency room diagnoses of psychogenic nonepileptic seizures with psychogenic status and functional (psychogenic) symptoms: Whopping.
Abstract Collecting 130 electronic medical records and diagnoses from emergency room stays of eleven patients with confirmed psychogenic nonepileptic seizure (PNES) over a 17-year period (2001-2018), 48 different diagnostic terms were retrieved. This emphasized the need for a consensual terminology encompassing not only PNES but also all functional transient (paroxysmal) events, including episodes of motor or sensory deficits, and cognitive symptoms. Rather than defining what it is not (PNES, stroke mimicks…), it would be more accurate to define what it is: a paroxysmal functional event. PMID: 31982830 [Pub...
Source: Epilepsy and Behaviour - January 22, 2020 Category: Neurology Authors: Kholi H, Vercueil L Tags: Epilepsy Behav Source Type: research

Integration of Real-Time Electronic Health Records and Wireless Technology in a Mobile Stroke Unit
Background: UCHealth's Mobile Stroke Unit (MSU) at University of Colorado Hospital is an ambulance equipped with a computed tomography (CT) scanner and tele-stroke capabilities that began clinical operation in Aurora, Colorado January 2016. As one of the first MSU's in the United States, it was necessary to design unique and dynamic information technology infrastructure. This includes high-speed cellular connectivity, Health Insurance Portability and Accountability Act compliance, cloud-based and remote access to electronic medical records (EMR), and reliable and rapid image transfer.
Source: Journal of Stroke and Cerebrovascular Diseases - July 11, 2019 Category: Neurology Authors: Brandi Schimpf, Kathy Deanda, David A. Severenuk, Tara M. Montgomery, Gregory D. Cooley, Robert G. Kowalski, Daniel Vela-Duarte, William J. Jones Source Type: research

The Predictive Capacity of the Buffalo Concussion Treadmill Test After Sport-Related Concussion in Adolescents
Conclusion This study found that the ΔHR (HRt minus resting HR) correlated with duration of clinical recovery in participants who were prescribed relative rest or a placebo-stretching program but not for participants prescribed sub-threshold aerobic exercise. A ΔHR of ≤50 bpm on the BCTT was 73% sensitive and 78% specific for predicting delayed recovery in concussed adolescents prescribed the current standard of care (i.e., cognitive and physical rest). This has implications for planning team and school activities in adolescents who sustain SRC. Ethics Statement This study was carried out in acco...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Combination of Dexmedetomidine and Ketamine for Magnetic Resonance Imaging Sedation
Conclusions: The efficacy of DEX–KET sedation was comparable to that of midazolam for MRI examination. DEX–KET was related to shorter scan time and lower occurrence of complications compared to midazolam. Introduction Neurocritically ill patients often require brain magnetic resonance imaging (MRI) in addition to conventional neurological evaluations. Brain MRI can reveal structural lesions with a high sensitivity due to its excellent spatial resolution and enhanced soft tissue contrast (1–3). To acquire MRI images, patients' cooperation is imperative. However, keeping patients with ...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Comprehensive risk factor evaluation of postoperative delirium following major surgery: clinical data warehouse analysis
ConclusionsBig data analytics could be applied to evaluate RFs in electronic medical records. We identified common RFs of POD, regardless of operation type. Big data analytics may be helpful for the comprehensive understanding of POD RFs, which can help physicians develop a general plan to prevent POD.
Source: Neurological Sciences - January 24, 2019 Category: Neurology Source Type: research

Mortality and Stroke Recurrence in a Rehabilitation Cohort of Patients with Cerebral Infarcts and Chagas Disease
Conclusions: Cardiac conditions did not correlate with mortality or recurrence. Age was a protective factor against recurrence, probably due to cumulative risk of IS over time, while initial mRS was associated with both outcomes. Treating diseases such as DM and bladder dysfunction, and early treatment to reduce the initial mRS could potentially prevent both outcomes; also, establishing a correct etiological diagnosis is important.Eur Neurol 2018;79:177 –184
Source: European Neurology - March 14, 2018 Category: Neurology Source Type: research

Validation of intracranial hemorrhage in the Norwegian Patient  Registry
ConclusionCoding of ICH discharge diagnoses in the NPR is of high quality, showing that data from this registry can safely be used for medical research. Administrative and clinical health registries are established to monitor and manage healthcare services. Data from these registries can be used in epidemiological studies as they are easily obtained, include high number of patients, and provide both high external validity and statistical power. However, in order to be useful in research, health registries need to have accurate diagnoses and sufficient coverage in the population they serve. We validated coding of intracran...
Source: Brain and Behavior - January 23, 2018 Category: Neurology Authors: Lise R. Øie, Mattis A. Madsbu, Charalampis Giannadakis, Anders Vorhaug, Heidi Jensberg, Øyvind Salvesen, Sasha Gulati Tags: ORIGINAL RESEARCH Source Type: research

Serum 1,5-Anhydroglucitol: Risk Factor of Acute Ischemic Stroke and Transient Ischemic Attack in Well-Controlled Diabetes
Conclusions: Low serum 1,5-AG levels could be a possible marker for AIS/TIA risk in patients with well-controlled DM.Cerebrovasc Dis 2017;44:325 –329
Source: Cerebrovascular Diseases - October 26, 2017 Category: Neurology Source Type: research

Assessment Model to Identify Patients With Stroke With a High Possibility of Discharge to Home Clinical Sciences
Conclusions—We have developed an assessment model for identifying patients with a high possibility of being discharged to their homes after an acute stroke. This model would be useful for health professionals to adequately plan patients’ discharge soon after their admission.
Source: Stroke - September 25, 2017 Category: Neurology Authors: Takahiro Itaya, Yusuke Murakami, Akiko Ota, Eiichi Nomura, Tomoko Fukushima, Masakazu Nishigaki Tags: Epidemiology, Quality and Outcomes Original Contributions Source Type: research

Impact of Neurologist In-Hospital 24/7 on stroke patients arriving to the Emergency Department activated as a Code Stroke (S8.003)
Conclusions:In-hospital 24/7 coverage for acute stroke treatment reduces door to alteplase treatment times significantly. For each minute reduction in a neurologist at the bedside for CS, a 2 minute and 18 second improvement in door to alteplase treatment time occurs. An associated reduction in mortality is also demonstrated. A limitation of this study includes a smaller number of post-implementation data. These data will need on-going monitoring to ensure enduring impact.Disclosure: Dr. Schneider has nothing to disclose. Dr. Jones has received personal compensation for activities with Genentech as a speaker. Dr. Gosnell h...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Schneider, A., Jones, R., Gosnell, J., Snyder, S., Taylor, R. Tags: Cerebrovascular Disease and Interventional Neurology: Acute Stroke Treatment Source Type: research

Age, Gender and Racial Disparities in Acute Stroke Therapy in a Large Non-Academic Health System (P3.261)
Conclusions:We confirmed known disparities in ATT rates between PSC and AH. No disparity in age or gender were identified in this population. Racial disparity was problematic because of a small number of non-white patients and a number of patients with no racial data captured. Better racial data collection, analysis of access to care, and care process modeling might impact these findings.Disclosure: Dr. Taylor has nothing to disclose. Dr. Jones has received personal compensation for activities with Genentech as a speaker. Dr. Gosnell has nothing to disclose. Dr. Snyder has nothing to disclose. Dr. Schneider has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Taylor, R., Jones, R., Gosnell, J., Snyder, S., Schneider, A. Tags: Cerebrovascular Disease Epidemiology Source Type: research

First Diagnosis of Atrial Fibrillation at the Time of Stroke
Conclusions: In this contemporary cohort, nearly one in 5 AF-related strokes occurred without a pre-stroke AF diagnosis. AF was readily diagnosed using standard rhythm monitoring. The vast majority of patients with newly diagnosed AF were at high enough pre-stroke risk to merit anticoagulation. In conclusion, our findings support screening for AF before stroke. Patients with past transient AF may merit more intensive screening.Cerebrovasc Dis 2017;43:192-199
Source: Cerebrovascular Diseases - February 16, 2017 Category: Neurology Source Type: research

LDL and Systolic Blood Pressure Are Associated with Coated-Platelet Levels in Patients with Asymptomatic Carotid Atherosclerosis (P1.235)
Conclusions: In asymptomatic patients with carotid atherosclerosis, higher LDL and lower SBP were associated with increased coated-platelet levels. The relationship between LDL and coated-platelet levels is consistent with the recognized role of hypercholesterolemia in cardiovascular disease. The significance of the association between lower SBP and higher coated-platelet levels is less clear. These findings should be confirmed in prospective studies. Supported by grants from the American Heart Association and Clinical Science Research & Development Service (CX000340).Disclosure: Dr. Kirkpatrick has nothing to disclose...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Kirkpatrick, A., Nguyen, N., Vincent, A., Guthery, L., Mathews, E., Malatinszky, G., Donna-Ferreira, F., Dale, G., Prodan, C. Tags: Carotid Disease Source Type: research

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