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Specialty: Emergency Medicine
Condition: Hemorrhagic Stroke

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Total 233 results found since Jan 2013.

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

Does Preexisting Antiplatelet Treatment Influence Postthrombolysis Intracranial Hemorrhage in Community-treated Ischemic Stroke Patients? An Observational Study.
CONCLUSIONS: The authors did not find that preexisting antiplatelet use was associated with postthrombolysis ICH or sICH in this cohort of community treated patients. Preexisting tobacco use, younger age, and lower severity were associated with lower odds of sICH. The meta-analyses demonstrated small, but statistically significant increases in the absolute risk of radiographic ICH and sICH, along with increased odds of sICH in patients with preexisting antiplatelet use. PMID: 23406073 [PubMed - in process]
Source: Accident and Emergency Nursing - February 1, 2013 Category: Emergency Medicine Authors: Meurer WJ, Kwok H, Skolarus LE, Adelman EE, Kade AM, Kalbfleisch J, Frederiksen SM, Scott PA Tags: Acad Emerg Med Source Type: research

Dental Prophylaxis and Periodontal Treatment are Protective Factors to Ischemic Stroke: Lee YL, Hu HY, Huang N, et al. Stroke 2013;44:1026–30.
This study was a retrospective cohort study comparing treatment groups for PD and subsequent risk for ischemic stroke utilizing the Taiwanese National Health Insurance Research Database.
Source: The Journal of Emergency Medicine - June 29, 2013 Category: Emergency Medicine Authors: Elaine Reno Tags: Abstracts 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

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

Review article: Why is there still a debate regarding the safety and efficacy of intravenous thrombolysis in the management of presumed acute ischaemic stroke? A systematic review and meta ‐analysis
ConclusionsThere is clear evidence of increased early mortality, increased rates of symptomatic intracranial haemorrhage and also of improved functional outcomes for patients with presumed acute ischaemic stroke treated with thrombolysis. The available data are unlikely to resolve the controversy regarding the use of intravenous thrombolysis in this population, and further randomised controlled trials are urgently required.
Source: Emergency Medicine Australasia - July 31, 2016 Category: Emergency Medicine Authors: Lachlan Donaldson, Emily Fitzgerald, Oliver Flower, Anthony Delaney Tags: Review Article Source Type: research

Prehospital Systolic Blood Pressure is Higher in Acute Stroke Compared with Stroke Mimics
Elevated blood pressure (BP) in patients with acute stroke is common and associated with poor outcomes. Previous, limited data suggests that acute BP reduction improves outcomes after intracerebral hemorrhage (ICH). Recent pilot studies have suggested pre-hospital BP lowering strategies but at this point pre-hospital blood pressure in patients with acute stroke are poorly understood.
Source: The Journal of Emergency Medicine - August 31, 2016 Category: Emergency Medicine Authors: Katherine Wurlitzer Source Type: research

Blood Pressure Management Goals in Stroke Care
Blood pressure management goals in stroke care You arrive at a small rural emergency healthcare facility to transport a 72-year-old female who presents to the ED with the worst headache of her life. She’s to be transported to a tertiary center with neurosurgical services. Upon further questioning you determine her headache was sudden onset with maximum intensity. When reviewing her history and medications, you note that she’s currently on Coumadin (warfarin) with an international normalized ratio (INR) of 3.5, with the following vital signs noted on the monitor upon entering the room: blood pressure of 209/75 mmHg; hea...
Source: JEMS Patient Care - May 1, 2018 Category: Emergency Medicine Authors: Ken Davis, BA, EMT-P, FP-C Tags: Patient Care Cardiac & Resuscitation Source Type: news

Imaging in neurointerventional stroke treatment: review of the recent trials and what your neurointerventionalist wants to know from emergency radiologists
This article summarizes the use of imaging in recent stroke trials in details, provides a stroke imaging protocol, and provides tips which radiologists should know to help their neurointerventionalists.
Source: Emergency Radiology - December 14, 2018 Category: Emergency Medicine Source Type: research

Modern Neuroimaging Techniques in Diagnosing Transient Ischemic Attack and Acute Ischemic Stroke
Neuroimaging should be obtained for all patients suspected of having acute ischemic stroke or transient ischemic attack. Noncontrast head computed tomography (CT) scans are used to exclude hemorrhage, evaluate for early brain injury, and exclude stroke mimics. CT angiography assists in identifying proximal vessel occlusions, dissection, or high-grade arterial stenoses. Additional imaging techniques have emerged to improve selection of patients likely to benefit from therapies. Artificial intelligence applications assist in acute stroke imaging assessment, identifying acute hemorrhage, and predicting risk of endovascular in...
Source: Emergency Medicine Clinics of North America - November 18, 2020 Category: Emergency Medicine Authors: Karen Greenberg, Julie Bykowski Source Type: research

Does Preexisting Antiplatelet Treatment Influence Postthrombolysis Intracranial Hemorrhage in Community‐treated Ischemic Stroke Patients? An Observational Study
ConclusionsThe authors did not find that preexisting antiplatelet use was associated with postthrombolysis ICH or sICH in this cohort of community treated patients. Preexisting tobacco use, younger age, and lower severity were associated with lower odds of sICH. The meta‐analyses demonstrated small, but statistically significant increases in the absolute risk of radiographic ICH and sICH, along with increased odds of sICH in patients with preexisting antiplatelet use. Resumen ¿Influye el Tratamiento Antiagregante Previo en la Hemorragia Intracraneal tras la Trombolisis en los Pacientes con Ictus Isquémicos Tratados en...
Source: Academic Emergency Medicine - February 13, 2013 Category: Emergency Medicine Authors: William J. Meurer, Heemun Kwok, Lesli E. Skolarus, Eric E. Adelman, Allison M. Kade, Jack Kalbfleisch, Shirley M. Frederiksen, Phillip A. Scott Tags: Original Research Contribution Source Type: research

Good outcome after intravenous thrombolysis for acute stroke in a patient under treatment with dabigatran
We describe an unusual case of treatment IV rt-PA for acute ischemic stroke in a patient receiving dabigatran for AF.
Source: The American Journal of Emergency Medicine - April 18, 2014 Category: Emergency Medicine Authors: Cátia Diogo, Josiana Duarte, Sofia Sobral, Paula Pestana, Hipólito Nzwalo, Henrique Rita, José Sousa e Costa Tags: Case Report Source Type: research

Evaluation and Management of the Child With Suspected Acute Stroke
Pediatric stroke occurs at an incidence of 1.6 to 13/100 000 and may be acute ischemic, hemorrhagic, or of sinus venous thrombosis etiology. As these children present to the emergency department, early consideration for this diagnosis is paramount in beginning medical management to optimize cerebral perfusion and minimize secondary injury. There are many identified risk factors in pediatric stroke including arteriopathies, cardiac disease (specifically congenital heart disease), and infection. Modifiable adult risk factors including hypertension, hyperlipidemia, and diabetes are rarely seen in pediatrics.
Source: Clinical Pediatric Emergency Medicine - February 4, 2015 Category: Emergency Medicine Authors: Lindsey Morgan Source Type: research

Rupture of an Occult Intracranial Mycotic Aneurysm after Intravenous Thrombolysis with Recombinant Tissue Plasminogen Activator for Acute Ischemic Stroke
We present a case of a stroke patient who was an appropriate candidate and was treated with rtPA who experienced a fatal subarachnoid hemorrhage due to a ruptured mycotic aneurysm (MA).
Source: The Journal of Emergency Medicine - October 6, 2017 Category: Emergency Medicine Authors: Jared Glenn, Margaret Strecker-McGraw, Ian McGraw, Karim Jabbar, Nathan A. James, C. Keith Stone Tags: Selected Topics: Neurological Emergencies Source Type: research