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Specialty: Emergency Medicine
Condition: Hemorrhagic Stroke
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Total 233 results found since Jan 2013.
Neurologic Injury in Adults Supported With Veno-Venous Extracorporeal Membrane Oxygenation for Respiratory Failure: Findings From the Extracorporeal Life Support Organization Database
Objectives: To assess in-hospital neurologic (CNS) complications in adult patients undergoing veno-venous extracorporeal membrane oxygenation for respiratory failure.
Design: Retrospective analysis of the Extracorporeal Life Support Organization’s data registry.
Setting: Data reported to Extracorporeal Life Support Organization from 350 international extracorporeal membrane oxygenation centers during 1992–2015.
Patients: Adults (≥ 18 yr old) supported with veno-venous extracorporeal membrane oxygenation for respiratory failure.
Interventions: None.
Measurements and Main Results: We included 4,988 adults supporte...
Source: Critical Care Medicine - July 15, 2017 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research
Systemic Thrombolysis, Catheter ‐Directed Thrombolysis, and Anticoagulation for Intermediate‐risk Pulmonary Embolism: A Simulation Modeling Analysis
ConclusionIn our model, for those eligible, CDT results in the largest number of QALYs for patients with intermediate‐risk PE, although it is relatively expensive and the absolute difference in QALYs between anticoagulation alone and CDT is small. Future studies that provide data on longitudinal quality‐of‐life outcomes of patients treated for PE and characteristics of CDT would be beneficial to augment model inputs, inform assumptions, and validate results.
Source: Academic Emergency Medicine - September 13, 2017 Category: Emergency Medicine Authors: Christopher Kabrhel, Ayman Ali, Jin G. Choi, Chin Hur Tags: Original Contribution Source Type: research
Outcomes in syncope research: a systematic review and critical appraisal
We present a critical analysis of the pros and cons of the commonly considered outcomes, and provide possible solutions to improve their choice in ED syncope studies. We also support global initiatives to promote the standardization of patient management and data collection.
Source: Internal and Emergency Medicine - January 18, 2018 Category: Emergency Medicine Source Type: research
Severe Symptoms, but a Truly Treatable Disease
BY NOURA MAHDI; DARRON LEWIS; JEREMY OSBORNE; & AHMED RAZIUDDIN, MDA 73-year-old man was brought to the emergency department from his nursing home for rectal bleeding and anemia. The patient mentioned he had had episodes of bright red rectal bleeding and constipation for a few months. A colonoscopy had been done prior to the visit, which revealed a large intestine tumor and biopsy confirming adenocarcinoma. He was awaiting an appointment with his surgeon.The patient reported bloody rectal leakage, and a CBC done at the nursing home showed a hemoglobin level of 7.2. He also complained of dyspnea but denied any other ...
Source: The Case Files - March 20, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research
Sonographic diameter of optic nerve sheath in differentiation of ischemic and hemorrhagic strokes; a diagnostic accuracy study
Differentiating between ischemic and hemorrhagic types is of special importance in the treatment process of patients with stroke. The present study was designed with the aim of evaluating the diagnostic accuracy of ultrasonographic optic nerve sheath diameter (ONSD) in differentiation of ischemic from hemorrhagic stroke.
Source: The American Journal of Emergency Medicine - August 17, 2018 Category: Emergency Medicine Authors: Mohammad Manouchehrifar, Masoumeh Lakestani, Parvin Kaskani, Saeed Safari Source Type: research
Brain Emergency Management Initiative for Optimizing Hub–Helicopter Emergency Medical Systems–Spoke Transfer Networks
ConclusionIn our hub–helicopter emergency medical services–spoke telestroke network, BEMI led to improved evaluation times. BEMI may serve as a model for future rapid stroke transfer pathways.
Source: Air Medical Journal - November 2, 2019 Category: Emergency Medicine Source Type: research
Remote Ischemic Conditioning in Emergency Medicine—Clinical Frontiers and Research Opportunities
Time-critical acute ischemic conditions such as ST-elevation myocardial infarction and acute ischemic stroke are staples in Emergency Medicine practice. While timely reperfusion therapy is a priority, the resultant acute ischemia/reperfusion injury contributes to significant mortality and morbidity. Among therapeutics targeting ischemia/reperfusion injury (IRI), remote ischemic conditioning (RIC) has emerged as the most promising.
RIC, which consists of repetitive inflation and deflation of a pneumatic cuff on a limb, was first demonstrated to have protective effect on IRI through various neural and humoral mechanisms. It...
Source: Shock - February 12, 2020 Category: Emergency Medicine Tags: Review Articles Source Type: research
Delayed vertebral artery dissection after mild trauma in a motor vehicle collision
We present the case of a 42-year-old patient who presented to the emergency department with diaphoresis and a complaint of neck pain one month after a low speed motor vehicle collision. The patient was transferred to a stroke center where cerebral angiography showed severe vertebral artery stenosis with likelihood of dissection after a noncontrast CT was negative for hemorrhage.
Source: The American Journal of Emergency Medicine - November 16, 2020 Category: Emergency Medicine Authors: Gregory Kacprzynski, Joshua Bucher, Gregory Nicholas Kacprzynski, Joshua Bucher Source Type: research
Utilization of lysis percentage via thromboelastography for tissue plasminogen activator-induced symptomatic intracranial hemorrhage
Alteplase, the only FDA approved tissue plasminogen activator (tPA), remains one of the cornerstones of acute ischemic stroke (AIS) management. Just as with endogenous tPA, recombinant tPA promotes the activation of plasmin and the subsequent degradation of cross-linked fibrin to fibrin byproducts [1]. The most feared complication of recombinant tPA administration is the development of symptomatic intracranial hemorrhage (sICH), which occurs in approximately 5.6% of tPA administrations, utilizing the European Cooperative Acute Stroke Study definition, with roughly half of these cases resulting in death [2].
Source: The American Journal of Emergency Medicine - January 16, 2021 Category: Emergency Medicine Authors: Brian W. Gilbert, J. Spencer Dingman, Joel B. Huffman Source Type: research
Case studies in prehospital care from London HEMS: pre-hospital administration of prothrombin complex concentrate to the head-injured patient
A case of pre-hospital administration of prothrombin complex concentrate to a patient anticoagulated with warfarin and with suspected intracranial haemorrhage is described. Effective, early reversal of anticoagulation by the time of arrival at hospital was achieved.
Source: Emergency Medicine Journal - February 13, 2013 Category: Emergency Medicine Authors: Lendrum, R. A., Kotze, J.-P., Lockey, D. J., Weaver, A. E. Tags: Drugs: cardiovascular system, Stroke Cases from hems Source Type: research
Subconjunctival hemorrhage in a patient on dabigatran (Pradaxa)
Dabigatran is a direct thrombin inhibitor that has gained increasing popularity for prevention of thromboembolic events such as stroke, pulmonary embolism, and myocardial ischemia. Because of the increasing use of this drug, emergency department (ED) physicians are going to be evaluating patients taking this medication. It is important to understand the potential for ocular bleeding complications associated with this class of anticoagulant. Traditionally, patients have been placed on vitamin K antagonists to decrease the risk of thromboembolism. In the RE-LY and RE-COVER studies, dabigatran showed non-inferiority to coumad...
Source: The American Journal of Emergency Medicine - September 24, 2012 Category: Emergency Medicine Authors: Tam M. Nguyen, Michael P. Phelan, Xiang Q. Werdich, Paul J. Rychwalski, Christopher M. Huff Tags: Case Reports Source Type: research
Transient ischemic attack in hereditary hemorrhagic telangiectasia
We describe the case of a 53-year-old woman with a previous history of recurrent epistaxis, admitted to our unit for a transient episode of diplopia and unbalance. Cerebrovascular screening showed the presence of a right to left shunt at saline contrast transcranial Doppler, related to 3 PAVMs detected by subsequent chest computed tomographic scan. Genetic screening evidenced deletion in endoglin gene (ENG), suggesting diagnosis of HHT type 1. Secondary cerebrovascular prevention with antithrombotic therapy was early stopped for the worsening of epistaxis. Neurologic symptoms are common in HHT, and saline contrast transcra...
Source: The American Journal of Emergency Medicine - February 4, 2013 Category: Emergency Medicine Authors: Gino Gialdini, Alberto Chiti, Michelangelo Mancuso, Eva Terni, Nicola Giannini, Giovanni Orlandi Tags: Case Reports Source Type: research
Hemorrhagic Complications in Emergency Department Patients Who Are Receiving Dabigatran Compared With Warfarin
Conclusion:
Our patients with dabigatran-induced bleeding had a more benign clinical course with a shorter length of stay compared with patients with warfarin-induced bleeding. As was the case in previous published reports, there were fewer intracranial hemorrhages in patients receiving dabigatran than warfarin. Sustaining an acute kidney injury potentially predisposes patients to bleeding while receiving dabigatran.
Source: Annals of Emergency Medicine - April 1, 2013 Category: Emergency Medicine Authors: Russell Berger, Steven D. Salhanick, Maureen Chase, Michael Ganetsky Tags: Toxicology Source Type: research
Validation of the San Francisco Syncope Rule in Two Hospital Emergency Departments in an Asian Population
ConclusionsIn this study, SFSR rule had a sensitivity of 94.2%. This suggests caution on the strict application of the rule to all patients presenting with syncope. It should only be used as an aide in clinical decision‐making in this population.
Resumen
Validación en una Población Asiática de la Escala de Síncope de San Francisco en Dos Servicios de Urgencias HospitalariosObjetivesValidar externamente la capacidad de la Escala de Síncope de San Francisco (San Francisco Syncope Rule (SFSR)) para identificar con certeza los pacientes que experimentarán un evento clínico grave a los 7 días siguientes en una poblac...
Source: Academic Emergency Medicine - May 14, 2013 Category: Emergency Medicine Authors: Camlyn Tan, Tiong Beng Sim, Shin Ying Thng Tags: Original Research Contribution Source Type: research
Independent Risk Factors for Intracranial Aneurysms and Their Joint Effect: A Case-Control Study: Vlak M, Rinkel G, Greebe P, Algra A. Stroke 2013;44:984–7.
Intracranial aneurysms are a major risk factor for spontaneous subarachnoid hemorrhage, and 3% of the population has an unruptured intracranial aneurysm (UIA). This case-control study of 206 Dutch patients with UIA and 574 age- and sex-matched controls evaluates risk factors for UIA.
Source: The Journal of Emergency Medicine - June 29, 2013 Category: Emergency Medicine Authors: Braden Meason Tags: Abstracts Source Type: research
