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Condition: Hemorrhagic Stroke
Therapy: Thrombolytic Therapy

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Total 340 results found since Jan 2013.

Intravenous Thrombolysis in Posterior Circulation Stroke
Conclusions: Up to date, no data about PCIS and IVT are available from RTCs. Based on limited results from retrospective clinical studies and case series, IVT is safer for use in PCIS than in ACIS. Patients with brainstem ischemia, vertebral artery occlusion, and absence of basilar or posterior cerebral artery occlusion could be considered for treatment with IVT even in borderline cases. Time to IVT in PCIS seems to be a less crucial factor than in ACIS. IVT for PCIS may be beneficial even after 4.5 h from symptom onset. Introduction History of Intravenous Thrombolysis—The Most Relevant Studies Intravenous...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology 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

Platelet Count Predicts Adverse Clinical Outcomes After Ischemic Stroke or TIA: Subgroup Analysis of CNSR II
Conclusion: In ischemic stroke or TIA patients with platelet count within normal range, platelet count may be a qualified predictor for long-term recurrent stroke, mortality, and poor functional outcome. Introduction Platelets exert a critical role in the pathogenesis of atherosclerotic complications of cardio-cerebrovascular disease, contributing to thrombus formation, and embolism (1, 2). Previous literature reported that platelets of various size and density are produced by megakaryocytes of different size and stages of maturation in different clinical conditions, suggesting various platelet patterns in differen...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

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

Pre-hospital Triage of Acute Ischemic Stroke Patients —Importance of Considering More Than Two Transport Options
Conclusion: Pre-hospital triage algorithms for AIS patients that only take into account the nearest CSC and the nearest PSC as transport destinations may be unable to identify the optimal transport destination for a significant proportion of patients. Introduction Background International guidelines recommend early administration of intravenous thrombolysis for eligible patients with acute ischemic stroke (AIS); in addition, patients with proximal large vessel occlusion (LVO) should receive mechanical thrombectomy (MT) as quickly as possible (1). As the clinical benefit of both thrombolysis (2–4) and MT (5&#...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology 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

Effect of a provincial system of stroke care delivery on stroke care and outcomes.
Abstract BACKGROUND:Systems of stroke care delivery have been promoted as a means of improving the quality of stroke care, but little is known about their effectiveness. We assessed the effect of the Ontario Stroke System, a province-wide strategy of regionalized stroke care delivery, on stroke care and outcomes in Ontario, Canada. METHODS:We used population-based provincial administrative databases to identify all emergency department visits and hospital admissions for acute stroke and transient ischemic attack from Jan. 1, 2001, to Dec. 31, 2010. Using piecewise regression analyses, we assessed the effect of the...
Source: cmaj - May 27, 2013 Category: Journals (General) Authors: Kapral MK, Fang J, Silver FL, Hall R, Stamplecoski M, O'Callaghan C, Tu JV Tags: CMAJ Source Type: research

China stroke surveillance report 2021
AbstractSince 2015, stroke has become the leading cause of death and disability in China, posing a significant threat to the health of its citizens as a major chronic non-communicable disease. According to the China Stroke High-risk Population Screening and Intervention Program, an estimated 17.8 million [95% confidence interval (CI) 17.6 –18.0 million] adults in China had experienced a stroke in 2020, with 3.4 million (95% CI 3.3–3.5 million) experiencing their first-ever stroke and another 2.3 million (95% CI 2.2–2.4 million) dying as a result. Additionally, approximately 12.5% (95% CI 12.4–12.5%) of stroke survi...
Source: Military Medical Research - July 19, 2023 Category: International Medicine & Public Health Source Type: research

Thrombolysis for acute ischaemic stroke.
CONCLUSIONS: Thrombolytic therapy given up to six hours after stroke reduces the proportion of dead or dependent people. Those treated within the first three hours derive substantially more benefit than with later treatment. This overall benefit was apparent despite an increase in symptomatic intracranial haemorrhage, deaths at seven to 10 days, and deaths at final follow-up (except for trials testing rt-PA, which had no effect on death at final follow-up). Further trials are needed to identify the latest time window, whether people with mild stroke benefit from thrombolysis, to find ways of reducing symptomatic intracrani...
Source: Cochrane Database of Systematic Reviews - August 3, 2014 Category: Journals (General) Authors: Wardlaw JM, Murray V, Berge E, Del Zoppo GJ Tags: Cochrane Database Syst Rev Source Type: research

Temporal Trends and Predictors of Drug Utilization and Outcomes in First-Ever Stroke Patients: A Population-Based Study Using the Singapore Stroke Registry
ConclusionsPrescription of secondary stroke preventive medications (particularly in ischemic stroke) was associated with more favorable outcomes, highlighting the importance of physician adherence to evidence-based pharmacotherapy.
Source: CNS Drugs - July 15, 2019 Category: Neurology Source Type: research

Neurophysiology tools to lower the stroke onset to treatment time during the golden hour: microwaves, bioelectrical impedance and near infrared spectroscopy
Ann Med. 2022 Dec;54(1):2658-2671. doi: 10.1080/07853890.2022.2124448.ABSTRACTReperfusion therapy administration timing in acute ischaemic stroke is the main determinant of patients' mortality and long-term disability. Indeed, the first hour from the stroke onset is defined the "golden hour", in which the treatment has the highest efficacy and lowest side effects. Delayed ambulance transport, inappropriate triage and difficulty in accessing CT scans lead to delayed onset to treatment time (OTT) in clinical practice. To date brain CT scan is needed to rule out intracranial haemorrhage, which is a major contraindication to t...
Source: Annals of Medicine - September 26, 2022 Category: Internal Medicine Authors: Lazzaro di Biase Adriano Bonura Maria Letizia Caminiti Pasquale Maria Pecoraro Vincenzo Di Lazzaro Source Type: research

Parkinsonism or Other Movement Disorders Presenting as Stroke Mimics.
CONCLUSION: Although rare, parkinsonism or other movement disorders may present as a stroke mimic with activation of a stroke code. Consulting neurologists should clarify the etiology for those patients with acute consciousness disturbance or motor weakness and avoid unnecessary thrombolysis. Key Words: Parkinson disease, parkinsonism, movement disorders, stroke code, thrombolysis. PMID: 28382611 [PubMed - in process]
Source: Acta Neurologica Taiwanica - April 8, 2017 Category: Neurology Tags: Acta Neurol Taiwan Source Type: research

Impact of code stroke on thrombolytic therapy in patients with acute ischemic stroke at a secondary referral hospital in Taiwan
ConclusionCode stroke is effective in reducing in-hospital delays. The accuracy of code stroke activation has acceptable sensitivity but low specificity. Rapid patient assessment by neurologists increases the number of patients eligible for thrombolytic therapy.
Source: Journal of the Chinese Medical Association - September 7, 2018 Category: General Medicine Source Type: research

Timing of Initiation of Oral Anticoagulation after Acute Ischemic Stroke in Patients with Atrial Fibrillation
AbstractPatients with atrial fibrillation (AF) who suffer an acute ischemic stroke are at risk for both hemorrhagic transformation and recurrent ischemic stroke in the acute post ‐stroke period. Oral anticoagulants are recommended for secondary stroke prevention in patients with AF. The optimal time to initiate anticoagulant therapy after acute ischemic stroke in patients with AF is uncertain. There is concern that early initiation increases the risk of hemorrhagic transfo rmation, whereas delayed initiation leaves the patient at risk for recurrent ischemic stroke. In this article, we provide a review of the risk of hemo...
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - November 6, 2019 Category: Drugs & Pharmacology Authors: Maureen A. Smythe, Dennis Parker, Candice L. Garwood, Adam Cuker, Steve R. Mess é Tags: REVIEW OF THERAPEUTICS Source Type: research