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Compliance with Early Use of Prophylactic Anticoagulation after Intracerebral Hemorrhage (P02.047)
CONCLUSIONS: Despite implementation of guideline-based practice, 12% of our ICH patients did not receive early prophylactic anticoagulation despite a clear lack of contraindication. Continued quality improvement towards guideline-driven care may be enhanced by the use of checklists to overcome individual physician biases and preferences.Disclosure: Dr. Hoang has nothing to disclose. Dr. John has nothing to disclose. Dr. Garg has received research support from the AHA. Dr. Busl has nothing to disclose. Dr. Temes has nothing to disclose. Dr. Bleck has nothing to disclose. Dr. Prabhakaran has nothing to disclose.
Source: Neurology - February 14, 2013 Category: Neurology Authors: Hoang, T., John, S., Garg, R., Busl, K., Temes, R., Bleck, T., Prabhakaran, S. Tags: P02 Cerebrovascular Disease II Source Type: research

Prevalence and Determinants of White Matter Hyperintensities in Young Stroke Patients (P03.160)
CONCLUSIONS: Our preliminary data suggest a high prevalence of WMHs in a young stroke population. We observed significant associations between mod-severe WMHs and hypertension, renal dysfunction, CMB burden, and cortical atrophy. Characterization of WMHs in young populations with specific stroke subtypes warrants further investigation.Disclosure: Dr. Catanese has nothing to disclose. Dr. Shoamanesh has nothing to disclose. Dr. Rayhill has nothing to disclose. Dr. Lau has nothing to disclose. Dr. Romero has nothing to disclose. Dr. Babikian has nothing to disclose. Dr. Benavente has received personal compensation for activi...
Source: Neurology - February 14, 2013 Category: Neurology Authors: Catanese, L., Shoamanesh, A., Rayhill, M., Lau, H., Romero, J., Babikian, V., Benavente, O., Kase, C., Pikula, A. Tags: P03 Cerebrovascular Disease III Source Type: research

Acute Stroke in Young Women Taking Phentermine (P01.249)
CONCLUSIONS: We present here two patients with mild underlying cerebrovascular risk factors who presented with acute stroke after taking diet pills containing phentermine. The public should be aware of the possible association between stroke and phentermine. More long-term outcomes research is necessary to understand the safety of phentermine-containing diet pills. Patients with cerebrovascular risk factors should be cautious about using Phentermine containing diet pills.Disclosure: Dr. Smit has nothing to disclose. Dr. Cutting has received personal compensation for activities with F1000. Dr. Conners has nothing to disclos...
Source: Neurology - February 14, 2013 Category: Neurology Authors: Smit, L., Cutting, S., Conners, J., Lee, V., Song, S. Tags: P01 Cerebrovascular Disease I 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

Decompressive craniectomy using gelatin film and future bone flap replacement.
Conclusions Decompressive craniectomy repair using an absorbable gelatin film barrier facilitates subsequent cranioplasty by preventing adhesions between intracranial contents and the overlying galea aponeurotica and temporalis muscle fascia. This technique makes cranioplasty dissection faster and potentially safer, which may improve clinical outcomes. The indications for gelatin film should be expanded to include placement in the epidural space after craniectomy. PMID: 23394343 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery - February 8, 2013 Category: Neurosurgery Authors: Oladunjoye AO, Schrot RJ, Zwienenberg-Lee M, Muizelaar JP, Shahlaie K Tags: J Neurosurg 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

Advances in Transcranial Doppler US: Imaging Ahead Neurologic/Head and Neck Imaging
Transcranial Doppler ultrasonography (US) is a noninvasive, portable technique for evaluating the intracranial vasculature. It has found its most useful clinical application in the detection of vasospasm involving the cerebral vessels after subarachnoid hemorrhage due to aneurysm rupture. The technique has become an integral part of monitoring and managing patients with subarachnoid hemorrhage in the neurologic intensive care unit. In addition, it has proved useful for evaluating the intracranial vasculature in patients with sickle cell disease, stroke, or brain death. Transcranial US originated as a "blind" nonimaging stu...
Source: Radiographics recent issues - January 15, 2013 Category: Radiology Authors: Kirsch, J. D., Mathur, M., Johnson, M. H., Gowthaman, G., Scoutt, L. M. Tags: Neuroradiology, Ultrasound, Vascular Imaging, Head and Neck Neurologic/Head and Neck Imaging Source Type: research

Prehospital thrombolysis in acute stroke: Results of the PHANTOM-S pilot study
Conclusions: The data suggest that prehospital stroke care in STEMO is feasible. No safety concerns have been raised so far. This new approach using prehospital tPA may be effective in reducing call-to-needle times, but this is currently being scrutinized in a prospective controlled study.
Source: Neurology - January 7, 2013 Category: Neurology Authors: Weber, J. E., Ebinger, M., Rozanski, M., Waldschmidt, C., Wendt, M., Winter, B., Kellner, P., Baumann, A., Fiebach, J. B., Villringer, K., Kaczmarek, S., Endres, M., Audebert, H. J., for the STEMO-Consortium Tags: CT, All Cerebrovascular disease/Stroke, Critical care, Patient safety ARTICLE Source Type: research

Association between radiographic Wallerian degeneration and neuropathological changes post childhood stroke
Aim  Wallerian degeneration is a radiological finding thought to reflect corticospinal tract degeneration. This finding on magnetic resonance imaging (MRI) is routinely used as a predictor of poor prognosis in childhood stroke. However, its validity has never been established. Our objective was to correlate Wallerian degeneration seen on MRI with histopathology. Method  We searched the databases of the Department of Pathology and Children’s Stroke registry at the Hospital for Sick Children, Toronto for autopsy specimens exhibiting focal infarcts from children born at term who underwent MRI after a stroke. The specime...
Source: Developmental Medicine and Child Neurology - November 22, 2012 Category: Child Development Authors: KEVIN C JONES, CYNTHIA HAWKINS, DEREK ARMSTRONG, GABRIELLE DEVEBER, DAUNE MACGREGOR, MAHENDRANATH MOHARIR, RAND ASKALAN Tags: ORIGINAL ARTICLE Source Type: research

Angiogram-Negative Subarachnoid Hemorrhage: Outcomes Data and Review of the Literature
We report data for 31 patients who presented to our institution from 2006 to the present. We performed a retrospective chart review, and report outcome data that include rates of rehemorrhage, hydrocephalus, vasospasm, permanent ischemic deficits, headaches, and outcomes based on modified Rankin Scale scores. We also performed a review of the literature and meta-analysis of the data therein. We compared rates of complications in the PMH subgroup and the diffuse-type hemorrhage subgroup. The chart review revealed no poor outcomes and no rehemorrhages in the patients with PMH. In the diffuse hemorrhage subgroup, 1 patient ha...
Source: Journal of Stroke and Cerebrovascular Diseases - April 1, 2012 Category: Neurology Authors: Scott Boswell, William Thorell, Steve Gogela, Elizabeth Lyden, Dan Surdell Tags: Original Articles Source Type: research

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