• Filter By:
• Specialty
• Source
• Condition
• Cancer
• Infectious Disease
• Drug
• Training
• Management
• Procedure
• Therapy
• Vaccine
• Nutrition
• Country

Thrombolytic therapy-associated acute myocardial infarction in patients with acute ischemic stroke: A treatment dilemma
Acute myocardial infarction (AMI) is uncommon in the acute phase of acute ischemic stroke (AIS) and occurs in approximately 1% of the population. Here, we report a paradoxical case of AMI during tissue plasminogen activator (t-PA) infusion for AIS. We review and analyze the previously reported cases. We found that only patients with AMI which occurred after thrombolytic therapy for AIS who received an adequate combination of anticoagulation plus percutaneous coronary intervention survived their events.
Source: The American Journal of Emergency Medicine - November 21, 2016 Category: Emergency Medicine Authors: Chih-Jen Yang, Po-Chuan Chen, Chin-Sheng Lin, Chia-Lin Tsai, Shih-Hung Tsai Source Type: research

Central venous sinus thrombosis presenting with generalized tonic-clonic seizures in a patient with no known risk factors
We present a case of a previously healthy woman with a new onset seizure, whose only other complaint was weakness despite a normal neurological examination. Her head computed tomography (CT) showed an intraparenchymal hemorrhage of the left frontal lobe and signs of infarction of the right frontal lobe.
Source: The American Journal of Emergency Medicine - October 9, 2016 Category: Emergency Medicine Authors: Patricia Khatib, Omar Mostafa, Erin L. Simon Tags: Case Reports Source Type: research

Preclinical and clinical data for factor Xa and “Universal” reversal agents
Oral Factor Xa (FXa) inhibitors, a growing class of direct-acting anticoagulants, are frequently used to prevent stroke and systemic embolism in patients with atrial fibrillation and to prevent and treat venous thromboembolism. These drugs reduce the risk of clotting at the expense of increasing the risk of bleeding, and currently they have no specific reversal agent. However, andexanet alfa, a recombinant modified FXa decoy molecule, is in a late-phase clinical trial in bleeding patients, and ciraparantag, a small molecule that appears to reverse many anticoagulants including the FXa inhibitors, is in development.
Source: The American Journal of Emergency Medicine - September 27, 2016 Category: Emergency Medicine Authors: Truman J. Milling, Scott Kaatz Tags: Review Source Type: research

Is it dangerous to treat acute ischemic stroke by thrombolytic therapy in patients with comorbid intracranial aneurysms
The safety of cerebral ischemic stroke patients with comorbid intracranial aneurysms treated by thrombolysis is still an unsolved mystery. We aimed to perform a secondary analysis and review to provide evidence on whether stroke patients with intracranial aneurysms have worse outcomes following thrombolysis.
Source: The American Journal of Emergency Medicine - December 16, 2015 Category: Emergency Medicine Authors: Jiayue Ding, Jie Han, Zhe Jing, Yue Jiang Source Type: research

Ischemic Stroke Differential Diagnose: Spontaneous Spinal Epidural Hematoma can be fatal
Spontaneous Spinal Epidural Hematoma (SSEH) is rarely seen, it is the important reason for the spinal cord compression. Patients generally visit the doctor due to the acute pain in the neck and interscapular area. The male patient 58years old was admitted to the emergency service of our hospital with the sudden onset neck pain and followed by rapidly right hemiparesis He arrived at our hospital 120minutes after the onset of her symptoms with suspected acute stroke. We assessed for acute stroke performed clinical examinations necessary for intravenous thrombolytic treatment with alteplase, No abnormality was observed in his...
Source: The American Journal of Emergency Medicine - January 21, 2015 Category: Emergency Medicine Authors: Huseyin Buyukgol, M. Kemal Ilik, Faik Ilik Source Type: research

Stroke: prospective evaluation of a prehospital management process based on rescuers under medical direction
Abstract: Background: Improving access to thrombolytic therapy for patients with ischemic stroke is challenging. We assessed a prehospital process based on firemen rescuers under strict medical direction, aimed at facilitating thrombolysis of eligible patients.Methods: This was a prospective observational study conducted over 4 months in Paris, France. Prehospital patients with suspected stroke were included after telephone consultation with a physician. If the time since the onset of symptoms was less than 6 hours, patients were transported directly to a neurovascular unit (NVU); if symptom onset was more than 6 hours ago...
Source: The American Journal of Emergency Medicine - February 3, 2014 Category: Emergency Medicine Authors: Laure Alhanati, Stéphane Dubourdieu, Clément Hoffmann, Francis Béguec, Stéphane Travers, Hugues Lefort, Olga Maurin, Daniel Jost, Laurent Domanski, Jean-Pierre Tourtier Tags: Original Contributions Source Type: research

Tissue plasminogen activator for transient ischemic attack: the case for “off-label” use of thrombolytics
We describe an illustrative case of a patient with recurring middle cerebral artery (MCA) ischemia, where our risk benefit analysis led to the administration of thrombolytic therapy despite the patient’s score of 0 on the National Institute of Health Stroke Score (NIHSS).
Source: The American Journal of Emergency Medicine - November 6, 2013 Category: Emergency Medicine Authors: Richard M. Sobel, Daniel T. Wu, Kristina Hester, Kim Anda Tags: Correspondence Source Type: research

Predictive value of the Cincinnati Prehospital Stroke Scale for identifying thrombolytic candidates in acute ischemic stroke
Abstract: Background: Despite the usefulness of the Cincinnati Prehospital Stroke Scale (CPSS) for rapid recognition of acute stroke, its ability to assess stroke severity is unclear. We investigated the usefulness of CPSS for assessment of stroke severity by comparing CPSS and National Institutes of Health Stroke Scale (NIHSS) scores in patients who were candidates for thrombolytic therapy at hospital admission within 6 hours of symptom onset.Methods: We conducted a retrospective analysis of a prospective registry database of consecutive patients included in the brain salvage through emergency stroke therapy program. In t...
Source: The American Journal of Emergency Medicine - September 23, 2013 Category: Emergency Medicine Authors: Je Sung You, Sung Phil Chung, Hyun Soo Chung, Hye Sun Lee, Jong Woo Park, Hyun Jong Kim, Shin Ho Lee, Incheol Park, Hahn Shick Lee Tags: Brief Reports Source Type: research

Simultaneous thrombosis of 2 vascular territories: is thrombolytic therapy a better option?
We have read with great interest the article by Akyuz and colleagues in the American Journal of Emergency Medicine and congratulate them for their observation. Their case exemplifies the concurrent occurrence of ST-segment elevation myocardial infarction (STEMI) and posterior circulation stroke that was eventually managed with thrombolytic therapy. Simultaneous thrombosis of 2 distant vascular territories is a rare and complicated clinical scenario. In these instances, there is usually an underlying cause linking both thrombotic events rather than being a mere coincidence. We have previously described the myocardial infarc...
Source: The American Journal of Emergency Medicine - July 1, 2013 Category: Emergency Medicine Authors: Hesham R. Omar, Devanand Mangar, Enrico M. Camporesi Tags: Correspondence Source Type: research

The locked-in syndrome: posterior stroke in the ED
We present this report and brief review as it is unusual to watch locked-in syndrome evolve in the ED. Providers should be aware of the presenting symptoms and the differential diagnosis for bulbar muscle weakness as well as the management of posterior stroke.
Source: The American Journal of Emergency Medicine - May 22, 2013 Category: Emergency Medicine Authors: Corey Goldberg, Stephen Topp, Christopher Hopkins Tags: Case Reports Source Type: research

Painless aortic dissection: thrombolytic and antithrombotic vigilance
We thank Huang et al for their interesting article on identification of painless aortic dissection (AD) before thrombolytic treatment for acute ischemic stroke. We would like to emphasize the importance of being vigilant to AD before initiating any contraindicated therapy. We recently had an 84-year-old man with history of atrial fibrillation and transient ischemic attack who presented to the emergency department with acute shortness of breath without chest pain. The symptom contributed to atrial fibrillation with rapid ventricular response. Chest x-ray showed increased soft tissue prominence of the aortic arch suspicious ...
Source: The American Journal of Emergency Medicine - May 20, 2013 Category: Emergency Medicine Authors: Promporn Suksaranjit, Kunatum Prasidthrathsint, Wonngarm Kittanamongkolchai, Supawat Ratanapo, Narat Srivali, Daych Chongnarungsin Tags: Correspondence Source Type: research

Rescue thrombolysis in the treatment of cardiac shock and acute stroke
The patients with ST-elevation myocardial infarction are primarily managed with percutaneous coronary intervention (PCI) or thrombolysis. It is well accepted that rescue PCI should be implemented in case of unsuccessful thrombolysis. However, the reverse, rescue thrombolysis, that is, administering of thrombolytic therapy in a patient in whom primary PCI fails, is not well defined. There are no available data about rescue thrombolysis so far. We represent a 43-year-old male patient with Buerger disease (thromboangiitis obliterans) who was admitted to our emergency department for cardiac shock related to inferior and right ...
Source: The American Journal of Emergency Medicine - April 19, 2013 Category: Emergency Medicine Authors: Sukru Akyuz, Mustafa Azmi Sungur, Cevdet Donmez, Aylin Sungur, Nese Cam Tags: Case Reports Source Type: research

Identification of painless aortic dissection before thrombolytic treatment for acute ischemic stroke
We reported a 57-year-old man with acute right hemisphere watershed ischemic stroke caused by painless type A aortic dissection was diagnosed in time with computed tomographic (CT) angiography. The possible detrimental impact which may have been incurred by thrombolytic therapy was avoided. We suggest that cerebral CT angiography, covering from the aortic arch to intracranial arteries, should be performed in acute ischemic stroke patients, particularly in those with watershed CT perfusion deficits, to exclude the possibility of aortic dissection before thrombolytic treatment.
Source: The American Journal of Emergency Medicine - February 11, 2013 Category: Emergency Medicine Authors: Chen-Hsiung Huang, Hui-Chun Huang, Kang-Hsu Lin, Wei-Kung Chen, Chon-Haw Tsai Tags: Case Reports Source Type: research

Optimal initial anticoagulant therapy in pulmonary thromboembolism: randomized trial suggested
Numerous lines of evidence suggest a need for an improvement in pulmonary thromboembolism (PTE) therapy: According to relevant US data (Heart Disease and Stroke Statistics–2012 Update), 30-day mortality of PTE is no less than 40.9%, which is clearly not acceptable .
Source: The American Journal of Emergency Medicine - November 19, 2012 Category: Emergency Medicine Authors: Goran P. Koracevic Tags: Correspondence Source Type: research

Pages: 1  2  3