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Time to ct scan imaging after symptom onset among ischeamic stroke patients presenting to a quaternary hospital in ghana
This study sought to determine the time of onset of symptoms to the time a CT imaging was done among patients presenting with acute stroke at the Korle-Bu Teaching Hospital.
Source: Journal of Stroke and Cerebrovascular Diseases - March 30, 2023 Category: Neurology Authors: F. Duodu, D. Brodie Mends, B. Agbinko-Djobalar, P. Pekyi-Boateng, M. Amerwornu, P Adjei, A Akpalu, K Nkromah Source Type: research

Telemedicine remote controlled stroke evaluation and treatment, the experience of radiographers, paramedics and junior doctors in a novel rural stroke management team
In the case of ischemic stroke, access to a Computed Tomography (CT) scanner and the start of thrombolytic therapy immediately is imperative. Transport to the nearest hospital from the remote, rural area of Ha...
Source: BMC Health Services Research - June 5, 2021 Category: General Medicine Authors: Elin Kjelle and Aud Mette Myklebust Tags: Research Source Type: research

Anticoagulant management by low-dose of low molecular weight heparin in patients with nonvalvular atrial fibrillation following hemorrhagic transformation and complicated with venous thrombosis: Five case reports and literature review
For patients with nonvalvular atrial fibrillation (NVAF) following hemorrhagic infarction (HI)/hemorrhage transformation (HT) and complicated with venous thrombosis, the management of anticoagulation is controversial. Our study intends to explore the safety and effectiveness of using low-dose of low molecular weight heparin (LMWH) to treat NVAF patients with HI (or HT) and complicated with venous thrombosis. Between January 2018 and January 2019, NVAF related acute ischemic stroke patients with HT/HI, hospitalized in the department of neurology or rehabilitation in our hospital, are enrolled retrospectively. Among them,...
Source: Medicine - February 19, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Acute ischemic stroke management in Lebanon: obstacles and solutions.
This study assesses the current practices of physicians in Lebanon routinely involved in ischemic stroke (IS) management. We conducted a prospective observational study of patients hospitalized at 8 different Lebanese hospitals in the period August 1, 2015 to July 31, 2016, with a diagnosis of acute stroke. Baseline characteristics and data on diagnostic studies, as well as treatments received during hospitalization and at discharge, were collected and analyzed. Two hundred and three strokes/transient ischemic attacks (TIAs) were recorded but only 173 patients (85%) with ischemic events were included in the study. The pati...
Source: Functional Neurology - May 27, 2020 Category: Neurology Tags: Funct Neurol Source Type: research

The management of patients with acute ischemic stroke while on direct oral anticoagulants (DOACs): data from an Italian cohort and a proposed algorithm
This study aimed at investigating whether there is any relationship between DOAC plasma levels and the stroke occurrence, on the basis of the phenotypic classification and pathophysiology of the stroke, in a cohort of DOAC-treated patients admitted to our hospital for AIS o ver 1-year period. A total of 28 patients had DOAC plasma levels determined in emergency and were included in the study, nine patients receiving dabigatran, 11 rivaroxaban and 8 apixaban. The DOAC levels were low in 8/28 patients (28.6% of the sample), intermediate in 4 (14.3%) and high in 16 (57.1% ). The most prevalent stroke subtype was the small ves...
Source: Journal of Thrombosis and Thrombolysis - April 16, 2020 Category: Hematology Source Type: research

Dural Sinus Thrombosis with Nonsymptomatic Persistent Falcine Sinus: A Case Report
A 24-year-old woman was admitted to our hospital after convulsive status epilepticus. A cerebral magnetic resonance venography revealed a persistent fetal falcine sinus. Additionally, the posterior third of the superior sagittal sinus was hypoplastic and the abnormal deep venous drainage was accompanied. These abnormalities had already been detected by magnetic resonance imaging several years ago. In the present scan, we discovered a sinus thrombosis in the hypoplastic superior sagittal sinus. In the cerebral angiography, we observed delayed venous return in the left parieto-occipital lobe and hypothesized that cerebral ve...
Source: Journal of Stroke and Cerebrovascular Diseases - August 8, 2019 Category: Neurology Authors: Ayako Shioya, Ryota Mashiko, Masanari Shiigai, Yasunobu Nakai, Nobuyuki Takahashi, Hiroyuki Kobayashi, Toshiyuki Irie, Akira Tamaoka Tags: Case Report Source Type: research

Pitfalls in the diagnosis and initial management of acute cerebral venous thrombosis.
Authors: Cai H, Ye X, Zheng W, Ma L, Hu X, Jin X Abstract Cerebral venous thrombosis is an important etiology of stroke in young patients. Its clinical manifestations are variable and based on different involved venous or sinus processes. Cerebral venous thrombosis could mimic ischemic infarction and is easy to misdiagnose. Although many patients have favorable outcomes, delayed or incorrect diagnosis due to atypical symptoms may lead to a poor prognosis. Here we present a case of a 33-year-old woman with transient headache and recurrent right extremity weakness whose symptoms progressed and were sustained in the h...
Source: Reviews in Cardiovascular Medicine - May 9, 2019 Category: Cardiology Tags: Rev Cardiovasc Med Source Type: research

Pentraxin 3 in Cardiovascular Disease
Giuseppe Ristagno1*, Francesca Fumagalli1, Barbara Bottazzi2, Alberto Mantovani2,3,4, Davide Olivari1, Deborah Novelli1 and Roberto Latini1 1Department of Cardiovascular Research, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy 2Humanitas Clinical and Research Center-IRCCS, Milan, Italy 3Humanitas University, Milan, Italy 4The William Harvey Research Institute, Queen Mary University of London, London, United Kingdom The long pentraxin PTX3 is a member of the pentraxin family produced locally by stromal and myeloid cells in response to proinflammatory signals and microbial moieties. The p...
Source: Frontiers in Immunology - April 16, 2019 Category: Allergy & Immunology Source Type: research

Cardiac Imaging Within Emergency CT Angiography for Acute Stroke Can Detect Atrial Clots
This study was approved by the ethics committee of the medical faculty of the Ruhr University Bochum. FIGURE 1 Figure 1. Flow chart showing the selection of the study population. Results A total of 59 patients underwent emergency CCTA (Figure 2A) for suspected stroke, of which 44 received the final diagnosis ischemic stroke. There were 17 patients who had ischemic stroke or TIA and known or newly diagnosed atrial fibrillation (Table 1; mean age: 77.5 years, standard deviation: 8.4 years; 53% female). As hypothesized, intracardiac thrombi could be visualized: once in an artificially occluded left atrial appe...
Source: Frontiers in Neurology - April 9, 2019 Category: Neurology Source Type: research

Leukoaraiosis is an independent predictor of intracranial hemorrhage in patients with atrial fibrillation
AbstractWe evaluated the predictive value of several clinical, radiological and laboratory parameters on the risk of predict intracranial hemorrhage (ICH) in patients with atrial fibrillation (AF). We conducted a case-control study on a consecutive hospital based series of patients with AF and ICH. A random sample of subjects with AF without ischemic or hemorrhagic stroke was selected from the same hospital in the same period to perform as the control group, with a ratio of two controls per case. All patients underwent the same evaluation protocol. Patients without neuroimaging exams were excluded. During the study period ...
Source: Journal of Thrombosis and Thrombolysis - March 13, 2019 Category: Hematology Source Type: research

Fool Me Once: An Uncommon Presentation of PE
​BY FREDDIE IRIZARRY-DELGADO; VAROON KAKAIYA; & AHMED RAZIUDDIN, MDAn 86-year-old African-American woman was brought to the ED by her daughter after two days of nutritional neglect, abdominal pain, and altered mental status. Her daughter said her mother felt lightheaded, appeared dehydrated, and vomited nonbilious watery fluid once. The patient had a history of diabetes mellitus type 2, DVT/PE, dementia, and early signs of parkinsonism.Her vital signs were remarkable only for tachypnea (24 bpm). Her troponin I was markedly elevated at 1.7 ng/mL. A D-dimer was ordered because of her history of unprovoked DVT/PE, and i...
Source: The Case Files - November 27, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Unusual Techniques for Preserving Surgical and Oncologic Safety in Hepatectomy of Advanced Adrenal Malignancy with Vena Cava and Liver Invasion
We report herein three cases of major hepatectomy with IVC invasion and discuss several surgical tips.Patients and MethodsFrom March 2011 to February 2014, we retrospectively reviewed three cases of adrenal malignancy with liver and IVC invasion. Based on the severity of the malignant tumor, each case illustrates a different method to address surgical complications and maintain oncologic safety. Case 1: A 34-year-old woman was diagnosed with adrenocortical tumor during medical examination. Tumor invaded the right lobe of the liver and very close to the IVC. Fortunately, there was little thrombosis inside the IVC; we perfor...
Source: Annals of Surgical Oncology - October 1, 2018 Category: Cancer & Oncology Source Type: research

Mobile Stroke Unit Reduces Time to Image Acquisition and Reporting INTERVENTIONAL
SUMMARY: Timely administration of thrombolytic therapy is critical to maximizing the likelihood of favorable outcomes in patients with acute ischemic stroke. Although emergency medical service activation overall improves the timeliness of acute stroke treatment, the time from emergency medical service dispatch to hospital arrival unavoidably decreases the timeliness of thrombolytic administration. Our mobile stroke unit, a new-generation ambulance with on-board CT scanning capability, reduces key imaging time metrics and facilitates in-the-field delivery of IV thrombolytic therapy.
Source: American Journal of Neuroradiology - July 9, 2018 Category: Radiology Authors: Nyberg, E. M., Cox, J. R., Kowalski, R. G., Vela-Duarte, D., Schimpf, B., Jones, W. J. Tags: INTERVENTIONAL Source Type: research

Doctors Beware: Abbott & #039;s HeartMate 3 Has a Safety Problem
Just when it seemed the HeartMate 3 was gaining momentum, Abbott warned physicians that outflow graft twisting may occur after the left ventricular assist device (LVAD) is implanted. The problem can trigger a persistent low-flow alarm that may signal a potential safety risk to patients, such as blood flow or clotting. The Abbott Park, IL-based company has not recalled any of the devices from patients or hospitals, but there have been 32 reports of outflow graft twisting (an incidence rate of 0.72%), including reports of low blood flow, clotting, and three patient deaths. No devices are being recalled from patients or hosp...
Source: MDDI - May 7, 2018 Category: Medical Devices Authors: Amanda Pedersen Tags: Cardiovascular Implants Source Type: news

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