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Total 1186 results found since Jan 2013.

Effects of alteplase on survival after ischaemic stroke (IST-3): 3 year follow-up of a randomised, controlled, open-label trial
We report the effect of intravenous alteplase on long-term survival after ischaemic stroke of participants in the Third International Stroke Trial (IST-3). Methods In IST-3, done at 156 hospitals in 12 countries (Australia, Europe, and the UK), participants (aged >18 years) were randomly assigned with a telephone voice-activated or web-based system in a 1:1 ratio to treatment with intravenous 0·9 mg/kg alteplase plus standard care or standard care alone within 6 h of ischaemic stroke. We followed up participants in the UK and Scandinavia (Sweden and Norway) for survival up to 3 years after randomisation using data...
Source: The Lancet Neurology - July 19, 2016 Category: Neurology Source Type: research

Carotid endarterectomy following thrombolysis for acute ischaemic stroke.
CONCLUSIONS: Our experience indicates that CEA post-thrombolysis has a low incidence of mortality. Further high quality evidence is required before CEA can be routinely recommended following IVT for acute ischaemic stroke.
. PMID: 28045369 [PubMed - as supplied by publisher]
Source: VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases - January 2, 2017 Category: Surgery Authors: Ahmed N, Kelleher D, Madan M, Sochart S, Antoniou GA Tags: Vasa Source Type: research

Outcomes of Endovascular Thrombectomy with and without Thrombolysis for Acute Large Artery Ischaemic Stroke at a Tertiary Stroke Centre
Conclusion: Our study highlights the relatively large proportion of patients suitable for EVT who have a contraindication to alteplase and raises the hypothesis that adding alteplase to successful EVT may not be necessary to optimize functional outcome. The results are consistent with observational data from other endovascular centres and support a randomised controlled trial of EVT versus EVT with bridging alteplase.Cerebrovasc Dis Extra 2017;7:95 –102
Source: Cerebrovascular Diseases Extra - May 2, 2017 Category: Neurology Source Type: research

Assessment of healthcare personnel knowledge of stroke care at a large referral hospital in sub-Saharan Africa – A survey based approach
Publication date: August 2017 Source:Journal of Clinical Neuroscience, Volume 42 Author(s): Chen Lin, Ravi Vakani, Peter Kussin, Mary Guhwe, Alfredo E. Farjat, Kingshuk Choudhury, David Renner, Chrispine Oduor, Carmelo Graffagnino There is no published literature regarding sub-Saharan health-care providers’ understanding of stroke management patterns. Understanding current stroke management knowledge is important in formulating future education opportunities for providers to optimize patient outcomes. A cross-sectional survey of acute stroke diagnosis, hospital management, and secondary prevention questions was administ...
Source: Journal of Clinical Neuroscience - June 29, 2017 Category: Neuroscience Source Type: research

A Diagnostic Approach to Stroke in Young Adults
Opinion statementOptimal diagnosis and management of stroke in young adults benefit from a multidisciplinary team, including a vascular neurology specialist. In addition to the “standard” vascular risk factors including smoking, hypertension, diabetes, and hyperlipidemia, one needs to consider alternative etiologies including substance abuse, carotid/vertebral artery dissections, and rare genetic conditions among others. Once a young patient is determined to have had a stroke, the next question a clinician should ask iswhy did this patient have a stroke? A “heart to head” diagnostic approach is recommended. A thoro...
Source: Current Treatment Options in Cardiovascular Medicine - September 25, 2017 Category: Cardiology Source Type: research

Outcomes of Endovascular Thrombectomy with and without Thrombolysis for Acute Large Artery Ischaemic Stroke at a Tertiary Stroke Centre
Conclusion: Our study highlights the relatively large proportion of patients suitable for EVT who have a contraindication to alteplase and raises the hypothesis that adding alteplase to successful EVT may not be necessary to optimize functional outcome. The results are consistent with observational data from other endovascular centres and support a randomised controlled trial of EVT versus EVT with bridging alteplase.Cerebrovasc Dis Extra 2017;7:95 –102
Source: Cerebrovascular Diseases Extra - October 25, 2017 Category: Neurology Source Type: research

Optimizing Prehospital Triage for Patients With Stroke Involving Large Vessel Occlusion
The past 20 years have witnessed a revolution in the paradigm of acute ischemic stroke treatment. In 1996, intravenous alteplase was shown to improve outcomes among patients treated within 3 hours of stroke onset. This finding upended the historical therapeutic nihilism about stroke, and with it the leisurely armchair approach to stroke treatment. The concept of so-called acute ischemic stroke emerged. This changed the nature and practice of vascular neurology, created a vigorous and sometimes controversial debate between vascular neurologists and emergency physicians about the merits of alteplase, and paved the way for mo...
Source: JAMA Neurology - September 4, 2018 Category: Neurology Source Type: research

The cost of stroke in a public hospital in Brazil: a one-year prospective study
Conclusions Reperfusion treatments were two-to-four times more expensive than conservative treatment. A cost-effectiveness study of the IS treatment option is necessary.RESUMO Os pa íses de baixa e media renda enfrentam orçamentos apertados na saúde, não somente devido aos novos recursos terapêuticos, mas relacionado ao custo oneroso do tratamento do acidente vascular cerebral. No entanto, poucos dados prospectivos sobre os custos do AVC, incluindo reperfusão cerebral de países de baixa e média renda estão disponíveis. Objetivo Mensurar os custos do atendimento ao AVC em um hospital público. Métodos Avaliamos p...
Source: Arquivos de Neuro-Psiquiatria - July 16, 2019 Category: Neurology Source Type: research

Early neutrophil-to-lymphocyte ratio is a prognostic marker in acute minor stroke or transient ischemic attack
In this study, we aimed to demonstrate early neutrophil-to-lymphocyte ratio is a prognostic marker in acute minor stroke or transient ischemic at tack. 196 patients diagnosed with acute minor stroke or transient ischemic attack within 24 h of symptom onset were enrolled. Patients were divided into three groups according to the neutrophil-to-lymphocyte ratio value (<  2, 2–3, >  3). Clinical, neuroradiological, laboratory and follow-up data were collected from electronic database. Functional outcome was assessed by modified Rankin Scale. Neutrophil-to-lymphocyte ratio associated with functional outcome of 90...
Source: Acta Neurologica Belgica - February 7, 2020 Category: Neurology Source Type: research

Endovascular treatment decision-making in acute ischemic stroke patients with large vessel occlusion and low National Institutes of Health Stroke Scale: insights from UNMASK EVT, an international multidisciplinary survey
ConclusionDespite the limited evidence for endovascular therapy in acute stroke patients with low NIHSS, most physicians in this survey decided to proceed with endovascular therapy. A randomized controlled trial seems warranted.
Source: Neuroradiology - February 14, 2020 Category: Radiology Source Type: research

Efficacy and safety of nerinetide for the treatment of acute ischaemic stroke (ESCAPE-NA1): a multicentre, double-blind, randomised controlled trial
Publication date: Available online 20 February 2020Source: The LancetAuthor(s): Michael D Hill, Mayank Goyal, Bijoy K Menon, Raul G Nogueira, Ryan A McTaggart, Andrew M Demchuk, Alexandre Y Poppe, Brian H Buck, Thalia S Field, Dar Dowlatshahi, Brian A van Adel, Richard H Swartz, Ruchir A Shah, Eric Sauvageau, Charlotte Zerna, Johanna M Ospel, Manish Joshi, Mohammed A Almekhlafi, Karla J Ryckborst, Mark W LowerisonSummaryBackgroundNerinetide, an eicosapeptide that interferes with post-synaptic density protein 95, is a neuroprotectant that is effective in preclinical stroke models of ischaemia-reperfusion. In this trial, we ...
Source: The Lancet - February 22, 2020 Category: General Medicine Source Type: research

Analysis of Thrombolysis Process for Acute Ischemic Stroke in Urban and Rural Hospitals in Nova Scotia Canada
Conclusions: Guidelines and clear protocols are critical in reducing treatment times and ensuring consistent access to treatment. The majority of treatment delays encountered are system delays, which can be appropriately planned for to reduce delays within the care pathway. There is a general consensus that there is an urban-rural treatment gap for acute ischemic stroke patients in Nova Scotia, and that continuing education is key in rural hospitals to improve Emergency Department (ED) physician comfort with treating patients with tPA.
Source: Frontiers in Neurology - March 15, 2021 Category: Neurology Source Type: research

Acute Ischemic Stroke
This article discusses the pathophysiology underlying the various types of ischemic stroke; the risk factors for ischemic stroke; stroke presentation; and the evidence-based treatments, nursing assessments, and monitoring protocols that are critical to patient recovery.PMID:34402461 | DOI:10.1097/01.NAJ.0000790184.66496.1d
Source: The American Journal of Nursing - August 17, 2021 Category: Nursing Authors: Nneka Lotea Ifejika Heather H Washington Kimberly R Glaser Source Type: research