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Analysis of Inpatient Thrombophilia Testing for Adults with an Ischemic Stroke or Transient Ischemic Attack and its Impact on Clinical Management (P1.123)
Conclusions: Inpatient thrombophilia testing did not affect management in the vast majority of patients with an ischemic stroke or TIA despite a positive test result. Therefore, by avoiding inpatient testing, healthcare costs may be reduced without affecting patient care.Disclosure: Dr. Gavva has nothing to disclose. Dr. Alberts has received personal compensation for activities with AGA medical, AstraZeneca, Bayer, Pfizer, Bistol-Myers-Squibb, Boehringer Ingelheim, diaDexus, Genentech, KOS, Medicine Company, PDL biopharma, Pfizer, Photothera, Sanofi. Dr. Johnson has nothing to disclose. Dr. Sarode has received personal com...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Gavva, C., Alberts, M., Johnson, M., Sarode, R. Tags: Cerebrovascular Disease: Epidemiology Source Type: research

Facial Colliculus and Opalski Stroke Syndromes Caused by Vertebral Artery Dissection. Case Report (P4.349)
Conclusion: Brainstem stroke syndromes are challenging to localize before brain imaging. In this case two embolic strokes happened. The first in the right facial colliculus causing the right 6th and 7th cranial nerves palsy. The second happened in the left lateral medulla extending below the pyramidal decussation causing a classical left lateral medullary syndrome with ipsilateral hemiparesis, which constitute a left Opalski stroke syndrome.Disclosure: Dr. Alghamdi has nothing to disclose. Dr. Ayoub has nothing to disclose. Dr. Alzahrani has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Alghamdi, S., Ayoub, O., Alzahrani, N. Tags: Cerebrovascular Case Reports Source Type: research

Strokes Occurring in the Hospital; Quality of Care and Outcome in a Tertiary Academic Medical Center (P6.045)
Conclusions: Increased symptom recognition was found within the ICU/ER cohorts staffed by specialized nurses. Only small number of patients with in-hospital strokes received brain imaging according to ASA/AHA guidelines which is an important opportunity for QI efforts for this group of patients.Disclosure: Dr. Kamal has nothing to disclose. Dr. Mowla has nothing to disclose. Dr. Shirani has nothing to disclose. Dr. Lail has nothing to disclose. Dr. Cheema has nothing to disclose. Dr. Memon has nothing to disclose. Dr. Deline has nothing to disclose. Dr. Crumlish has nothing to disclose. Dr. Singh has nothing to disclose. D...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Kamal, H., Mowla, A., Shirani, P., Lail, N., Cheema, B., Memon, A., Deline, C., Crumlish, A., Singh, K., Ching, M., Sawyer, R. Tags: In-Hospital Stroke and Stroke Complications Source Type: research

Cryptogenic Stroke: Making the Management Less Cryptic
Cryptogenic stroke (CS) accounts for 20% to 40% of ischemic strokes. CS is defined as a cortical infarct suggestive of an embolic stroke with no identifiable cardiac etiology, large vessel occlusive disease, or small vessel lacunar stroke. The likely etiologies for CS are patent foramen ovale (PFO) and paroxysmal atrial fibrillation, which can be detected by transesophageal echocardiography and long-term cardiac rhythm monitoring. In a busy academic hospital, the stroke service is frequently asked to provide a rational approach to patients with such a presentation. The 2011 American Heart Association/American Stroke Associ...
Source: Cardiology in Review - June 4, 2016 Category: Cardiology Tags: Review Articles Source Type: research

Utilization of Emergent Neuroimaging for Thrombolysis‐Eligible Stroke Patients
CONCLUSIONSAmong acute stroke patients, noncontrast CT was the most common initial imaging strategy in clinical practice in the 2005–2012 time period, though use of concomitant CTA grew to one‐quarter of cases, suggestive of an upward trend.
Source: Journal of Neuroimaging - June 13, 2016 Category: Radiology Authors: Nerses Sanossian, Katherine A. Fu, David S. Liebeskind, Sidney Starkman, Scott Hamilton, J. Pablo Villablanca, Adrian M. Burgos, Robin Conwit, Jeffrey L. Saver Tags: Clinical Investigative Study Source Type: research

Potentially Missed Diagnosis of Ischemic Stroke in the Emergency Department in the Greater Cincinnati/Northern Kentucky Stroke Study
ConclusionIn a large population‐based sample of AIS cases, 1 in 7 cases were not diagnosed as AIS in the ED, but the impact on acute treatment rates is likely small. Missed diagnosis was more common among those with decreased LOC, suggesting the need for improved diagnostic approaches in these patients.This article is protected by copyright. All rights reserved.
Source: Academic Emergency Medicine - June 16, 2016 Category: Emergency Medicine Authors: Tracy E. Madsen, Jane Khoury, Rhonda Cadena, Opeolu Adeoye, Kathleen A. Alwell, Charles J. Moomaw, Erin McDonough, Matthew L. Flaherty, Simona Ferioli, Daniel Woo, Pooja Khatri, Joseph P. Broderick, Brett M. Kissela, Dawn Kleindorfer Tags: Original Contribution Source Type: research

Utilization of Emergent Neuroimaging for Thrombolysis ‐Eligible Stroke Patients
CONCLUSIONSAmong acute stroke patients, noncontrast CT was the most common initial imaging strategy in clinical practice in the 2005–2012 time period, though use of concomitant CTA grew to one‐quarter of cases, suggestive of an upward trend.
Source: Journal of Neuroimaging - June 13, 2016 Category: Radiology Authors: Nerses Sanossian, Katherine A. Fu, David S. Liebeskind, Sidney Starkman, Scott Hamilton, J. Pablo Villablanca, Adrian M. Burgos, Robin Conwit, Jeffrey L. Saver Tags: Clinical Investigative Study Source Type: research

Emerging temporal trends in tissue plasminogen activator use: Results from the BASIC project
Conclusions: Dramatic increases in tPA use were apparent in this community without an academic medical center. Primary stroke center certification likely contributed to this rise. Results suggest that increases in tPA use were greater in higher severity patients compared to lower severity patients, and a gap between MAs and NHWs in tPA administration may be emerging.
Source: Neurology - November 20, 2016 Category: Neurology Authors: Domino, J. S., Baek, J., Meurer, W. J., Garcia, N., Morgenstern, L. B., Campbell, M., Lisabeth, L. D. Tags: Medical care, All Cerebrovascular disease/Stroke, All epidemiology ARTICLE Source Type: research

Assessment of Economic Aspects of Stroke in Different Clinical Management Settings: Academic vs. Non-academic (P3.055)
Conclusions:The academic status of healthcare facilities plays a key role in cost and charge of the management of stroke patients. Despite more employment of laboratory, imaging and resources in academic setting, comparison of prognosis, patient safety and clinical outcome in two groups remains unclear. Significant decrease in the cost-to-charge ratio may cause higher patients’ copay which reflects more in academic settings and uninsured individuals. Further studies to investigate effects of alterations in the cost-to-charge ratio on patients’ beneficiary is necessary.Disclosure: Dr. Fahimi has nothing to discl...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Fahimi, G., Elliott, R.-J., Seifi, A. Tags: Practice, Policy, and Ethics III Source Type: research

Corticomotor Excitability Effects of Peripheral Nerve Electrical Stimulation to the Paretic Arm in Stroke
Conclusions: A 1-hr PNS alone to the paretic arm could increase corticomotor excitability in both hemispheres, together with hand dexterity improvement in people presented with mild-to-moderate motor impairment in the paretic upper limb after stroke. To Claim CME Credits: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME Objectives: Upon completion of this article, the readers should be able to: (1) Understand the effects of a stroke on the corticomotor excitability of the lesioned and intact hemisphere; (2) Describe the effect of peripheral nerve electrical stimulati...
Source: American Journal of Physical Medicine and Rehabilitation - September 20, 2017 Category: Rehabilitation Tags: Original Research Articles CME Article . 2017 Series . Number 13 Source Type: research

Age, Sex, and Racial Differences in Neuroimaging Use in Acute Stroke: A Population-Based Study ADULT BRAIN
CONCLUSIONS: Within a large, biracial stroke/TIA population, there is variation in the use of advanced neuroimaging by age and race, depending on the care center type.
Source: American Journal of Neuroradiology - October 6, 2017 Category: Radiology Authors: Vagal, A., Sanelli, P., Sucharew, H., Alwell, K. A., Khoury, J. C., Khatri, P., Woo, D., Flaherty, M., Kissela, B. M., Adeoye, O., Ferioli, S., De Los Rios La Rosa, F., Martini, S., Mackey, J., Kleindorfer, D. Tags: ADULT BRAIN Source Type: research

Acute Phase Predictors of 6-Month Functional Outcome in Italian Stroke Patients Eligible for In-Hospital Rehabilitation
Conclusions According to the Barthel Index and modified Rankin Scale, early mobilization is an early predictor of favorable outcome. To Claim CME Credits Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME Objectives Upon completion of this article, the reader should be able to: (1) Incorporate prognostic factors of good clinical outcomes after stroke in developing treatment plans for patients admitted to rehabilitation; (2) Identify acute phase indicators associated with favorable 6-mo outcome after stroke; and (3) Recognize the cut-off for early mobilization link...
Source: American Journal of Physical Medicine and Rehabilitation - June 20, 2018 Category: Rehabilitation Tags: Original Research Articles CME Article . 2018 Series . Number 7 Source Type: research

Neuropsychological outcome following thalamic stroke in adolescence: an identical twin comparison.
CONCLUSIONS: These results suggest risk for deficits in encoding of new verbal information following bilateral thalamic stroke in adolescence, as well as risk for persistent cognitive deficits despite initial improvements. This is consistent with descriptions of anterograde memory impairments in adults with similar lesions. PMID: 30472911 [PubMed - as supplied by publisher]
Source: The Clinical Neuropsychologist - November 24, 2018 Category: Psychiatry & Psychology Authors: Godfrey M, Gillis MM, Khurana D, Poletto E, Tarazi RA Tags: Clin Neuropsychol Source Type: research

Evaluation of an OSA risk stratifying and treatment protocol during inpatient rehabilitation of post-stroke patients.
CONCLUSIONS: The use of APAP in high-risk patients was poorly tolerated and did not improve post-stroke recovery. Further studies with larger sample sizes are needed to determine the effect of APAP treatment on short-term recovery. PMID: 31290082 [PubMed - as supplied by publisher]
Source: Sleep and Breathing - July 8, 2019 Category: Sleep Medicine Authors: McKee Z, Wilson RD, Auckley DH Tags: Sleep Breath Source Type: research

Neuroimaging in Randomized, Multi-Center Clinical Trials of Endovascular Treatment for Acute Ischemic Stroke: A Systematic Review.
Abstract Appropriate use and analysis of neuroimaging techniques is an inevitable aspect of clinical trials for patients with acute ischemic stroke. Neuroimaging examinations were recently used to define the core eligibility criteria and outcomes in acute ischemic stroke research. Recent clinical trials for endovascular treatment in acute ischemic stroke have also demonstrated the efficacy or safety of endovascular treatment using various imaging modalities as well as clinical indices. Furthermore, independent imaging reviews and imaging core laboratory assessments are essential to manage and analyze imaging data ...
Source: Korean J Radiol - December 31, 2019 Category: Radiology Authors: Suh CH, Jung SC, Kim B, Cho SJ, Woo DC, Oh WY, Lee JG, Kim KW Tags: Korean J Radiol Source Type: research