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Source: The American Journal of Emergency Medicine
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Total 261 results found since Jan 2013.
An educational intervention allows for greater prehospital recognition of acute stroke
We performed a study to determine whether a brief educational intervention directed at pre-hospital providers would increase the identification of stroke victims in the pre-hospital setting. The purpose of this IRB approved, before-and-after research project was to determine whether the implementation of Advanced Stroke Life Support Class (ASLS) [1] training for pre-hospital providers would lead to improved field identification of stroke.
Source: The American Journal of Emergency Medicine - May 23, 2017 Category: Emergency Medicine Authors: Tara K. Henry-Morrow, Bryan D. Nelson, Erin Conahan, Claranne Mathiesen, Bernadette Glenn-Porter, Matthew T. Niehaus, Lauren M. Porter, Mitchell R. Gesell, Gregory T. Monaghan, Jeanne L. Jacoby Tags: Correspondence Source Type: research
Chemotherapy induced stroke mimic: 5-Fluorouracil encephalopathy fulfilling criteria for tissue plasminogen activator therapy
Stroke mimics, especially those involving chemotherapy related neurotoxicity, can confound the clinical diagnosis of acute stroke. Here we describe the case of a 63year-old male with a recent history of stage IIIC colon cancer who presented with confusion on the second day of modified FOLFOX6 (5-fluorouracil/oxaliplatin) chemotherapy and subsequently received alteplase, tissue plasminogen activator therapy (tPA), for presumed ischemic stroke. Magnetic resonance imaging scans after tPA administration did not reveal evidence of an infarction and the patients' neurological symptoms resolved completely after discontinuation of...
Source: The American Journal of Emergency Medicine - July 6, 2017 Category: Emergency Medicine Authors: May Thuy Nguyen, Robyn Stoianovici, Luigi Brunetti Source Type: research
Contribution of routine cardiac biological markers to the etiological workup of ischemic stroke
Optimization of the detection of atrial fibrillation following stroke is mandatory. Unfortunately, access to long-term cardiac monitoring is limited in many centers. The aim of this study was to assess the potential usefulness of three routine biological markers, troponin, D-dimers and BNP, measured in acute stroke phase in the selection of patients at risk of cardio-embolic stroke.
Source: The American Journal of Emergency Medicine - May 17, 2018 Category: Emergency Medicine Authors: C. Tomich, J.S. Liegey, S. Sagnier, S. Olindo, M. Poli, S. Debruxelles, F. Rouanet, P. Renou, I. Sibon Source Type: research
Clinical usefulness of brain-derived neurotrophic factor and visinin-like protein-1 in early diagnostic tests for acute stroke
Lack of a rapid biochemical test for acute stroke is a limitation in the diagnosis and management of acute stroke. The aim of this study is to evaluate the efficacy of BDNF and VILIP-1 as diagnostic markers in acute ischemic stroke and as predictors of mortality.
Source: The American Journal of Emergency Medicine - February 25, 2019 Category: Emergency Medicine Authors: Abdullah Algin, M. Ozgur Erdogan, Irfan Aydin, M. Kaan Poyraz, Mehmet Sirik Source Type: research
Thrombolysis for atlantoaxial dislocation mimicking acute ischemic stroke: Case report and review
The frequency of stroke mimics among stroke patients has been reported to be up to 30%, and that in patients who receive thrombolytic therapy ranges between 1% and 16%. Atlantoaxial dislocation with myelopathy mimicking stroke is extremely rare. An 83-year-old man with a history of old cerebellar infarction presented to the emergency department with acute left hemiplegia after a chiropractic manipulation of the neck and back several hours before symptom onset. Mild hypoesthesia was observed on his left limbs.
Source: The American Journal of Emergency Medicine - March 26, 2019 Category: Emergency Medicine Authors: Adam Tsou, Yu-Hsiu Juan, Tsu-Yi Chen, Shinn-Kuang Lin Source Type: research
Thrombolysis for atlantoaxial dislocation mimicking acute ischemic stroke
The frequency of stroke mimics among stroke patients has been reported to be up to 30%, and that in patients who receive thrombolytic therapy ranges between 1% and 16%. Atlantoaxial dislocation with myelopathy mimicking stroke is extremely rare. An 83-year-old man with a history of old cerebellar infarction presented to the emergency department with acute left hemiplegia after a chiropractic manipulation of the neck and back several hours before symptom onset. Mild hypoesthesia was observed on his left limbs.
Source: The American Journal of Emergency Medicine - March 26, 2019 Category: Emergency Medicine Authors: Adam Tsou, Yu-Hsiu Juan, Tsu-Yi Chen, Shinn-Kuang Lin Tags: Case Report Source Type: research
Neighborhood-level stroke hot spots within major United States cities
Identifying communities at high risk of stroke is an important step in improving systems of stroke care. Stroke is known to show spatial clustering at the state and county levels, but it is not known if clusters are present within city boundaries.
Source: The American Journal of Emergency Medicine - June 24, 2019 Category: Emergency Medicine Authors: Daniel A. Dworkis, James Marvel, Nerses Sanossian, Sanjay Arora Source Type: research
Implementation of a pilot electronic stroke outcome reporting system for emergency care providers
Emergency department (ED) providers and clinicians find that feedback on acute stroke patients is rewarding, valuable to professional development, and helpful for practice improvement. However, feedback is rarely provided, particularly for patients with stroke. Here we describe the implementation of an electronic stroke outcome reporting tool for providing feedback to ED providers.
Source: The American Journal of Emergency Medicine - July 10, 2019 Category: Emergency Medicine Authors: William L. Scheving, Joseph M. Ebersole, Michael Froehler, Donald Moore, Kiersten Brown-Espaillat, James Closser, Wesley H. Self, Michael J. Ward Source Type: research
Evaluating Target: Stroke guideline implementation on assessment and treatment times for patients with suspected stroke
Immediate ischemic stroke treatment improves outcomes and early alteplase administration is recommended for patients within window. We implemented stroke guidelines through a neuro-resuscitation initiative (NRI) and hypothesized that the intervention would decrease times to assessment and treatment.
Source: The American Journal of Emergency Medicine - February 12, 2020 Category: Emergency Medicine Authors: Danielle Albright, Robert Alunday, Eric Schaller, Huy Q. Tran, Cameron S. Crandall Source Type: research
Can non-contrast head CT and stroke severity be used for stroke triage? A population-based study
Acute ischemic stroke (AIS) patients may benefit from endovascular thrombectomy (EVT) up to 24 h since last known normal (LKN). Advanced imaging is required for patient selection. Small or rural hospitals may not have sufficient CT technician and radiology support to rapidly acquire and interpret images. We estimated transfer rates using non-contrast head CT and stroke severity to select p atients to be transferred to larger centers for evaluation.
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Charles Kircher, Amanda Humphries, Dawn Kleindorfer, Kathleen Alwell, Heidi Sucharew, Charles J. Moomaw, Jason Mackey, Felipe De Los Rios La Rosa, Brett Kissela, Opeolu Adeoye Source Type: research
SARS-CoV-2 infection and its association with thrombosis and ischemic stroke: A review COVID-19, thrombosis, and ischemic stroke
This review of current literature provides background to the COVID-19 pandemic, as well as an examination of potential pathophysiologic mechanisms behind development of thrombosis and ischemic stroke related to COVID-19. SARS-CoV-2 infection is well-documented to cause severe pneumonia, however, thrombosis and thrombotic complications, such as ischemic stroke, have also been documented in a variety of patient demographics. SARS-CoV-2 infection is known to cause a significant inflammatory response, as well as invasion of vascular endothelial cells, resulting in endothelial dysfunction.
Source: The American Journal of Emergency Medicine - September 28, 2020 Category: Emergency Medicine Authors: Jonathan Snell Source Type: research
Computed tomographic and magnetic resonance abnormalities of basal ganglion secondary to nonketotic hyperglycemia in a patient with stroke
Ischemic stroke is a disease that frequently presents to the emergency department (ED). Diabetes mellitus is a well-known risk factor for stroke. Here, we present a diabetic patient who visited our ED with muscle weakness of unilateral side but who was found to have hyperattenuation on computed tomography and hyperintensity on T1-weighted magnetic resonance imaging at his unilateral basal ganglion, which is frequently found in patients with hyperglycemia-induced chorea-ballismus.
Source: The American Journal of Emergency Medicine - May 3, 2013 Category: Emergency Medicine Authors: Chih-Yu Liang, Jiun-Nong Lin Tags: Case Reports Source Type: research
Drill down analysis of door-to-needle time of acute ischemic stroke patients treated with intravenous tissue plasminogen activator
Target stroke guidelines recommend a door-to-needle time of ≤60 minutes for acute ischemic stroke (AIS) patients treated with intravenous (IV) tissue-type plasminogen activator (tPA). We sought to analyze all diagnostic steps involved in the acute evaluation and treatment of AIS with IV tPA and to look for causes of delay in door to needle time (DNT).
Source: The American Journal of Emergency Medicine - August 7, 2014 Category: Emergency Medicine Authors: Jon W. Schrock, Marija Lum Tags: Original Contribution Source Type: research
Readministration of intravenous alteplase in acute ischemic stroke patients: case series and systematic review
Background: Because of a high risk of recurrence of ischemic events, some patients may be candidates for readministration of intravenous (IV) alteplase. Methods: We performed a single-center review and performed a search on PubMed from January 1966 to April 2014 for cases of readministration of alteplase. Favorable outcome was defined by a modified Rankin scale of 0 to 2 at discharge or at 1 to 3 months, improvement of greater than or equal to 4 points within 24 hours in the National Institutes of Health Stroke Scale score, or as a major improvement in the 72-hour National Institutes of Health Stroke Scale score.
Source: The American Journal of Emergency Medicine - July 30, 2014 Category: Emergency Medicine Authors: Adnan I. Qureshi, Ahmed A. Malik, Melissa Freese, Michelle J. Thompson, Asif A. Khan, M. Fareed K. Suri Tags: Case Report Source Type: research
Good outcome after intravenous thrombolysis for acute stroke in a patient under treatment with dabigatran
We describe an unusual case of treatment IV rt-PA for acute ischemic stroke in a patient receiving dabigatran for AF.
Source: The American Journal of Emergency Medicine - April 18, 2014 Category: Emergency Medicine Authors: Cátia Diogo, Josiana Duarte, Sofia Sobral, Paula Pestana, Hipólito Nzwalo, Henrique Rita, José Sousa e Costa Tags: Case Report Source Type: research
