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Source: The American Journal of Emergency Medicine
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Total 261 results found since Jan 2013.
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
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
Cerebral Oximetry with Cerebral Blood Volume Index (CBVI) in detecting Pediatric Strokes in a Pediatric Emergency Department
Despite pediatric stroke awareness and Pediatric Stroke Activation systems, recognition and imaging delays along with activation inconsistency still occurs. Reliable objective pediatric stroke detection tool are needed to improve detection and activations. Cerebral rcSO2 with cerebral blood volume index (CBVI) can detect abnormal cerebral physiology.
Source: The American Journal of Emergency Medicine - July 22, 2015 Category: Emergency Medicine Authors: Thomas J. Abramo, Z. Leah Harris, Mark Meredith, Kristen Crossman, Abby Williams, Sheila McMorrow, Jennifer Dindo, Angela Gordon, Maria Melguizo-Castro, Zhuopei Hu, Todd Nick Tags: Original Contribution Source Type: research
Wallenberg's Lateral Medullary Syndrome in an Adolescent
Concussion and sports-related injuries are common in children. Given the heightened awareness about concussion in recent years, there has been an increase in the diagnosis of concussion in children presenting to the emergency department with head injuries. Often, little consideration is given to other etiologies of neurologic symptoms such as stroke. This may be due to the fact that stroke is uncommon in children when compared to adults. However, there are several case reports of arterial dissection and stroke in the pediatric age group resulting from trivial trauma.
Source: The American Journal of Emergency Medicine - May 11, 2016 Category: Emergency Medicine Authors: Elizabeth Ruedrich, Mahesh Chikkannaiah, Gogi Kumar Tags: Case Report Source Type: research
Wallenberg's lateral medullary syndrome in an adolescent
Concussion and sports-related injuries are common in children. Given the heightened awareness about concussion in recent years, there has been an increase in the diagnosis of concussion in children presenting to the emergency department with head injuries. Often, little consideration is given to other etiologies of neurologic symptoms such as stroke. This may be due to the fact that stroke is uncommon in children when compared to adults. However, there are several case reports of arterial dissection and stroke in the pediatric age group resulting from trivial trauma.
Source: The American Journal of Emergency Medicine - May 11, 2016 Category: Emergency Medicine Authors: Elizabeth Day Ruedrich, Mahesh Chikkannaiah, Gogi Kumar Tags: Case Report Source Type: research
The use of an emergency department dysphagia screen is associated with decreased pneumonia in acute strokes
Dysphagia is a common problem for patients after an acute stroke which can lead to hospital acquired pneumonia (HAP) increasing morbidity and mortality. The Joint Commission has directed that stroke certified hospitals perform a dysphagia screen at the time of initial presentation. We sought to evaluate if our ED dysphagia screen was correlated with lower rates of pneumonia in acute stroke patients.
Source: The American Journal of Emergency Medicine - March 22, 2018 Category: Emergency Medicine Authors: Jon W. Schrock, Linda Lou, Benjamin A.W. Ball, J. Van Etten Source Type: research
Admission rates of ED patients with transient ischemic attack have increased since 2000
This study is conducted in 6 New Jersey EDs with annual ED visits from 25000 to 65000. Consecutive patients seen by ED physicians between January 1, 2000, and December 31, 2010, were included. We identified TIA visits using the International Classification of Diseases, Ninth Revision, code. We analyzed the admission rates for TIA testing for significant differences using the Student t test and calculated 95% confidence intervals.Results: Of the 2622659 visits in the database, 8216 (0.3%) were for TIA. Females comprised 57%. There was a statistically significant increase in the annual admission rates for TIA patients from 2...
Source: The American Journal of Emergency Medicine - July 31, 2013 Category: Emergency Medicine Authors: Siama Durrani-Tariq, Barnet Eskin, John R Allegra Tags: Original Contributions Source Type: research
Bun/creatinine ratio-based hydration for preventing stroke-in-evolution after acute ischemic stroke
Source: The American Journal of Emergency Medicine - April 4, 2014 Category: Emergency Medicine Authors: Leng-Chieh Lin, Jiann-Der Lee, Yen-Chu Hung, Chia-Hao Chang, Jen-Tsung Yang Source Type: research
Association of physician risk tolerance with emergency department computed tomography use for isolated dizziness/vertigo patients
Dizziness/vertigo is one of the most common principal complaints in the emergency department (ED) [1], accounting for 2.5% of all ED presentations [2]. Although the most common causes of dizziness/vertigo are benign, potential life-threatening stroke especially cerebellar or brain stem infarction should be considered in the differential diagnosis, because isolated dizziness without other concurrent neurological symptoms can be the sole presentation of these conditions [3-5]. Non-contrast brain computed tomography (CT) provides the necessary information for emergency management of most patients with suspected stroke and is ...
Source: The American Journal of Emergency Medicine - July 30, 2014 Category: Emergency Medicine Authors: Fu-Jen Cheng, Chien-Hung Wu, Yuan-Jhen Syue, Pai-Chun Yen, Kuan-Han Wu Source Type: research
Dabigatran-related coagulopathy: when can we assume the effect has “worn off”?
This issue of American Journal of Emergency Medicine presents a timely report that should be noted by all practicing emergency physicians. Nzwalo et al [1] describe a 61-year-old man with nonvalvular atrial fibrillation, taking 150 mg dabigatran twice daily for stroke protection, who presented to their emergency department (ED) with an acute ischemic stroke (AIS). The patient had a normal creatinine clearance and a normal thrombin time (TT). He was treated with intravenous recombinant tissue plasminogen activator (rt-PA) with good neurologic outcome and no bleeding complications.
Source: The American Journal of Emergency Medicine - August 28, 2014 Category: Emergency Medicine Authors: Charles V. Pollack, Jerrold H. Levy, John Eikelboom, Jeffrey I. Weitz, Frank W. Sellke, Menno V. Huisman, Thorsten Steiner, Pieter Kamphuisen, Richard A. Bernstein Tags: Controversies Source Type: research
Association of physician risk tolerance with ED CT use for isolated dizziness/vertigo patients
Dizziness/vertigo is one of the most common principal complaints in the emergency department (ED) [1], accounting for 2.5% of all ED presentations [2]. Although the most common causes of dizziness/vertigo are benign, potential life-threatening stroke especially cerebellar or brain stem infarction should be considered in the differential diagnosis because isolated dizziness without other concurrent neurologic symptoms can be the sole presentation of these conditions [3-5]. Noncontrast brain computed tomography (CT) provides the necessary information for emergency management of most patients with suspected stroke and is the...
Source: The American Journal of Emergency Medicine - July 30, 2014 Category: Emergency Medicine Authors: Fu-Jen Cheng, Chien-Hung Wu, Yuan-Jhen Syue, Pai-Chun Yen, Kuan-Han Wu Tags: Correspondence Source Type: research
Acute pediatric stroke—what’s the hurry? A case for emergency physician-performed echocardiography
We describe a case of acute ischemic stroke for which emergent, physician-sonographer–performed transthoracic echocardiography (TTE) changed his outcome. The patient in this case presented with left-sided hemiparesis, with subsequent CT Angiography (CTA) imaging and follow-on neurosurgical embolectomy for a proximal middle cerebral artery occlusion after which showed early recovery of muscular deficit.
Source: The American Journal of Emergency Medicine - April 18, 2014 Category: Emergency Medicine Authors: Christopher D. Thom, Scott E. Sparks Tags: Case Report Source Type: research
