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Source: The American Journal of Emergency Medicine

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Total 261 results found since Jan 2013.

The utility of bolus intravenous nicardipine for hypertensive emergencies in the ED
We describe the first 2 documented cases of use of nicardipine administered as an IV bolus dose in the emergency department (ED) for hypertensive emergencies involving acute ischemic stroke and hemorrhagic stroke.
Source: The American Journal of Emergency Medicine - March 20, 2016 Category: Emergency Medicine Authors: Stephanie N. Komura, Nadia I. Awad Tags: Case Report Source Type: research

Cerebral hyperperfusion syndrome: a rare postoperative complication of carotid endarterectomy
Acute neurological deficits are common presentations to the emergency department. Cerebral hyperperfusion syndrome, a rare phenomenon which can occur within one month following carotid surgical revascularization, may be challenging for the emergency physician to diagnose in the setting of an acute neurological presentation. Carotid arterial disease contributes 15-20% of ischemic cerebrovascular accidents and surgical revascularization is the commonest intervention for preventing stroke in patients with significant carotid disease.
Source: The American Journal of Emergency Medicine - March 5, 2016 Category: Emergency Medicine Authors: Mina Guirgis, Kishore Sieunarine Source Type: research

Cerebral hyperperfusion syndrome: A rare postoperative complication of carotid endarterectomy
Acute neurological deficits are common presentations to the emergency department. Cerebral hyperperfusion syndrome, a rare phenomenon which can occur within one month following carotid surgical revascularization, may be challenging for the emergency physician to diagnose in the setting of an acute neurological presentation. Carotid arterial disease contributes 15 –20% of ischemic cerebrovascular accidents and surgical revascularization is the commonest intervention for preventing stroke in patients with significant carotid disease.
Source: The American Journal of Emergency Medicine - March 4, 2016 Category: Emergency Medicine Authors: Mina Guirgis, Kishore Sieunarine Tags: Case Report Source Type: research

Protective effects of cyclosporine A and hypothermia on neuronal mitochondria in a rat asphyxial cardiac arrest model
Cyclosporine A (CsA) was neuroprotective in the settings of traumatic brain injury and stroke. We sought to investigate the protective effects of CsA and hypothermia on neuronal mitochondria after cardiac arrest.Methods and Results.Five groups were included: sham (S), normothermia (N), CsA (C), hypothermia (H), and CsA plus hypothermia (C+H). Cardiac arrest was induced by 10min of asphyxia. CsA (10mg/kg) was administered immediately after return of spontaneous circulation in the CsA groups. Temperature of the rats was maintained at 33±0.5°C after return of spontaneous circulation in the hypothermia groups.
Source: The American Journal of Emergency Medicine - March 1, 2016 Category: Emergency Medicine Authors: Jie Liu, Yue Wang, Qiwei Zhuang, Meng Chen, Yufeng Wang, Lina Hou, Fei Han Tags: Original Contributions Source Type: research

Brugada Electrocardiogram Pattern Induced by Cannabis; is cannabis safe?
The objective of this study was to present a case report that bring attention to relationship between cannabis consumption and Brugada electrocardiogram pattern (BEP). Here we present a case of a 19-year-old male patient with symptomatic BEP induced after cannabis consumption. With the potential for more widespread legalization of cannabis several studies are raising the issue of adverse vascular effects of cannabis, including myocardial infarction, sudden cardiac death, cardiomyopathy, stroke, transient ischemic attack, and cannabis arteritis.
Source: The American Journal of Emergency Medicine - December 30, 2015 Category: Emergency Medicine Authors: Joaquín Valle Alonso, Beatrix Theo, F. Javier Fonseca del Pozo, Miguel Angel Aguayo, Almudena Sanchez Tags: Case Report Source Type: research

Admission serum lactate predicts mortality in aneurysmal subarachnoid hemorrhage
Aneurysmal SAH is the most devastating form of hemorrhagic stroke. Primary predictors of mortality are based on initial clinical presentation. Initial serum lactic acid levels have been shown to predict mortality and disease severity. Initial serum lactate may be an objective predictor or mortality.
Source: The American Journal of Emergency Medicine - December 30, 2015 Category: Emergency Medicine Authors: Imo P. Aisiku, Peng Roc Chen, Hanh Truong, Daniel R. Monsivais, Jonathan Edlow Tags: Original Contribution Source Type: research

Brugada electrocardiogram pattern induced by cannabis; is cannabis safe?
The objective of this study was to present a case report that brings attention to relationship between cannabis consumption and Brugada electrocardiogram pattern. Here, we present a case of a 19-year-old male patient with symptomatic Brugada electrocardiogram pattern induced after cannabis consumption. With the potential for more widespread legalization of cannabis, several studies are raising the issue of adverse vascular effects of cannabis, including myocardial infarction, sudden cardiac death, cardiomyopathy, stroke, transient ischemic attack, and cannabis arteritis.
Source: The American Journal of Emergency Medicine - December 29, 2015 Category: Emergency Medicine Authors: Joaqu ín Valle Alonso, Beatrix Huei-Yi Teo, F. Javier Fonseca del Pozo, Miguel Angel Aguayo, Almudena Sanchez Tags: Case Report Source Type: research

Is it dangerous to treat acute ischemic stroke by thrombolytic therapy in patients with comorbid intracranial aneurysms
The safety of cerebral ischemic stroke patients with comorbid intracranial aneurysms treated by thrombolysis is still an unsolved mystery. We aimed to perform a secondary analysis and review to provide evidence on whether stroke patients with intracranial aneurysms have worse outcomes following thrombolysis.
Source: The American Journal of Emergency Medicine - December 16, 2015 Category: Emergency Medicine Authors: Jiayue Ding, Jie Han, Zhe Jing, Yue Jiang Source Type: research

When stroke is more than stroke
We describe a case of aortic dissection presenting as right middle cerebral artery syndrome who received intravenous thrombolysis complicated by aortic rupture with a fatal outcome. A Medline search shows that this is the first report of aortic rupture since the inception of thrombolysis for acute stroke.
Source: The American Journal of Emergency Medicine - November 18, 2015 Category: Emergency Medicine Authors: Shing Ching, Soo Moi Ting Tags: Case Report Source Type: research

Computed tomography angiography in acute stroke (revisiting the 4Ps of imaging)
Imaging in acute stroke has traditionally focussed on the 4Ps—parenchyma, pipes, perfusion, and penumbra—and has increasingly relied upon advanced techniques including magnetic resonance imaging to evaluate such patients. However, as per European Magnetic Resonance Forum estimates, the availability of magnetic resonance imaging scanners for the general population in India (0.5 per million inhabitants) is quite low as compared to Europe (11 per million) and United States (35 per million), with most of them only present in urban cities.
Source: The American Journal of Emergency Medicine - November 3, 2015 Category: Emergency Medicine Authors: Shriram Varadharajan, Jitender Saini, Ullas V. Acharya, Arun Kumar Gupta Tags: Brief Report Source Type: research

CT Angiography in acute stroke (Revisiting the 4Ps of Imaging)
Imaging in acute stroke has traditionally focussed on the 4 Ps - Parenchyma, Pipes, Perfusion and Penumbra and has increasingly relied upon advanced techniques including Magnetic Resonance Imaging (MRI) to evaluate such patients. However as per European Magnetic Resonance Forum (EMRF) estimates, the availability of MRI scanners for the general population in India (0.5 per million inhabitants) is quite low as compared to Europe (11 per million) and USA (35 per million), with the vast majority of them only present in urban cities.
Source: The American Journal of Emergency Medicine - November 3, 2015 Category: Emergency Medicine Authors: Shriram Varadharajan, Jitender Saini, Ullas VA, Arun Kumar Gupta Source Type: research

Bradycardia caused by Intravenous Nicardipine in an Elderly Patient with Acute Ischemic Infarct
We report the case of an elderly patient with an acute ischemic stroke who developed nicardipineinduced bradycardia in the ED.
Source: The American Journal of Emergency Medicine - August 17, 2015 Category: Emergency Medicine Authors: Michael E. Abboud, Sarah E. Frasure Tags: Case Report Source Type: research

Cerebral oximetry with cerebral blood volume index in detecting pediatric stroke in a pediatric ED
Despite pediatric stroke awareness and pediatric stroke activation systems, recognition and imaging delays along with activation inconsistency still occur. Reliable objective pediatric stroke detection tools are needed to improve detection and activations. Regional cerebral oxygen saturation (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, Rawle Seupaul, Abby Williams, Sheila McMorrow, Jennifer Dindo, Angela Gordon, Maria Melguizo-Castro, Zhuopei Hu, Todd Nick Tags: Original Contribution 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

Achieving Regionalization through Rural Inter-hospital Transfer
Regionalization of emergency medical care aims to provide consistent and efficient high quality care leading to optimal clinical outcomes by matching patient needs with appropriate resources at a network of hospitals. Regionalized care has been shown to improve outcomes in trauma, myocardial infarction, stroke, cardiac arrest, and acute respiratory distress syndrome. In rural areas, effective regionalization often requires inter-hospital transfer. The decision to transfer is complex and includes such factors as capabilities of the presenting hospital, capacity at the receiving hospital, financial, geographic, and patient-p...
Source: The American Journal of Emergency Medicine - May 29, 2015 Category: Emergency Medicine Authors: Leah Feazel, Adam B. Schlichting, Gregory R. Bell, Dan M. Shane, Azeemuddin Ahmed, Brett Faine, Andrew Nugent, Nicholas M. Mohr Tags: Review Source Type: research