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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

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

Successful management of heat stroke associated with multiple-organ dysfunction by active intravascular cooling
We report successful cooling with initial intravascular cooling use that rapidly achieved the target temperature with continued normothermia thereafter.
Source: The American Journal of Emergency Medicine - June 12, 2014 Category: Emergency Medicine Authors: Hideyuki Hamaya, Toru Hifumi, Kenya Kawakita, Tomoya Okazaki, Kazutaka Kiridume, Natsuyo Shinohara, Yuko Abe, Koshiro Takano, Masanobu Hagiike, Yasuhiro Kuroda Tags: Case Report Source Type: research

Successful management of heat stroke associated with multiple organ dysfunction by active intravascular cooling
Source: The American Journal of Emergency Medicine - June 12, 2014 Category: Emergency Medicine Authors: Hideyuki Hamaya, Toru Hifumi, Kenya Kawakita, Tomoya Okazaki, Kazutaka Kiridume, Natsuyo Shinohara, Yuko Abe, Koshiro Takano, Masanobu Hagiike, Yasuhiro Kuroda Source Type: research

Successful management of heat stroke associated with multiple-organ dysfunction by active intravascular cooling
We report successful cooling with initial intravascular cooling use that rapidly achieved the target temperature with continued normothermia thereafter.
Source: The American Journal of Emergency Medicine - June 12, 2014 Category: Emergency Medicine Authors: Hideyuki Hamaya, Toru Hifumi, Kenya Kawakita, Tomoya Okazaki, Kazutaka Kiridume, Natsuyo Shinohara, Yuko Abe, Koshiro Takano, Masanobu Hagiike, Yasuhiro Kuroda Source Type: research

Acute psychosis presenting as a sole manifestation of left atrial myxoma: a new paradigm
Atrial myxomas are the most common benign cardiac tumors. Neurological manifestations associated with left atrial myxoma are seen infrequently in the form of embolic stroke of intracranial hemorrhage. Psychiatric manifestations are however exceedingly rare. We hereby present a case who presented with acute psychosis as a sole manifestation of an underlying left atrial myxoma.
Source: The American Journal of Emergency Medicine - May 12, 2014 Category: Emergency Medicine Authors: Rajendra Singh Jain, Kadam Nagpal, Rahul Jain, Swayam Prakash, Rahul Handa Tags: Case Report Source Type: research

Implementation of a clinical pathway based on a computerized physician order entry system for ischemic stroke attenuates off-hour and weekend effects in the emergency department
Source: The American Journal of Emergency Medicine - May 11, 2014 Category: Emergency Medicine Authors: Jong Min Yang, Yoo Seok Park, Sung Phil Chung, Hyun Soo Chung, Hye Sun Lee, Je Sung You, Shin Ho Lee, Incheol Park Source Type: research

Posterior cerebral artery stroke presenting as alexia without agraphia
Source: The American Journal of Emergency Medicine - April 28, 2014 Category: Emergency Medicine Authors: Bhawna Sharma, Rahul Handa, Swayam Prakash, Kadam Nagpal, Indu Bhana, Pankaj Kumar Gupta, Sunil Kumar, Mahendra Singh Sisodiya Tags: Case Report Source Type: research

Posterior Cerebral artery stroke presenting as Alexia without Agraphia
Source: The American Journal of Emergency Medicine - April 26, 2014 Category: Emergency Medicine Authors: Bhawna Sharma, Rahul Handa, Swayam Prakash, Kadam Nagpal, Indu Bhana, Pankaj Kumar Gupta, Sunil Kumar, Mahendra Singh Sisodiya 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

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

Acute Pediatric Stroke – What’s the Hurry? A Case for Emergency Physician Performed Echocardiography
Source: The American Journal of Emergency Medicine - April 16, 2014 Category: Emergency Medicine Authors: Christopher D. Thom, Scott E. Sparks Source Type: research

Good outcome after intravenous thrombolysis for acute stroke in a patient under treatment with dabigatran
Source: The American Journal of Emergency Medicine - April 16, 2014 Category: Emergency Medicine Authors: Cátia Diogo, Josiana Duarte, Sofia Sobral, Paula Pestana, Hipólito Nzwalo, Henrique Rita, José Sousa Costa Source Type: research

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