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Infarct location predicts outcome in distal MCA occlusions (P4.255)
Conclusions:ASPECTS regions M3 and M6 are key predictors of functional outcome following isolated distal MCA infarction. These findings will be helpful in stratifying outcomes if validated in future studies.Disclosure: Dr. Khan has nothing to disclose. Dr. Baird has nothing to disclose. Dr. Goddeau has nothing to disclose. Dr. Silver has received personal compensation for activities with Women's Health Initiative, SOCRATES trial, MedLink, Medscape, and Ebix. Dr. Henninger has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Khan, M., Baird, G., Goddeau, R., Silver, B., Henninger, N. Tags: Acute and Diagnostic Imaging in Ischemic Stroke and TIA Source Type: research

Early Clinical Improvement in Central Retinal Artery Occlusion is Associated with Central Retinal Artery Recanalization (P4.262)
Conclusions:In our case series, no patient without early recanalization of the CRA had ECI. Further studies are merited to determine the impact of CRA recanalization timing and, furthermore, whether fibrinolytic therapy is associated with improved CRA recanalization rates and long-term visual acuity in CRAO patients.Disclosure: Dr. Alkuwaiti has nothing to disclose. Dr. Male has nothing to disclose. Dr. Hendriksen has nothing to disclose. Dr. Engel has nothing to disclose. Dr. Reshi has nothing to disclose. Dr. Ezzeddine has received personal compensation for activities with Air Liquide as a Scientific Advisory Board membe...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Alkuwaiti, M., Male, S., Hendriksen, S., Engel, K., Reshi, R. A., Ezzeddine, M., Emiru, T., Logue, C., Streib, C. Tags: Thrombolysis and Acute Evaluation in Ischemic Stroke Source Type: research

Historical Perspective of Cambodian Medicine with a focus on Neurology (P2.051)
Conclusions:The Keck School of Medicine of USC received a grant from World Federation of Neurology, which allowed faculty to travel to Cambodia and teach the clinical and diagnostic aspects of neurology over the course of two years. We expect a neurology residency to start in 2017 to help the patient population that suffers from stroke, seizure disorders and various other types of neurological disorders. Even though the past has had its rough patches, the future has untapped potential.Study Supported by: This study was supported by World Federation of Neurology.Disclosure: Dr. Singh has nothing to disclose. Dr. Sahai-Sriva...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Singh, S., Sahai-Srivastava, S., Khosa, S., Mishra, S. Tags: History of Neurology Source Type: research

Symptomatic Intracranial Hemorrhage after IV tPA for Acute Ischemic Stroke Patients with Relative Contraindications to Treatment (P4.267)
Conclusions:12 AIS patients with Class 3 exclusion criteria were treated with IV tPA. Our eight cases of IV tPA in pICH patients adds substantially to the existing literature. In this study, 25% of patients with pICH developed symptomatic ICH after IV tPA. Although the low number of eligible patients limits interpretation of our findings, continued caution when considering IV tPA for AIS patients with pICH may be warranted. More data is needed to clarify the impact these relative contraindications have on the treatment of AIS.Disclosure: Dr. Smith has nothing to disclose. Dr. Alkuwaiti has nothing to disclose. Dr. Bell has...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Smith, K., Alkuwaiti, M., Bell, C., Lindsay, D., Heyer, A., Reshi, R., Ezzeddine, M., Streib, C. Tags: Thrombolysis and Acute Evaluation in Ischemic Stroke Source Type: research

Time Trend Analysis of Intravenous Thrombolytic Delivery across the Academic Year: an Academic Tertiary Medical Center Experience (P4.278)
Conclusions:Although not statistically significant, there is a decrease in DTN time (4.38 minutes) from the first academic quarter to the last quarter. Over the course of academic year, residents become more efficient in managing AIS, but ample attending supervision is the key to resident confidence and best patient care.Disclosure: Dr. Mehla has nothing to disclose. Dr. Shah has nothing to disclose. Dr. Lail has nothing to disclose. Dr. Vaughn has nothing to disclose. Dr. Joshi has nothing to disclose. Dr. Deline has nothing to disclose. Dr. Sawyer has nothing to disclose. Dr. Ching has nothing to disclose. Dr. Mowla has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Mehla, S., Shah, H., Lail, N., Vaughn, C., Joshi, S., Deline, C., Sawyer, R., Ching, M., Mowla, A. Tags: Thrombolysis and Acute Evaluation in Ischemic Stroke Source Type: research

Target Stroke Implementation: Best Practice Strategies Cut Thrombolysis Time to < 30 minutes in a 1,550 Bed Academic Urban County Hospital (P4.280)
Conclusions:Individualized hospital gap analysis identifies targeted interventions to shorten treatment times. DTN and DTG time can be reduced with implementation of simple, low-cost interventions, with persistent effect and no increase in symptomatic intracranial hemorrhage or stroke mimic treatment.Disclosure: Dr. Marulanda-Londoño has nothing to disclose. Dr. Bhatt has nothing to disclose. Dr. Atchaneeyasakul has nothing to disclose. Dr. Asdaghi has nothing to disclose. Dr. Malik has nothing to disclose. Dr. Akram has nothing to disclose. Dr. Zhang has nothing to disclose. Dr. D’Amour has nothing to disclos...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Marulanda-Londono, E., Bhatt, N., Atchaneeyasakul, K., Asdaghi, N., Malik, A., Akram, N., Zhang, T., DAmour, D., Hesse, K., Sacco, R., Romano, J. Tags: Thrombolysis and Acute Evaluation in Ischemic Stroke Source Type: research

Rapidly improving neurological deficit of stroke; case series in Academic institute, KAUH, Jeddah (P4.283)
Conclusions:Rapidly improving patient represent a challenge to whether tPA should be given. However, the good outcome with thrombolytic therapy observed in our study, will hopfuly support the decision to treat.Study Supported by: nonDisclosure: Dr. khoja has nothing to disclose. Dr. Alshaer has nothing to disclose. Dr. al-Turkistani has nothing to disclose. Dr. Al-Mekhalfi has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: khoja, a., Al-Shaer, D., al-Turkistani, a., Al-Mekhalfi, M. Tags: Thrombolysis and Acute Evaluation in Ischemic Stroke Source Type: research

Resident door to needle Analysis: A retrospective Chart rEview (RACE) (P4.285)
Conclusions:Recognition and token awards for neurology residents can lead to shorter DTN times which could, in turn, improve outcomes in AIS. However, this approach requires a continued review of diagnostic accuracy and adverse events to ensure quality of care is not compromised for the sake of speed.Disclosure: Dr. Patel has nothing to disclose. Dr. Mehta has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Patel, N., Mehta, S. Tags: Thrombolysis and Acute Evaluation in Ischemic Stroke Source Type: research

Analysis of current clinical practice on initiation of anticoagulation in patients with acute ischemic stroke. (P4.298)
Conclusions:Physicians with a subspecialty in vascular neurology, those with more years of experience in practice, and those practicing at academic institutions tended to initiate anticoagulation later.Disclosure: Dr. Olivas has nothing to disclose. Dr. Ajani has nothing to disclose. Dr. Yao has nothing to disclose. Dr. Sangha has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Olivas, E., Ajani, Z., Yao, J., Sangha, N. Tags: In-Hospital Stroke Care Source Type: research

The Experience of Spoke Hospitals in an Academic Telestroke Network (P1.278)
Conclusions:Within this single hub-spoke telestroke system in the Northeast, we found that spoke hospitals perceive the advantages of telestroke to be in enabling improved rates and efficiency of tPA administration. Barriers to use were most often related to technological challenges rather than concerns about patient care or patients’ perceptions. Future work should further explore how to better meet the needs of spoke hospitals in caring for stroke patients.Disclosure: Dr. Gadhia has nothing to disclose. Dr. Schwamm has received personal compensation for activities with Lundbeck, LifeImage, and Medtronic as a consul...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Gadhia, R., Schwamm, L., Viswanathan, A., Whitney, C., Moreno, A., Zachrison, K. S. Tags: Pre-Hospital Stroke, Tele-Stroke, and mHealth Source Type: research

Clinical features of acute stroke in young adults - a qualitative study of patient experiences (P3.260)
Conclusions:Young adults with acute stroke may have atypical clinical features that interfere with accessing care and receiving an accurate diagnosis.Disclosure: Dr. Jones has nothing to disclose. Dr. Huggins has nothing to disclose. Dr. Thaler has received personal compensation for activities with St. Jude Medical WL and Gore Associates as a consultant. Dr. Han has nothing to disclose. Dr. Leung has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Jones, D., Huggins, H., Thaler, D., Han, P., Leung, L. Tags: Cerebrovascular Disease Epidemiology Source Type: research

Age, Gender and Racial Disparities in Acute Stroke Therapy in a Large Non-Academic Health System (P3.261)
Conclusions:We confirmed known disparities in ATT rates between PSC and AH. No disparity in age or gender were identified in this population. Racial disparity was problematic because of a small number of non-white patients and a number of patients with no racial data captured. Better racial data collection, analysis of access to care, and care process modeling might impact these findings.Disclosure: Dr. Taylor has nothing to disclose. Dr. Jones has received personal compensation for activities with Genentech as a speaker. Dr. Gosnell has nothing to disclose. Dr. Snyder has nothing to disclose. Dr. Schneider has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Taylor, R., Jones, R., Gosnell, J., Snyder, S., Schneider, A. Tags: Cerebrovascular Disease Epidemiology Source Type: research

Findings from the University of Minnesota Posterior Circulation Stroke Database (P3.262)
Conclusions:Our work adds to the meager literature on AIPCS. Further studies of medical and endovascular intervention in AIPCS secondary to LAA are particularly needed in order to define optimal treatment in this patient subset.Disclosure: Dr. Bell has nothing to disclose. Dr. Anderson has received personal compensation in an editorial capacity Neurology: Clinical Practice and Continuum Audio. Dr. Lakshminarayan has nothing to disclose. Dr. Jagadeesan has nothing to disclose. Dr. Reshi has nothing to disclose. Dr. Miller has nothing to disclose. Dr. Ezzeddine has received personal compensation for activities with Air Liqui...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Bell, C., Anderson, D., Lakshminarayan, K., Jagadeesan, B., Reshi, R. A., Miller, B., Ezzeddine, M., Streib, C. Tags: Cerebrovascular Disease Epidemiology 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

Safety Outcome of Carotid Artery Stenting in Long Carotid Lesion with Proximal versus Distal Embolic Protection Devices (P3.077)
Conclusions:Patients with carotid lesion length >10mm undergoing CAS with PPD shows a trend to better safety outcomes including perioperative stroke than patients with DPD. A larger prospective study is needed to confirm this finding.Disclosure: Dr. Saini has nothing to disclose. Dr. Atchaneeyasakul has nothing to disclose. Dr. Goswami has nothing to disclose. Dr. Ambekar has nothing to disclose. Dr. Ramdas has nothing to disclose. Dr. Guada has nothing to disclose. Dr. Yavagal has received personal compensation for activities with Medtronic and Guidepoint as a consultant.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Saini, V., Atchaneeyasakul, K., Goswami, A., Ambekar, S., Ramdas, K., Guada, L., Yavagal, D. Tags: Cerebrovascular Disease and Interventional Neurology ePoster Session Source Type: research

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