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Timeliness of Neurology Consultations in the Emergency Department: A Quality Evaluation (P4.280)
CONCLUSIONS: Neurologic consultations called from the ED, excluding acute strokes, were completed in an average of 57 minutes. Reasons for prolonged consultations included waiting for results, staffing patients with two neurology services, and multiple simultaneous consult requests. Our department plans to re-evaluate ED consult times every three months to troubleshoot any timing issues that arise. Future studies could evaluate how length of neurology ED consults affects outcomes.Disclosure: Dr. Holden has nothing to disclose. Dr. Lewis has received personal compensation in an editorial capacity for Neurology and Continuum...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Holden, S., Lewis, S. Tags: Practice, Policy, and Ethics: Training and Common Practices in Neurology Source Type: research

Hydration Practices for the Acute Stroke Patient in an Academic, Certified Stroke Center (P3.125)
Conclusions: Although dehydration is common in the acute stroke population, initiation of fluid supplementation is delayed and many patients spend time without fluids. This provides a foundation for a system improvement project targeting time to fluid administration as well as the development of a fluid resuscitation algorithm for future prospective trials as we attempt to improve clinical outcome.Disclosure: Dr. Bahouth has nothing to disclose. Dr. Hillis has received research support from Allon Pharmaceutical. Dr. Gottesman has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Bahouth, M., Hillis, A., Gottesman, R. Tags: Cerebrovascular Disease and Interventional Neurology: Primary and Comprehensive Stroke Centers Source Type: research

Reducing Time to Treatment - The Role of Stroke Neurologist as First Responder (S5.006)
CONCLUSIONS: The use of a stroke-trained attending neurologist as a first responder and stroke team leader resulted in rapid patient evaluation and faster decision regarding thrombolytic therapy, improving time to treatment and time to CT.Disclosure: Dr. Ozark has nothing to disclose. Dr. Sabatino has nothing to disclose. Dr. Holmstedt has nothing to disclose. Dr. Turan has received personal compensation for activities with Gore Laboratories Inc., and Boehringer Ingelheim Pharmaceuticals Inc. Dr. Turan has received research support from Stryker Co., the National Institutes of Health, and AstraZeneca.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Ozark, S., Sabatino, P., Holmstedt, C., Turan, T. Tags: Cerebrovascular Disease and Interventional Neurology: Pre-hospital, Telemedicine, and Related Topics Source Type: research

Utility of Workup for Thrombophilias in a Single Center - A Qualitative Perspective (P1.125)
ConclusionStroke is considered cryptogenic in about 30-40 percent cases. Hypercoagulable testing is often ordered in this clinical setting. So far our results are consistent with other reports in the literature that such testing has limited clinical utility. Our results highlight the need to develop stringent clinical guidelines for HT in the setting of ischemic strokes.Disclosure: Dr. Shah has nothing to disclose. Dr. Anderson has nothing to disclose. Dr. Drake has received personal compensation for activities with UCB Pharma as a speaker. Dr. Proytcheva has nothing to disclose. Dr. Coull has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Shah, A., Anderson, N., Drake, K., Proytcheva, M., Coull, B. Tags: Cerebrovascular Disease and Interventional Neurology: Ischemic Stroke Subtype Source Type: research

Stroke And Cerebrovascular Risk Factors Knowledge In Patients Admitted To A Cardiovascular Ward. (P1.135)
Conclusion: Even in these selected population, with previous or current CVD, a large amount of RF and a high rate of previous medical consultations, knowledge about stroke showed to be very low indicating a poor quality of preventive measures and the need to emphasize educational interventions.Disclosure: Dr. Muñoz has nothing to disclose. Dr. Gonzalez Toledo has nothing to disclose. Dr. Pagani Cassara has nothing to disclose. Dr. Tamargo has nothing to disclose. Dr. Thomson has nothing to disclose. Dr. Nadile has nothing to disclose. Dr. Ferre has nothing to disclose. Dr. Klein has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Munoz Giacomelli, F., Gonzalez Toledo, M., Pagani Cassara, F., Tamargo, A., Thomson, A., Nadile, D., Ferre, A., Klein, F. Tags: Cerebrovascular Disease and Interventional Neurology: Atrial Fibrillation and Miscellaneous Source Type: research

Stroke Among Hospitalized Patients Diagnosed With Vertebrobasilar Insufficiency: A Retrospective Cohort Study (P1.152)
CONCLUSIONS:The proportion of cerebrovascular events in patients hospitalized for VBI was low within one year. Unimproved symptom during follow-up was a significant predictor of stroke.Study Supported by:Natural Science Foundation of China (No. 81301988) to Li Yang.Disclosure: Dr. Yang has nothing to disclose. Dr. Bai has nothing to disclose. Dr. Zhao has nothing to disclose. Dr. Xiao has nothing to disclose. Dr. Yang has nothing to disclose. Dr. Kasner has received personal compensation for activities with Pfizer Inc, Novartis, AstraZeneca Pharmaceuticals, Parexel, Brainsgate, Medtronic, Inc., and Boehringer Ingelheim. Dr...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Yang, L., Bai, H., Zhao, X., Xiao, Y., Yang, Y., Kasner, S., Tan, L. Tags: Cerebrovascular Disease and Interventional Neurology: Intracranial Disease Source Type: research

Awareness of Stroke and Knowledge of its Warning Signs and Risk Factors in a Developing Country (P7.133)
CONCLUSIONS: The study clearly revealed lack of public’s knowledge about stroke, its warning symptoms and risk factors in the community investigated. Improvement in stroke awareness level can be achieved by health education utilizing the media tools preferred by the targeted population. Study Supported by:Disclosure: Dr. Sokrab has nothing to disclose. Dr. Sokrab has nothing to disclose. Dr. Hassan has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Sokrab, O., Sokrab, A., Hassan, E. F. Tags: Cerebrovascular Disease and Interventional Neurology: Barriers and Opportunities in Acute Stroke Treatment Source Type: research

Predictors of Outcome in Patients with Acute M2 Occlusion (P7.149)
CONCLUSIONS: The majority of patients withisolated M2 occlusion strokes have a good 90-day outcome, which is predicted by younger age, lower aNIHSS, and smaller infarct size. Further investigations are required to identify specific factors predicting death in this patient population.Disclosure: Dr. Khan has nothing to disclose. Dr. Zhang has nothing to disclose. Dr. Moonis has nothing to disclose. Dr. Goddeau has nothing to disclose. Dr. Henninger has received personal compensation for activities with Brainsgate as a consultant.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Khan, M., Zhang, J., Moonis, M., Goddeau, R., Henninger, N. Tags: Cerebrovascular Disease and Interventional Neurology: Predictors of Outcome After Ischemic Stroke Source Type: research

Correlation of NIH Stroke Scale Change and Vascular Risk Factors in Acute Stroke Patients (P7.164)
Conclusion:In this small sample, change in NIH stroke scale admission through discharge may be a useful quality outcome measure in acute stroke. Tobacco use was harmful in this sample. Presence of hypertension and absence of diabetes showed benefit in select acute stroke outcomes. Investigating the special cause improvements in this population may help identify ways to improve outcomes. Shewhart control charts may provide useful information when examining quality that might be missed on routine statistical methods.Disclosure: Dr. Krishnamohan has nothing to disclose. Dr. Dobbs has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Krishnamohan, P., Dobbs, M. Tags: Cerebrovascular Disease and Interventional Neurology: Post-Stroke Function Source Type: research

Discharge Delays on an Inpatient Neurology Service (P6.006)
Conclusions: More than half of patients admitted to our inpatient neurology ward services experienced discharge delays of one or more days, with the majority due to placement at inpatient rehabilitation facilities.Disclosure: Dr. Batra has nothing to disclose. Dr. Salinas has nothing to disclose. Dr. Cohen has received personal compensation for activities with EM Gladiators LLC.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Batra, A., Salinas, J., Cohen, A. Tags: General Neurology V Source Type: research

Stroke in a Young Patient: A Sentinel Presentation of Neurosyphilis and HIV (P2.109)
Conclusions: Neurosyphilis should be a diagnostic consideration in young patients with ischemic stroke. Clinicians should be aware of the high incidence of concomitant syphilis and HIV in at-risk populations. Effort should be made to inquire about high-risk behaviors and initiate testing for these infections early in the diagnostic workup to avoid missing these crucial diagnoses.Disclosure: Dr. Flaherty has nothing to disclose. Dr. Cutting has received personal compensation for activities with F1000.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Flaherty, E., Cutting, S. Tags: Cerebrovascular Disease and Interventional Neurology: Childhood and Young Adult Source Type: research

Neurology House Staff Experience Doesn't Affect Acute Stroke Treatment (P5.119)
CONCLUSIONS: We did not find evidence of a "July phenomenon" in acute stroke care. Similar quality of acute stroke care is provided regardless of the time of year.Disclosure: Dr. Marco has nothing to disclose. Dr. Stillman has nothing to disclose. Dr. Marshall has nothing to disclose. Dr. Willey has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Marco, G. C., Stillman, J., Elkind, M., Marshall, R., Willey, J. Tags: Cerebrovascular Disease and Interventional Neurology: Epidemiology Source Type: research

Quantitative Video-oculography to Differentiate Stroke from Vestibular Neuritis in Acute Vertigo-Vestibulo-ocular Reflex Gain Distributions and Optimal Test Thresholds for Diagnosis (P6.289)
CONCLUSIONS: Peripheral and central causes of AVS can be differentiated by quantitative, portable video-oculography. Some AICA strokes mimic vestibular neuritis closely. Disclosure: Dr. Saber Tehrani has nothing to disclose. Dr. Mantokoudis has nothing to disclose. Dr. Wozniak has nothing to disclose. Dr. Eibenberger has nothing to disclose. Dr. Kattah has received personal compensation for activities with Pfizer, Inc. as a consultant. Dr. Guede has nothing to disclose. Dr. Zee has received personal compensation for activities with Sun Pharma and Abbott. Dr. Zee has received royalty payments from Oxford Universi...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Saber Tehrani, A., Mantokoudis, G., Wozniak, A., Eibenberger, K., Kattah, J., Guede, C., Zee, D., Newman-Toker, D. Tags: Neuro-ophthalmology/Neuro-otology II Source Type: research

Utility of Pelvic MRV in Evaluation of Patients with Cryptogenic Stroke and PFO (P4.228)
CONCLUSIONS: Our data expands on prior study showing that pelvic MRV has the potential to identify a stroke source in patients with cryptogenic stroke, absent identifiable hypercoagulability state, and PFO.Disclosure: Dr. Osgood has nothing to disclose. Dr. Budman has nothing to disclose. Dr. Henninger has received personal compensation for activities with Brainsgate as a consultant.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Osgood, M., Budman, E., Henninger, N. Tags: Cerebrovascular Disease and Interventional Neurology: Cardiac Source Type: research

NIH Stroke Scale Change Correlates with Length of Stay in Intensive Care Unit Stroke Patients (P3.099)
Conclusion: NIHSS change appears to be related to the ICU LOS and discharge disposition. Application of Shewhart control charts may provide valuable additional information providing us with opportunities to improve health care delivery. In this study, control charts found wider variation in NIHSS over hospital stays for ischemic stroke compared to intracerebral hemorrhage, suggesting that for ischemic patients there are more opportunities to secure a good outcome as well as more risks of clinical worsening, depending on care provision.Disclosure: Dr. Krishnamohan has nothing to disclose. Dr. Fan has nothing to disclose. Dr...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Krishnamohan, P., Fan, Q., Dobbs, M. Tags: Cerebrovascular Disease and Interventional Neurology: Clinical Management Source Type: research

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