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Source: The American Journal of Emergency Medicine
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Total 261 results found since Jan 2013.
Symptomatic intracranial hemorrhage in patients with admission hyperglycemia and diabetes after mechanical thrombectomy: A systematic review and meta-analysis
Symptomatic intracranial hemorrhage (sICH) is a severe complication of revascularization therapy. We aimed to investigate the association of admission hyperglycemia and sICH after mechanical thrombectomy in patients with acute ischemic stroke.
Source: The American Journal of Emergency Medicine - February 22, 2021 Category: Emergency Medicine Authors: Lin Zang, Dan Zhang, Yanyan Yao, Yujie Wang Source Type: research
Idarucizumab (PRADAXA ®) as a sole reversal agent in an unstable hemorrhagic shock patient on an unknown anticoagulant with elevated protime/international normalized ratio (PT/INR).
We present a case of an 85-year-old female with an unknown medication history, shortness of breath and severe anemia due to an upper gastrointestinal bleed. Laboratory abnormalities were significant for INR 6.43 and serum creatinine 2.21 mg/dL.
Source: The American Journal of Emergency Medicine - February 5, 2021 Category: Emergency Medicine Authors: Sara Kutner, Nicholas Scaturo, Brett Williams Source Type: research
Utilization of lysis percentage via thromboelastography for tissue plasminogen activator-induced symptomatic intracranial hemorrhage
Alteplase, the only FDA approved tissue plasminogen activator (tPA), remains one of the cornerstones of acute ischemic stroke (AIS) management. Just as with endogenous tPA, recombinant tPA promotes the activation of plasmin and the subsequent degradation of cross-linked fibrin to fibrin byproducts [1]. The most feared complication of recombinant tPA administration is the development of symptomatic intracranial hemorrhage (sICH), which occurs in approximately 5.6% of tPA administrations, utilizing the European Cooperative Acute Stroke Study definition, with roughly half of these cases resulting in death [2].
Source: The American Journal of Emergency Medicine - January 16, 2021 Category: Emergency Medicine Authors: Brian W. Gilbert, J. Spencer Dingman, Joel B. Huffman Source Type: research
Effect of COVID19 on prehospital pronouncements and ED visits for stroke and myocardial infarction
In this study, our goal was to determine if there was an increase in prehospital ALS pronouncements and a decrease in ED visits for potentially serious conditions such as MI and stroke during the peak of the COVID-19 pandemic in northern NJ.
Source: The American Journal of Emergency Medicine - January 14, 2021 Category: Emergency Medicine Authors: Nikhil Jain, Michael Berkenbush, David C. Feldman, Barnet Eskin, John R. Allegra Source Type: research
Rapid and severe neurologic deterioration due to influenza associated encephalopathy in a healthy child
We present the clinical details of a previously well child with two days of mild viral symptoms who progressed from playful and active to severe neurologic injury over the course of eight hours.
Source: The American Journal of Emergency Medicine - January 2, 2021 Category: Emergency Medicine Authors: Dominic DiPrinzio, Taylor Roth, Jay D. Fisher Source Type: research
Tenecteplase for thrombolysis in stroke patients: Systematic review with meta-analysis
Alteplase is an approved treatment for acute ischemic stroke. Tenecteplase is a genetically modified form of alteplase, with lower cost and a more favourable pharmacokinetic profile allowing bolus injection. The aim of this study was to compare both drugs in adult patients with acute ischemic stroke undergoing thrombolysis.
Source: The American Journal of Emergency Medicine - December 24, 2020 Category: Emergency Medicine Authors: M. Oliveira, M. Fidalgo, L. Font ão, J. Antão, S. Marques, V. Afreixo, T. Gregório Source Type: research
Risk factors for acute stroke-associated pneumonia and prediction of neutrophil-to-lymphocyte ratios
This study aimed to analyze the risk factors for stroke-associated pneumonia (SAP) and assess the predictive effect of neutrophil-to-lymphocyte ratio (NLR) on acute SAP.
Source: The American Journal of Emergency Medicine - December 19, 2020 Category: Emergency Medicine Authors: Sara M. Witcraft, Laura J. Dixon, Patric Leukel, Aaron A. Lee Source Type: research
External validation of prehospital stroke scales for emergent large vessel occlusion
It is suggested that a prehospital scale should be utilized to identify patients with emergent large vessel occlusion (ELVO). We aimed to perform external validation of nine ELVO scales.
Source: The American Journal of Emergency Medicine - December 11, 2020 Category: Emergency Medicine Authors: Yu-Chen Chiu, Ming-Ju Hsieh, Yen-Heng Lin, Sung-Chun Tang, Jen-Tang Sun, Wen-Chu Chiang, Li-Kai Tsai, Chung-Wei Lee, Yu-Ching Lee, Jiann-Shing Jeng Source Type: research
Inter- ED transfer for patents with acute large vessel stroke: Efficiency vs thoroughness tradeoff
We thank the authors for their interest and agree that timely intervention for patients with large vessel occlusion (LVO) is associated with improved outcomes. Given the clear importance of timely treatment, the primary exposure we were interested in was the time spent at transferring EDs for patients who were transferred and ultimately received mechanical thrombectomy for LVO.
Source: The American Journal of Emergency Medicine - December 3, 2020 Category: Emergency Medicine Authors: MichaelJ. Ward, Michael Froehler, William L. Scheving, Kimberly Hart, Candace D. McNaughton Source Type: research
Case series: Hyperdense basilar artery identified on unenhanced head CT in three cases of pediatric basilar artery occlusion
Acute basilar artery occlusion (BAO) is an easily missed, potentially devastating type of ischemic stroke. Children with BAO can present with a range of clinical symptoms, from headache, dizziness, nausea and/or vomiting [1-3] to profound alterations of consciousness, including locked-in syndrome and coma [2]. Typically in children with BAO, only an unenhanced head Computed Tomography (CT) is initially performed. When an obvious finding is not identified, such as intracranial hemorrhage, the unenhanced CT is rarely carefully further scrutinized by emergency physicians.
Source: The American Journal of Emergency Medicine - November 26, 2020 Category: Emergency Medicine Authors: Jennifer K. Potter, Jonathan D. Clemente, Andrew W. Asimos Source Type: research
Comments on “Inter-facility transfer for patients with acute large vessel occlusion stroke receiving mechanical thrombectomy.”
We read the recently-published article by Schevin et al. [1] with great interest. We commended the authors for looking into the work flow in Emergency Departments (ED) in patients with acute ischemia from large vessel occlusion (AIS-LVO) to assess where the longest delays to thrombectomy might occur. Unfortunately, this study is significantly underpowered to comment on patient outcomes. In this retrospective study of 95 patients undergoing mechanical thrombectomy (MT), the authors showed that patients' total ED length of stay and successful MT were not associated with good neurological outcome, defined as 90-day modified R...
Source: The American Journal of Emergency Medicine - November 25, 2020 Category: Emergency Medicine Authors: Quincy K. Tran, Nicholas Morris Source Type: research
Delayed vertebral artery dissection after mild trauma in a motor vehicle collision
We present the case of a 42-year-old patient who presented to the emergency department with diaphoresis and a complaint of neck pain one month after a low speed motor vehicle collision. The patient was transferred to a stroke center where cerebral angiography showed severe vertebral artery stenosis with likelihood of dissection after a noncontrast CT was negative for hemorrhage.
Source: The American Journal of Emergency Medicine - November 16, 2020 Category: Emergency Medicine Authors: Gregory Kacprzynski, Joshua Bucher, Gregory Nicholas Kacprzynski, Joshua Bucher Source Type: research
Factors associated with hospitalization for ischemic stroke and TIA following an emergency department headache visit
Misdiagnosis of cerebrovascular disease among Emergency Department (ED) patients with headache has been reported. We hypothesized that markers of substandard diagnostic processes would be associated with subsequently ischemic cerebrovascular events among patients discharged from the ED with a headache diagnosis even after adjusting for demographic variables and medical history.
Source: The American Journal of Emergency Medicine - November 6, 2020 Category: Emergency Medicine Authors: Ava L. Liberman, Jenny Lu, Cuiling Wang, Natalie T. Cheng, Khadean Moncrieffe, Richard B. Lipton Source Type: research
Language preference does not influence stroke patients' symptom recognition or emergency care time metrics
Our objective was to determine whether acute ischemic stroke (AIS) patients' language preference is associated with differences in time from symptom discovery to hospital arrival, activation of emergency medical services, door-to-imaging time (DTI), and door-to-needle (DTN) time.
Source: The American Journal of Emergency Medicine - November 2, 2020 Category: Emergency Medicine Authors: Kori S. Zachrison, Shaw Natsui, Betty M. Luan Erfe, Nicte I. Mejia, Lee H. Schwamm Source Type: research
SARS-CoV-2 infection and its association with thrombosis and ischemic stroke: A review COVID-19, thrombosis, and ischemic stroke
This review of current literature provides background to the COVID-19 pandemic, as well as an examination of potential pathophysiologic mechanisms behind development of thrombosis and ischemic stroke related to COVID-19. SARS-CoV-2 infection is well-documented to cause severe pneumonia, however, thrombosis and thrombotic complications, such as ischemic stroke, have also been documented in a variety of patient demographics. SARS-CoV-2 infection is known to cause a significant inflammatory response, as well as invasion of vascular endothelial cells, resulting in endothelial dysfunction.
Source: The American Journal of Emergency Medicine - September 28, 2020 Category: Emergency Medicine Authors: Jonathan Snell Source Type: research
