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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

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

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

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

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

SARS-CoV-2 infection and its association with thrombosis and ischemic stroke: a review
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

Inter-facility transfer for patients with acute large vessel occlusion stroke receiving mechanical thrombectomy
Mechanical thrombectomy (MT) is the preferred treatment for large vessel occlusion (LVO) ischemic stroke, and neurological outcome improves with earlier treatment. Patients with LVO frequently require inter-facility transfer to access MT but delays at transferring EDs may worsen neurological outcomes.
Source: The American Journal of Emergency Medicine - September 20, 2020 Category: Emergency Medicine Authors: William L. Scheving, Michael Froehler, Kimberly Hart, Candace D. McNaughton, Michael J. Ward Source Type: research

Does prolonged emergency department length of stay(EDLOS) affect the outcomes of acute ischemic stroke patients?
The effect of emergency department length of stay (EDLOS) on outcomes of patients with acute ischemic stroke (AIS) remains largely unexamined. We aimed to investigate the association between EDLOS and outcomes in AIS patients.
Source: The American Journal of Emergency Medicine - August 30, 2020 Category: Emergency Medicine Authors: Yan Wu, Xuechun Wu, Hong Pan, Yafang Zhu, Yan Qin, Yongrong Sun, Chun-Feng Liu, Yongjun Cao, Rongfang Shi, Xia Zhang Source Type: research

Can non-contrast head CT and stroke severity be used for stroke triage? A population-based study
Acute ischemic stroke (AIS) patients may benefit from endovascular thrombectomy (EVT) up to 24  h since last known normal (LKN). Advanced imaging is required for patient selection. Small or rural hospitals may not have sufficient CT technician and radiology support to rapidly acquire and interpret images. We estimated transfer rates using non-contrast head CT and stroke severity to select p atients to be transferred to larger centers for evaluation.
Source: The American Journal of Emergency Medicine - August 14, 2020 Category: Emergency Medicine Authors: Charles Kircher, Amanda Humphries, Dawn Kleindorfer, Kathleen Alwell, Heidi Sucharew, Charles J. Moomaw, Jason Mackey, Felipe De Los Rios La Rosa, Brett Kissela, Opeolu Adeoye Source Type: research

Priapism in a patient with coronavirus disease 2019 (COVID-19)
Thromboembolic complications related to SARS-CoV-2 have been extensively reported. They include deep vein thrombosis, pulmonary embolism, ischemic stroke, and acute coronary syndrome. Penile thrombosis has not been reported as a thrombotic complication of SARS-CoV-2 infection with hypercoagulability.Here we describe a case of priapism as a thromboembolic complication in a patient with COVID-19 who recovered from acute respiratory distress syndrome (ARDS). We discuss the underlying pathophysiological mechanisms mainly related to an hypercoagulability state.
Source: The American Journal of Emergency Medicine - June 17, 2020 Category: Emergency Medicine Authors: Myriam Lamamri, Ala Chebbi, Jordan Mamane, Sofia Abbad, Milena Munuzzolini, Florence Sarfati, St éphane Legriel Tags: Case Report Source Type: research

Priapism in a patient with coronavirus disease 2019 (COVID-19): A case report
Thromboembolic complications related to SARS-CoV-2 have been extensively reported. They include deep vein thrombosis, pulmonary embolism, ischemic stroke, and acute coronary syndrome. Penile thrombosis has not been reported as a thrombotic complication of SARS-CoV-2 infection with hypercoagulability.Here we describe a case of priapism as a thromboembolic complication in a patient with COVID-19 who recovered from acute respiratory distress syndrome (ARDS). We discuss the underlying pathophysiological mechanisms mainly related to an hypercoagulability state.
Source: The American Journal of Emergency Medicine - June 16, 2020 Category: Emergency Medicine Authors: Myriam Lamamri, Ala Chebbi, Jordan Mamane, Sofia Abbad, Milena Munuzzolini, Florence Sarfati, St éphane Legriel Source Type: research

Thromboelastography for prediction of hemorrhagic transformation in patients with acute ischemic stroke
Thromboelastography (TEG) provides a rapid assessment of the hemostatic processes of a patient in emergency settings. There are limited data on TEG as a predictive tool for hemorrhagic transformation in patients with acute ischemic stroke. We investigated whether TEG values on admission could predict hemorrhagic transformation in patients with acute ischemic stroke.
Source: The American Journal of Emergency Medicine - May 22, 2020 Category: Emergency Medicine Authors: Gina Yu, Youn-Jung Kim, Sang-Beom Jeon, Won Young Kim Source Type: research

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