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Source: The American Journal of Emergency Medicine
Condition: Ischemic Stroke

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Total 125 results found since Jan 2013.

Abnormal troponin level as short-term predictor of poor outcome in acute atrial fibrillation
Abstract: Background: The link between minor troponin (cardiac troponin I [cTnI]) elevations and atrial fibrillation (AF) is still debated.Methods: A total of 948 patients with AF lasting less than 48 hours participated in the study and were required to undergo 1-month and 12-month follow-up. The exclusion criteria were represented by younger than 18 years, the presence of hemodynamic instability, or severe comorbidity. Primary end point was the composite of ischemic vascular events inclusive of stroke, acute coronary syndrome, revascularization, and death.Results: In the short term, 4 patients (5%) of 78 with abnormal cTn...
Source: The American Journal of Emergency Medicine - February 11, 2013 Category: Emergency Medicine Authors: Alberto Conti, Yuri Mariannini, Gabriele Viviani, Claudio Poggioni, Gabriele Cerini, Margherita Luzzi, Maurizio Zanobetti, Francesca Innocenti, Luigi Padeletti, Gian Franco Gensini Tags: Original Contributions Source Type: research

Transient ischemic attack in hereditary hemorrhagic telangiectasia
We describe the case of a 53-year-old woman with a previous history of recurrent epistaxis, admitted to our unit for a transient episode of diplopia and unbalance. Cerebrovascular screening showed the presence of a right to left shunt at saline contrast transcranial Doppler, related to 3 PAVMs detected by subsequent chest computed tomographic scan. Genetic screening evidenced deletion in endoglin gene (ENG), suggesting diagnosis of HHT type 1. Secondary cerebrovascular prevention with antithrombotic therapy was early stopped for the worsening of epistaxis. Neurologic symptoms are common in HHT, and saline contrast transcra...
Source: The American Journal of Emergency Medicine - February 4, 2013 Category: Emergency Medicine Authors: Gino Gialdini, Alberto Chiti, Michelangelo Mancuso, Eva Terni, Nicola Giannini, Giovanni Orlandi Tags: Case Reports Source Type: research

Troponin rise and poor outcome in patients with acute atrial fibrillation: rationale and criteria of selection of patients
The role of new onset atrial fibrillation (AF) as a marker of thromboembolic risk has been demonstrated in the setting of acute myocardial infarction . Thus, someone might inquire the role of acute AF in patients with abnormal troponin not fulfilling criteria of acute myocardial infarction and might question if the minor reported range of troponin I (cTn-I) values in the study population of Conti et al (from 0.15 to 7.0 ng/mL) may not be linked with a secondary ischemic mechanism, likely an imbalance between demand and supply . However, the independent predictive value of abnormal troponin for a composite of stroke, acute ...
Source: The American Journal of Emergency Medicine - May 22, 2013 Category: Emergency Medicine Authors: Alberto Conti, Yuri Mariannini, Erica Canuti Tags: Correspondence Source Type: research

Painless aortic dissection: thrombolytic and antithrombotic vigilance
We thank Huang et al for their interesting article on identification of painless aortic dissection (AD) before thrombolytic treatment for acute ischemic stroke. We would like to emphasize the importance of being vigilant to AD before initiating any contraindicated therapy. We recently had an 84-year-old man with history of atrial fibrillation and transient ischemic attack who presented to the emergency department with acute shortness of breath without chest pain. The symptom contributed to atrial fibrillation with rapid ventricular response. Chest x-ray showed increased soft tissue prominence of the aortic arch suspicious ...
Source: The American Journal of Emergency Medicine - May 20, 2013 Category: Emergency Medicine Authors: Promporn Suksaranjit, Kunatum Prasidthrathsint, Wonngarm Kittanamongkolchai, Supawat Ratanapo, Narat Srivali, Daych Chongnarungsin Tags: Correspondence Source Type: research

Hemichorea after multiple bee stings
We report the case of a 50-year-old man who developed involuntary movements of the left leg 24 hours after multiple bee stings, and the cause was confirmed to be a right temporal infarction on a diffusion magnetic resonance imaging scan. Thus, we concluded that the involuntary movement disorder was caused by right temporal infarction that occurred after multiple bee stings.
Source: The American Journal of Emergency Medicine - October 28, 2013 Category: Emergency Medicine Authors: Jin Young An, Ji Seon Kim, Jin Hong Min, Kyu Hong Han, Jun Ho Kang, Jung Soo Park, Hoon Kim, Suk Woo Lee Tags: Case Reports Source Type: research

Reperfusion strategy for simultaneous ST-segment elevation myocardial infarction and acute ischemic stroke within a time window
Source: The American Journal of Emergency Medicine - March 5, 2014 Category: Emergency Medicine Authors: Héctor González-Pacheco, Aurelio Méndez-Domínguez, Gerardo Vieyra-Herrera, Francisco Azar-Manzur, Aloja Meave-González, Hugo Rodríguez-Zanella, Carlos Martínez-Sánchez 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

Reperfusion strategy for simultaneous ST-segment elevation myocardial infarction and acute ischemic stroke within a time window
Source: The American Journal of Emergency Medicine - March 5, 2014 Category: Emergency Medicine Authors: Héctor González-Pacheco, Aurelio Méndez-Domínguez, Gerardo Vieyra-Herrera, Francisco Azar-Manzur, Aloja Meave-González, Hugo Rodríguez-Zanella, Carlos Martínez-Sánchez Source Type: research

Improved Door-to-Needle Times and Neurological Outcomes when IV-tPA is Administered by Emergency Physicians with Advanced Neuroscience Training
The neurologic emergency department (neuro ED) at our medical center is staffed by emergency medicine physicians who have specialized neuroscience training and give IV tPA independently for acute ischemic stroke patients. Door-to-needle times (DTN), discharge location, and discharge NIHSS scores were studied between the neurologic emergency department and main emergency department with the hypothesis that all measures would be better in the neuro ED group.
Source: The American Journal of Emergency Medicine - November 28, 2014 Category: Emergency Medicine Authors: Karen Greenberg, Christina R. Maxwell, Keisha D. Moore, Michael D’Ambrosio, Kenneth Liebman, Erol Veznedaroglu, Geri Sanfillippo MSN, Cynthia Diaz, Mandy J. Binning Source Type: research

Bradycardia caused by Intravenous Nicardipine in an Elderly Patient with Acute Ischemic Infarct
We report the case of an elderly patient with an acute ischemic stroke who developed nicardipineinduced bradycardia in the ED.
Source: The American Journal of Emergency Medicine - August 17, 2015 Category: Emergency Medicine Authors: Michael E. Abboud, Sarah E. Frasure Tags: Case Report Source Type: research

Brugada Electrocardiogram Pattern Induced by Cannabis; is cannabis safe?
The objective of this study was to present a case report that bring attention to relationship between cannabis consumption and Brugada electrocardiogram pattern (BEP). Here we present a case of a 19-year-old male patient with symptomatic BEP induced after cannabis consumption. With the potential for more widespread legalization of cannabis several studies are raising the issue of adverse vascular effects of cannabis, including myocardial infarction, sudden cardiac death, cardiomyopathy, stroke, transient ischemic attack, and cannabis arteritis.
Source: The American Journal of Emergency Medicine - December 30, 2015 Category: Emergency Medicine Authors: Joaquín Valle Alonso, Beatrix Theo, F. Javier Fonseca del Pozo, Miguel Angel Aguayo, Almudena Sanchez Tags: Case Report Source Type: research

Cerebral hyperperfusion syndrome: a rare postoperative complication of carotid endarterectomy
Acute neurological deficits are common presentations to the emergency department. Cerebral hyperperfusion syndrome, a rare phenomenon which can occur within one month following carotid surgical revascularization, may be challenging for the emergency physician to diagnose in the setting of an acute neurological presentation. Carotid arterial disease contributes 15-20% of ischemic cerebrovascular accidents and surgical revascularization is the commonest intervention for preventing stroke in patients with significant carotid disease.
Source: The American Journal of Emergency Medicine - March 5, 2016 Category: Emergency Medicine Authors: Mina Guirgis, Kishore Sieunarine Source Type: research

Differentiating contrast staining after acute ischemic stroke from hemorrhagic transformation during emergency evaluation
A hyperdense lesion observed in a computed tomography (CT) image of the brain is usually suspected to be a hemorrhage during an emergency evaluation. Other rare differential diagnoses include contrast-induced encephalopathy (CIN) and acute cerebral infarction with contrast staining (CS). Recent contrast administration is a common risk factor for both CIN and CS. The former has been associated with favorable neurological outcomes, whereas CS might have complications, such as hemorrhagic transformation (HT).
Source: The American Journal of Emergency Medicine - May 17, 2016 Category: Emergency Medicine Authors: Sing-Kong Ho, Jen-Kuang Lee, Yen-Jun Lai, Tzu-Chiao Lin, Cheng-Wei Liu Source Type: research

Fatal hemopericardium after intravenous recombinant transplasminogeen activator (rt-PA) for acute ischaemic stroke
A 57-year old man presented to the emergency department with complaints of nausea, fatigue and burning throat which had been present since one week. Except for mild mental retardation and epilepsy for which anti-epileptic medication was used, he was healthy. Physical examination was normal except for tachycardia (133 beats /minute). Laboratory investigation showed creatine kinase (CK) of 220 U/L (10–171), CK-MB 15 U/L (0–15) and troponine 10,8 ug/L (
Source: The American Journal of Emergency Medicine - May 26, 2016 Category: Emergency Medicine Authors: Hanna Hensen, Fianne Spaander, Matthijs Bax, Hille Koppen Source Type: research

Differentiating contrast staining after acute ischemic stroke from hemorrhagic transformation during emergency evaluation
A hyperdense lesion observed in a computed tomographic (CT) image of the brain is usually suspected to be a hemorrhage during an emergency evaluation. Other rare differential diagnoses include contrast-induced encephalopathy (CIN) and acute cerebral infarction with contrast staining (CS). Recent contrast administration is a common risk factor for both CIN and CS. The former has been associated with favorable neurologic outcomes, whereas CS might have complications, such as hemorrhagic transformation (HT).
Source: The American Journal of Emergency Medicine - May 17, 2016 Category: Emergency Medicine Authors: Sing-Kong Ho, Jen-Kuang Lee, Yen-Jun Lai, Tzu-Chiao Lin, Cheng-Wei Liu Tags: Case Report Source Type: research