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Management of acute ischemic stroke in patients with COVID-19 infection: Insights from an international panel
A corona virus (SARS-CoV-2) has infected 986,776 persons as of April 2nd, 2020 over a period of 4  months. There is a possibility that Coronavirus Disease 2019 (COVID-19) infection increases the risk of stroke similar to other respiratory tract infections [1]. Approximately 5% of hospitalized patients with COVID-19 infection suffer from stroke with over 80% of them being ischemic stroke [2]. T he reported mortality is 39% in patient with stroke [2] and COVID-19 infection which is much higher than the mortality observed in patients with stroke without COVID-19 infection [3].
Source: The American Journal of Emergency Medicine - May 9, 2020 Category: Emergency Medicine Authors: Adnan I. Qureshi, Foad Abd-Allah, Fahmi Alsenani, Emrah Aytac, Afshin Borhani-Haghighi, Alfonso Ciccone, Camilo R. Gomez, Erdem Gurkas, Chung Y. Hsu, Vishal Jani, Liqun Jiao, Adam Kobayashi, Jun Lee, Jahanzeb Liaqat, Mikael Mazighi, Rajsrinivas Parthasara Source Type: research

Is caval index an appropriate tool for predicting hypovolemia in stroke
We have read with interest the recent article, “Challenge of Intravascular Volume Assessment in Acute Ischemic Stroke” by Miller J.B. et al. [1].
Source: The American Journal of Emergency Medicine - March 11, 2020 Category: Emergency Medicine Authors: Engin Ozakin, Kadir Ugur Mert Source Type: research

The impact of helicopter emergency medical service on acute ischemic stroke patients: A systematic review
Helicopter emergency medical services (HEMS) is commonly elected transport for acute ischemic stroke (AIS) known as a time-critical illness.
Source: The American Journal of Emergency Medicine - February 14, 2020 Category: Emergency Medicine Authors: Shachar Tal, Saban Mor Source Type: research

Evaluating Target: Stroke guideline implementation on assessment and treatment times for patients with suspected stroke
Immediate ischemic stroke treatment improves outcomes and early alteplase administration is recommended for patients within window. We implemented stroke guidelines through a neuro-resuscitation initiative (NRI) and hypothesized that the intervention would decrease times to assessment and treatment.
Source: The American Journal of Emergency Medicine - February 12, 2020 Category: Emergency Medicine Authors: Danielle Albright, Robert Alunday, Eric Schaller, Huy Q. Tran, Cameron S. Crandall Source Type: research

Prehospital time intervals and management of ischemic stroke patients
Quantify prehospital time intervals, describe prehospital stroke management, and estimate potential time saved if certain procedures were performed en route to the emergency department (ED).
Source: The American Journal of Emergency Medicine - February 6, 2020 Category: Emergency Medicine Authors: Timmy Li, Jeremy T. Cushman, Manish N. Shah, Adam G. Kelly, David Q. Rich, Courtney M.C. Jones Source Type: research

Impact of CT scanner location on door to imaging time for emergency department stroke evaluation
Stroke is a potentially serious condition commonly diagnosed in the ED. Time to diagnosis can be crucial to maximizing outcome in a majority of ischemic stroke cases amenable to thrombolytic therapy.
Source: The American Journal of Emergency Medicine - August 13, 2019 Category: Emergency Medicine Authors: William Bonadio Source Type: research

Thrombolysis for atlantoaxial dislocation mimicking acute ischemic stroke: Case report and review
The frequency of stroke mimics among stroke patients has been reported to be up to 30%, and that in patients who receive thrombolytic therapy ranges between 1% and 16%. Atlantoaxial dislocation with myelopathy mimicking stroke is extremely rare. An 83-year-old man with a history of old cerebellar infarction presented to the emergency department with acute left hemiplegia after a chiropractic manipulation of the neck and back several hours before symptom onset. Mild hypoesthesia was observed on his left limbs.
Source: The American Journal of Emergency Medicine - March 26, 2019 Category: Emergency Medicine Authors: Adam Tsou, Yu-Hsiu Juan, Tsu-Yi Chen, Shinn-Kuang Lin Source Type: research

Thrombolysis for atlantoaxial dislocation mimicking acute ischemic stroke
The frequency of stroke mimics among stroke patients has been reported to be up to 30%, and that in patients who receive thrombolytic therapy ranges between 1% and 16%. Atlantoaxial dislocation with myelopathy mimicking stroke is extremely rare. An 83-year-old man with a history of old cerebellar infarction presented to the emergency department with acute left hemiplegia after a chiropractic manipulation of the neck and back several hours before symptom onset. Mild hypoesthesia was observed on his left limbs.
Source: The American Journal of Emergency Medicine - March 26, 2019 Category: Emergency Medicine Authors: Adam Tsou, Yu-Hsiu Juan, Tsu-Yi Chen, Shinn-Kuang Lin Tags: Case Report Source Type: research

Clinical usefulness of brain-derived neurotrophic factor and visinin-like protein-1 in early diagnostic tests for acute stroke
Lack of a rapid biochemical test for acute stroke is a limitation in the diagnosis and management of acute stroke. The aim of this study is to evaluate the efficacy of BDNF and VILIP-1 as diagnostic markers in acute ischemic stroke and as predictors of mortality.
Source: The American Journal of Emergency Medicine - February 25, 2019 Category: Emergency Medicine Authors: Abdullah Algin, M. Ozgur Erdogan, Irfan Aydin, M. Kaan Poyraz, Mehmet Sirik Source Type: research

How should we treat patients who wake up with a stroke? A review of recent advances in management of acute ischemic stroke
Acute ischemic strokes account for 85% of all strokes and are the fifth leading cause of mortality in the United States. About one in five of all ischemic strokes occur during sleep and are not noticed until the patient wakes up with neurological deficits. There is growing evidence to support that a significantly higher number of stroke patients could benefit from more aggressive care, especially those patients who wake up with strokes. There is increasing research to support a physiologically-based approach based on advanced imaging rather than simply a time-based determination of whether or not a patient would benefit from reperfusion.
Source: The American Journal of Emergency Medicine - February 21, 2019 Category: Emergency Medicine Authors: Danielle Biggs, Michael E. Silverman, Frank Chen, Brian Walsh, Peter Wynne Source Type: research

Financial relationships with industry among guideline authors for the management of acute ischemic stroke
To characterize the prevalence of industry relationships among authors of acute ischemic stroke (AIS) guidelines and its association with graded evidence.
Source: The American Journal of Emergency Medicine - January 24, 2019 Category: Emergency Medicine Authors: Joshua D. Niforatos, Richard M. Pescatore Source Type: research

Optimal treatment modality for coexisting acute myocardial infarction and ischemic stroke
We present a rare case of coexisting thrombosis of the coronary artery and mid cerebral artery that was managed successfully with tissue plasminogen activator thrombolytic therapy.
Source: The American Journal of Emergency Medicine - December 31, 2018 Category: Emergency Medicine Authors: Fatih Gungoren, Feyzullah Besli, Zulkif Tanriverdi, Ozcan Kocaturk Source Type: research

Tenecteplase utility in acute ischemic stroke patients: A clinical review of current evidence
Acute ischemic stroke is leading cause of disability in the United States. Treatment is aimed at reducing impact of cerebral clot burden and life-long disability. Traditional fibrinolytic treatment with recombinant tissue plasminogen activator (tPA) has shown to be effective but at high risk of major bleeding. Multiple studies have evaluated tenecteplase as an alternative to tPA.
Source: The American Journal of Emergency Medicine - November 14, 2018 Category: Emergency Medicine Authors: Amelia Nelson, Gregory Kelly, Richard Byyny, Catherine Dionne, Candice Preslaski, Kevin Kaucher Source Type: research

Acute ischemic stroke in a trauma cohort: Incidence and diagnostic challenges
We report its incidence in trauma patients following their presentation at our institution.
Source: The American Journal of Emergency Medicine - November 3, 2018 Category: Emergency Medicine Authors: Kevin Yeboah, Aakash Bodhit, Ali Al Balushi, Erik Krause, Abhay Kumar Source Type: research

Pharmacoeconomic impact of an alternative workflow process for stroke
The objective of this study was to evaluate a new multidisciplinary process in which intravenous alteplase (tPA) waste, used for acute ischemic stroke (AIS), was salvaged in an attempt to maximize cost effectiveness without impacting door-to-needle (DTN) administration times.
Source: The American Journal of Emergency Medicine - October 16, 2018 Category: Emergency Medicine Authors: Brian W. Gilbert, Joel B. Huffman, Joe Slechta, Christine Porter, John M. Gallagher Source Type: research

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