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The significance of repetitive yawning in the emergency patient - A warning of imminent death or disability
Premortem yawning is absent from almost all major medical textbooks but has been associated for more than 2000  years with impending death from acute infections and hemorrhage and was commonly known during the Bubonic Plague pandemic [1,2]. Medical reports of premortem yawning identify multiple causes of shock including vasovagal reflex, severe hypoxia/anemia/hypoglycemia, stroke, and intracranial hyperten sion [3-5].
Source: The American Journal of Emergency Medicine - July 2, 2020 Category: Emergency Medicine Authors: Joan E. Rothenberg Tags: Correspondence 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

The impact of IV alteplase on long-term patient survival: The Georgia Coverdell acute stroke registry's experience
This study assessed the impact of thrombolytic treatment by alteplase on 1-year mortality and readmission among acute ischemic stroke patients.
Source: The American Journal of Emergency Medicine - July 31, 2017 Category: Emergency Medicine Authors: Moges S. Ido, Michael R. Frankel, Ike S. Okosun, Richard B. Rothenberg Tags: Original Contribution Source Type: research

The impact of intravenous alteplase on long-term patient survival: The Georgia Coverdell acute stroke registry's experience
This study assessed the impact of thrombolytic treatment by alteplase on 1-year mortality and readmission among acute ischemic stroke patients.
Source: The American Journal of Emergency Medicine - July 31, 2017 Category: Emergency Medicine Authors: Moges S. Ido, Michael R. Frankel, Ike S. Okosun, Richard B. Rothenberg Source Type: research

Can we imagine a survival chain also for ischemic stroke?
I read with great interest the article about the University of Amiens experience in the management of acute stroke [1] and the concept of “door-to-needle” time, so similar to the best known “door-to-balloon” one. During my recent training period in an excellent Stroke Unit, I've directly experienced a quite brand new concept, brought by mechanical thrombectomy, the “door-to-reperfusion” time. We know from meta-analysis dat a that for every 9-minute delay in reperfusion, 1 of every 100 treated patients had a worse disability outcome (+1 point on MrS scale) [2].
Source: The American Journal of Emergency Medicine - May 29, 2017 Category: Emergency Medicine Authors: Aurora Vecchiato Source Type: research

The challenge of coprescription of antiplatelet therapy and oral anticoagulants
The coexistence of symptomatic carotid artery stenosis and nonvalvular atrial fibrillation (NVAF) in the recently reported 85year old man [1] bears out the findings of the study which documented a 24.3% prevalence of high-grade (50% or more) carotid artery stenosis among 103 consecutive NVAF patients (mean age 69) who presented with stroke [2]. Among these patients with high-grade stenosis 66.7% had stenosis ipsilateral to the cerebral infarct [2]. Given the fact that patients with symptomatic carotid artery stenosis are at high risk of stroke recurrence and/or worsening neurological disability during the first 14days foll...
Source: The American Journal of Emergency Medicine - May 22, 2017 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Source Type: research

Approach to the diagnosis and treatment of acute subarachnoid hemorrhage in a patient with sickle cell disease
We report a case of subarachnoid hemorrhage in a 38-year-old patient with sickle cell anemia. This case highlights the limitations of noncontrast computed tomography in the diagnosis of subarachnoid hemorrhage in patients with sickle cell disease as well as the special needs of this patient population in addressing the treatment of stroke.
Source: The American Journal of Emergency Medicine - August 29, 2014 Category: Emergency Medicine Authors: Matthew Lyon, Justin Jeter, Richard Lottenberg Tags: Case Report Source Type: research

Simultaneous thrombosis of 2 vascular territories: is thrombolytic therapy a better option?
We have read with great interest the article by Akyuz and colleagues in the American Journal of Emergency Medicine and congratulate them for their observation. Their case exemplifies the concurrent occurrence of ST-segment elevation myocardial infarction (STEMI) and posterior circulation stroke that was eventually managed with thrombolytic therapy. Simultaneous thrombosis of 2 distant vascular territories is a rare and complicated clinical scenario. In these instances, there is usually an underlying cause linking both thrombotic events rather than being a mere coincidence. We have previously described the myocardial infarc...
Source: The American Journal of Emergency Medicine - July 1, 2013 Category: Emergency Medicine Authors: Hesham R. Omar, Devanand Mangar, Enrico M. Camporesi Tags: Correspondence Source Type: research