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Source: The American Journal of Emergency Medicine
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Total 261 results found since Jan 2013.
When stroke is more than stroke
We describe a case of aortic dissection presenting as right middle cerebral artery syndrome who received intravenous thrombolysis complicated by aortic rupture with a fatal outcome. A Medline search shows that this is the first report of aortic rupture since the inception of thrombolysis for acute stroke.
Source: The American Journal of Emergency Medicine - November 18, 2015 Category: Emergency Medicine Authors: Shing Ching, Soo Moi Ting Tags: Case Report Source Type: research
Serum albumin: a risk of stroke?
In this study, 753 patients with acute first-ever ischemic stroke were enrolled, and 692 patients completed the measurements of recurrent outcome 1 year after stroke through home interviews. The study indicated serum albumin levels of patients with recurrence stroke were significantly lower than those of patients without recurrence (37.07 ±4.21 g/L vs 38.91±3.25 g/L, P
Source: The American Journal of Emergency Medicine - October 20, 2016 Category: Emergency Medicine Authors: Haohui He, Jun Guo Source Type: research
The authors respond: Studying prehospital supplemental oxygen in acute stroke
We appreciate the opportunity to respond to this letter and thank you to the author for taking time to raise these important issues regarding the potential role of prehospital supplemental oxygen (sO2) for stroke. This is an area that needs additional – including prospective – studies to better understand the potential benefits and harms of sO2 for acute stroke. In this retrospective cohort study, the Get with the Guidelines-Stroke (GWTG-S) database was used to identify adult acute stroke patients who presented to an academic Comprehensive St roke Center via EMS between January 1, 2013 and December 31, 2017.
Source: The American Journal of Emergency Medicine - February 26, 2020 Category: Emergency Medicine Source Type: research
Identification of painless aortic dissection before thrombolytic treatment for acute ischemic stroke
We reported a 57-year-old man with acute right hemisphere watershed ischemic stroke caused by painless type A aortic dissection was diagnosed in time with computed tomographic (CT) angiography. The possible detrimental impact which may have been incurred by thrombolytic therapy was avoided. We suggest that cerebral CT angiography, covering from the aortic arch to intracranial arteries, should be performed in acute ischemic stroke patients, particularly in those with watershed CT perfusion deficits, to exclude the possibility of aortic dissection before thrombolytic treatment.
Source: The American Journal of Emergency Medicine - February 11, 2013 Category: Emergency Medicine Authors: Chen-Hsiung Huang, Hui-Chun Huang, Kang-Hsu Lin, Wei-Kung Chen, Chon-Haw Tsai Tags: Case Reports Source Type: research
Isolated basilar artery dissection—a rare cause of stroke in young adult
Syncope accounts for approximately 1% to 2% of emergency department visits each year and up to 6% of hospital admissions . The causes of syncope are numerous, from common benign disorders to life-threatening processes including transient ischemic attack and even stroke. Although cervicocerebral artery dissection is an uncommon etiology in ischemic stroke, it is the second leading cause in patients younger than 45 years, and most of them predominantly involved the extracranial artery . Dissections of intracranial arteries are increasingly being recognized with advanced imaging study; however, isolated basilar artery dissect...
Source: The American Journal of Emergency Medicine - June 17, 2013 Category: Emergency Medicine Authors: Yu-Wei Tsao, Jiann-Hwa Chen, Pai-Hao Huang, Wei-Lung Chen Tags: Case Reports Source Type: research
Torsade de pointes indicates early neurologic damage in acute ischemic stroke
We report the case of a 78-year-old woman with ischemic stroke who presented with TdP as the initial manifestation of early neurologic deterioration. We hypothesized that an increase in intracranial pressure may result in neurohormonal activation, QT prolongation, and then myocardial damage, leading to TdP. We highlight that new onset of TdP in a patient with stroke may reflect neurologic deterioration, requiring further evaluation and specific intervention.
Source: The American Journal of Emergency Medicine - September 25, 2013 Category: Emergency Medicine Authors: Li-Yen Huang, Wei-Shiang Lin, Wen-Yu Lin, Cheng-Chung Cheng, Shu-Meng Cheng, Tsung-Neng Tsai Tags: Case Reports Source Type: research
Nonconvulsive status epilepticus masquerading as stroke
This case describes a patient with multiple stroke risk factors—including prior stroke—who presented to the emergency department with symptoms suggestive of stroke and who received a rapid stroke work up but was later found to be in nonconvulsive status epilepticus (NCSE). This case report highlights the challenge and importance of making an accurate diagnosis in NCSE, and we have included teaching points to help clinicians understand the clinical manifestations and diagnosis of NCSE as well as how it may impact a patient's prognosis.
Source: The American Journal of Emergency Medicine - August 28, 2014 Category: Emergency Medicine Authors: Christopher Kennel, Andreas Michas-Martin, Brian D. Berman, Sharon Poisson Tags: Case Report Source Type: research
Factors associated with delayed evaluation of patients with potential stroke in US EDs
The American Heart Association/American Stroke Association guidelines recommend all patients presenting to emergency departments (EDs) with a potential stroke be seen within 10 minutes of arrival, although this may not be achieved in all patients. We sought to identify factors associated with delayed evaluation of ED patients with potential stroke.
Source: The American Journal of Emergency Medicine - August 26, 2014 Category: Emergency Medicine Authors: Jonathan Taylor, Ken Uchino, M. Shazam Hussain, Jestin N. Carlson Tags: Original Contribution Source Type: research
Diagnostic value of plasma Signal Peptide-Cub-Egf domain-containing protein-1 (SCUBE-1) in an experimental model of acute ischemic stroke
Considering the critical role of early action in management of stroke, there is still a need for a biomarker that would reliably assist in the early diagnosis and patient selection for tissue plasminogen activator (t-PA) therapy, which has provided a considerable success in terms of mortality and morbidity of patients with stroke. This is particularly important if this novel biochemical marker that could give rapid results, specific for brain damage and that can be used in the emergency setting for early diagnosis and differentiation from other conditions that mimics some stroke findings [1,2].
Source: The American Journal of Emergency Medicine - December 2, 2014 Category: Emergency Medicine Authors: Turkmen Suha, Eryigit Umut, Karaca Yunus, Mentese Ahmet, Uzun Sumer Aysegul, Yulug Esin, Aksut Nurhak, Gazioglu Sibel, Gunduz Abdulkadir Tags: Original Contribution Source Type: research
Cerebral oximetry with cerebral blood volume index in detecting pediatric stroke in a pediatric ED
Despite pediatric stroke awareness and pediatric stroke activation systems, recognition and imaging delays along with activation inconsistency still occur. Reliable objective pediatric stroke detection tools are needed to improve detection and activations. Regional cerebral oxygen saturation (rcso2) with cerebral blood volume index (CBVI) can detect abnormal cerebral physiology.
Source: The American Journal of Emergency Medicine - July 22, 2015 Category: Emergency Medicine Authors: Thomas J. Abramo, Z. Leah Harris, Mark Meredith, Kristen Crossman, Rawle Seupaul, Abby Williams, Sheila McMorrow, Jennifer Dindo, Angela Gordon, Maria Melguizo-Castro, Zhuopei Hu, Todd Nick Tags: Original Contribution Source Type: research
Serum albumin level is associated with the recurrence of acute ischemic stroke
Previous studies have confirmed that low serum albumin levels in acute ischemic stroke patients increased the risk for poor outcome and death, demonstrating the neuroprotective role of albumin. However, there are few studies investigating the relationship between albumin levels and recurrence of stroke. The aim of this study was to evaluate the effect of serum albumin level on the risk of recurrence in patients with acute ischemic stroke.
Source: The American Journal of Emergency Medicine - June 12, 2016 Category: Emergency Medicine Authors: Qing Zhang, Yi-Xiong Lei, Qiang Wang, Yong-Ping Jin, Rong-Li Fu, He-Hong Geng, Ling-Ling Huang, Xiao-Xiao Wang, Pei-Xi Wang Tags: Original Contribution Source Type: research
Fatal hemopericardium after intravenous recombinant transplasminogeen activator (rt-PA) for acute ischemic stroke
Intravenous recombinant transplasminogeen activator (rt-PA) treatment is considered as standard acute phase treatment in ischemic stroke. In the initial stroke guidelines, recent myocardial infarction (MI) was listed as a contraindication for rt-PA treatment due to the increased risk of myocardial wall rupture. However, in the recent American Heart Association/American Stroke Association guideline, it is regarded only as a relative contraindication, and in the European guidelines, currently it is not listed as a contraindication.
Source: The American Journal of Emergency Medicine - May 26, 2016 Category: Emergency Medicine Authors: Hanna Hensen, Fianne Spaander, Matthijs Bax, Hille Koppen Tags: Case Reports Source Type: research
Utility of point of care assessment of platelet reactivity (using the PFA-100 ®) to aid in diagnosis of stroke
Rapid and accurate diagnosis of patients presenting with symptoms of stroke is needed to facilitate the timely delivery of proven effective treatment for patients with acute ischemic stroke (AIS).The aim of this study was to determine whether early assessment of platelet reactivity in patients presenting with symptoms of AIS was associated with a diagnosis of AIS, transient ischemic attack (TIA), or stroke mimic.
Source: The American Journal of Emergency Medicine - November 14, 2016 Category: Emergency Medicine Authors: Claire Pearson, Karin Przklenk, Valerie Mika, Syed Imran Ayaz, Morgan Ellis, Preet Varade, Rosa Tolomello, Robert D. Welch Source Type: research
