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Saving the brain initiative – Developing an effective hub-and-spoke model to improve the acute stroke management pathways in urban India
We aimed to develop and evaluate a hub-and-spoke model in the East Delhi by assessing knowledge and creating awareness through sensitization programs in target communities and among general physicians (GPs) along with implementation of a standard stroke management protocol (SMP) at our institute in order to extend the benefit of thrombolytic therapy.
Source: Journal of the Neurological Sciences - August 9, 2018 Category: Neurology Authors: Suman Kushwaha, Puneet Talwar, Niketa Chandel, Aldrin Anthony, Siddharth Maheshwari, Sarbjeet Khurana Source Type: research

Hyperglycemia predicts unfavorable outcomes in acute ischemic stroke patients treated with intravenous thrombolysis among a Chinese population: A prospective cohort study
In this study, we investigated whether an elevated admission serum glucose level in the 3-h time window of intravenous thrombolysis for acute ischemic stroke determined poor functional outcomes among Chinese population.
Source: Journal of the Neurological Sciences - March 16, 2018 Category: Neurology Authors: Sheng-Feng Lin, A-Ching Chao, Han-Hwa Hu, Ruey-Tay Lin, Chih-Hung Chen, Lung Chan, Huey-Juan Lin, Yu Sun, Yung-Yang Lin, Po-Lin Chen, Shinn-Kuang Lin, Ming-Hui Sun, Cheng-Yu Wei, Yu-Te Lin, Jiunn-Tay Lee, Chi-Huey Bai, Taiwan Thrombolytic Therapy for Acut Source Type: research

MRI based thrombolysis for FLAIR-negative stroke patients within 4.5 –6h after symptom onset
To investigate the feasibility of DWI-FLAIR mismatch in identifying patients who might benefit from thrombolytic therapy within 4.5 –6h, we analyzed the data of 105 ischemic stroke patients with known time of symptom onset who underwent MRI within 6h of stroke and thrombolysis between December 2006 and December 2013. They were divided into three groups: symptom onset within 4.5h (n=66); 4.5–6h and FLAIR images negative (n=9) ; and 4.5–6h and FLAIR images positive (n=30). Outcome of thrombolysis was assessed for each group by recanalization rate, National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) scores.
Source: Journal of the Neurological Sciences - November 8, 2016 Category: Neurology Authors: Xiao-Er Wei, Jia Zhou, Wen-Bin Li, Yu-Wu Zhao, Ming-Hua Li, Yue-Hua Li Source Type: research

Acute recanalization and hyperperfusion in MCA territory due to sole t-PA bolus. A case report
Tissue plasminogen activator (t-PA) is the only approved thrombolytic therapy for the treatment of stroke patients. However, there is discussion whether the current dosing of t-PA (0.9mg/kg) is the optimal choice for all patients [1]. It is also unknown whether the duration of administration (1h) is being optimal. Moreover, there is no information available about the effectiveness of a sole t-PA bolus. The following case demonstrates effectiveness and importance of the bolus of t-PA.
Source: Journal of the Neurological Sciences - September 24, 2014 Category: Neurology Authors: Carsten M. Klingner, Stefan Brodoehl, Christian Hohenstein, Otto W. Witte, Albrecht Günther Tags: Letter to the editor Source Type: research

Spontaneous sternocleidomastoid muscle hematoma following thrombolysis for acute ischemic stroke
We report the case of an 83y.o. woman with right facio-brachio-crural hemiparesis, left deviation of the head and aphasia who developed, after thrombolytic therapy, a spontaneous sternocleidomastoid muscle hematoma that regressed few days later. To our knowledge, this is the first case reported in the literature of asymptomatic and spontaneous skeletal muscle hematoma following thrombolysis for the treatment of acute ischemic stroke. The occurrence of lateral cervical tuberculosis lymphadenitis ipsilateral to sternocleidomastoid muscle hematoma may suggest a causal relationship between local chronic inflammation of active ...
Source: Journal of the Neurological Sciences - April 28, 2014 Category: Neurology Authors: Nadia Mariagrazia Giannantoni, Giacomo Della Marca, Aldobrando Broccolini, Fabio Pilato, Paolo Profice, Roberta Morosetti, Pietro Caliandro, Giovanni Frisullo Tags: Letters to the Editor Source Type: research