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Optimizing Prehospital Triage for Patients With Stroke Involving Large Vessel Occlusion
The past 20 years have witnessed a revolution in the paradigm of acute ischemic stroke treatment. In 1996, intravenous alteplase was shown to improve outcomes among patients treated within 3 hours of stroke onset. This finding upended the historical therapeutic nihilism about stroke, and with it the leisurely armchair approach to stroke treatment. The concept of so-called acute ischemic stroke emerged. This changed the nature and practice of vascular neurology, created a vigorous and sometimes controversial debate between vascular neurologists and emergency physicians about the merits of alteplase, and paved the way for mo...
Source: JAMA Neurology - September 4, 2018 Category: Neurology Source Type: research

In-Hospital Stroke
There have been tremendous strides in standardization of the care for acute ischemic stroke since widespread use of thrombolytic therapy began almost 20 years ago. Efficacy is still limited by delayed presentation to the emergency department following stroke symptom onset, although this has also improved in that period with education of emergency medical services and the community at large. The real improvement lies in development of streamlined and standardized protocols for “code stroke,” so that thrombolysis rates of 20% are becoming typical and door-to-needle times are just as typically under 1 hour. These encourag...
Source: JAMA Neurology - May 4, 2015 Category: Neurology Source Type: research

Effect of Stroke Education Pamphlets vs a 12-Minute Culturally Tailored Stroke Film
This cluster randomized clinical trial of stroke preparedness among black and Hispanic churchgoers evaluates the effect of culturally tailored 12-minute stroke films on stroke preparedness vs the usual care practice of distributing stroke education pamphlets.
Source: JAMA Neurology - July 1, 2019 Category: Neurology Source Type: research

Presentation After TIA and Minor Stroke in Relation to the UK FAST Public Education Campaign
This population-based study investigates the association of public education with improving delays and failure in seeking medical attention among consecutive patients with first transient ischemic attack or stroke.
Source: JAMA Neurology - July 2, 2018 Category: Neurology Source Type: research

Discharge Educational Strategies for Reduction of Vascular Risk in Stroke and Transient Ischemic Attack
This randomized clinical trial determines the efficacy of a culturally tailored skills-based educational intervention with telephone follow-up compared with standard discharge care on systolic blood pressure reduction in a multiethnic cohort of patients with mild/moderate stroke/transient ischemic attack.
Source: JAMA Neurology - October 8, 2018 Category: Neurology Source Type: research