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Improvement of Door-to-Imaging Time in Acute Stroke Patients by Implementation of an All-Points Alarm
In patients with acute ischemic stroke, thrombolysis offers an opportunity to effectively reduce disability and dependency. The success of this treatment is time-dependent. The crucial diagnostic step before initiation of treatment is cerebral imaging. With the aim of reducing in-hospital delays, our hospital’s interdisciplinary stroke management group implemented an all-points alarm to improve in-hospital time delay (the period between arrival to the emergency department and performance of cerebral imaging). The alarm simultaneously alerted all involved staff (from the neurologist to in-hospital transport) to the arriva...
Source: Journal of Stroke and Cerebrovascular Diseases - September 9, 2011 Category: Neurology Authors: Christian H. Nolte, Uwe Malzahn, York Kühnle, Christoph J. Ploner, Jacqueline Müller-Nordhorn, Martin Möckel Tags: Original Articles Source Type: research
People Having Stroke Should Get Therapy Within 60 Minutes Of Hospital Arrival
People having an ischemic stroke should receive clot-dissolving therapy - if appropriate - within 60 minutes of arriving at the hospital, according to new American Stroke Association guidelines published in the American Heart Association journal Stroke. Ischemic stroke, which accounts for nine in 10 strokes, is caused by a blood clot in the arteries leading to the brain. Calling 9-1-1 immediately after recognizing any of the warning signs of stroke - and getting to a stroke center as fast as possible - are still the most important steps for optimal stroke care...
Source: Health News from Medical News Today - February 5, 2013 Category: Consumer Health News Tags: Stroke Source Type: news
Determinants of Emergency Medical Services Use in a Brazilian Population with Acute Ischemic Stroke
This study evaluates the determinants of EMS use in a Brazilian population with acute ischemic stroke. We performed a post hoc analysis of prospectively collected data of consecutive patients admitted to a Brazilian tertiary hospital with acute ischemic stroke. Groups were compared according to their mode of arrival to the hospital: those brought by EMS and those arriving at the hospital by their own means. Among 165 patients evaluated between January and December 2009, 17.6% arrived by EMS and 82.4% arrived by their own means. After multivariate adjustment, individuals with higher National Institutes of Health Stroke Scal...
Source: Journal of Stroke and Cerebrovascular Diseases - October 3, 2011 Category: Neurology Authors: Gustavo W. Kuster, Monique Bueno Alves, Miguel Cendoroglo Neto, Gisele Sampaio Silva Tags: Original Articles Source Type: research
The search for paroxysmal atrial fibrillation in cryptogenic stroke: Leave no stone unturned
Atrial fibrillation (AF), a well-established cause of ischemic stroke, is found in up to 25% of first strokes.1,2 Most patients with stroke from AF will benefit from anticoagulation for secondary stroke prevention, so finding AF as a cause of ischemic stroke is critical. Many patients with AF have paroxysmal AF (PAF), in which periods of normal sinus rhythm alternate with sometimes brief episodes of AF. Conventional monitoring for AF in the hospital or for a small number of days as an outpatient may therefore miss the diagnosis of PAF. Although most of the data to support anticoagulation for stroke patients with AF come fr...
Source: Neurology - April 22, 2013 Category: Neurology Authors: Flint, A. C., Tayal, A. H. Tags: All Cerebrovascular disease/Stroke EDITORIALS Source Type: research
Prehospital stroke care: New prospects for treatment and clinical research
Brain cells die rapidly after stroke and any effective treatment must start as early as possible. In clinical routine, the tight time–outcome relationship continues to be the major limitation of therapeutic approaches: thrombolysis rates remain low across many countries, with most patients being treated at the late end of the therapeutic window. In addition, there is no neuroprotective therapy available, but some maintain that this concept may be valid if administered very early after stroke. Recent innovations have opened new perspectives for stroke diagnosis and treatment before the patient arrives at the hospital....
Source: Neurology - July 29, 2013 Category: Neurology Authors: Audebert, H. J., Saver, J. L., Starkman, S., Lees, K. R., Endres, M. Tags: All Clinical trials, All Cerebrovascular disease/Stroke VIEWS & amp;amp; REVIEWS Source Type: research
Establishment of an effective acute stroke telemedicine program for Australia: protocol for the Victorian Stroke Telemedicine project
RationaleUrgent treatment of acute stroke in rural Australia is problematic partly because of limited access to medical specialists. Utilization of telemedicine could improve delivery of acute stroke treatments in rural communities.
AimThe study aims to demonstrate enhanced clinical decision making for use of thrombolysis within 4·5 h of ischemic stroke symptom onset in a rural setting using a telemedicine specialist support model.
DesignA formative program evaluation research design was used. The Victorian Stroke Telemedicine program was developed and will be evaluated over five stages to ensure successful implementati...
Source: International Journal of Stroke - October 22, 2013 Category: Neurology Authors: Dominique A. Cadilhac, Natasha Moloczij, Sonia Denisenko, Helen Dewey, Peter Disler, Bruce Winzar, Ian Mosley, Geoffrey A. Donnan, Christopher Bladin Tags: Protocols Source Type: research
Methodology of the Field Administration of Stroke Therapy – Magnesium (FAST‐MAG) phase 3 trial: Part 2 – prehospital study methods
DiscussionThe suite of prehospital trial methods developed for the FAST‐MAG Trial enable enrollment of patients in very early time windows, including the hyperacute, ‘golden hour’ period immediately after stroke onset.
Source: International Journal of Stroke - January 20, 2014 Category: Neurology Authors: Jeffrey L. Saver, Sidney Starkman, Marc Eckstein, Samuel Stratton, Frank Pratt, Scott Hamilton, Robin Conwit, David S. Liebeskind, Gene Sung, Nerses Sanossian, Tags: Protocol Source Type: research
Stroke Awareness in the Saudi Community Living in Riyadh: Prompt Public Health Measures Must Be Implemented
Background: Stroke is very prevalent in the Kingdom of Saudi Arabia, approaching 43.8 per 100,000 people. Stroke outcome is known to be affected by the level of stroke awareness in the community. We conducted this study to assess the level of stroke awareness in the Saudi population.Methods: A validated survey of 11 questions was used to assess the level of stroke awareness among the Saudi population. The survey was distributed in a 1-month period to every adult Saudi citizen visiting 10 shopping centers, 10 large supermarkets, 4 hospitals, and 2 universities.Results: Two thousand eight hundred sixty-two people completed t...
Source: Journal of Stroke and Cerebrovascular Diseases - May 15, 2013 Category: Neurology Authors: Ahmed Alaqeel, AlBatool AlAmmari, Nourah AlSyefi, Fawaz Al-Hussain, Yousef Mohammad Tags: Original Articles Source Type: research
Predictive Value of Plasma d-Dimer Levels for Cancer-related Stroke: A 3-Year Retrospective Study
Background: Cerebrovascular disease is the second leading cause of central nervous system pathology in cancer patients. Cancer-associated hypercoagulation plays an important role in cancer-related stroke. The present study aims to test whether plasma d-dimer levels could predict comorbid malignancy in patients with ischemic stroke.Methods: Five hundred sixteen stroke patients with measured d-dimer levels and who were consecutively admitted to our stroke center from 2009 to 2012 were included. Cancer status was determined by medical chart, and 59 patients were identified to have active cancer. An additional 48 cancer patien...
Source: Journal of Stroke and Cerebrovascular Diseases - December 2, 2013 Category: Neurology Authors: Yi-Jen Guo, Ming-Hung Chang, Po-Lin Chen, Yu-Shan Lee, Yu-Chia Chang, Yi-Chu Liao Tags: Original Articles Source Type: research
Revised iScore to Predict Outcomes after Acute Ischemic Stroke
The iScore is a validated tool to predict mortality and functional outcome after acute ischemic stroke. It incorporates stroke subtype according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification as one of its factors. However, the TOAST stroke subtype may not be easily determined without extensive investigations. We aimed to test if the stroke subtype can be substituted by the Oxfordshire Community Stroke Project (OCSP) classification. We applied the iScore and the revised iScore, in which the TOAST subtype was replaced by the OCSP classification, to patients admitted to a single hospital for acute...
Source: Journal of Stroke and Cerebrovascular Diseases - April 7, 2014 Category: Neurology Authors: Sheng-Feng Sung, Yu-Wei Chen, Ling-Chien Hung, Huey-Juan Lin Tags: Original Articles Source Type: research
Changes in Serum Growth Factors in Stroke Rehabilitation Patients and Their Relation to Hemiparesis Improvement
Predicting recovery from hemiparesis after stroke is important for rehabilitation. A few recent studies reported that the levels of some growth factors shortly after stroke were positively correlated with the clinical outcomes during the chronic phase. The aim of this study was to examine the relationships between the serum levels of growth factors (vascular endothelial growth factor [VEGF], insulin-like growth factor-I [IGF-I], and hepatocyte growth factor [HGF]) and improvement in hemiparesis in stroke patients who received rehabilitation in a postacute rehabilitation hospital. Subjects were 32 stroke patients (cerebral ...
Source: Journal of Stroke and Cerebrovascular Diseases - April 25, 2014 Category: Neurology Authors: Hideto Okazaki, Hidehiko Beppu, Kenmei Mizutani, Sayaka Okamoto, Shigeru Sonoda Tags: Original Articles Source Type: research
Recent advances in TeleStroke: a systematic review on applications in prehospital management and Stroke Unit treatment or TeleStroke networking in developing countries
TeleStroke has become an increasing means to overcome shortage of stroke expertise in underserved areas. This rapidly growing field has triggered a large amount of publications in recent years. We aimed to analyze recent advances in the field of telemedicine for acute stroke, with main focus on prehospital management, Stroke Unit treatment and network implementations in developing countries. Out of 260 articles, 25 were selected for this systematic review: 9 regarding prehospital management, 14 regarding Stroke Unit treatment and 2 describing a network in developing countries. Prehospital management showed that stroke reco...
Source: International Journal of Stroke - November 10, 2014 Category: Neurology Authors: Gordian J. Hubert, Peter Müller‐Barna, Heinrich J. Audebert Tags: Review Source Type: research
Suicide after stroke
In their article "Poststroke suicide attempts and completed suicides: A socioeconomic and nationwide perspective,"1 Dr. Eriksson and colleagues focused on suicide after a serious brain injury (stroke). The authors work at Umea University in Sweden and the study was supported by the Swedish Council for Health and the Swedish Research Council. The study followed more than 220,000 people for 12 years after their stroke. Within this group, the authors counted the number of people who were admitted to a hospital for a suicide attempt and the number of people who died due to suicide. They found that younger less-educated men who...
Source: Neurology - April 27, 2015 Category: Neurology Authors: Karceski, S. Tags: Stroke in young adults, Other cerebrovascular disease/ Stroke, All Cerebrovascular disease/Stroke PATIENT PAGES Source Type: research
Ethnic Differences in Associations Between Blood Pressure and Stroke in South Asian and European Men Epidemiology/Population
We report findings from a UK cohort study of 1375 European and 1074 South Asian men, not receiving antihypertensive medication, aged 40 to 69 years at baseline (1988–1991). Assessment included BP, blood tests, anthropometry, and questionnaires. Incident stroke was established at 20 years from death certification, hospital and primary care records, and participant report. South Asians had higher systolic BP, diastolic BP, and mean arterial pressure than Europeans, and similar pulse pressure. Associations between systolic BP or diastolic BP and stroke were stronger in South Asians than Europeans, after adjustment for a...
Source: Hypertension - August 12, 2015 Category: Cardiology Authors: Eastwood, S. V., Tillin, T., Chaturvedi, N., Hughes, A. D. Tags: Cerebrovascular disease/stroke, Risk Factors, Epidemiology Epidemiology/Population Source Type: research
Long-Term Effect of Participation in an Early Exercise and Education Program on Clinical Outcomes and Cost Implications, in Patients with TIA and Minor, Non-Disabling Stroke
AbstractParticipation in exercise and education programs following transient ischemic attack (TIA) or minor stroke may decrease cardiovascular disease risk. The purpose of this study was to assess the long-term effect (3.5 years) of an exercise and education program administered soon after TIA or minor stroke diagnosis on clinical outcome measures (stroke classification and number, patient deaths, hospital/emergency department admission) and cost implications obtained from standard hospital records. Hospital records were screened for 60 adults (male,n = 31; 71 ± 10 years), diagnosed with TIA or non-disabling stroke...
Source: Translational Stroke Research - November 13, 2016 Category: Neurology Source Type: research
