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Survivor gives us a lens into regional systems of care for acute ischemic stroke in North Dakota
I just got back from the North Dakota Mission: Lifeline STEMI and Acute Stroke Conference in Bismark, ND. I had a great time and I learned a lot. I often get asked to speak in various venues about acute STEMI and 12-lead ECG interpretation, but for this conference they wanted me to talk mostly about stroke. That turned out to be a good thing because it forced me to read the 2013 AHA / ASA Guildelines for the Early Management of Patients With Acute Ischemic Stroke to make sure I was asking intelligent questions during the panel discussion (which I moderated) and also giving accurate information for the class I taught about ...
Source: EMS 12-Lead - May 31, 2013 Category: Cardiology Authors: Tom Bouthillet Tags: ems-topics patient-management North Dakota Mission Lifeline Stroke Source Type: research

Tissue Plasminogen Activator Thrombolytic Therapy for Acute Ischemic Stroke in 4 Hospital Groups in Japan
In October 2005 in Japan, the recombinant tissue plasminogen activator (tPA) alteplase was approved for patients with acute ischemic stroke within 3 hours of onset at a dose of 0.6 mg/kg. The present study was undertaken to assess the safety and efficacy of alteplase in Japan. Between October 2005 and December 2009, a total of 114 consecutive patients admitted to 4 hospitals received intravenous tPA within 3 hours of stroke onset. Clinical backgrounds and outcomes were investigated. The patients were divided into 2 chronological groups: an early group, comprising 45 patients treated between October 2005 and December 2007,...
Source: Journal of Stroke and Cerebrovascular Diseases - October 4, 2011 Category: Neurology Authors: Syoichiro Kono, Kentaro Deguchi, Nobutoshi Morimoto, Tomoko Kurata, Shoko Deguchi, Tohru Yamashita, Yoshio Ikeda, Tohru Matsuura, Hisashi Narai, Nobuhiko Omori, Yasuhiro Manabe, Taijyun Yunoki, Yoshiki Takao, Sanami Kawata, Kenichi Kashihara, Koji Abe Tags: Original Articles Source Type: research

Repeated Episodes of Ischemic Stroke over a Short Period in a Patient with Essential Thrombocythemia on Anticoagulant Therapy
A 69-year-old man who had essential thrombocythemia, for which he was taking no medications, suddenly developed aphasia and right hemiplegia and was admitted to the hospital. He was thought to have had an embolic stroke and was initially treated with warfarin. Although the international normalized ratio was in the therapeutic range, he had 3 additional ischemic stroke episodes with the same symptoms after the index stroke. Magnetic resonance angiographic examinations revealed serial changes in middle cerebral artery stenosis. After administration of an antiplatelet agent and hydroxyurea, he had no additional strokes.
Source: Journal of Stroke and Cerebrovascular Diseases - August 14, 2012 Category: Neurology Authors: Masaki Naganuma, Kazuya Isoda, Shinsuke Nishi, Kiyotaka Ito, Teruyuki Hirano Tags: Case Reports Source Type: research

Prehospital Reversal of Warfarin-Related Coagulopathy in Intracerebral Hemorrhage in a Mobile Stroke Treatment Unit Clinical and Research Innovations
Source: Stroke - April 27, 2015 Category: Neurology Authors: Gomes, J. A., Ahrens, C. L., Hussain, M. S., Winners, S., Rasmussen, P. A., Uchino, K., on behalf of the Cleveland Pre-Hospital Acute Stroke Treatment Study Group Tags: Coumarins, Anticoagulants Clinical and Research Innovations Source Type: research

Stroke Care during the COVID-19 Pandemic: International Expert Panel Review
This study, prepared by a large international panel of stroke experts, assesses the rapidly growing research and personal experience with COVID-19 stroke and offers recommendations for stroke management in this challenging new setting: modifications needed for prehospital emergency rescue and hyperacute care; inpatient intensive or stroke units; posthospitalization rehabilitation; follow-up including at-risk family and community; and multispecialty departmental developments in the allied professions.Summary: The severe acute respiratory syndrome coronavirus 2 uses spike proteins binding to tissue angiotensin-converting enz...
Source: Cerebrovascular Diseases - March 23, 2021 Category: Neurology Source Type: research

Mobile stroke units for prehospital thrombolysis, triage, and beyond: benefits and challenges
Publication date: March 2017 Source:The Lancet Neurology, Volume 16, Issue 3 Author(s): Klaus Fassbender, James C Grotta, Silke Walter, Iris Q Grunwald, Andreas Ragoschke-Schumm, Jeffrey L Saver In acute stroke management, time is brain. Bringing swift treatment to the patient, instead of the conventional approach of awaiting the patient's arrival at the hospital for treatment, is a potential strategy to improve clinical outcomes after stroke. This strategy is based on the use of an ambulance (mobile stroke unit) equipped with an imaging system, a point-of-care laboratory, a telemedicine connection to the hospital, and ap...
Source: The Lancet Neurology - February 15, 2017 Category: Neurology Source Type: research

Secondary prevention treatment after acute stroke in older South Asian, Chinese and other Canadians: a retrospective data analysis.
Abstract BACKGROUND: Little is known about whether there are differences in medication use between older patients of Chinese descent, those of South Asian descent and other Canadian patients after acute ischemic or primary intracerebral hemorrhagic stroke. The aim of this population-based study was to evaluate potential ethnic differences in secondary prevention pharmacotherapy after acute stroke. METHODS: Using health administrative data, we conducted a retrospective analysis of all patients aged 66 years or more admitted to hospital with acute stroke in Ontario (1997-2011) and British Columbia (1997-2009). ...
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Khan NA, McAlister FA, Pilote L, Palepu A, Quan H, Hill MD, Fang J, Kapral MK Tags: CMAJ Open Source Type: research

Ischemic Stroke Management: Posthospitalization and Transition of Care
Am Fam Physician. 2023 Jul;108(1):70-77.ABSTRACTIschemic stroke is a major cause of morbidity and mortality worldwide. Ischemic stroke and transient ischemic attack exist on a continuum of the same disease process. Ischemic stroke is common, and more than 85% of stroke risk is attributed to modifiable risk factors. The initial management of acute stroke is usually performed in the emergency department and hospital settings. Family physicians have a key role in follow-up, ensuring that a complete diagnostic evaluation has been performed, addressing modifiable risk factors, facilitating rehabilitation, and managing chronic s...
Source: American Family Physician - July 13, 2023 Category: Primary Care Authors: Scott T Larson Brigit E Ray Jason Wilbur Source Type: research

New aspects of stroke medicine.
Abstract Systemic thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) remains the only effective and approved medical treatment of acute ischemic stroke. Several studies have demonstrated the importance of rapid recanalization. The efficacy of thrombectomy has so far not been sufficiently shown in randomized clinical trials; therefore, inclusion of suitable patients in one of the currently ongoing randomized trials is of great importance. The early treatment with magnesium after acute ischemic stroke during the pre-hospital phase did not prove to be neuroprotective. Intermittent pneumatic compr...
Source: Der Nervenarzt - June 28, 2014 Category: Neurology Authors: Diener HC, Frank B, Hajjar K, Weimar C Tags: Nervenarzt Source Type: research

Detecting Nonvalvular Atrial Fibrillation and Anticoagulant Therapy in Cardioembolic Ischemic Stroke.
Authors: Min J, Farooq MU Abstract Nonvalvular Atrial fibrillation (NVAF) is the most common cardiac arrhythmia associated with an increase in risk of stroke and systemic thromboembolism. Strokes related to AF are associated with higher mortality, greater disability, longer hospital stays, and lower chance of being discharged home. The present review will focus on the current status of detecting NVAF and stroke prevention when there is AF. The CHA2DS2-VASc risk stratification scheme is discussed for the identification of patients who are at risk for thromboembolic stroke related to NVAF. Patient with a CHA2DS2-VASc...
Source: Postgraduate Medicine - June 9, 2016 Category: Internal Medicine Tags: Postgrad Med Source Type: research

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