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Overcoming Barriers to Reduce Door to Needle Times in Acute Ischemic Stroke Patients: Field to CT (I6.011)
CONCLUSION: Taking patients Direct to CT has significantly reduced time to evaluation, DTCT, and DTN.. Numerous barriers to Direct to CT were identified at the pre-hospital, ED, CT and stroke team levels. Some of these concerns are ongoing and will take time and effort to overcome. Strengths noted were the EMS capability of pre-hospital Intravenous line establishment, blood draws, and EKG performance as well as IV tPA initiation in the CT area.Disclosure: Dr. Panezai has nothing to disclose. Dr. Chukwuneke has nothing to disclose. Dr. Arango has nothing to disclose. Dr. Brar has nothing to disclose. Dr. Daniel has nothing ...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Panezai, S., Chukwuneke, F., Arango, A., Brar, J., Daniel, J., Korya, D., Mehta, S., Moussavi, M., Kirmani, J. Tags: Future Directions and Challenges in Stroke Team Action Therapy (STAT) Poster Presentations Source Type: research

Acute stroke in the field: iTREAT, you treat, we all one day will treat ... better
The use of telemedicine in the ambulance for more precise and rapid prehospital/emergency medical service (EMS) care of patients with acute stroke dates back to 1988 by the University of Maryland TeleBAT (telemedicine for the Brain Attack Team) system.1 The TeleBAT Team, which used this approach to determine the patient's NIH Stroke Scale (NIHSS) score, prophetically described a novel approach that could shorten the time to treatment because emergency medical technicians can transmit their videotaped assessment to the emergency room, providing emergency medicine physicians and neurologists with earlier viewing of the strok...
Source: Neurology - July 3, 2016 Category: Neurology Authors: Levine, S. R., Switzer, J. A. Tags: Clinical neurology examination, All Cerebrovascular disease/Stroke EDITORIALS Source Type: research

Stroke vision, aphasia, neglect (VAN) assessment--a novel emergent large vessel occlusion screening tool: pilot study and comparison with current clinical severity indices
Conclusions The VAN screening tool accurately identified ELVO patients and outperformed a NIHSS ≥6 severity threshold and may best allow clinical teams to expedite care and mobilize resources for ELVO patients. A larger study to both validate this screening tool and compare with others is warranted.
Source: Journal of NeuroInterventional Surgery - January 12, 2017 Category: Neurosurgery Authors: Teleb, M. S., Ver Hage, A., Carter, J., Jayaraman, M. V., McTaggart, R. A. Tags: Open access, Ischemic stroke Source Type: research

Pulmonary embolism in acute ischaemic stroke (p4.293)
Conclusions:PE was observed in 0.32% of AIS and associated with high rates of death and disability. CTA stroke protocol images from aortic arch to vertex allows visualization of upper pulmonary arteries and detection PE in AIS.Disclosure: Dr. Eswaradass has nothing to disclose. Dr. Dey has nothing to disclose. Dr. Singh has nothing to disclose. Dr. Hill has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Eswaradass, P. V., Dey, S., Singh, D., Hill, M. Tags: In-Hospital Stroke Care Source Type: research

Predicting brain atrophy from resting-state functional connectivity and structural connectivity in ischemic stroke (P5.297)
Conclusions:Resting-state functional connectivity with the lesion location can predict atrophy of remote brain regions after ischemic stroke, independent of structural white-matter connectivity.Study Supported by: M.D.F. was supported by the National Institutes of Health (R21 MH099196, K23 NS083741), Dystonia Medical Research Foundation, National Parkinson’s Foundation, and NFL Players Association. A.J. was supported by a Postdoctoral Fellowship from the Natural Sciences and Engineering Research Council of Canada (NSERC PDF 454617). A.D.B. was supported by 4K12HD027748-24.Disclosure: Dr. Jannati has nothing to disclo...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Jannati, A., Boes, A. D., Horn, A., Pascual-Leone, A., Kuceyeski, A., Fox, M. D. Tags: Stroke Recovery and Rehabilitation Source Type: research

Saving Vanessa, part 1: A mystery rash, a stroke and an epic rescue
Vanessa’s rash first appeared on her arms and legs when she 3 or 4 months old. It was red and bumpy and went away when she was sick with a virus, which happened often. Then it would come back. The dermatology team she saw at Boston Children’s Hospital was puzzled. “I was expecting they were going to think it was nothing, but they took it very seriously,” says Katherine Bell, one of Vanessa’s mothers. “They took a biopsy and very quickly realized they had no idea what it was.” Vanessa’s case was even featured at a regional dermatology conference where doctors take up mystery patients. “A hundred to 150 der...
Source: Thrive, Children's Hospital Boston - July 25, 2017 Category: Pediatrics Authors: Nancy Fliesler Tags: Diseases & Conditions Our Patients’ Stories Dr. Carolyn Rogers Dr. Pui Lee Dr. Robert Sundel Dr. Scellig Stone Dr. Todd Lyons stroke Source Type: news

Cerebral microbleeds and the risk of intracerebral haemorrhage after thrombolysis for acute ischaemic stroke: systematic review and meta-analysis
Conclusions The available evidence does not demonstrate a statistically significant increased risk of symptomatic ICH after thrombolysis for ischaemic stroke in patients with CMBs. However, in view of the methodological limitations of the studies included, the clinical relevance of any potential hazard associated with CMBs remains uncertain. Further studies are warranted to evaluate whether the risk of ICH might outweigh the benefit of thrombolysis, especially in patients with multiple lobar CMBs suggestive of cerebral amyloid angiopathy.
Source: Journal of Neurology, Neurosurgery and Psychiatry - February 15, 2013 Category: Neurosurgery Authors: Charidimou, A., Kakar, P., Fox, Z., Werring, D. J. Tags: Genetics, Stroke, Radiology, Radiology (diagnostics) Cerebrovascular disease Source Type: research

Thrombolysis for acute ischemic stroke in South Africa
ConclusionsOur findings indicate that the use of thrombolysis in routine clinical practice in a South African setting has similar safety and early efficacy outcomes to developed and other developing countries.
Source: International Journal of Stroke - May 22, 2013 Category: Neurology Authors: Alan Bryer, Sean Wasserman Tags: Short Report Source Type: research

Incidence of Venous Thromboembolism in the Wake of the Clots in Legs Or sTockings after Stroke (CLOTS) Study Brief Reports
Conclusions— Discontinuation of compressive stockings did not increase venous thromboembolism incidence. There was a trend toward more deep vein thrombosis and fewer PEs after CLOTS, which might be because of increased clinical vigilance in the diagnosis of deep vein thrombosis, but a chance variation cannot be excluded.
Source: Stroke - September 23, 2013 Category: Neurology Authors: Jain, P., Ward, E., Nevatte, T., Roffe, C. Tags: Deep vein thrombosis Brief Reports Source Type: research

Diffusion mr correlates of motor function recovery after stroke: a systematic review
Conclusions FA is the most commonly measured metric but there was considerable heterogeneity in study design and analysis. Most studies were cross–sectional, confined to sub–cortical, ischaemic strokes at late stages, and involved younger patients than typical of the stroke population. Further evaluation of the utility of DTI as a biomarker for use in stroke recovery trials is needed.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Kalladka, D., Muir, K. Tags: Stroke, Radiology, Radiology (diagnostics) Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP), London, 23-24 October 2013 Source Type: research

The halifax acute stroke imaging study (hasis): does ct perfusion scanning in acute ischemic stroke predict final infarct volume?
Conclusions Results from HASIS suggest information from admission CTP and SI in suspected AIS patients can predict final infarct volume, where final volume of infarcted brain will not be smaller than that predicted by CTP CBV or CTA SI.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Langlands, G., Shankar, J., Simpkin, W., Christian, C., Phillips, S. Tags: Stroke, Radiology, Radiology (diagnostics) Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP), London, 23-24 October 2013 Source Type: research

Alberta Stroke Program Early Computed Tomography Score to Select Patients for Endovascular Treatment: Interventional Management of Stroke (IMS)-III Trial Clinical Sciences
Conclusions— ASPECTS is a strong predictor of outcome and a predictor of reperfusion. ASPECTS did not identify a subpopulation of subjects that particularly benefitted from endovascular therapy immediately after routine intravenous tPA. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00359424.
Source: Stroke - January 27, 2014 Category: Neurology Authors: Hill, M. D., Demchuk, A. M., Goyal, M., Jovin, T. G., Foster, L. D., Tomsick, T. A., von Kummer, R., Yeatts, S. D., Palesch, Y. Y., Broderick, J. P., for the IMS3 Investigators Tags: Angiography, Computerized tomography and Magnetic Resonance Imaging, Thrombolysis, Angioplasty and Stenting Clinical Sciences Source Type: research

Evaluating Middle Cerebral Artery Atherosclerotic Lesions in Acute Ischemic Stroke Using Magnetic Resonance T1-weighted 3-Dimensional Vessel Wall Imaging
Background: Atherosclerotic lesions in intracranial arteries are a leading cause of ischemic stroke. Magnetic resonance angiography (MRA) is often used to assess atherosclerotic changes by detecting luminal narrowing, whereas it cannot directly visualize atherosclerotic lesions. Here, we used a 3-dimensional vessel wall imaging (3D-VWI) technique to evaluate intracranial arterial wall changes in acute stroke.Methods: Eighteen consecutive patients with acute noncardioembolic stroke in the middle cerebral artery (MCA) territory who were prospectively examined with a 1.5-T magnetic resonance scanner were studied. T1-weighted ...
Source: Journal of Stroke and Cerebrovascular Diseases - July 22, 2013 Category: Neurology Authors: Tatsunori Natori, Makoto Sasaki, Mitsuharu Miyoshi, Hideki Ohba, Noriyuki Katsura, Mao Yamaguchi, Shinsuke Narumi, Hiroyuki Kabasawa, Kohsuke Kudo, Kenji Ito, Yasuo Terayama Tags: Original Articles Source Type: research

Six-Minute Magnetic Resonance Imaging Protocol for Evaluation of Acute Ischemic Stroke: Pushing the Boundaries Clinical Sciences
Conclusions— A 6-minute multimodal MR protocol with good diagnostic quality is feasible for the evaluation of patients with acute ischemic stroke and can result in significant reduction in scan time rivaling that of the multimodal computed tomographic protocol.
Source: Stroke - June 23, 2014 Category: Neurology Authors: Nael, K., Khan, R., Choudhary, G., Meshksar, A., Villablanca, P., Tay, J., Drake, K., Coull, B. M., Kidwell, C. S. Tags: CT and MRI, Acute Cerebral Infarction, Computerized tomography and Magnetic Resonance Imaging Clinical Sciences Source Type: research

Atrial Fibrillation and Cognitive Decline-The Role of Subclinical Cerebral Infarcts: The Atherosclerosis Risk in Communities Study Clinical Sciences
Conclusions— The association of incident AF with cognitive decline in stroke-free individuals can be explained by the presence or development of SCIs, raising the possibility of anticoagulation as a strategy to prevent cognitive decline in AF.
Source: Stroke - August 25, 2014 Category: Neurology Authors: Chen, L. Y., Lopez, F. L., Gottesman, R. F., Huxley, R. R., Agarwal, S. K., Loehr, L., Mosley, T., Alonso, A. Tags: Cerebrovascular disease/stroke, Arrhythmias, clinical electrophysiology, drugs, Computerized tomography and Magnetic Resonance Imaging, Epidemiology Clinical Sciences Source Type: research