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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

Perception Of Stroke Symptoms And Utilization Of Emergency Medical Systems In Argentina (P7.132)
CONCLUSIONS:These results suggest a low level of stroke symptoms awareness in our country even in a population of middle/high socioeconomic level. The role and procedures of EMS in Argentina should be revised as early arrival and treatment appear to be associated with no utilization of them.Study Supported by:Disclosure: Dr. Hawkes has nothing to disclose. Dr. Calandri has nothing to disclose. Dr. Farez has received personal compensation for activities with Merck Serono. Dr. Farez has received research support from Novartis. Dr. Arena has nothing to disclose. Dr. Pujol Lereis has nothing to disclose. Dr. Ameriso has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Hawkes, M., Calandri, I., Farez, M., Arena, J., Pujol Lereis, V., Ameriso, S. Tags: Cerebrovascular Disease and Interventional Neurology: Barriers and Opportunities in Acute Stroke Treatment Source Type: research

Balancing access and quality in comprehensive stroke care
The establishment of stroke units and stroke centers has transformed the inpatient care of cerebrovascular disease and resulted in improved outcomes for patients hospitalized with stroke. Studies show that organized care as part of a stroke unit results in reduced mortality and disability after stroke,1 and that patients hospitalized at primary stroke centers have lower mortality and are more likely to receive thrombolytic therapy.2
Source: Neurology - March 23, 2015 Category: Neurology Authors: Kelly, A. G., Attia, J. Tags: All Health Services Research, Other cerebrovascular disease/ Stroke, All Cerebrovascular disease/Stroke, All epidemiology EDITORIALS Source Type: research

Embolic stroke with spontaneous recanalization (P3.085)
Conclusions This study infers that thrombolysis remarkably improves clinical outcome in patients with embolic stroke who do not have visible arterial occlusion at presentation. A prospective study to validate these results is being planned.Disclosure: Dr. Lahoti has nothing to disclose. Dr. Gokhale has nothing to disclose. Dr. Caplan has received personal compensation in an editorial capacity for JAMA Neurology. Dr. Michel has received personal compensation for activities with Servier, Sanofi-Aventis Pharmaceuticals, and Boehringer Ingelheim Pharmaceuticals, as a speaker, steering committee member, and/or advisory board me...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Lahoti, S., Gokhale, S., Caplan, L., Michel, P., Samson, Y., Rosso, C., Limaye, K., Hinduja, A., Singhal, A., Ali, S., Kryscio, R., Dedhia, N., Hastak, S., Liebeskind, D., Pettigrew, L. Tags: Cerebrovascular Disease and Interventional Neurology: Hemorrhagic and Ischemic Stroke Source Type: research

Serum Albumin Is Associated with Cerebral Hemorrhage in Post-Intravenous Thrombolytic Therapy for Acute Stroke : A Retrospective Chart Review (P4.222)
CONCLUSION: Albumin may provide additional protection against hemorrhagic conversion after IV thrombolytic use in acute ischemic stroke. Study Supported by: noneDisclosure: Dr. Kamal has nothing to disclose. Dr. Li has nothing to disclose. Dr. Smith has nothing to disclose. Dr. Mustafa has nothing to disclose. Dr. Sawyer has nothing to disclose. Dr. Ching has nothing to disclose. Dr. Mehta has received personal compensation for activities with Biogen Idec, and Teva Neuroscience as a speaker, and with the Gerson Lehrman Group as a consultant.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Kamal, H., Li, P., Smith, K., Mustafa, G., Sawyer, R., Ching, M., Mehta, B. Tags: Cerebrovascular Disease and Interventional Neurology: Acute Stroke Thrombolysis Source Type: research

Thrombolytic therapy for stroke in patients with preexisting cognitive impairment
Conclusions: Ischemic stroke patients with PSCI should receive rtPA if they are eligible. This conclusion cannot be extended to severe cognitive impairment or severe strokes. Classification of evidence: This study provides Class IV evidence that in patients with PSCI presenting with acute ischemic stroke, IV rtPA improves outcomes.
Source: Neurology - June 9, 2014 Category: Neurology Authors: Murao, K., Leys, D., Jacquin, A., Kitazono, T., Bordet, R., Bejot, Y., Kimura, K., Godefroy, O., Wakisaka, Y., Moulin, S., Ago, T., Sibon, I., Bombois, S., Mas, J.-L., Henon, H., Pasquier, F., Giroud, M., Cordonnier, C., Okada, Y., On behalf of the OPHELI Tags: All Cerebrovascular disease/Stroke, All Cognitive Disorders/Dementia, MCI (mild cognitive impairment), Infarction ARTICLE Source Type: research

90 Day Outcome after Reperfusion Therapy of Stroke Patients with Baseline Disability: Unique Observations from Patients Treated on the Mobile Stroke Unit (P6.052)
Conclusion: In comparison to previously published data our analysis shows unfavorable outcome in the majority of patients with baseline disability who received thrombolytic therapy. The small sample size is a limitation to this analysis, and further studies are needed to assess if this subpopulation should be included in clinical trials assessing new therapies or modalities to deliver them.Disclosure: Dr. almaghrabi has nothing to disclose. Dr. Sarraj has nothing to disclose. Dr. Bowry has nothing to disclose. Dr. Parker has nothing to disclose. Dr. Yamal has nothing to disclose. Dr. Grotta has received personal compensati...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Almaghrabi, T., Sarraj, A., Bowry, R., Parker, S., Yamal, J.-M., Grotta, J. Tags: Prehospital Stroke Care and Uses of NIHSS Source Type: research

Acute Stroke Therapy in Infective Endocarditis - Case Series and Systematic Review (P6.295)
Conclusions:Endovascular thrombectomy alone appears to be safer than IV-tPA alone in the management of AIS in patients with IE.Disclosure: Dr. Marquardt has nothing to disclose. Dr. Cho has nothing to disclose. Dr. Zhang has nothing to disclose. Dr. Uchino has nothing to disclose. Dr. Wisco has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Marquardt, R., Cho, S.-M., Zhang, L., Uchino, K., Wisco, D. Tags: Cardiovascular Issues in Ischemic Stroke Source Type: research

Thrombolytic Outcomes for Acute Ischemic Stroke in Patients with Primary Brain Tumors in the United States (P4.220)
Conclusions: Thrombolytic therapy is an independent predictor of ICH in patients with primary brain tumors. Thrombolysis outcomes are less favorable in malignant brain tumors compared to benign tumors.Disclosure: Dr. Murthy has nothing to disclose. Dr. Moradiya has nothing to disclose. Dr. Shah has nothing to disclose. Dr. Shastri has nothing to disclose. Dr. Bershad has nothing to disclose. Dr. Suarez has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Murthy, S., Moradiya, Y., Shah, S., Shastri, A., Bershad, E., Suarez, J. Tags: Cerebrovascular Disease and Interventional Neurology: Acute Stroke Thrombolysis Source Type: research

Why Ischemic Stroke Patients Do Not Receive Thrombolytic Treatment? (P7.122)
CONCLUSIONS:This retrospective analysis suggests that less than half of the patients presenting within 4 hours of symptom onset receive rt-PA. The most common reason was minor or rapidly improving symptoms. A significant proportion of patients did not receive rt-PA because patient or family refused. Minority of patients had absolute contraindication. More patient and family education is needed to allay fears of rt-PA use.Disclosure: Dr. Lee has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Lahoti, S., Lee, J. Tags: Cerebrovascular Disease and Interventional Neurology: Issues in Acute Stroke Treatment Source Type: research

Rapidly improving neurological deficit of stroke; case series in Academic institute, KAUH, Jeddah (P4.283)
Conclusions:Rapidly improving patient represent a challenge to whether tPA should be given. However, the good outcome with thrombolytic therapy observed in our study, will hopfuly support the decision to treat.Study Supported by: nonDisclosure: Dr. khoja has nothing to disclose. Dr. Alshaer has nothing to disclose. Dr. al-Turkistani has nothing to disclose. Dr. Al-Mekhalfi has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: khoja, a., Al-Shaer, D., al-Turkistani, a., Al-Mekhalfi, M. Tags: Thrombolysis and Acute Evaluation in Ischemic Stroke Source Type: research

Cerebral hemorrhage following thrombolytic therapy for stroke: Are neutrophils really neutral?
An ideal biomarker can accurately predict disease risk stratification. The longstanding link between inflammatory responses and atherosclerotic disease and vascular events suggests great promise for inflammatory measures as biomarkers in stroke and other vascular disease. Recent studies across multiple areas and disciplines have suggested that leukocytes, as an inflammatory marker, and specifically neutrophils, may hold promise in predicting poor outcomes in various cardiovascular diseases (e.g., heart failure, acute coronary syndromes, stable coronary artery disease), including stroke, as well as in neoplasms, infections,...
Source: Neurology - October 19, 2015 Category: Neurology Authors: Roever, L., Levine, S. R. Tags: All Cerebrovascular disease/Stroke, All epidemiology, Prevalence studies, Risk factors in epidemiology, Intracerebral hemorrhage EDITORIALS Source Type: research

Intravenous Thrombolysis in Anticoagulated and Thrombocytopenic Ischemic Stroke Patients Does Not Increase the Risk of Intracerebral Hemorrhage (P4.271)
Conclusions:These data suggest that IV rt-PA can be safely administered in coagulopathic and thrombocytopenic patients. Although rates of sICH and mortality were similar to the NINDS cohort, caution may be needed to identify certain hemorrhagic risk factors. Routine exclusion of anticoagulated or thrombocytopenic patients is not supported and the use of IV rt-PA in these patients may increase the eligibility for acute stroke therapy, particularly at institutions where IA therapy is unavailable.Disclosure: Dr. Barazangi has received personal compensation for activities with Genentech. Dr. Sorensen has nothing to disclose. D...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Barazangi, N., Sorensen, S., Chen, C., Wong, C., Yee, A., Ke, M., Rose, J., Grosvenor, D., Bedenk, A., Fernandes, J., Tong, D. Tags: Thrombolysis and Acute Evaluation in Ischemic Stroke Source Type: research

Reducing Time to Treatment - The Role of Stroke Neurologist as First Responder (S5.006)
CONCLUSIONS: The use of a stroke-trained attending neurologist as a first responder and stroke team leader resulted in rapid patient evaluation and faster decision regarding thrombolytic therapy, improving time to treatment and time to CT.Disclosure: Dr. Ozark has nothing to disclose. Dr. Sabatino has nothing to disclose. Dr. Holmstedt has nothing to disclose. Dr. Turan has received personal compensation for activities with Gore Laboratories Inc., and Boehringer Ingelheim Pharmaceuticals Inc. Dr. Turan has received research support from Stryker Co., the National Institutes of Health, and AstraZeneca.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Ozark, S., Sabatino, P., Holmstedt, C., Turan, T. Tags: Cerebrovascular Disease and Interventional Neurology: Pre-hospital, Telemedicine, and Related Topics Source Type: research

An Executable Graphical Model for In Silico Prototyping of Processes for Acute Stroke Care (P1.019)
CONCLUSIONS: In silico care process prototyping permits evaluation of proposed innovations in simulated settings. 1. Grotta JC. tPA for stroke: important progress in achieving faster treatment. JAMA. 2014 Apr 23-30;311(16):1615-7. 2. Ford AL et al. Reducing door-to-needle times using Toyota's lean manufacturing principles and value stream analysis. Stroke. 2012 Dec;43(12):3395-8. 3. Meretoja A et al. Reducing in-hospital delay to 20 minutes in stroke thrombolysis. Neurology. 2012 Jul 24;79(4):306-13. Study Supported by:Genentech, Inc.Disclosure: Dr. Norris has received personal compensation for activities with Genentech. D...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Norris, D., Levy, D. Tags: Cerebrovascular Disease and Interventional Neurology I ePosters Source Type: research

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