56,241 results match your criteria Acute Stroke Management

Characteristics, Management, and Case-Fatality of Patients Hospitalized for Stroke with a Diagnosis of COVID-19 in France.

Neuroepidemiology 2021 Jun 24:1-7. Epub 2021 Jun 24.

Department of Non-Communicable Diseases, Cardiovascular Diseases and Stroke Program, Santé Publique France, Saint-Maurice, France.

Introduction: COVID-19 was found to be associated with an increased risk of stroke. This study aimed to compare characteristics, management, and outcomes of hospitalized stroke patients with or without a hospital diagnosis of CO-VID-19 at a nationwide scale.

Methods: This is a cross-sectional study on all French hospitals covering the entire French population using the French national hospital discharge databases (Programme de Médicalisation des Systèmes d'Information, included in the Système National des Données de Santé). Read More

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Clinical characteristics and outcomes of patients with takotsubo syndrome versus spontaneous coronary artery dissection.

Cardiol J 2021 Jun 24. Epub 2021 Jun 24.

University Heart Center, Department of Cardiology, University Hospital Zurich, Switzerland.

Background: Takotsubo syndrome (TTS) and spontaneous coronary artery dissection (SCAD) are now increasingly recognized. Both conditions predominantly affect females; however, the exact pathophysiology remains unclear. Large multi-center databases can help elucidate the underlying mechanism and optimize treatments to improve outcomes by allowing us to compare features and outcomes of patients with TTS and patients with SCAD. Read More

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General anesthesia with remimazolam in a patient with mitochondrial encephalomyopathy: a case report.

JA Clin Rep 2021 Jun 23;7(1):51. Epub 2021 Jun 23.

Department of Anesthesiology and Intensive Care Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka, 431-3192, Japan.

Background: Systemic anesthetic management of patients with mitochondrial disease requires careful preoperative preparation to administer adequate anesthesia and address potential disease-related complications. The appropriate general anesthetic agents to use in these patients remain controversial.

Case Presentation: A 54-year-old woman (height, 145 cm; weight, 43 kg) diagnosed with mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes underwent elective cochlear implantation. Read More

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Outcomes related to anticoagulation management for mechanical valve replacements.

J Thorac Dis 2021 May;13(5):2874-2884

Division of Cardiac Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Background: This study evaluates anticoagulation management and its impact on longitudinal clinical outcomes in patients undergoing mechanical valve replacement.

Methods: Patients undergoing mechanical mitral valve replacement (MVR) or aortic valve replacement (AVR) from 2010-2018 at a single center were included. Patients were stratified into therapeutic and non-therapeutic anticoagulation groups based on the median percentage of international normalized ratio (INR) values within the reference range (2. Read More

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Diffuse Cerebral Edema After Moyamoya Disease-Related Intracerebral Hemorrhage: A Case Report.

Neurohospitalist 2021 Jul 10;11(3):251-254. Epub 2020 Dec 10.

Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Moyamoya disease (MMD) is a rare, progressive occlusive disease characterized by bilateral internal carotid artery hypoplasia that often presents with ischemic stroke and intracerebral hemorrhage (ICH). Although MMD-related ICH is generally managed similarly to spontaneous ICH, we present a case in which standard management strategies may have led to an unprecedented devastating outcome. A 37-year-old female without any previous medical history presented with headache and right-sided weakness. Read More

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Endovascular Treatment of Acute Ischemic Stroke in Clinical Practice: Analysis of Workflow and Outcome in a Tertiary Care Center.

Front Neurol 2021 7;12:657345. Epub 2021 Jun 7.

Hannover Medical School, Institute for Diagnostic and Interventional Neuroradiology, Hannover, Germany.

Pre- and intra-hospital workflow in mechanical recanalization of large cervicocephalic arteries in patients with acute ischemic stroke still needs optimization. In this study, we analyze workflow and outcome in our routine care of stroke patients undergoing mechanical thrombectomy as a precondition for such optimization. Processes of pre- and intra-hospital management, causes of treatment delay, imaging results (Alberta Stroke Program Early Computed Tomography Score, localization of vessel occlusion), recanalization (modified thrombolysis in cerebral infarction score), and patient outcome (modified Rankin scale at discharge and at the end of inpatient rehabilitation) were analyzed for all patients who underwent mechanical thrombectomy between April 1, 2016, and September 30, 2018, at our site. Read More

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Arterial Thrombosis in an Asymptomatic COVID-19 Complicated by Malignant Middle Cerebral Artery Syndrome: A Case Report and Literature Review.

Int Med Case Rep J 2021 14;14:401-405. Epub 2021 Jun 14.

Department of Radiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Coronavirus disease 2019 (COVID-19) is a severe infectious respiratory disease caused by the novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Multiple studies in the literature highlight the association between COVID-19 and stroke. We report a case of acute ischemic stroke in a COVID-19 patient without displaying symptoms of active COVID-19 infection or risk factors for stroke with further review of the literature. Read More

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Racial and ethnic disparities in subjective cognitive decline: a closer look, United States, 2015-2018.

Sangeeta Gupta

BMC Public Health 2021 Jun 24;21(1):1173. Epub 2021 Jun 24.

Department of Public and Allied Health Sciences, Delaware State University, 1200 N DuPont Highway, Dover, Delaware, 19901, USA.

Background: Subjective cognitive decline (SCD), characterized by self-experience of deterioration in cognitive performance may be a precursor to Alzheimer's disease (AD). Given the association of AD with dependence and disability for a long duration, earlier the detection, the sooner people and their families can receive information regarding better management. It is critical to explore disparities amongst racial and ethnic populations with SCD in order to facilitate targeted interventions. Read More

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Improving Prehospital Stroke Diagnosis Using Natural Language Processing of Paramedic Reports.

Stroke 2021 Jun 24:STROKEAHA120033580. Epub 2021 Jun 24.

Department of Neurology, University of Chicago, IL. (Z.P., S.J.M., J.L.H., S.P.).

Background And Purpose: Accurate prehospital diagnosis of stroke by emergency medical services (EMS) can increase treatments rates, mitigate disability, and reduce stroke deaths. We aimed to develop a model that utilizes natural language processing of EMS reports and machine learning to improve prehospital stroke identification.

Methods: We conducted a retrospective study of patients transported by the Chicago EMS to 17 regional primary and comprehensive stroke centers. Read More

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J Card Fail 2021 Jun 20. Epub 2021 Jun 20.

Department of Medicine, Division of Cardiology, Columbia University, New York, New York, USA. Electronic address:

Background: Heart failure predisposes to intracardiac thrombus (ICT) formation. There is limited data on prevalence and impact of pre-existing ICT on postoperative outcomes in LVAD patients. We examined the risk for stroke and death in this patient population. Read More

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Evaluating the Use of Oral Trials for Inpatient Dysphagia Management: An Initial Cross-Sectional Database Study.

Am J Speech Lang Pathol 2021 Jun 23:1-12. Epub 2021 Jun 23.

Department of Speech and Language Therapy, Derbyshire Community Health Services, Royal Derby Hospital, United Kingdom.

Purpose Oral trials, otherwise known as or are widely used in dysphagia management. However, to date, no studies have investigated the effectiveness of oral trials or outlined how the approach is utilized in everyday practice. This article aims to start a dialogue regarding this much-used but little-evidenced dysphagia intervention by exploring three main aspects to (a) identify the patient demographics and environments in which oral trials are used in hospital, (b) explore clinical decision making around the approach, and (c) consider clinical implications around current findings and future areas for research. Read More

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Hypotension during endovascular treatment under general anesthesia for acute ischemic stroke.

PLoS One 2021 23;16(6):e0249093. Epub 2021 Jun 23.

Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Objective: The effect of anesthetic management (general anesthesia [GA], conscious sedation, or local anesthesia) on functional outcome and the role of blood pressure management during endovascular treatment (EVT) for acute ischemic stroke is under debate. We aimed to determine whether hypotension during EVT under GA is associated with functional outcome at 90 days.

Methods: We retrospectively collected data from patients with a proximal intracranial occlusion of the anterior circulation treated with EVT under GA. Read More

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[Arterial ischemic stroke in children].

Rev Prat 2021 Jan;71(1):75-78

"Centre national de référence de l'AVC de l'enfant, service de médecine physique et réadaptation pédiatrique, et Inserm CIC1408, CHU de Saint-Étienne, Saint-Étienne, France".

Arterial ischemic stroke in children Stroke in children is an event of sudden occurrence with severe impact on the child's life. Most children will have consequences, lasting all lifelong. Early recognition of first symptoms, most often unilateral sudden motor deficit, is crucial to launch a pediatric stroke alert. Read More

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January 2021

Management of tandem occlusions in patients who receive rtPA.

J Thromb Thrombolysis 2021 Jun 23. Epub 2021 Jun 23.

Department of Neurological Surgery, The Ohio State University Wexner Medical Center, 410 W 10th Ave, Columbus, OH, 43210, USA.

Background: Tandem occlusions exist in 17-32% of large vessel occlusion (LVO) strokes. A significant concern is bleeding when carotid stenting is performed in tandem with thrombectomy due the administration of antiplatelet agents such as glycoprotein IIb/IIIa inhibitors (GP2b3aI) after receiving rtPA, but data are limited in this setting.

Methods: A mutlicenter, retrospective chart review was conducted at two comprehensive stroke centers to assess the safety and efficacy of using GP2b3aI to facilitate carotid stent placement simultaneously with endovascular thrombectomy in patients who have received rtPA. Read More

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Catheter ablation for atrial fibrillation in left ventricular assist device: A case report.

Medicine (Baltimore) 2021 Jun;100(25):e26308

Division of Cardiology, Department of Medicine, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Introduction: Mechanical circulatory support such as the left ventricular assist device (LVAD) has become widely implemented in the treatment of end-stage heart failure, whether as bridge-to-transplant or as destination therapy. The hemodynamic effects of arrhythmia on LVADs and its management are significant in determining the long-term outcome of these patients. Both atrial arrhythmia and ventricular arrhythmia are commonly seen after implantation of the device. Read More

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Tissue outcome prediction in hyperacute ischemic stroke: Comparison of machine learning models.

J Cereb Blood Flow Metab 2021 Jun 23:271678X211024371. Epub 2021 Jun 23.

Institut de Psychiatrie et Neurosciences de Paris (IPNP), INSERM U1266, Paris, France.

Machine Learning (ML) has been proposed for tissue fate prediction after acute ischemic stroke (AIS), with the aim to help treatment decision and patient management. We compared three different ML models to the clinical method based on diffusion-perfusion thresholding for the voxel-based prediction of final infarct, using a large MRI dataset obtained in a cohort of AIS patients prior to recanalization treatment. Baseline MRI (MRI), including diffusion-weighted sequence (DWI) and Tmax maps from perfusion-weighted sequence, and 24-hr follow-up MRI (MRI) were retrospectively collected in consecutive 394 patients AIS patients (median age = 70 years; final infarct volume = 28mL). Read More

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Endovascular treatment of anterior cerebral artery occlusions.

J Neurointerv Surg 2021 Jun 22. Epub 2021 Jun 22.

Department of Neuroradiology, Alfried Krupp Hospital Ruttenscheid, Essen, Germany.

There are limited data on endovascular treatment (EVT) for anterior cerebral artery (ACA) occlusions. This review focuses on aspects related to ACA EVT: ACA anatomy, clinical and imaging findings, prognosis of ACA stroke, and ACA thrombectomy techniques. The ACA anatomy, and the regions supplied by the ACA, are highly variable; frequent anatomical variants include azygos ACA, triplicated ACA and fenestrations of the anterior communicating artery. Read More

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Stroke thrombectomy complication management.

J Neurointerv Surg 2021 Jun 22. Epub 2021 Jun 22.

Department for Diagnostic and Interventional Neuroradiology, Inselspital Universitatsspital Bern, Bern, Switzerland

Endovascular mechanical thrombectomy (EVT) is widely accepted as the first-line treatment for acute ischemic stroke in patients with large vessel occlusion. Being an invasive treatment, this method is associated with various preoperative, perioperative, and postoperative complications. These complications may influence peri-interventional morbidity and mortality and therefore treatment efficacy and clinical outcome. Read More

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Reducing stroke burden through a targeted self-management intervention for reducing stroke risk factors in high-risk Ugandans: A protocol for a randomized controlled trial.

PLoS One 2021 22;16(6):e0251662. Epub 2021 Jun 22.

Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center & Case Western Reserve University School of Medicine, Cleveland, OH, United States of America.

Introduction: Stroke burden is rapidly increasing globally. Modifiable risk factors offer an opportunity to intervene, and targeting hypertension is a key actionable target for stroke risk reduction in sub-Saharan Africa. This 3-site planned randomized controlled trial builds on promising preliminary data. Read More

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Left Ventricular Noncompaction Cardiomyopathy as a Potential Cause of Bilateral Posterior Cerebral Artery Stroke - a Rare and Unique Clinical Occurrence.

Am J Case Rep 2021 Jun 22;22:e931103. Epub 2021 Jun 22.

Department of Neurology, University of Massachusetts Medical School, Worcester, MA, USA.

BACKGROUND Bilateral posterior cerebral artery (PCA) occlusions are exceedingly rare, and are considered a devastating phenomenon that presents as cortical blindness. Predominant causes of PCA infarcts include cardiac and arterial embolisms. Left ventricular noncompaction (LVNC) cardiomyopathy is also an extremely rare cardiopathology. Read More

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