Stroke; a journal of cerebral circulation
-
Emergency medical dispatchers play an important role in optimizing stroke care if they are able to accurately identify calls regarding acute cerebrovascular disease. This study was undertaken to assess the diagnostic accuracy of the current national protocol guiding dispatcher questioning of 911 callers to identify stroke (QA Guide version 11.1 of the National Academy Medical Priority Dispatch System). ⋯ Dispatcher recognition of stroke calls using the widely employed Medical Priority Dispatch System algorithm is suboptimal, with failure to identify more than half of stroke patients as likely stroke. Revisions to the current national dispatcher structured interview and symptom identification algorithm for stroke may facilitate more accurate recognition of stroke by emergency medical dispatchers.
-
The morbidity and mortality of subarachnoid hemorrhage (SAH) are high, and established risk factors are scarce. We prospectively assessed the association of blood pressure, smoking, and body mass with the risk of aneurysmal SAH. ⋯ Systolic and diastolic blood pressure were strong predictors of aneurysmal SAH, and there was a substantially increased risk associated with smoking. However, high body mass was associated with reduced risk of aneurysmal SAH.
-
Comparative Study
Accuracy of transcranial Doppler compared with CT angiography in diagnosing arterial obstructions in acute ischemic strokes.
Patients with acute ischemic stroke and intracranial arterial obstructions have a poor prognosis and a high probability of deteriorating at 24 hours. We aimed to evaluate the diagnostic accuracy of power motion mode Doppler (PMD-TCD) compared with CT angiography as standard in diagnosing intracranial arterial obstructions in patients presenting with ischemic stroke of <24 hours. ⋯ PMD-TCD is valid compared with CT angiography for the diagnosis of arterial occlusions in patients with acute ischemic stroke, especially in middle cerebral artery obstructions.
-
Comparative Study
Hemorrhagic and ischemic strokes compared: stroke severity, mortality, and risk factors.
Stroke patients with hemorrhagic (HS) and ischemic strokes were compared with regard to stroke severity, mortality, and cardiovascular risk factors. ⋯ Strokes are generally more severe in patients with HS. Within the first 3 months after stroke, HS is associated with a considerable increase of mortality, which is specifically associated with the hemorrhagic nature of the lesion.
-
Vasospasm is an important complication of subarachnoid hemorrhage, but is variably defined in the literature. ⋯ DCI is a more clinically meaningful definition than either symptomatic deterioration alone or the presence of arterial spasm by angiography or TCD.