Cerebrovascular diseases
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Cerebrovascular diseases · Jan 2008
Multicenter Study Comparative Study Controlled Clinical TrialInitiation of oral anticoagulation after acute ischaemic stroke or transient ischaemic attack: timing and complications of overlapping heparin or conventional treatment.
Oral anticoagulation is highly effective for secondary prevention of cardioembolic strokes in patients with atrial fibrillation (AF). There are no studies investigating timing and complications of different strategies for initiation of oral anticoagulation after acute stroke or transient ischaemic attack (TIA). ⋯ Initiation of oral anticoagulation after acute ischaemic stroke yielded low complication rates independent of antithrombotic co-medication. Heparin bridging was associated with a longer stay in acute care hospitals.
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Cerebrovascular diseases · Jan 2008
Functional outcome 3 months after stroke predicts long-term survival.
When reporting stroke survival and prognostic factors with a possible effect on outcome, the starting point for the observation of a clinical cohort usually is the onset of stroke or the acute admission of a patient. Thus, acute and early mortality inflict prognosis on long-term outcome. In order to give a more robust analysis of long-term survival after the acute period we chose to start our observation with 3-month survivors. ⋯ The influence of disability on survival is stronger than that of several other well-known prognostic factors. This finding indicates that any intervention in the acute phase that may improve functional status at 3 months will also have favourable secondary effects on survival in the long term.
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Cerebrovascular diseases · Jan 2008
Comparative StudyVisual grading system for vasospasm based on perfusion CT imaging: comparisons with conventional angiography and quantitative perfusion CT.
The purpose of this study was to compare simple visual grading of perfusion CT (PCT) maps to a more quantitative, threshold-based interpretation of PCT parameters in the characterization of presence and severity of vasospasm. ⋯ We propose a user-friendly visual grading system for PCT maps in patients with suspected vasospasm. This visual approach compares favorably to the results of DSA. Sensitive MTT maps should be used for screening, and specific CBF maps for confirmation of vasospasm.
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Cerebrovascular diseases · Jan 2008
Clinical severity predicts time to hospital admission in patients with spontaneous intracerebral hemorrhage.
In this study we analyzed whether demographic, clinical and neuroradiological parameters are associated with time to hospital admission in patients with spontaneous intracerebral hemorrhage (ICH). We a priori hypothesized that the earlier a patient was admitted to hospital, the worse the clinical status would be. ⋯ Clinically more severely affected patients were admitted to hospital earlier. This highlights the importance of most rapid diagnosis of ICH. Efforts should be made to get less severely affected patients admitted earlier as they might be ideal candidates for emerging innovative treatments.