Cerebrovascular diseases
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Fever after acute cerebral injury is associated with unfavorable functional outcome and increased mortality, but there is controversy about the optimal antipyretic treatment. This study investigated an institutional standard operating procedure (SOP) for fever treatment in stroke patients including a sequence of pharmacologic and physical interventions. ⋯ This SOP may help to optimize antipyretic treatment for stroke patients.
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Cerebrovascular diseases · Jan 2011
Persistent hyperglycemia at 24-48 h in acute hyperglycemic stroke patients is not associated with a worse functional outcome.
Recently, it was shown that the relation between admission glucose and functional outcome after ischemic stroke is described by a J-shaped curve, with a glucose range of 3.7-7.3 mmol/l associated with a favorable outcome. We tested the hypothesis that persistence of hyperglycemia above this threshold at 24-48 h after stroke onset impairs 3-month functional outcome. ⋯ In ischemic stroke patients with acute hyperglycemia, persistent hyperglycemia (>7.3 mmol/l) at 24-48 h after stroke onset is not associated with a worse functional outcome at 3 months whether the patient was previously diabetic or not.
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Cerebrovascular diseases · Jan 2011
Local head and neck cooling leads to hypothermia in healthy volunteers.
Prehospital cooling of acute stroke patients would be ideal when associated with minor or no side effects. Therefore, we evaluated a cooling cap for the surface of head and cervical regions in awake volunteers. ⋯ Treatment with the cooling device was well tolerated by all participants. The technique had measurable effects on core body temperature (rectal) and tympanic temperature (may reflect temperature at the external ear and skin rather than intracranial). It can be considered as a simple therapeutic approach to patients with suspected stroke in the prehospital setting.
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Cerebrovascular diseases · Jan 2011
Immediate regression of leukoaraiosis after carotid artery revascularization.
Leukoaraiosis (LA) affects cognition after stroke and reversal of LA may improve cognitive performance. We aimed to determine the impact of cerebral perfusion and circle of Willis (CoW) flow patterns on the extent of LA after carotid artery revascularization. ⋯ CoW anomalies may contribute to LA in patients with carotid artery stenosis, and restoration of cerebral perfusion by carotid artery revascularization can reduce LA severity.
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Cerebrovascular diseases · Jan 2011
Management of patients with transient ischemic attack is safe in an outpatient clinic based on rapid diagnosis and risk stratification.
Transient ischemic attack (TIA) patients are at high risk of short-term stroke, myocardial infarction and vascular death. Stroke risk is reduced by immediate treatment initialization. Stroke unit treatment is recommended for TIA patients. We established an outpatient TIA clinic to address the question whether outpatient evaluation of suspected TIA is safe. ⋯ Based on risk stratification, outpatient evaluation of TIA is safe. TIA mimics are frequent.