Cerebrovascular diseases
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Prior epidemiological work has shown higher mortality in ischemic stroke patients admitted on weekends, which has been termed the 'weekend effect'. Our aim was to assess stroke patient outcomes in order to determine the significance of the 'weekend effect' at 2 comprehensive stroke centers. ⋯ Our results suggest that comprehensive stroke centers (CSC) may ameliorate the 'weekend effect' in stroke patients. These results may be due to 24/7 availability of stroke specialists, advanced neuroimaging, or ongoing training and surveillance of specialized nursing care available at CSC. While encouraging, these results require confirmation in prospective studies.
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Cerebrovascular diseases · Jan 2009
ReviewPoststroke emotional and behavior impairment: a narrative review.
Emotional and behavioral disturbances are a frequent complication in stroke survivors. They are underdiagnosed, have a high impact on quality of life and are often a precipitant of institutionalization. ⋯ In this article, we update some of the most common or relevant poststroke emotional and behavioral disturbances, including poststroke mania and poststroke depression, poststroke anxiety disorders, posttraumatic stress disorder, personality changes with focus on apathy and disturbances of emotional expression control. Significant advances in the management of poststroke emotional and behavioral disturbances will need the use of comparable instruments and methods and multicenter collaboration.
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Cerebrovascular diseases · Jan 2009
ReviewQuality of life after stroke: the importance of a good recovery.
Health-related quality of life (HRQoL) is a recognized and important outcome after stroke. An increased survival and the presence of moderate impairment in long-term stroke survivors impact their HRQoL. ⋯ Physical and psychosocial well-being is greatly affected in stroke survivors and their caregivers.
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Cerebrovascular diseases · Jan 2009
Multicenter StudyEuropean Stroke Facilities Survey: the German and Austrian perspective.
The aim of this nested analysis was to identify the major components of stroke centers and other facilities actually available for acute stroke patients in hospitals of Germany and Austria. ⋯ This survey shows that the minimum level of care is met in Germany and Austria in 63% of hospitals treating stroke patients, whereas the European average is 48.6%. However, the lack of stroke center coverage should encourage health policy decision makers to further improve the infrastructure for acute stroke care in order to make stroke centers available to every stroke victim.
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Cerebrovascular diseases · Jan 2009
Comparative StudyPerfusion CT improves diagnostic accuracy for hyperacute ischemic stroke in the 3-hour window: study of 100 patients with diffusion MRI confirmation.
Conventional noncontrast CT (NCCT) is insensitive to hyperacute cerebral infarction in the first 3 h. Our aim was to determine if CT perfusion (CTP) can improve diagnostic accuracy over NCCT for patients presenting with stroke symptoms in the 3-hour window. ⋯ In a retrospective cohort of 100 patients with symptoms of hyperacute stroke in the 3-hour window, CTP provided improved sensitivity and accuracy over NCCT.