Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · May 2010
Anterior circulation ischemia due to dolichoectatic internal carotid artery.
Intracranial dolichoectatic carotid and middle cerebral artery (ICDA) may cause ischemia by multiple mechanisms, including thrombosis, embolism, and occlusion of the involved arteries. We sought clinical and hemodynamic mechanisms in 8 patients with ICDA and stroke, corresponding to 0.4% of our patients with ischemic stroke, and compared these data with those for patients having ICDA without stroke. Hypertension and transient ischemic attack were the significant findings in patients with stroke compared with those without stroke. Patients with stroke were more likely to have an embolism from the stagnated vascular bed and less frequently had compression of the neighboring structure of the elongated arteries.
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J Stroke Cerebrovasc Dis · May 2010
Randomized Controlled Trial Comparative StudyComparison of outcomes after intracerebral hemorrhage and ischemic stroke.
Intracerebral hemorrhage (ICH) is associated with a greater average initial stroke severity, higher mortality, and poorer long-term neurologic outcomes than ischemic stroke. The purpose of this study was to determine whether the poorer prognosis of ICH is independent of initial stroke severity. ⋯ Among conscious stroke patients, ICH is an independent predictor of poor neurologic outcome, nearly doubling the odds of long-term disability. However, ICH is not associated with higher mortality compared with ischemic stroke after adjusting for initial stroke severity and other baseline characteristics.
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J Stroke Cerebrovasc Dis · May 2010
Randomized Controlled TrialEffectiveness of stroke education in the emergency department waiting room.
The purpose of this study was to evaluate the effectiveness of stroke education provided to patients and their significant others in the emergency department (ED) waiting area. Our focus was on the 4 main aspects of stroke: signs and symptoms, risk factors, behavior modification, and the urgency to seek medical attention. We hypothesized that showing educational videos, providing one-on-one counseling, and distributing literature would result in greater stroke knowledge and positive behavioral modification. ⋯ ED stroke education, which includes video program, one-on-one counseling, and written educational materials, is able to significantly increase stroke knowledge. Modification and reinforcement of education is needed to achieve better knowledge retention and favorable lifestyle modifications.
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J Stroke Cerebrovasc Dis · May 2010
ReviewDiagnosis and management of pediatric arterial ischemic stroke.
Pediatric stroke is among the top 10 causes of death in children and an important cause of chronic morbidity, with an incidence of 3.3/100,000 children/year. Risk factors associated with stroke in children include cardiac diseases, hematologic and vascular disorders, and infection. Clinical presentation varies depending on age, underlying cause, and stroke location. ⋯ In this article we review the cause, pathophysiology, clinical presentation, diagnosis, acute management, secondary prevention, and outcome of children with stroke. The approach to patients with sickle cell disease and Moyamoya disease is also discussed. Up to date studies to determine the optimal acute treatment of childhood stroke and secondary prevention and risk factor modification are critically needed.