Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Mar 2014
Meta AnalysisPooled assessment of computed tomography interpretation by vascular neurologists in the STRokE DOC telestroke network.
The objective of this pooled analysis was to determine the level of agreement between central read and each of 2 groups (spoke radiologists and hub vascular neurologists) in interpreting head computed tomography (CT) scans of stroke patients presenting to telestroke network hospitals. ⋯ Both vascular neurologists and reports from spoke radiologists had excellent reliability in identifying radiologic rt-PA contraindications. These pooled findings demonstrate that telestroke evaluation of head CT scans for acute rt-PA assessments is reliable.
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J Stroke Cerebrovasc Dis · Mar 2014
Favorable functional recovery in overweight ischemic stroke survivors: findings from the China National Stroke Registry.
Obesity paradox has been reported because of the inverse relationship between the body mass index (BMI) and mortality in stroke patients. The relationship between BMI and functional recovery in stroke survivors is less well established. We explored the impact of BMI on functional recovery and mortality in stroke patients in the China National Stroke Registry (CNSR). ⋯ The stroke obesity paradox can be extended to include functional recovery but should not be interpreted as the fatter the better.
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J Stroke Cerebrovasc Dis · Mar 2014
Long-term adherence to national guidelines for secondary prevention of ischemic stroke: a prospective cohort study in a public hospital in Chile.
Clinical guidelines for the secondary prevention of ischemic stroke have been developed, but their publication is insufficient to make them effective. Our aim was to investigate adherence to Chilean guidelines, its associated variables, and to determine prognosis at follow-up. ⋯ The observed significant decrease in adherence to oral anticoagulation in patients with cardioembolic stroke suggests a need for the implementation of specific strategies to achieve the desired secondary prevention goals in these patients. Future research into the evaluation of other factors that could be associated with the lack of adherence to these guidelines, measurements of therapeutic goals, and new therapeutic strategies that are easier to use and that are associated with less risk could improve the prognosis of these patients.
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J Stroke Cerebrovasc Dis · Mar 2014
Case ReportsCerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy without anterior temporal pole involvement: a case report.
The location of white matter lesions, especially in the anterior temporal poles (ATP), is helpful in the diagnosis of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). We report a 49-year-old man with CADASIL who developed migraine with atypical aura, silent lacunar infarcts, and leukoencephalopathy without involvement of the ATP. ⋯ Particularly in patients with CADASIL, the aura is often atypical (hemiplegic, basilar, or prolonged). A diagnosis of CADASIL should be considered in patients with lacunar infarcts, leukoencephalopathy, and migraine with atypical aura, even in the absence of white matter lesion in the ATPs.
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The time from symptom onset to seeking medical assistance (decision delay) accounts for a proportion of prehospital delay in acute stroke. The aims of this study were to identify factors related to decision delay and calling the emergency medical services (EMS) as the first medical contact. ⋯ The decision to seek medical assistance in acute stroke accounts for more than half of the prehospital delay. Severity of symptoms and living together are related to an early decision (≤1 hour). Previous stroke knowledge does not affect decision delay or EMS use.