Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Sep 2015
Multicenter StudyPrehospital Stroke Identification: Factors Associated with Diagnostic Accuracy.
Stroke patients misdiagnosed by emergency medical services (EMS) providers have been shown to receive delayed in-hospital care. We aim at determining the diagnostic accuracy of Fire Department of New York (FDNY) EMS providers for stroke and identifying potential reasons for misdiagnosis. ⋯ FDNY EMS care providers missed more than a third of stroke cases. Seizures and other atypical presentations contribute significantly to stroke misdiagnosis in the field. Our findings highlight the need for better prehospital stroke identification methods.
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J Stroke Cerebrovasc Dis · Sep 2015
Case ReportsCerebral Vasospasm and Delayed Cerebral Ischemia after Warfarin-Induced Subarachnoid Hemorrhage.
Subarachnoid hemorrhage (SAH) associated with anticoagulation is a rare event. About 30% of in-hospital patients with aneurysmal SAH develop delayed cerebral ischemia (DCI); however, the occurrence of vasospasm and DCI in patients with nonaneurysmal SAH is still controversial. ⋯ In conclusion, this case report suggests that vasospasm and consequent DCI is a possible mechanism of secondary lesion after anticoagulation-induced SAH. To our knowledge, this is the first report of vasospasm and DCI due to warfarin-associated SAH.
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J Stroke Cerebrovasc Dis · Sep 2015
Observational StudyNeurochecks as a Biomarker of the Temporal Profile and Clinical Impact of Neurologic Changes after Intracerebral Hemorrhage.
We sought to determine whether a quantitative neurocheck biomarker could characterize the temporal pattern of early neurologic changes after intracerebral hemorrhage (ICH), and the impact of those changes on long-term functional outcomes. ⋯ Neurochecks are effective at detecting clinically important neurologic changes in the intensive care unit setting that are relevant to patients' long-term outcomes. The initial 12 hours is a period of frequent and prognostically important neurologic changes in patients with ICH.
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J Stroke Cerebrovasc Dis · Sep 2015
Detection and Predictors of Paroxysmal Atrial Fibrillation in Acute Ischemic Stroke and Transient Ischemic Attack Patients in Singapore.
Detection of paroxysmal atrial fibrillation (pAF) is important for optimal secondary stroke prevention. Data are limited from Asia regarding inpatient occurrence and predictors of pAF to optimize electrocardiographic (ECG) monitoring despite it having nearly two thirds of the world's population and different subtypes of stroke from the West. ⋯ pAF occurred in 8% of AIS and TIA in a hospitalized cohort of Asian patients. All patients without known atrial fibrillation should undergo CEM for at least 3 days during hospitalization and priority given to patients with predictors of pAF in centers with resource constraints.
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J Stroke Cerebrovasc Dis · Sep 2015
Causes and Predictors for Hospital Readmission after Ischemic Stroke.
Readmission after stroke is frequent, but limited data are available in Europe. This study aimed at assessing frequencies, causes, and factors associated with early and late unplanned readmissions within 1 year after discharge from ischemic stroke hospitalization. ⋯ Readmission after ischemic stroke is frequent, especially in the early period after discharge. Diagnoses and predictors varied according to time point for readmission, reflecting different underlying mechanisms for causes of readmission. Causes of early readmission may include a prothrombotic state and disposition for recurrent infections.