Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Jan 2013
Multicenter Study Comparative StudyComparison of single versus multiple spontaneous extra- and/or intracranial arterial dissection.
Anecdotal data suggest that approximately 20% of patients with a spontaneous extra- and/or intracranial arterial dissection have multiple arterial involvement. Limited data exist regarding the clinical and angiographic characteristics of patients with multiple arterial dissections. We compared the clinical and angiographic features of patients with spontaneous multiple extra- and/or intracranial arterial dissections with those who have a single arterial dissection. ⋯ The presence of multiple, simultaneous spontaneous extra- and/or intracranial arterial dissections must be considered when a single spontaneous arterial dissection is identified.
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J Stroke Cerebrovasc Dis · Jan 2013
Comparative StudyDiffusion tensor imaging for intracerebral hemorrhage outcome prediction: comparison using data from the corona radiata/internal capsule and the cerebral peduncle.
Magnetic resonance-diffusion tensor imaging (DTI) was used to predict motor outcome for patients with intracerebral hemorrhage. We compared the predictive accuracy of data sampled from the cerebral peduncle with data from the corona radiata/internal capsule. This study included 32 subjects with thalamic or putaminal hemorrhage or both. ⋯ FA values from within the cerebral peduncle more accurately predicted motor outcome and is a promising technique for clinical application.
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J Stroke Cerebrovasc Dis · Jan 2013
Comparative StudyAcute care and long-term mortality among elderly patients with intracerebral hemorrhage who undergo chronic life-sustaining procedures.
Little is known about patients with intracerebral hemorrhage (ICH) who undergo chronic life-sustaining procedures. We sought to explore variations in treatment, Medicare payments, and mortality among elderly patients with ICH who received a feeding tube, a tracheostomy, or neither chronic life-sustaining procedure. Medicare Provider Analysis and Review files from 2004 linked to Center for Medicaid and Medicare Services denominator files through January 2005 were analyzed. ⋯ Our findings show high 1-year mortality among elderly patients with ICH, even in those who undergo chronic life-sustaining procedures. Medicare payments for patients who undergo tracheostomy are substantial. More information about functional outcomes is needed.
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J Stroke Cerebrovasc Dis · Nov 2012
Case ReportsIntravenous thrombolysis in a stroke patient taking dabigatran.
We describe the use of intravenous thrombolysis with recombinant tissue plasminogen activator (IV-rtPA) in a patient with concomitant dabigatran use. A 64-year-old man with a history of coronary artery disease, pacemaker placement, and atrial fibrillation developed acute right arm/face weakness and dysarthria. He was unable to list his home medications. ⋯ We report a case of an acute stroke patient taking dabigatran who received IV-rtPA. In the acute stroke setting, clinicians should be aware of the increasing use of dabigatran in patients with atrial fibrillation when considering IV-rtPA. Although aPTT does not provide a linear response to dabigatran therapy, the presence of a completely normal PTT may exclude therapeutic dabigatran anticoagulation.
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J Stroke Cerebrovasc Dis · Nov 2012
Multicenter StudyPredictors of cerebral venous thrombosis and arterial ischemic stroke in young Asian women.
The management and outcome of cerebral venous thrombosis (CVT) may be different from that of arterial ischemic stroke (AIS). Clinically differentiating the 2 diseases on clinical grounds may be difficult. The main objective of this study was to identify predictors differentiating CVT from AIS in a large cohort of young Asian women, based on risk factors and investigations. ⋯ There was no difference in outcome between patients with obstetric and nonobstetric CVT. Our data indicate that in young Asian women, predictors of CVT differ from those for AIS. These findings could be useful in the early identification and diagnosis of patients with CVT.