Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Sep 2010
Comparative StudyA comparison of characteristics and resource use between in-hospital and admitted patients with stroke.
Although in-hospital stroke is not a common occurrence, it is important to identify what components of stroke care these patients receive. The aims of this study were to estimate the clinical characteristics, process of stroke care, and mortality in patients admitted to hospital with stroke compared with patients with in-hospital strokes. ⋯ This study demonstrated that in-hospital patients with stroke had worse stroke severity, and poorer access to a number of components of stroke care compared with admitted patients with stroke. All hospitals should include, in their stroke policies and guidelines, evidence-based pathways that prioritize the needs of patients who have a stroke while in hospital.
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J Stroke Cerebrovasc Dis · Jul 2010
Bilateral paramedian thalamic artery infarcts: report of 10 cases.
The paramedian thalamic arteries can arise as a pair from each P1 of the posterior cerebral artery, but they may also arise equally from a common trunk off one P1, thus supplying thalamus bilaterally. Such a common trunk is called the artery of Percheron and supplies the mesial aspects of both thalami and the rostral midbrain. This is a retrospective review of 1,253 consecutive patients with ischemic stroke enrolled in a stroke registry within an 8-year period (January 2001-December 2008). ⋯ Although neurologic deficits and hypersomnia recovered to large extent in patients with paramedian thalamic infarcts, cognitive deficits that were mainly linked with bilateral and left-sided lesions often persisted. Vertical gaze paresis tended to improve and never seriously disturbed the patient's activities. We believe that these kinds of strokes have been commonly overlooked, especially without widespread use of MRI.
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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.