Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Aug 2017
Impact of Hospital Admission for Patients with Transient Ischemic Attack.
To determine the impact of admission among transient ischemic attack (TIA) patients in the emergency department (ED). ⋯ Less than half of patients admitted with a diagnosis of TIA retained that diagnosis at hospital discharge. Although admitted patients were more likely to receive diagnostic procedures, we did not identify improvements in outcomes among admitted patients; however, evaluating care for patients with TIA is limited by the reliability of secondary data analysis.
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J Stroke Cerebrovasc Dis · Aug 2017
Intracerebral Hemorrhagic Expansion Occurs in Patients Using Non-Vitamin K Antagonist Oral Anticoagulants Comparable with Patients Using Warfarin.
Non-vitamin K antagonist oral anticoagulant (NOAC) use has significantly reduced intracerebral hemorrhagic (ICH) risk compared with standard anticoagulant treatment. Hematoma expansion (HE) is a known predictor of mortality in warfarin-associated ICH. Little is known about HE in patients using NOACs. ⋯ In our coagulopathic NOAC patient population, HE occurs within 6 hours in 44% of patients. This case series did not have sufficient statistical power to detect significant differences between the groups. To our knowledge, this is one of the largest case series reporting on HE with concomitant NOAC use.
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J Stroke Cerebrovasc Dis · Jul 2017
Comparative StudyUse of Geospatial Modeling to Evaluate the Impact of Telestroke on Access to Stroke Thrombolysis in Ontario.
The treatment of acute ischemic stroke in Ontario is coordinated through a network of stroke centers, supplemented by emergency telemedicine consultations to nonstroke centers through the Ontario Telemedicine Network's province-wide Telestroke program. Using geoinformatics, we sought to evaluate the overall impact of Telestroke on access to stroke thrombolysis in Ontario. ⋯ The vast majority of people in Ontario have access to stroke thrombolysis. The provincial Telestroke program improves timeliness of access for those living in Southern Ontario, although some remote rural and Northern communities remain without access. Geoinformatics may likewise prove useful in coordinating provincial access to endovascular thrombectomy.
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J Stroke Cerebrovasc Dis · Jul 2017
Multicenter Study Comparative StudymStroke: "Mobile Stroke"-Improving Acute Stroke Care with Smartphone Technology.
This study aimed to evaluate the effect of method and time of system activation on clinical metrics in cases utilizing the Stop Stroke (Pulsara, Inc.) mobile acute stroke care coordination application. ⋯ Incorporating real-time prehospital data obtained via smartphone technology provides unique insight into acute stroke codes. Activation of mobile electronic stroke coordination in the field appears to promote a more expedited and successful care process.
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J Stroke Cerebrovasc Dis · Jul 2017
Case ReportsSystemic Thrombolysis in Acute Ischemic Stroke after Dabigatran Etexilate Reversal with Idarucizumab-A Case Report.
Idarucizumab is a reversal agent for dabigatran etexilate. By reversing the anticoagulating effect of dabigatran etexilate with idarucizumab (Praxbind), patients presenting with an acute ischemic stroke can now be eligible for thrombolysis. ⋯ Reversal of dabigatran etexilate using idarucizumab was safe and successful with no recombinant tissue plasminogen activator interactions.