Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Mar 2016
Multicenter StudyGender and Time to Arrival among Ischemic Stroke Patients in the Greater Cincinnati/Northern Kentucky Stroke Study.
Some studies of stroke patients report longer prehospital delays in women, but others conflict; studies vary in their inclusion of factors including age and stroke severity. We aimed to investigate the relationship between gender and time to emergency department (ED) arrival and the influence of age and stroke severity on this relationship. ⋯ After adjusting for factors including age, NIHSS score, and living alone, women and men with ischemic stroke had similar times to arrival. Arrival time is not likely a major contributor to differences in outcome between men and women.
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J Stroke Cerebrovasc Dis · Mar 2016
Prolonged Stay of Stroke Patients in the Emergency Department May Lead to an Increased Risk of Complications, Poor Recovery, and Increased Mortality.
Following an acute stroke (AS), patients are at an increased risk of developing complications that may affect prognosis. With overcrowding in the emergency department (ED), patients stay longer hours to days before transfer to a proper stroke ward. The aim of this study was to evaluate the effect of increasing length of stay (LOS) in the ED on the risk of stroke-related complications. ⋯ Delays in transferring AS patients from the ED may lead to an increase in complications resulting in an increased LOS and slower recovery.
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J Stroke Cerebrovasc Dis · Mar 2016
Comparative StudyComparisons of Apparent Diffusion Coefficient Values in Penumbra, Infarct, and Normal Brain Regions in Acute Ischemic Stroke: Confirmatory Data Using Bootstrap Confidence Intervals, Analysis of Variance, and Analysis of Means.
There is no consensus about apparent diffusion coefficient (ADC) values in acute stroke regions that could be used by clinicians in a day-to-day clinical practice; regional measures using confidence intervals (CIs) and a graphic representation of means are scarce in the literature. Our aim in this study was to compare ADC values in infarct, penumbra, and normal brain regions in patients with acute ischemic stroke (AIS). ⋯ ADC values might be used as reference data in acute stroke-specific populations; CIs would provide radiologists and clinicians with additional quantitative tools to evaluate penumbra, infarct, and normal brain tissue and to tailor follow-up and treatment options for selected patients.
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J Stroke Cerebrovasc Dis · Mar 2016
Case ReportsA Case of Unexpected Symptomatic Vasospasm after Clipping Surgery for an Unruptured Intracranial Aneurysm.
Delayed symptomatic vasospasm after clipping surgery for unruptured aneurysm is rarely reported. We report a case of a 62-year-old woman who presented with symptomatic vasospasm 11 days after clipping surgery for an unruptured aneurysm. ⋯ The patient complained of a prolonged unexpected headache 1 week after the operation. We should recognize prolonged unexpected headache as a warning sign of vasospasm.
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J Stroke Cerebrovasc Dis · Feb 2016
Case ReportsReport of Dramatic Improvement after a Lumboperitoneal Shunt Procedure in a Case of Anticoagulation Therapy-Resistant Cerebral Venous Thrombosis.
Cerebral venous thrombosis (CVT), which typically progresses from either acute or subacute onset, presents with symptoms related to intracranial hypertension (e.g., headache and papilledema) and brain parenchymal lesions (e.g., aphasia and hemiplegia). Anticoagulation therapy is generally accepted as a treatment for CVT and often leads to good clinical outcomes. However, we experienced a case of CVT with an uncommon clinical course. ⋯ Another mechanism is impaired CSF absorption in the thrombosed sinuses, resulting in intracranial hypertension. We speculated that the latter mechanism strongly influenced our case, thus explaining the uncommon clinical course and effectiveness of the LP shunt procedure. Although LP shunting is not a common treatment for CVT, this case report could indicate the usefulness of this procedure for CVT with chronic progression and resistance to anticoagulation therapy.