Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · May 2015
Frequency of new pulmonary neoplasm incidentally detected by computed tomography angiography in acute stroke patients-a single-center study.
Incidental findings of suspect lung opacities are common in computed tomography (CT)-based thorax examinations, especially in high-risk patients, such as stroke patients. Screening with CT of the thorax has detected lung cancer in approximately .31%-1.20% of high-risk populations. The aim of the present study was to report the frequency of suspect lung opacities on routine acute stroke imaging. ⋯ Malignant lung opacities were found in approximately 1% of this high-risk population, whereas our findings do not support full CT of the thorax as routine on stroke patients.
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J Stroke Cerebrovasc Dis · May 2015
Transient Neurologic Deficits: Can Transient Ischemic Attacks Be Discriminated from Migraine Aura without Headache?
Transient neurologic deficits (TNDs) are often considered first to be transient ischemic attacks (TIAs) but TND with normal brain imaging is also characteristic of other prevalent conditions like migraine aura leading to potential confusion. We aimed to determine if migraine aura with headache (MA) and migraine aura without headache (MAWH) can be distinguished from TIA on clinical or paraclinical ground using validated international criteria. ⋯ Despite some sociodemographic, clinical, and paraclinical differences in the presentation of these TND, there is no feature accurately distinguishing between TIA and TND associated with migrainous phenomena when validated actual criteria are used, leading to probable confusion in most studies. There is a need to develop reliable criteria and/or tests for this purpose.
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J Stroke Cerebrovasc Dis · Apr 2015
Acute renal failure worsens in-hospital outcomes in patients with intracerebral hemorrhage.
Occurrence of acute renal failure (ARF) is more common in patients with intracerebral hemorrhage (ICH) compared with those with other stroke subtypes. We sought to determine the frequency and effect of ARF on in-hospital outcomes of patients with ICH. ⋯ In patients with ICH, ARF is associated with significantly higher rates of in-hospital mortality and moderate-to-severe disability at the time of discharge.
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J Stroke Cerebrovasc Dis · Apr 2015
Multicenter Study Observational StudyTelestroke: variations in intravenous thrombolysis by spoke hospitals.
Telestroke extends stroke expertise to underserved hospitals and facilitates treatment with tissue plasminogen activator (tPA). We investigated the variability in tPA treatment rates across 2 large telestroke networks-consisting of hubs at Georgia Regents Medical Center (GRMC) and Medical University of South Carolina (MUSC) and their affiliated spoke hospitals-to identify spoke-related factors predictive of greater tPA use. ⋯ The application of telestroke has variable results on tPA delivery in spoke hospitals. However, the presence of a stroke nurse coordinator at the spoke facilitated treatment of ischemic stroke cases with tPA.
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J Stroke Cerebrovasc Dis · Apr 2015
Diffuse patterns of nonaneurysmal subarachnoid hemorrhage originating from the Basal cisterns have predictable vasospasm rates similar to aneurysmal subarachnoid hemorrhage.
Nonaneurysmal subarachnoid hemorrhage (SAH) has been historically associated with a benign clinical course. However, recent studies have suggested that nonaneurysmal SAH can present with different hemorrhage patterns that may be associated with differential rates of morbidity. Herein, we analyze a retrospective consecutive cohort of patients with nonaneurysmal SAH to determine outcomes. We also seek to evaluate a validated radiographic grading scale to determine its utility in predicting vasospasm in the setting of different hemorrhage patterns. ⋯ Nonaneurysmal SAH is associated with the potential for vasospasm, with higher rates in the diffuse versus perimesencephalic SAH patterns. The BNI grading scale for aneurysmal SAH can be used to predict the risk of vasospasm in diffuse, nonaneurysmal SAH.