Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · May 2014
Multicenter Study Comparative Study Observational StudyCurrent status of recanalization therapy in acute ischemic stroke with symptomatic intracranial arterial occlusion in Korea.
Recent methodological advances in recanalization therapy may alter recanalization strategies and clinical outcomes in patients with symptomatic occlusion of intracranial cerebral arteries. However, few studies have analyzed these changes at a national level, with none conducted in Korea. ⋯ The variety and active use of endovascular approaches were quite noticeable. As a whole, recanalization therapy tended to contribute to favorable outcomes despite a significant increase of symptomatic hemorrhage.
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The timing of tracheostomy in stroke patients unable to protect their airway has become a topic of debate. Proponents for early tracheostomy (ET) cite benefits including less ventilation-associated pneumonia, less sedative drug use, shorter length of stay, and reduced mortality in comparison with late tracheostomy (LT). ⋯ Early tracheostomy for stroke patients may reduce the incidence of ventilator-associated pneumonia, thereby shortening the hospital stay and lowering total hospital costs. These relationships warrant further investigation in a large prospective multicenter trial.
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J Stroke Cerebrovasc Dis · May 2014
Atrial fibrillation and paroxysmal atrial fibrillation detection in patients with acute ischemic stroke.
Studies about continuous electrocardiographic (ECG) monitoring in detection of paroxysmal atrial fibrillation (PAF) in Asian patients with acute ischemic stroke are very limited. We looked for the prevalence and associated factors of atrial fibrillation (AF) and PAF in Thai patients with acute ischemic stroke. ⋯ AF/PAF was one of the common causes of ischemic stroke in Thai patients. Most PAF was detected by continuous ECG monitoring. Snapshot 12-lead ECG and continuous ECG monitoring should be recommended in all patients with acute ischemic stroke.
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J Stroke Cerebrovasc Dis · Apr 2014
A simple bedside stroke dysphagia screen, validated against videofluoroscopy, detects dysphagia and aspiration with high sensitivity.
Early identification of dysphagia is associated with lower rates of pneumonia after acute stroke. The Barnes-Jewish Hospital Stroke Dysphagia Screen (BJH-SDS) was previously developed as a simple bedside screen performed by nurses for sensitive detection of dysphagia and was previously validated against the speech pathologist's clinical assessment for dysphagia. In this study, acute stroke patients were prospectively enrolled to assess the accuracy of the BJH-SDS when tested against the gold standard test for dysphagia, the videofluoroscopic swallow study (VFSS). ⋯ The BJH-SDS, validated against videofluoroscopy, is a simple bedside screen for sensitive identification of dysphagia and aspiration in the stroke population.
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J Stroke Cerebrovasc Dis · Apr 2014
Racial and gender differences in stroke severity, outcomes, and treatment in patients with acute ischemic stroke.
Previous research has indicated that women and blacks have worse outcomes after acute ischemic stroke (AIS). Little research has been done to investigate the combined influence of race and gender in the presentation, treatment, and outcome of patients with AIS. We sought to determine the association of race and gender on initial stroke severity, thrombolysis, and functional outcome after AIS. ⋯ Race and gender were not significantly associated with short-term outcome, although black women were significantly less likely to be treated with tPA. Black women had more tPA exclusions than any other group. The primary reason for tPA exclusion in this study was not arriving within 3 hours of stroke symptom onset. Given the growth in incident strokes projected in minority groups in the next 4 decades, identifying factors that contribute to black women not arriving to the emergency department in time are of great importance.