Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Mar 2014
Case ReportsSubarachnoid hemorrhage after resuscitation from out-of-hospital cardiac arrest.
This study was undertaken to retrospectively investigate clinical features of subarachnoid hemorrhage (SAH) with cardiopulmonary arrest in patients achieving return of spontaneous circulation (ROSC) in order to explore the possibility of long-term survival. ⋯ Cardiac arrest caused by SAH is a disease state with a grave prognosis, but there is the possibility of a good survival outcome when the administration of a small dose of adrenaline results in the rapid recovery of brainstem reflexes.
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J Stroke Cerebrovasc Dis · Mar 2014
Comparative StudyThrombolysis for acute ischemic stroke: do patients treated out of hours have a worse outcome?
Previous studies on the impact of nonworking hours (NWH) have produced conflicting results. We aimed to compare the time to treatment with thrombolysis between NWH and working hours (WH) at an Australian comprehensive stroke center. ⋯ Our study showed that the "NWH effect" increased the door-to-needle time. The patients treated out of hours did not have a worse outcome.
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J Stroke Cerebrovasc Dis · Mar 2014
Speech-language pathologist-led fiberoptic endoscopic evaluation of swallowing: functional outcomes for patients after stroke.
Dysphagia is a common complication after stroke and is associated with the development of pneumonia. Early detection of dysphagia and specifically aspiration is, therefore, critical in the prevention of pneumonia. Fiberoptic endoscopic evaluation of swallowing (FEES) is a safe bedside instrumental tool for detecting dysphagia and aspiration and, therefore, has the potential to inform dysphagia management. This study investigated the clinical utility of a speech-language pathologist-led FEES service on functional outcomes for patients after acute stroke. ⋯ When used selectively, FEES services have potential for improving functional outcomes for patients after stroke.
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J Stroke Cerebrovasc Dis · Feb 2014
Case ReportsCentral alveolar hypoventilation (Ondine's curse) caused by megadolichobasilar artery.
Central alveolar hypoventilation (CAH) syndrome is a clinical condition that is characterized by the loss of automatic breathing, particularly during sleep. Most forms in adults are caused by brainstem ischemia, mass, infection, demyelinating disease, or anoxic-ischemic damage. We present a case of a fatal symptomatic acquired CAH syndrome caused by megadolichobasilar artery. ⋯ During an unobserved episode, the patient was found unresponsive, with chemical signs of prolonged hypoventilation not explainable by cardiopulmonary disease. A diaphragmatic pacemaker, assisted ventilation, and repeated resuscitation were refused by the patient, who died some days later. CAH is a rare complication that can occur in patients with megadolichobasilar artery.
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J Stroke Cerebrovasc Dis · Feb 2014
Case ReportsPostoperative brain stroke after shoulder arthroscopy in the lateral decubitus position.
The beach chair position is used frequently for shoulder arthroscopy surgery. However, the beach chair position has been reported to be linked to postoperative cerebral stroke. ⋯ The patient experienced a brief period of intraoperative hypotension. Physicians should be aware of this potential complication that could be irrelevant to the position used.