Cerebrovascular diseases
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Cerebrovascular diseases · Jan 2009
Multicenter StudyEuropean Stroke Facilities Survey: the German and Austrian perspective.
The aim of this nested analysis was to identify the major components of stroke centers and other facilities actually available for acute stroke patients in hospitals of Germany and Austria. ⋯ This survey shows that the minimum level of care is met in Germany and Austria in 63% of hospitals treating stroke patients, whereas the European average is 48.6%. However, the lack of stroke center coverage should encourage health policy decision makers to further improve the infrastructure for acute stroke care in order to make stroke centers available to every stroke victim.
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Cerebrovascular diseases · Jan 2009
Multicenter StudyUtilization of intravenous tissue plasminogen activator for ischemic stroke: are there sex differences?
We evaluated whether there were sex-related differences in the administration of intravenous tissue plasminogen activator (IV-tPA) to patients with acute ischemic stroke admitted to US academic medical centers. ⋯ Women admitted to academic hospitals receive IV-tPA as often as men; however, a substantial percentage of both women and men are not arriving within the 3-hour time window required for diagnostic assessment and administration of intravenous thrombolytic therapy. Additional efforts are needed to improve the rapid identification, evaluation and treatment of stroke patients.
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Cerebrovascular diseases · Jan 2009
Multicenter StudyCurrent management and risk of recurrent stroke in cerebrovascular patients with right-to-left cardiac shunt.
Right-to-left cardiac shunt (RLS) is considered a risk factor for stroke, especially in patients aged <55 years. We aimed to investigate the current management and prognosis in consecutive patients with RLS and otherwise cryptogenic cerebrovascular events. ⋯ Our multicenter hospital-based cohort study confirmed low recurrent event rates in RLS patients with otherwise cryptogenic stroke or TIA, as well as a great heterogeneity of current management. Despite the lack of scientific evidence, a substantial number of RLS-positive patients underwent PDC for secondary stroke prevention.
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Cerebrovascular diseases · Jan 2009
Multicenter StudyResidual flow at the site of intracranial occlusion on transcranial Doppler predicts response to intravenous thrombolysis: a multi-center study.
We examined if transcranial Doppler (TCD) flow findings at the site of intracranial occlusions predict outcomes of stroke patients receiving intravenous rt-PA treatment. ⋯ The pretreatment residual flow at intracranial occlusion predicts the likelihood of complete recanalization, time of recanalization and long-term outcome. No detectable residual flow indicates the least chance to achieve recanalization and recovery with systemic thrombolysis and may support an early decision for combined endovascular rescue.
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Cerebrovascular diseases · Jan 2008
Multicenter Study Comparative Study Controlled Clinical TrialInitiation of oral anticoagulation after acute ischaemic stroke or transient ischaemic attack: timing and complications of overlapping heparin or conventional treatment.
Oral anticoagulation is highly effective for secondary prevention of cardioembolic strokes in patients with atrial fibrillation (AF). There are no studies investigating timing and complications of different strategies for initiation of oral anticoagulation after acute stroke or transient ischaemic attack (TIA). ⋯ Initiation of oral anticoagulation after acute ischaemic stroke yielded low complication rates independent of antithrombotic co-medication. Heparin bridging was associated with a longer stay in acute care hospitals.