Cerebrovascular diseases
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Cerebrovascular diseases · Jan 2009
Multicenter StudyStroke in the very elderly: hospital care, case fatality and disposition.
The worldwide growing number of older people represents a new phenomenon. Considering that the prevalence of stroke increases with age and higher life expectancy, the prevalence of stroke will likely rise in the next decade. However, limited information is available about the burden of stroke in individuals over 90. ⋯ In our study, stroke patients over 90 had higher risk-adjusted mortality, longer hospitalization, and were less likely to be discharged to their original place of residence. In view of these findings, strategies need to be implemented to facilitate equal access to specialized stroke care for the elderly.
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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 2009
Randomized Controlled Trial Multicenter StudyFrequency of sustained intracranial pressure elevation during treatment of severe intraventricular hemorrhage.
Elevated intracranial pressure (ICP) is an important marker of neurological deterioration. The occurrence and significance of elevated ICP and low cerebral perfusion pressure (CPP) in aggressively treated spontaneous intraventricular hemorrhage (IVH) are not defined. ⋯ In the intensive care unit, initial ICP measured with an EVD was uncommonly elevated (1/11 patients) in this group of severe IVH patients despite acute obstructive hydrocephalus. Frequent monitoring reveals ICP elevation >20 mm Hg in 14% of observations during use of EVD. ICP elevation, though it can occur, is not routinely associated with EVD closure for thrombolytic treatment with UK.
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Cerebrovascular diseases · Jan 2009
Multicenter StudyAntithrombotic therapy influences location, enlargement, and mortality from intracerebral hemorrhage. The Bleeding with Antithrombotic Therapy (BAT) Retrospective Study.
To determine whether the use of oral antithrombotic agents before the onset of intracerebral hemorrhage (ICH) affects hematoma features and early patient outcome. ⋯ Prior medication with antiplatelet agents, warfarin, or both was predictive of cerebellar hemorrhage, hematoma enlargement, and early death in Japanese ICH patients.
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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.