Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Jul 2011
Comparative StudyDistance from home to hospital and thrombolytic utilization for acute ischemic stroke.
Treatment of acute stroke with thrombolytic therapy has been limited because of the narrow treatment window. Distance from home to hospital may affect arrival time and likelihood of receiving thrombolytic therapy for acute stroke. The present study included stroke subjects seen at Barnes Jewish Hospital in 2006-2007, residing in St Louis City/County, who were at home at the time of the stroke (n = 416). ⋯ The adjusted RR of thrombolytic treatment was 0.59 (95% CI, 0.34-0.99) for group B versus group A. Our data indicate that patients living in close proximity to the hospital are more likely to receive thrombolytic therapy for stroke compared with those living farther away. This finding cannot be explained by earlier arrival time.
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J Stroke Cerebrovasc Dis · Jul 2011
Case ReportsVenous cerebral infarction in a patient with peripheral hemodialysis shunt and occlusion of the left brachiocephalic vein.
Intracranial venous congestion is a rare condition in hemodialysis patients with central venous occlusion. We report a patient with cerebral venous infarction resulting from high reflex flow into the cranium induced by an arteriovenous hemodialysis shunt in the arm and occlusion of the brachiocephalic vein. This case illustrates that abnormal extracranial venous circulation should be considered when cerebral venous congestion is assumed to produce neurologic symptoms in patients with an arteriovenous shunt.
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J Stroke Cerebrovasc Dis · Jul 2011
Life satisfaction and return to work after aneurysmal subarachnoid hemorrhage.
This study was conducted to investigate life satisfaction and employment status after aneurysmal subarachnoid hemorrhage (SAH) and to explain the associations between life satisfaction and demographic, disease-related, psychological, and personality characteristics. Subjects with SAH (n = 141) living at home 2-4 years after the SAH responded to a mailed questionnaire. Outcomes were life satisfaction, as measured with the Life Satisfaction Questionnaire 9 (LiSat-9), and employment status. ⋯ Our data indicate that return to work is a major issue for individuals who survive an SAH. Not returning to work, disability, depression, and passive coping are associated with reduced life satisfaction. Thus, vocational reintegration after SAH merits more attention during rehabilitation.