Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Jul 2017
Validation of the National Institutes of Health Stroke Scale-8 to Detect Large Vessel Occlusion in Ischemic Stroke.
Patients with acute ischemic stroke and large vessel occlusion (LVO) may benefit from prehospital identification and transfer to a center offering endovascular therapy. ⋯ Accuracy of the NIHSS-8 to identify LVO in a population of patients with suspected acute stroke is comparable to existing prehospital stroke scales. The scale can be performed by EMS with reasonable reliability. Further validation in the field is needed to assess accuracy of the scale to identify patients with LVO eligible for endovascular treatment in a prehospital setting.
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J Stroke Cerebrovasc Dis · Jul 2017
Review Meta AnalysisThe Association between Carotid Artery Atherosclerosis and Silent Brain Infarction: A Systematic Review and Meta-analysis.
Carotid atherosclerosis is responsible for ~20% of ischemic strokes, but it is unclear whether carotid disease is associated with the presence of downstream silent brain infarction (SBI). We performed a systematic review and meta-analysis to study the relationship between SBI and 2 separate manifestations of carotid atherosclerosis, carotid intima-media thickening (IMT) and luminal stenosis. ⋯ Two forms of atherosclerotic disease, carotid IMT and stenosis, are both significantly associated with SBI. This review highlights a lack of consistent definitions for carotid disease measures and little evidence evaluating SBI prevalence downstream from carotid stenosis.
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J Stroke Cerebrovasc Dis · Jul 2017
Multicenter Study Comparative StudymStroke: "Mobile Stroke"-Improving Acute Stroke Care with Smartphone Technology.
This study aimed to evaluate the effect of method and time of system activation on clinical metrics in cases utilizing the Stop Stroke (Pulsara, Inc.) mobile acute stroke care coordination application. ⋯ Incorporating real-time prehospital data obtained via smartphone technology provides unique insight into acute stroke codes. Activation of mobile electronic stroke coordination in the field appears to promote a more expedited and successful care process.
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J Stroke Cerebrovasc Dis · Jul 2017
Comparative StudyUse of Geospatial Modeling to Evaluate the Impact of Telestroke on Access to Stroke Thrombolysis in Ontario.
The treatment of acute ischemic stroke in Ontario is coordinated through a network of stroke centers, supplemented by emergency telemedicine consultations to nonstroke centers through the Ontario Telemedicine Network's province-wide Telestroke program. Using geoinformatics, we sought to evaluate the overall impact of Telestroke on access to stroke thrombolysis in Ontario. ⋯ The vast majority of people in Ontario have access to stroke thrombolysis. The provincial Telestroke program improves timeliness of access for those living in Southern Ontario, although some remote rural and Northern communities remain without access. Geoinformatics may likewise prove useful in coordinating provincial access to endovascular thrombectomy.
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J Stroke Cerebrovasc Dis · Jul 2017
Case ReportsSystemic Thrombolysis in Acute Ischemic Stroke after Dabigatran Etexilate Reversal with Idarucizumab-A Case Report.
Idarucizumab is a reversal agent for dabigatran etexilate. By reversing the anticoagulating effect of dabigatran etexilate with idarucizumab (Praxbind), patients presenting with an acute ischemic stroke can now be eligible for thrombolysis. ⋯ Reversal of dabigatran etexilate using idarucizumab was safe and successful with no recombinant tissue plasminogen activator interactions.