Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Mar 2018
Multicenter Study Comparative StudyDerivation and Validation of the Emergency Medical Stroke Assessment and Comparison of Large Vessel Occlusion Scales.
This study aims to develop a simple scale to identify patients with prehospital stroke with large vessel occlusion (LVO), without losing sensitivity for other stroke types. ⋯ The EMSA has superior abilities to identify LVO versus 3I-SS and stroke versus 3I-SS and C-STAT. The EMSA has similar ability to triage patients with stroke compared with the FAST-ED and RACE, but is simpler to perform and interpret.
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J Stroke Cerebrovasc Dis · Mar 2018
Multicenter StudySafety of Intravenous Thrombolysis in Chronic Intracranial Hemorrhage: A Five-Year Multicenter Study.
Although the recently updated U.S. alteplase label removed "history of intracranial hemorrhage (ICH)" as a contraindication, there are very limited data on the safety of intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) patients with chronic ICH. We sought to evaluate IVT safety in AIS patients with a history of ICH. ⋯ Our study indicates that IVT might be safe among AIS patients with a history of chronic ICH. Further research with a larger sample size is required to confirm our finding and define the shortest time interval between the hemorrhagic and ischemic events that can be associated with the safe administration of IVT.
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J Stroke Cerebrovasc Dis · Jan 2018
Multicenter StudyOutcomes of Nonagenarians with Acute Ischemic Stroke Treated with Intravenous Thrombolytics.
Nonagenarians are under-represented in thrombolytic trials for acute ischemic stroke (AIS). The effectiveness of intravenous thrombolytics in nonagenarians in terms of safety and outcome is not well established. ⋯ Nonagenarians treated with thrombolytics showed lower stroke-related disability at 90 days than those not treated, without significant difference in sICH and in-hospital mortality rates. These observations cannot exclude a residual confounding effect, but provide evidence that thrombolytics should not be withheld from nonagenarians because of age alone.
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J Stroke Cerebrovasc Dis · Sep 2017
Multicenter StudyPredictors of In-Hospital Mortality after Decompressive Hemicraniectomy for Malignant Ischemic Stroke.
The purpose of this retrospective multicenter, pooled-data analysis was to determine the factors associated with in-hospital mortality in decompressive hemicraniectomy (DHC) for malignant middle cerebral artery (MMCA) stroke. ⋯ Direct physical factors, such as MCA with additional territory infarct, extent of midline shift, and postoperative consciousness level, bore a significant relationship to in-hospital mortality in MMCA patients undergoing DHC.
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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.