STROKEAHA: January 16, 2014 Intravenous thrombolysis with tissue plasminogen activator (tPA) is the only therapy proven to improve outcome in ischemic stroke. Studies of intravenous thrombolysis show that response to therapy is time-dependent; the sooner the patients receive tPA, the better the chance of good outcome.1 The required brain imaging before tPA administration delays the initiation of […]
STROKEAHA: January 16, 2014 The simultaneous publication of 3 randomized control trials comparing intravenous thrombolysis therapy to the endovascular treatment (EVT) of acute ischemic stroke might have lead to the erroneous conclusion that EVT has no place in the management of acute ischemic stroke.1–3However, careful analysis of these studies shows that these reports have shortcomings because […]
STROKEAHA: January 7, 2014 Current guidelines advocate intravenous thrombolysis for patients with ischemic stroke <4.5 hours from onset without additional imaging beyond noncontrast computed tomography (CT) of the brain.1 Rapid administration of intravenous tissue-type plasminogen activator (IV-tPA) will reduce disability. Treatment of patients within 3 hours has an odds ratio of 1.53 (95% confidence interval, 1.26–1.86) for […]
STROKEAHA: December 24, 2013 Organized stroke unit care is a form of care provided in hospital by nurses, doctors, and therapists who specialize in looking after patients with stroke and work as a coordinated team. This care has been provided in different ways, including: (1) a ward dedicated to patients with stroke; (2) through a mobile […]
J NeuroIntervent Surg: January 2, 2014 While intravenous administration of tissue plasminogen activator (tPA) remains the only FDA-approved treatment modality for acute ischemic stroke, many patients do not meet the criteria for intravenous tPA and are offered intra-arterial therapy. Rapid advances in devices and approaches have marked the evolution of thrombectomy over the past decade from […]
STROKEAHA: January 2, 2014 Background and Purpose—Thrombolysis in acute stroke is effective up to 4.5 hours after symptom onset but relies on early recognition, prompt arrival in hospital, and timely brain scanning. This study aimed to establish the cost-effectiveness of increasing thrombolysis rates through a series of hypothetical change strategies designed to optimize the acute care […]
Wiley: 12/23/13 Background Treatment rates with intravenous tissue plasminogen activator vary by region, which can be partially explained by organizational models of stroke care. A recent study demonstrated that prehospital factors determine a higher thrombolysis rate in a centralized vs. decentralized model in the north of the Netherlands. Aim To investigate prehospital factors that may explain […]
Etsmjournal: 12/1/14 Stroke is regularly accompanied by dysphagia and other factors associated with decreased nutritional intake. Dysphagia with aspiration pneumonia and insufficient nutritional intake lead to worse outcome after stroke. This guideline is the first chapter of the guideline “Clinical Nutrition in Neurology” of the German Society for Clinical Nutrition (DGEM) which itself is one part […]
STROKEAHA: December 12, 2013 Background and Purpose—When optimally managed, patients with stroke are less likely to have further vascular events. We aimed to identify factors associated with optimal use of secondary prevention therapies in long-term survivors of stroke. Methods—We carefully documented discharge medications at baseline and self-reported use of medications at annual follow-up in the Northeast Melbourne […]
J NeuroIntervent Surg: 9/7/13 Abstract Purpose To evaluate the clinical outcome and MRI findings after carotid artery stenting (CAS) without post-dilatation. Methods Between May 2005 and April 2012, a total of 169 consecutive patients (61.4% symptomatic) underwent 176 CAS procedures performed with an embolic protection device (GuardWire, n=116; FilterWire EZ, n=60). All stents were deployed without post-dilatation. Periprocedural […]
