Articles Tagged With: stroke
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Recognizing Stroke Mimics: A Guide for Primary Care
Acute ischemic stroke is a common and significant cause of mortality and morbidity in the United States, ranking fifth among all causes of death. However, timely recognition and treatment is complicated by the fact that there are multiple conditions that mimic acute ischemic stroke. A comprehensive review suggested that approximately 74% of patients presenting with apparent acute stroke symptoms ultimately were diagnosed with stroke, thus indicating that 26% of patients had their symptoms produced by “stroke mimics.” Therefore, prompt diagnosis is complicated by a multitude of stroke mimic etiologies, including structural intracranial abnormalities, infection, syncope, vertigo, seizure, and migraine patterns, as well as underlying psychiatric causes and demyelinating diseases.
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Mechanical Thrombectomy for Acute Ischemic Stroke
Stroke is a debilitating illness affecting millions of individuals across the globe. While effective and life-saving treatment modalities exist at a majority of stroke receiving centers in the form of IV thrombolytics, there is an emerging new standard in acute ischemic stroke with mechanical thrombectomy.
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Intensive Monitoring for Asymptomatic Atrial Fibrillation Did Not Prevent Strokes
Screening with an implantable loop recorder resulted in dramatically higher rates of atrial fibrillation detection and ensuing anticoagulation, but without a significant decrease in risk of stroke or systemic embolism by six years of follow-up.
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Cardiology, Stroke Malpractice Cases Involve ED Providers’ Communication Gaps
Cutting corners with poor communication can lead to devastating patient outcomes.
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USPSTF Recommends Against Using Aspirin as a Heart Attack Prevention Tool
Instead of protecting against various cardiovascular ailments, the drug might cause more harm than good in otherwise healthy older patients.
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In Young Adults, Marijuana Use Is Not Associated with Increased Risk of Early Onset Ischemic Stroke
Marijuana use, both recreational and medical, is increasing among young adults, and many states are legalizing its use. A variety of cardiovascular effects have been described, which could increase the risk of cardiovascular complications, including stroke, and some observational studies have suggested an increased stroke risk from marijuana use. But there are few epidemiological studies that have evaluated this association.
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Clinical and Perfusion Mismatch Criteria Both Are Reliable in Identifying Patients Who Will Benefit from Endovascular Therapy
Since 2015, when multiple clinical trials were published showing the efficacy of endovascular thrombectomy (EVT) for large vessel occlusion within six hours of stroke onset, additional criteria have been developed to identify those patients who will benefit from EVT beyond six hours. The AURORA investigators collected patient data from six large clinical trials and performed a meta-analysis to determine if a clinical mismatch or an imaging mismatch protocol was better at predicting good outcomes in patients treated between six hours and 24 hours after the onset of clinical stroke symptoms.
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Basilar Artery Occlusion: Endovascular Thrombectomy and Medical Therapy Have Similar Outcomes
Basilar artery occlusion is a rare form of ischemic stroke and accounts for about 10% of large vessel occlusions reported in the literature. These investigators conducted a randomized trial, enrolling patients from 2011 through 2019, even though multiple studies published in 2015 demonstrated benefit of endovascular therapy in anterior circulation large vessel occlusions. Efficacy and safety were compared with medical therapy in patients who underwent endovascular therapy within six hours after the estimated time of onset of symptoms.
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Telestroke Consultation Increases Rate of Thrombolysis and Reduces Mortality
Real-time video conferencing between the patient, a remotely located stroke specialist, and the bedside healthcare provider in a hospital emergency department is referred to as “telestroke.” However, there are little data comparing its benefit with in-person evaluation and treatment for hospitals that do not have in-hospital stroke specialists 24 hours per day, seven days per week.
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Intensive Lowering of Blood Pressure Does Not Affect the Progression of Small Vessel Disease
Small vessel disease of the brain accounts for 20% to 25% of all ischemic strokes and is a common cause of vascular cognitive impairments. The major risk factor for small vessel disease is hypertension. Targeting a systolic blood pressure of 120 mmHg to 125 mmHg has been recommended, but this has not been confirmed as effective in preventing stroke or long-term cognitive impairment in these patients.