An Observation on the Time of Hospital Arrival and Correct Diagnosis with CT in Acute Cerebral Stroke Patients

Abstract We chemically synthesized an isotopically labeled internal standard, isodesmosine-13C3,15N1, and established an isotope-dilution LC-MS/MS method. Plasma concentrations of desmosine and isodesmosine in acute cerebral stroke patients and healthy controls were determined. The desmosine concentration was markedly higher in plasma from acute stroke patients compared with healthy controls. Desmosines are novel biomarkers for evaluating the extent of vascular injury after acute cerebral stroke.

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Diagnosis of cerebral hemorrhage before the era of computed tomography

Orvosi Hetilap ◽

10.1556/oh.2013.29739 ◽

2013 ◽

Vol 154 (44) ◽

pp. 1743-1746

Author(s):

Gergely Hofgárt ◽

Rita Szepesi ◽

Bertalan Vámosi ◽

László Csiba

Keyword(s):

Computed Tomography ◽

Cerebrospinal Fluid ◽

Positive Predictive Value ◽

Predictive Value ◽

Hemorrhagic Stroke ◽

Cranial Computed Tomography ◽

Cerebral Stroke ◽

Daily Routine ◽

Stroke Patients ◽

The Difference

Introduction: During the past decades there has been a great progress in neuroimaging methods. Cranial computed tomography is part of the daily routine now and its use allows a fast diagnosis of parenchymal hemorrhage. However, before the availability of computed tomography the differentiation between ischemic and hemorrhagic stroke was based on patient history, physical examination, percutan angiography and cerebrospinal fluid sampling, and the clinical utility could be evaluated by autopsy of deceased patients. Aim: The authors explored the diagnostic performance of cerebrospinal fluid examination for the diagnosis of ischemic and hemorrhagic stroke. Method: Data of 200 deceased stroke patients were retrospectively evaluated. All patients had liquor sampling at admission and all of them had brain autopsy. Results: Bloody or yellowish cerebrospinal fluid at admission had a positive predictive value of 87.5% for hemorrhagic stroke confirmed by autopsy, while clear cerebrospinal fluid had positive predictive value of 90.7% for ischemic stroke. Patients who had clear liquor, but autopsy revealed hemorrhagic stroke had higher protein level in the cerebrospinal fluid, but the difference was not statistically significant (p = 0.09). Conclusions: The results confirm the importance of pathological evaluation of the brain in cases deceased from cerebral stroke. With this article the authors wanted to salute for those who contributed to the development of the Hungarian neuropathology. In this year we remember the 110th anniversary of the birth, and the 60th anniversary of the death of professor Kálmán Sántha. Professor László Molnár would be 90 years old in 2013. Orv. Hetil., 154 (44), 1743–1746.

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Effects of Batroxobin with Continuous Transcranial Doppler Monitoring in Patients with Acute Cerebral Stroke: A Randomized Controlled Trial

Echocardiography ◽

10.1111/echo.12559 ◽

2014 ◽

Vol 31 (10) ◽

pp. 1283-1292 ◽

Cited By ~ 3

Author(s):

He Yitao ◽

Ma Kefu ◽

Tang Bingshan ◽

Fu Xuejun ◽

Zhan Ying ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Transcranial Doppler ◽

Controlled Trial ◽

Cerebral Stroke ◽

Randomized Controlled ◽

Acute Cerebral Stroke

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Assessment of the Effects of Rehabilitation on Balance Impairment in Patients After Ischemic Stroke According to Selected Tests and Scales

Polish Hyperbaric Research ◽

10.1515/phr-2015-0011 ◽

2015 ◽

Vol 51 (2) ◽

pp. 55-63 ◽

Cited By ~ 1

Author(s):

Magdalena Jaworska ◽

Tomasz Tuzim ◽

Małgorzata Starczyńska ◽

Magdalena Wilk-Frańczuk ◽

Agnieszka Pedrycz

Keyword(s):

Test Group ◽

Berg Balance Scale ◽

Modern Medicine ◽

Cerebral Stroke ◽

Stroke Patients ◽

Timed Up And Go ◽

Balance Test ◽

Raising Awareness ◽

Proprioceptive Neuromuscular Facilitation ◽

Age Range

Abstract Cerebral stroke is one of the most important issues for modern medicine. Despite the fact that numerous activities have been undertaken for the purpose of raising awareness and significance of prevention, this condition still remains one of the main reasons behind disability. The objective of the work was to assess the effects of the type of therapy, age and period from the incident occurrence, on the progress of rehabilitation of imbalance and body stability observed in a group of researched patients, on the basis of results obtained according to the Berg Balance Scale, tandem balance test, Kwolek’s loading symmetry index and Timed Up and Go test. The test group comprised of 55 post-stroke patients. The group consisted of 29 women (52.73%) and 26 men (47.27%). The average age of the subjects was 61.02 years (age range between 33-85 years). A number of the patients were subjected to rehabilitation with the use of classic kinesitherapy, whereas the remaining group underwent rehabilitation based on the proprioceptive neuromuscular facilitation method (PNF).

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Abstract 17: Prehospital Deterioration During Transport by Emergency Medical Services for Stroke Patients: A Population-Based Study

Stroke ◽

10.1161/str.48.suppl_1.17 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Sabreena J Gillow ◽

Heidi Sucharew ◽

Kathleen Alwell ◽

Charles J Moonmaw ◽

Daniel Woo ◽

...

Keyword(s):

Atrial Fibrillation ◽

Multivariate Analysis ◽

Univariate Analysis ◽

Onset Time ◽

Population Based ◽

Neurological Deterioration ◽

Stroke Patients ◽

Stroke Subtype ◽

Hospital Arrival ◽

Neurologic Deterioration

Introduction: Stroke patients can experience neurological change in the prehospital setting. We sought to identify factors associated with prehospital neurologic deterioration. Methods: Among the Greater Cincinnati/Northern Kentucky region (pop. ~1.3 million), we screened all 15 local hospitals’ admissions from 2010 for acute stroke, and included patients with age ≥20 and complete EMS records. Glasgow Coma Scale (GCS) at hospital arrival was compared with GCS evaluated by EMS, with decrease ≥2 points considered neurologic deterioration. Data obtained included age, sex, race, medical history, antiplatelet or anticoagulant use, stroke subtype [ischemic (IS), ICH, or SAH] and IS subtype (e.g., small vessel, large vessel, cardioembolic), seizure at onset, time from symptom onset to EMS arrival, time from EMS to hospital arrival, blood pressure and serum glucose on EMS arrival, and EMS level of training. Univariate analysis was completed using Wilcoxon rank sum test for continuous measures and chi-square or Fisher’s exact test for categorical measures. Multivariate analysis was completed on variables with p ≤ 0.20 in the univariate analysis. Results: Of 2708 total stroke patients, 1097 (870 IS, 176 ICH, 51 SAH) had EMS records (median [IQR] age 74 [61, 83] years; 56% female; 21% black). Onset to EMS arrival was ≤4.5 hours for 508 cases (46%), and median time from EMS to hospital arrival was 26 minutes. Neurological deterioration occurred in 129 cases (12%), including 9.1% of IS and 22% of ICH/SAH. In multivariate analysis, black race, atrial fibrillation, ICH or SAH subtype, and ALS transport were associated with neurological deterioration. Conclusion: Atrial fibrillation may predict prehospital deterioration in stroke, and preferential transport of patients with acute worsening to centers capable of managing hemorrhagic stroke may be justifiable. Further studies are needed to identify why race is associated with deterioration and potential areas of intervention.

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Abstract T P251: Factors for Delayed Medical Care Seeking among Elderly Stroke Patients in Korea

Stroke ◽

10.1161/str.45.suppl_1.tp251 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Jeongha sim ◽

Dongchoon Ahn ◽

cha-nam shin

Keyword(s):

Ischemic Stroke ◽

Medical Care ◽

Acute Ischemic Stroke ◽

Statistical Significance ◽

Care Seeking ◽

Stroke Patients ◽

Convenience Sample ◽

Hospital Arrival ◽

Stroke Education ◽

Korean Elderly

Background: Stroke is the second leading cause of death in Korea and the prevalence of acute ischemic stroke among older adults continues to grow, which is known to be related to delayed hospital arrival after the onset of symptoms. Thus, decreasing the incidence of elderly stroke is a major health promotion objective in Korea, yet little is reported about the factors associated with the delayed medical care seeking behavior among elderly stroke patients in Korea. Purpose: The purpose of this study was to understand factors of delayed medical care seeking among elderly stroke patients in order to develop intervention strategies to improve the health of this population. Methods: A cross-sectional, descriptive study was conducted in a convenience sample of 233 hospitalized elderly patients with acute ischemic stroke using a self-administered survey. Descriptive statistics and chi-square test were used for data analysis. Results: More than half of them were male (60.5%) with age of 61 and older (76.9%), and relied on the opinion of their children or friends when deciding medical care for stroke (58.3%). Regarding the reasons of seeking medical care, there was no statistical significance between individuals who arrived at a hospital within three hours of the onset of symptoms and who arrived after three hours. Reasons for delayed hospital arrival were significantly different between groups (individuals of hospital arrival within three hours vs. individuals with hospital arrival after three hours), which include lack of knowledge about the severity of stroke and unawareness of symptoms (χ2 = 24.1), or inconvenience of a hospital visit, waiting for the effects of alternative medications, and stroke during sleep (χ2 = 55.1) with p <0.001. Conclusions: In conclusion, this study helped identify factors delaying hospital arrival after the onset of symptoms among Korean elderly stroke patients. Interventions should include stroke education focusing on the severity of stroke and related symptoms. The stroke education should target not only elderly stroke patients but their family members and friends. It may result in overall national health by decreasing prevalence of stroke among Korean elderly population.

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Clinical and Neurological Symptoms in Acute Brain Stroke from Gender Dymorphism and Age Features

INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY RESEARCH AND ANALYSIS ◽

10.47191/ijmra/v4-i10-09 ◽

2021 ◽

Vol 04 (10) ◽

Author(s):

N.M. Vakhabova ◽

Keyword(s):

Social Problems ◽

Neurological Symptoms ◽

Cerebral Stroke ◽

Stroke Outcomes ◽

Cerebrovascular Accidents ◽

Clear Tendency ◽

The World ◽

Brain Stroke ◽

Age Features ◽

Acute Cerebral Stroke

To date, CVD, in particular acute cerebrovascular accidents, have a clear tendency to increase. The existing domestic and especially foreign literature testifies to the established important medical and social problems of acute cerebral stroke in the society of humanity around the world. Stroke can develop at any age, but its frequency and prevalence increase with age. About 80% of strokes occur in people over 65, with age having a major impact on stroke outcomes.

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