scholarly journals Case Report : Mr. I 56 years old with Stroke Non Hemoragic

2021 ◽  
Vol 2 (2) ◽  
pp. 84-90
Author(s):  
Akhlish Dzikrullah Ahmad ◽  
Agung Ikhssani
Keyword(s):  
Ischemic Stroke ◽  
Case Report ◽  
Cause Of Death ◽  
Cerebral Artery ◽  
Intravenous Thrombolysis ◽  
Acute Stage ◽  
Double Burden ◽  
Middle Income ◽  
Middle Income Countries ◽  
Tissue Plasminogen

Stroke is one of the most common diseases that cause functional impairment and disability. Stroke is the second leading cause of death and the leading cause of disability worldwide. Its incidence is increasing as the population ages. In addition, more young people have strokes in low- and middle-income countries. Data in Indonesia shows that stroke is the third most common cause of death, followed by diabetes mellitus and hypertension with a mortality rate of 138,268 people or 9.7% of the total deaths. Indonesia has a double burden in dealing with health problems. Lacunar strokes, a type of ischemic stroke, are small and located in non-cortical areas. Lacunar infarctions are caused by occlusion of small branches penetrating within the cerebral vessels of the circle of Willis, including branches of the middle cerebral artery, anterior cerebral artery, posterior cerebral artery, or spinal cord. basilar artery. The principle of treatment for acute lacunar stroke is very similar to that of acute ischemic stroke. The initial goals of acute stage treatment are to ensure medical stability and determine candidacy for thrombolysis. Tissue plasminogen activator (TPA) improves outcomes for patients with ischemic stroke. Once intracerebral hemorrhage has been ruled out, intravenous thrombolysis is an important step in treatment. Acute lacunar infarction is efficiently treated with TPA. This case report discusses a 56 year old Mr I diagnosed with a non-hemorrhagic stroke.

scholarly journals Intravenous Thrombolysis of Occlusion in the Middle Cerebral and Retinal Arteries from Presumed Ventricular Myxoma

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Cheung-Ter Ong ◽  
Rei-Yeuh Chang
Keyword(s):  
Emergency Department ◽  
Ischemic Stroke ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Intravenous Thrombolysis ◽  
Case Description ◽  
Stroke Patients ◽  
Tissue Plasminogen ◽  
The Right

Background. Although thrombolytic therapy has been shown to be beneficial to stroke patients, the effectiveness of intravenous thrombolysis in ischemic stroke patients with ventricle myxoma is unknown.Case Description. A 22-year-old woman with left hemiplegia was sent to the emergency department at a teaching hospital. The magnetic resonance angiography showed occlusion of the right middle cerebral artery, and the echocardiography showed a mass in the left ventricle. Intravenous recombined tissue plasminogen activator (rt-PA) was administrated, and the postthrombolysis transcranial Doppler exam showed that her right middle cerebral artery was circulative. The patient's condition improved gradually, and no complication was observed up to 16 months of follow-up.Conclusion. Intravenous rt-PA is a reasonable treatment for stroke patients with ventricle myxoma.

Association of admission leukocyte count with clinical outcomes in acute ischemic stroke patients undergoing intravenous thrombolysis with recombinant tissue plasminogen activator

2020 ◽  
Vol 17 ◽  
Author(s):  
Jie Chen ◽  
Fu-Liang Zhang ◽  
Shan Lv ◽  
Hang Jin ◽  
Yun Luo ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Leukocyte Count ◽  
Intravenous Thrombolysis ◽  
Recombinant Tissue Plasminogen Activator ◽  
Functional Independence ◽  
Tissue Plasminogen ◽  
Poor Outcomes

Objective:: Increased leukocyte count are positively associated with poor outcomes and all-cause mortality in coronary heart disease, cancer, and ischemic stroke. The role of leukocyte count in acute ischemic stroke (AIS) remains important. We aimed to investigate the association between admission leukocyte count before thrombolysis with recombinant tissue plasminogen activator (rt-PA) and 3-month outcomes in AIS patients. Methods:: This retrospective study included consecutive AIS patients who received intravenous (IV) rt-PA within 4.5 h of symptom onset between January 2016 and December 2018. We assessed outcomes including short-term hemorrhagic transformation (HT), 3-month mortality, and functional independence (modified Rankin Scale [mRS] score of 0–2 or 0–1). Results:: Among 579 patients who received IV rt-PA, 77 (13.3%) exhibited HT at 24 h, 43 (7.4%) died within 3 months, and 211 (36.4%) exhibited functional independence (mRS score: 0–2). Multivariable logistic regression revealed admission leukocyte count as an independent predictor of good and excellent outcomes at 3 months. Each 1-point increase in admission leukocyte count increased the odds of poor outcomes at 3 months by 7.6% (mRS score: 3–6, odds ratio (OR): 1.076, 95% confidence interval (CI): 1.003–1.154, p=0.041) and 7.8% (mRS score: 2–6, OR: 1.078, 95% CI: 1.006–1.154, p=0.033). Multivariable regression analysis revealed no association between HT and 3-month mortality. Admission neutrophil and lymphocyte count were not associated with 3-month functional outcomes or 3-month mortality. Conclusion:: Lower admission leukocyte count independently predicts good and excellent outcomes at 3 months in AIS patients undergoing rt-PA treatment.

scholarly journals Intravenous thrombolysis for stroke in pregnancy should be administered if the benefit outweighs the risk: A case report and recommended diagnostic workup

2021 ◽  
Vol 17 ◽  
pp. 174550652199949
Author(s):  
Marek Bojda ◽  
Andrea Cimprichová ◽  
Bibiana Vavríková ◽  
Alena Filipková ◽  
Zuzana Gdovinová
Keyword(s):  
Case Report ◽  
Pregnant Woman ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Intravenous Thrombolysis ◽  
Recombinant Tissue Plasminogen Activator ◽  
Sudden Onset ◽  
Diagnostic Workup ◽  
Successful Outcome ◽  
Tissue Plasminogen

Introduction: There is an ongoing debate about the use of recombinant tissue plasminogen activator in acute stroke during pregnancy. The aim of our case report is to present that even in a small stroke centre intravenous thrombolysis can be used on a pregnant woman if the benefit outweighs the risk and to summarize the diagnostic workup in a pregnant woman with stroke. Case report: Our case describes a 31-year-old woman presenting in her third trimester with a sudden onset of slurred speech, severe right hemiparesis, facial nerve central palsy, eyes deviation to the left, right side hemianopia, hemisensory loss, psychomotor agitation and pain in the right lower limb. She was successfully treated with recombinant tissue plasminogen activator with almost complete recovery (NIHSS 1 after 10 days), and 23 days after intravenous thrombolysis, she delivered in the 37th week a healthy male infant. The first documented successful outcome from thrombolysis for this condition in Slovakia supports the notion of giving intravenous recombinant tissue plasminogen activator to pregnant patients with disabling ischaemic stroke who meet the criteria for thrombolysis. Discussion: At the end of case study, a recommended diagnostic workup for acute treatment of stroke in pregnant women is presented.

scholarly journals Suicide prevention in low- and middle-income countries: part perceptions, partial solutions

2017 ◽  
Vol 211 (5) ◽  
pp. 264-265 ◽  
Author(s):  
K. S. Jacob
Keyword(s):  
Public Health ◽  
Suicide Prevention ◽  
Cause Of Death ◽  
Population Based ◽  
Personal Distress ◽  
Public Health Perspective ◽  
Middle Income ◽  
Common Cause ◽  
Middle Income Countries ◽  
Low And Middle Income

SummarySuicide, a common cause of death in many low- and middle-income countries, has often been viewed through a medical/psychiatric lens. Such perspectives medicalise social and personal distress and suggest individual and medication-based treatments. This editorial argues for the need to examine suicide from a public health perspective and suggests the need for population-based social and economic interventions.

scholarly journals Thromboembolic complications following tissue plasminogen activator therapy in patients of acute ischemic stroke - Case report and possibility for detection of cardiac thrombi

Open Medicine ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 551-555 ◽  
Author(s):  
Junko Yamaguchi ◽  
Kosaku Kinoshita ◽  
Marina Hirabayashi ◽  
Satoshi Hori ◽  
Makoto Furukawa ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Case Report ◽  
Transesophageal Echocardiography ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Time Window ◽  
Ulnar Artery ◽  
Diagnostic Methods ◽  
Thromboembolic Complications ◽  
Tissue Plasminogen

AbstractMany reports focus on the probability of intracranial hemorrhage as a complication after recombinant tissue plasminogen activator (rt-PA) therapy. However, thromboembolic complications are not well discussed. We experienced a case in which severe thromboembolic complications occurred in the right radial and right ulnar artery. Arterial fibrillation was observed in this case. If multiple thrombi exist in the atrium or ventricle, multiple small embolic particles may appear following thrombolytic therapy, and that may be a potential risk of secondary thromboembolic complications due to incomplete dissolution of thrombi. Transesophageal echocardiography is a standard method to detect intracardiac sources of emboli in the case of arterial fibrillation. Transesophageal echocardiography is, however, an invasive method for patients with ischemic stroke during rt-PA therapy. High resolution enhanced CT could be a useful tool and may be a reliable alternative to transthoracic echocardiography. Careful assessment of thromboembolic complications following rt-PA therapy in patients with arterial fibrillation is needed. In this case report and mini review, we would like to discuss about the accurate diagnostic methods to detect cardiac or undetermined embolic sources and provide expedited stroke care. These embolic sources may be more readily discovered during rt-PA therapy within the limited therapeutic time window.

scholarly journals EXAMINING THE DOUBLE BURDEN OF MALNUTRITION FOR PRESCHOOL CHILDREN AND WOMEN OF REPRODUCTIVE AGE IN LOW- AND MIDDLE-INCOME COUNTRIES: A SCOPING REVIEW PROTOCOL

2021 ◽  
Author(s):  
Jason Mulimba Were ◽  
SAVERIO STRANGES ◽  
Ishor Sharma ◽  
Juan-Camilo Vargas-Gonzalez ◽  
M. Karen Campbell
Keyword(s):  
Preschool Children ◽  
Scoping Review ◽  
Reproductive Age ◽  
World Health ◽  
Women Of Reproductive Age ◽  
Double Burden ◽  
Middle Income ◽  
Middle Income Countries ◽  
Double Burden Of Malnutrition ◽  
Low And Middle Income

Introduction: The majority of the populations in Low-and Middle-Income Countries (LMICs) are encountering the double burden of malnutrition (DBM): the coexistence of both undernutrition and overnutrition sequalae. With DBM being a new phenomenon in research, little is known about its etiology, operational definitions and risk factors influencing its manifestation. The proposed scoping review is aimed at mapping literature with regards to the DBM phenomenon among preschool children and women of reproductive age in LMICs who are among the most high-risk groups to encounter DBM. Methods: A comprehensive literature search will be conducted in the following electronic databases: MEDLINE, EMBASE, Scopus, CINAHL, LILACS and ProQuest Dissertations & Thesis Global. Additionally, searches in other government and institutional sources (World Health Organization website and university repositories) and forward and backward citation tracking of seminal articles will also be done. Two reviewers will independently conduct title and abstract screening and full text screening. Similarly, data extraction and coding will independently be done by two reviewers. Information extracted from included literature will be analysed qualitatively using thematic analysis approach and reported as per the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Ethics and Dissemination: Ethical approval is not required for this study because the review is based on literature from publicly available sources. The dissemination of our findings will be done through presentations in relevant conferences and publication in a peer-reviewed journal.

scholarly journals Cerebral microbleeds and intravenous thrombolysis: case report

2006 ◽  
Vol 64 (3b) ◽  
pp. 855-857 ◽  
Author(s):  
Adriana Bastos Conforto ◽  
Leandro Tavares Lucato ◽  
Claudia da Costa Leite ◽  
Eli Faria Evaristo ◽  
Fábio Iuji Yamamoto ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Case Report ◽  
Intracranial Hemorrhage ◽  
Intravenous Thrombolysis ◽  
Cerebral Microbleeds

Intravenous thrombolysis is an important procedure that has significant impact on ischemic stroke prognosis. However, intracranial hemorrhage (ICH) is a feared complication of this procedure. It has been suggested that cerebral microbleeds (CMBs) may increase the risk of ICH after thrombolysis. We report on a 69 years-old woman with multiple CMBs submitted to intravenous thrombolysis without complications.

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