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2.1
Ischemic Stroke

Presentation

CASE PRESENTATION: We report the case of a 71-year-old hypertensive Caucasian woman with non-valvular atrial fibrillation treated with dabigatran 150 mg twice daily, who presented with acute ischemic stroke causing right-sided hemiparesis and aphasia. [ncbi.nlm.nih.gov]

Entire Body System

  • Disability

    The prognosis was death or major disability (modified Rankin Scale score ≥ 3) at 3 months after acute ischemic stroke. RESULTS: 22.87% (118/516) of patients had serum hs-cTnT elevation (≥14 ng/l). [ncbi.nlm.nih.gov]

  • Pain

    CASE PRESENTATION: The first case was a 56-year-old African man who presented with an acute infero-basal ST elevation myocardial infarction 6 hours after chest pain onset. [ncbi.nlm.nih.gov]

  • Weakness

    However, she developed evolving left-sided motor weakness over the course of 2 days and presented to our pediatric emergency department where she was found to have an ischemic stroke in the right corona radiata with a right internal carotid artery dissection [ncbi.nlm.nih.gov]

  • Falling

    One ischemic infarction and two transient ischemic attacks occurred with the same symptoms (inability to walk unassisted and tendency to fall to the left) during the first 2 years post-treatment. [ncbi.nlm.nih.gov]

    She has a CHA 2 DS 2 -VASc score of 2 (woman and hypertension) and falls into the category where we should have an in-depth conversation about the risks and benefits of anticoagulant therapy. [medpagetoday.com]

  • Epilepsy

    Most children have relatively mild deficits, but those who have greater neurologic deficits, poststroke epilepsy, or strokes early in life are at risk for lower overall cognitive function. [ncbi.nlm.nih.gov]

    Birnbaum, MD Quality Leadership Award Named as one of the 100 Best Hospitals in America by Becker's Hospital Review Level 4 (highest) c omprehensive epilepsy center National Cancer Institute-designated cancer center More successful high-risk liver transplants [nebraskamed.com]

Respiratoric

  • Aspiration

    During stent retrieval, continuous manual aspiration was applied through the guiding catheter, and several large pieces of thrombus were aspirated into the catheter along with the clot, which was adhered to the stent. [ncbi.nlm.nih.gov]

Gastrointestinal

  • Overeating

    […] is a shift towards stronger frontal left-lateralization of the fMRI activation over the first year post-stroke. [ncbi.nlm.nih.gov]

Cardiovascular

  • Heart Failure

    During OAC with therapeutic INR, congestive heart failure (odds ratio [OR]: 2.33, 95% confidence interval [CI]: 1.18-4.58) and hypercholesterolemia (OR: 2.52, 95% CI: 1.51-4.19) were more common in patients with ischemic stroke/TIA, whereas a history [ncbi.nlm.nih.gov]

    Myocardial ischemia and coronary disease in heart failure. Preview https://doi.org/10.1007/s10741-019-09831-z Heart Failure Reviews; Pagliaro BR, Cannata F et. al. [allmedx.com]

    Steinhart Model for Acute Heart Failure (AHF) in Undifferentiated Dyspnea Diagnoses acute heart failure with NT-proBNP in undifferentiated dyspneic patients. [mdcalc.com]

    Szummer KE, Solomon SD, Velazquez EJ, et al.: Heart failure on admission and the risk of stroke following acute myocardial infarction: the VALIANT registry. Eur Heart J 26(20): 2114, 2005. [PubMed: 15972293] 47. [accessmedicina.mhmedical.com]

    Secondary outcome variables included the following variables recommended by the Utstein resuscitation registry templates for OHCA: age (years), sex (male or female), weight (kg), past medical history (hypertension, diabetes mellitus, heart failure, or [ccforum.biomedcentral.com]

Eyes

  • Blurred Vision

    Sudden feeling of dizziness, blurred vision, nausea/vomiting, weakness in both legs or double vision. A seizure is a warning of temporary impairment of cerebral blood flow. [bumrungrad.com]

Neurologic

  • Intracranial Hemorrhage

    Under high-dose and dual antiplatelet therapy, none of the three patients showed symptomatic intracranial hemorrhaging. However, one case showed reocclusion of the placed stent after acute thrombosis. [ncbi.nlm.nih.gov]

  • Aphasia

    At discharge, our patient was able to walk unassisted and had only residual aphasia. Twenty days later, she had completely recovered motor function of her right side, with further progressive improvement of aphasia. [ncbi.nlm.nih.gov]

  • Seizure

    We compared patients with early-onset seizures with all seizure-free patients, whereas the patients with late-onset seizures were compared with the 1-week survivors without any seizures. [ncbi.nlm.nih.gov]

    A seizure is a warning of temporary impairment of cerebral blood flow. Abnormal mental confusion lasting up to several hours without loss of consciousness. [bumrungrad.com]

    Prediction of Alcohol Withdrawal Severity Scale Screens hospitalized patients for complicated alcohol withdrawal (seizures, delirium tremens). [mdcalc.com]

  • Dysarthria

    RESULTS: The hemiparesis and the central facial palsy were fully remitted 3 days after the onset of symptoms, and the dysarthria was remitted 2 days afterwards. [ncbi.nlm.nih.gov]

  • Confusion

    Emotional disturbance; some patients may experience confusion, memory loss, irrational thinking. It is very important for the family to understand and show concern and support, which will benefit the patient. [bumrungrad.com]

    At the level of behavior, therefore, the disease can be confuse... Ankylosing spondylitis with cervical fracture, cardiac arrest, locked-in syndrome and d... [allmedx.com]

    Confusion Assessment Method for the ICU (CAM-ICU) Establishes ability to detect delirium in high risk settings. COPD Assessment Test (CAT) Quantifies impact of COPD symptoms on patients' overall health. [mdcalc.com]

Workup

Stroke workup revealed a patent foramen ovale; however, no evidence of deep venous thrombosis was found. Hypercoagulability workup revealed an elevated ANA. [ncbi.nlm.nih.gov]

Treatment

In his medical history, the patient did not have any contraindication for thrombolytic treatment. To avoid delays to thrombolytic therapy, blood samples were taken, and after that, IV bolus alteplase treatment was applied. [ncbi.nlm.nih.gov]

Prognosis

[…] in evaluating the prognosis of stroke patients. [ncbi.nlm.nih.gov]

Etiology

CONCLUSION: DWI detects AIS accurately; the positivity of these evaluations in the ER is associated only with NIHSS on admission, time to DWI, brainstem location, and AIS etiology. [ncbi.nlm.nih.gov]

Epidemiology

Further large epidemiologic studies need to be done to confirm these findings. [ncbi.nlm.nih.gov]

Appel LJ, Braun LT, Chaturvedi S, Creager MA, Culebras A, Eckel RH, Hart RG, Hinchey JA, Howard VJ, Jauch EC, Levine SR, Meschia JF, Moore WS, Nixon JV, Pearson TA; American Heart Association Stroke Council; Council on Cardiovascular Nursing; Council on Epidemiology [passeportsante.net]

[…] and Public Health, University of Ottawa, Ottawa, ON, Canada 4 Department of Surgery, University of Ottawa, Ottawa, ON, Canada 5 Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada 6 Department of Medicine, Division of [bmj.com]

Schievink WI, Roiter V: Epidemiology of cervical artery dissection. Front Neurol Neurosci 20: 12, 2005. [PubMed: 17290107] 28. [accessmedicina.mhmedical.com]

Pathophysiology

PURPOSE OF REVIEW: This article provides an overview of cerebrovascular hemodynamics, acute stroke pathophysiology, and collateral circulation, which are pivotal in the modern imaging of ischemic stroke that guides the care of the patient with stroke. [ncbi.nlm.nih.gov]

Prevention

After receiving appropriate care the patient should be followed up with medical supervision to prevent further damage. Prevention Prevention is the top priority in caring for the patient exposed to risk factors for stroke. [bumrungrad.com]

CONCLUSIONS: There is insufficient evidence regarding cases for which DOACs would be suitable for the prevention of thromboembolism and regarding its long-term efficacy and safety in patients with cancer. [ncbi.nlm.nih.gov]

In 1991, the seminal study proving the benefits of warfarin in preventing stroke, the Stroke Prevention in Atrial Fibrillation (SPAF) trial, was published. [medpagetoday.com]

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2.1
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