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41. Management of Stroke in Neonates and Children Full Text available with Trip Pro

% and hemiparesis in 36% to 75% and are clinically covert in 14% to 40%. Braun et al found that cardioembolic stroke may present with abrupt onset compared with a stuttering or fluctuating presentation in children with stroke caused by arteriopathy. Diagnosis of cerebral infarction is often made when imaging is obtained for other reasons (cardiac arrest, extracorporeal membrane oxygenation cannulation). Children with moyamoya-type arteriopathies are distinguished by a high prevalence of transient ischemic (...) in a delayed manner, that are presumed to have occurred in the perinatal period. These infants typically present with pathological early handedness or seizures, leading to brain imaging and the diagnosis of a remote infarction. As in adults, pediatric stroke can also be classified according to whether the underlying cause is ischemic or hemorrhagic, as detailed in the NIH Common Data Elements. Ischemic stroke includes arterial ischemic stroke (AIS) and venous infarction caused by cerebral sinovenous

2019 American Heart Association

42. Heart Disease and Stroke Statistics Full Text available with Trip Pro

. Physical Inactivity e99 5. Nutrition e119 6. Overweight and Obesity e138 Health Factors and Other Risk Factors 7. High Blood Cholesterol and Other Lipids e161 8. High Blood Pressure e174 9. Diabetes Mellitus e193 10. Metabolic Syndrome e212 11. Kidney Disease e233 12. Sleep e249 Cardiovascular Conditions/Diseases 13. Total Cardiovascular Diseases e257 14. Stroke (Cerebrovascular Disease) e281 15. Congenital Cardiovascular Defects and Kawasaki Disease e327 16. Disorders of Heart Rhythm e346 17. Sudden (...) (95% CI, 17.3–18.1 million) deaths were attributed to CVD globally, which amounted to an increase of 14.5% (95% CI, 12.1%–17.1%) from 2006. The age-adjusted death rate per 100 000 population was 277.9 (95% CI, 272.1–284.6), which represents a decrease of 14.5% (95% CI, −16.2% to −12.5%) from 2006. Stroke (Cerebrovascular Disease) (Chapter 14) An estimated 7.0 million Americans ≥20 years of age self-report having had a stroke, and the overall stroke prevalence was an estimated 2.5%. In the National

2019 American Heart Association

43. Clinical Guidelines for Stroke Management

continuum of stroke care, across 8 chapters: Imaging Cardiac investigations Thrombolysis Neurointervention Medical interventions Surgical interventions Smoking Diet Physical activity Obesity Alcohol Weakness Loss of sensation Vision Amount of rehabilitation Cardiorespiratory fitness Sitting Standing up Standing balance Walking Upper limb activity Assessment of communication deficits Aphasia Dysarthria Apraxia of speech Cognitive communication disorder in right hemisphere stroke Assessment of cognition (...) Clinical Guidelines for Stroke Management InformMe - Clinical Guidelines for Stroke Management 2017 Our websites {{ user.firstName }} {{ user.lastName }} Go back {{ user.firstName }} {{ user.lastName }} Where am I? / / Clinical Guidelines for Stroke Management 2017 The Clinical Guidelines for Stroke Management 2017 updates and supersedes the Clinical Guidelines for Stroke Management 2010. The Clinical Guidelines have been updated in accordance with the 2011 NHMRC Standard for clinical practice

2017 Clinical Practice Guidelines Portal

44. A review of the evidence for the use of telemedicine within stroke systems of care Full Text available with Trip Pro

stroke as an outcome event. Further study is warranted to determine whether such systems may be useful for remote staffing of prevention clinics or specialized centers for management of transient ischemic attacks. Notification and Response of EMS If EMS providers could identify potential stroke patients and transport them to designated stroke centers, more patients might be able to receive appropriate therapies. Prehospital stroke assessment tools have been developed to help EMS personnel identify (...) of teleradiology to acute stroke per se is a recent phenomenon. In 1990, the first mobile magnetic resonance imaging (MRI) scanner became available in the Netherlands, and teleradiology was used by MRI specialists to support local physicians. From 1992 to 1993, expert opinion was sought in 43 cases, or 3% of the total scanner volume, with suspected subacute cerebral ischemia or infarction listed by the expert reviewer as probably MRI artifact in 2 cases. In 2000, Yamada et al used a mobile phone system

2009 American Academy of Neurology

45. Canadian stroke best practice recommendations: telestroke best practice guidelines update

. This includes early triage and management of transient ischemic attack and minor stroke patients. With the emergence of acute EVT, a further important role for Telestroke is the ability of the Telestroke phys- ician to select appropriate patients that can be trans- ferred for EVT. Barriers to Telestroke include reimbursement agreements, infrastructure, sta?ng, training, partnership development, fragmentation of care and lack of coordination, 30 and limited internet access for some people living in rural (...) Moses 16 , Kelley Rayner 17 , Andrew Samis 18,19 , Elisabeth Smitko 3 , Marilyn Vibe 20 , Gord Gubitz 2,21 , Dariush Dowlatshahi 22,23 , StephenPhillips 2,21 andFrankLSilver 24,25 ;onbehalfoftheHeart and Stroke Foundation Canadian Stroke Best Practice Committees Abstract Every year, approximately 62,000peoplewith stroke andtransient ischemic attack aretreated in Canadian hospitals. The 2016 update of the Canadian Stroke Best Practice Recommendations Telestroke guideline is a comprehensivesummaryof

2017 CPG Infobase

46. Stroke and Transient Ischemic Attack ? Acute and Long-Term Management

reduces the chance of stroke. • Thrombolytic eligible patients should receive tissue plasminogen activator (tPA) as quickly as possible (within 4.5 hours of clearly defined symptom onset). • Early mobilization and appropriate positioning within 24 hours are associated with improved outcomes. • Management on a stroke rehabilitation unit improves functional outcomes. Definitions A transient ischemic attack (TIA) is a brief episode of neurologic dysfunction caused by focal brain or retinal ischemia (...) assessment and treatment are considered critical to reducing disability and mortality related to stroke. 2 BCGuidelines.ca: Stroke and Transient Ischemic Attack – Acute and Long-Term Management (2015) Risk Factors and Primary Prevention The major treatable risk factors for cerebrovascular atherosclerotic disease are similar to those for coronary atherosclerosis. 4 Table 1. Risk factors for stroke or TIA Non-modifiable risk factors Modifiable risk factors • Age • Hypertension • Previous stroke or TIA

2015 Clinical Practice Guidelines and Protocols in British Columbia

47. Palliative and End-of-Life Care in Stroke

studies have docu- mented early clinical, radiographic, and laboratory variables associated with mortality and disability, and clinical practice guidelines 33,34 and various prediction models exist for each stroke type. Prognostic estimates can be based on these pre- diction models or alternatively on clinician experience with prior similar cases. There are certain stroke syndromes (eg, acute basilar artery infarct with coma and apnea, and malig- nant middle cerebral artery infarct) with high risk (...) to be associated with poor out- come after SAH include hyperglycemia, aneurysm size and location, amount of blood measured by Hijdra scores, and late complications such as rebleeding and delayed cerebral ischemia. 46,75–78 Despite limitations to our methods for formulating a prog- nostic estimate, patients and families need some estimate of what the future holds to help guide decision making. As a result, the formulation of a survival and outcome prediction for patients with stroke should be individualized

2014 Congress of Neurological Surgeons

48. Management of Ischaemic Stroke (2nd Edition)

score 1 1 2 1 2 1 1 1 9 CHA 2 DS 2 VASc score Patients (n=7329) Adjusted stroke rate (%/year b ) 0 1 2 3 4 5 6 7 8 9 0% 1.3% 2.2% 3.2% 4.0% 6.7% 9.8% 9.6% 6.7% 15.2% 1 422 1230 1730 1718 1159 679 294 82 14 b Based on Lip et al. 53 AF = atrial ?brillation; EF = ejection fraction (as documented by echocardiography, radionuclide ventriculography, cardiac catheterization, cardiac magnetic resonance imaging, etc.); LV = left ventricular; TIA = transient ischaemic attack. See text for definitions. a Prior (...) Council of the Ministry of Health Malaysia for review and approval. Objectives These guidelines are intended to provide awareness and education in • identifying symptoms and signs of stroke • scope of various types and causes of ischaemic stroke These guidelines are intended to provide evidence in • management of acute ischaemic stroke • primary and secondary prevention of ischaemic stroke These guidelines however do not cover • management of cerebral haemorrhage • stroke rehabilitation (already

2012 Ministry of Health, Malaysia

49. Stroke early management

of the Société française neuro-vasculaire (French Neurovascular Society) and the Directorate for Hospital and Organisation of Care.. These guidelines complement those on vascular prevention in patients with ischemic attack or transient ischemic attack (TIA) 1 which cover the prevention of vascular events (stroke, myocardial infarction and vascular death) after the acute phase in patients who have had a cerebral infarct (CI), and after diagnosis for patients with a TIA. In Western countries, stroke (...) SMUR Mobile emergency unit TIA Transient Ischemic Attack Stroke: early management (alert, prehospital phase, initial hospital phase, indications for thrombolysis) HAS / Guidelines Department / May 2009 5 Guidelines 1 Introduction 1.1 Subject and objectives ? Subject These clinical practice guidelines concern the early management of stroke: alert, prehospital phase, initial hospital phase, indications for thrombolysis. They were drafted by the Haute Autorité de Santé (HAS) at the joint request

2010 HAS Guidelines

50. Multisociety Consensus Quality Improvement Guidelines for Intraarterial Catheter Directed Treatment of Acute Ischemic Stroke From the American Society of Neuroradiology, Canadian Interventional Radiology Association, Cardiovascular and Interventional Radi

= thrombolysis in cerebral infarction, tPA = tissue plasminogen activator INTRODUCTION Stroke is the fourth leading cause of adult death and disability in the United States and the third leading cause of death in Canada, Europe, and Japan. Throughout the developed world, stroke systems of care are under development. High-level evidence exists concerning ef?cacy for intrave- nous (IV) ?brinolysis using recombinant tissue plasminogen activator (tPA) for treatment of ischemic stroke. The evidence for ef?cacy (...) with ?lling of all distal branches Complete or essentially complete reperfusion (3a or 3b) 3a – – – Essentially complete perfusion of ‘‘major’’ vascular territory but not necessarily absolutely normal (4 90% reperfusion of entire territory) 3b – – – Complete and normal ?lling of all territories; completely normal cerebral angiogram AOL = arterial occlusive lesion, IMS = Interventional Management of Stroke, INSTOR = Interventional Stroke Therapy Outcomes Registry, TIMI = Thrombolysis in Myocardial

2013 Society of Interventional Radiology

51. Inclusion of stroke in cardiovascular risk prediction instruments

Carotid Artery Disease Symptomatic carotid artery disease is symptomatic by virtue of leading to stroke or transient ischemic attack (TIA), includingretinalevents.Thus,symptomaticcarotiddiseaseis the one variety of cerebrovascular disease that is already explicitly included among risk equivalents. As noted previ- ously, however, symptomatic carotid disease only accounts for10% of cerebral infarctions. Seven studies are cited to support carotid disease as a risk equivalent, with sample sizes ranging (...) 1998 Downloaded from http://ahajournals.org by on March 27, 2019before consideration and approval by the AHA Science Advisory and Coordinating Committee. There are several reasons to consider stroke patients, and particularly patients with atherosclerotic stroke, among the groups of patients at high absolute risk of coronary and cardiovascular disease. First, evidence suggests that patients with ischemic stroke are at high absolute risk of fatal or nonfatal myocardial infarction or sudden death

2012 American Academy of Neurology

52. ASN/CIRA/CIRSE/SCAI/SIR/SNS/ESMINT/SVIN Multisociety Consensus Quality Improvement Guidelines for Intraarterial Catheter-directed Treatment of Acute Ischemic Stroke

. Neurosurgery 2011; 68:1618– 1623. 14. Tarr R, Hsu D, Kulcsar Z, et al. The POST trial: initial post- market experience of the Penumbra system: revascularization of large vessel occlusion in acute ischemic stroke in the United States and Europe. J Neurointerv Surg 2010; 2:341–344. 15. Higashida RT, Furlan AJ, Roberts H, et al. Trial design and reporting standards for intra-arterial cerebral thrombolysis for acute ischemic stroke. Stroke 2003; 34:e109–e137. 16. The Thrombolysis in Myocardial Infarction (TIMI (...) intervention alone in re- vascularization of acute carotid terminus occlusion. Stroke 2009; 40:2092–2097. 58. Shi ZS, Loh Y, Walker G, Duckwiler GR. Clinical outcomes in middle cerebral artery trunk occlusions versus secondary divi- sion occlusions after mechanical thrombectomy: pooled analysis of the Mechanical Embolus Removal in Cerebral Ischemia (MERCI) and Multi MERCI trials. Stroke 2010; 41:953–960. 59. Arkadir D, Eichel R, Gomori JM, Ben Hur T, Cohen JE, Leker RR. Multimodal reperfusion therapy

2013 Society for Cardiovascular Angiography and Interventions

53. Recommendations for the Implementation of Telehealth in Cardiovascular and Stroke Care: A Policy Statement From the American Heart Association Full Text available with Trip Pro

for their engagement at all steps of the healthcare process, mobile technologies can strengthen the provider-patient relationship. Mobile Stroke Units Mobile stroke units are emergency medical services vehicles equipped with a computed tomography scanner, tissue-type plasminogen activator, and a means to access stroke expertise either on board or via telehealth that can be used to diagnose and treat acute ischemic stroke in the field. Early attempts at mobile ambulance-based telehealth were hampered by inadequate (...) Recommendations for the Implementation of Telehealth in Cardiovascular and Stroke Care: A Policy Statement From the American Heart Association Recommendations for the Implementation of Telehealth in Cardiovascular and Stroke Care: A Policy Statement From the American Heart Association | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019

2016 American Heart Association

54. Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

been noted in several animal models. , Last, depression has been reported after transient ischemic attack and minor stroke (National Institutes of Health Stroke Scale score ≤5 at discharge). , Proposed biological factors contributing to PSD include lesion location, genetic susceptibility, inflammation, neurogenesis in response to ischemia, alterations in neurotrophic factors, disruption of cortico-striato-pallido-thalamic-cortical projections, and alterations in serotonergic, noradrenergic (...) -analysis of 51 studies conducted before June 2004 and revealed a pooled frequency estimate of PSD of 33% (95% confidence interval [CI], 29%–36%). All studies included ischemic stroke, most included intracerebral hemorrhage, and the majority excluded subarachnoid hemorrhage and transient ischemic attack. Valid methods were used to ascertain depression in these studies. The primary end point was the proportion of patients who met the diagnostic category of depression, which included the following: (1

2016 American Heart Association

55. Status of Cardiovascular Disease and Stroke in Hispanics/Latinos in the United States Full Text available with Trip Pro

likely to receive preventive health services. Spanish-speaking Hispanics were far less likely to be knowledgeable of heart attack and stroke symptoms than English-speaking Hispanics, NHBs, and NHWs. Language and Health Literacy There is an important role for health literacy, because it influences the ability to negotiate health systems, understand and act on health treatment and advice, and seek timely and appropriate health care. , Lower health literacy predicted increased all-cause mortality among (...) Status of Cardiovascular Disease and Stroke in Hispanics/Latinos in the United States Status of Cardiovascular Disease and Stroke in Hispanics/Latinos in the United States | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January 2019 This site uses cookies. By continuing to browse

2014 American Heart Association

56. Scientific rationale for the inclusion and exclusion criteria for intravenous alteplase in acute ischemic stroke

… Placebo … 1711 (29.3) … … … … ATLANTIS indicates Alteplase Thrombolysis for Acute Noninterventional Therapy in Ischemic Stroke; ECASS II, European Cooperative Acute Stroke Study II; IST-3, Third International Stroke Trial; MCA, middle cerebral artery; NINDS, National Institute of Neurological Diseases and Stroke; and tPA, tissue-type plasminogen activator. * Only the first 276 patients received placebo; open control thereafter. Overall, 1711 stroke patients ≥80 years of age participated (...) in many studies, and can be used by health professionals with various levels of training. , Some literature suggests that the NIHSS is weighted more toward language deficits, hence giving higher scores to left compared with right hemispheric ischemic strokes with equivalent volumes of infarct. Although the NIHSS was developed by the investigators of the original 2 NINDS alteplase trials, the exclusion criteria for minor stroke were not based purely on the NIHSS. In the manual of operations from

2015 American Academy of Neurology

57. Secondary Prevention of Ischemic Heart Disease and Stroke in Adults

]) • Ischemic stroke and transient ischemic attack (TIA), both referred to as “stroke” in this document. Other types of IVD (e.g., peripheral vascular disease, ischemic bowel disease) are not addressed. Objectives: Improve secondary prevention of IVD by assembling in one location core recommendations for the actions that should be taken or considered. Key points: Secondary prevention. Patients with IHD or stroke should receive intensive secondary prevention interventions, which offer large absolute risk (...) for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2011, 42:227-276. Gerstein HC, Miller ME, Byington RP, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med 2008; 358: 2545–2559 Patel A, MacMahon S, Chalmers J, Neal B, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008; 358:2560

2014 University of Michigan Health System

58. Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke Full Text available with Trip Pro

d) Recent acute myocardial infarction (within previous 3 mo) Notes The checklist includes some FDA-approved indications and contraindications for administration of intravenous rtPA for acute ischemic stroke. Recent guideline revisions have modified the original FDA-approved indications. A physician with expertise in acute stroke care may modify this list. Onset time is defined as either the witnessed onset of symptoms or the time last known normal if symptom onset was not witnessed. In patients (...) only if it appears >6 h after stroke <6 6 Total 5834 … Placebo … 1711 (29.3) … … … … ATLANTIS indicates Alteplase Thrombolysis for Acute Noninterventional Therapy in Ischemic Stroke; ECASS II, European Cooperative Acute Stroke Study II; IST-3, Third International Stroke Trial; MCA, middle cerebral artery; NINDS, National Institute of Neurological Diseases and Stroke; and tPA, tissue-type plasminogen activator. * Only the first 276 patients received placebo; open control thereafter. Overall, 1711

2015 American Heart Association

59. Guidelines for the Prevention of Stroke in Women

regularly, as they were for prenatal care. Postpartum preeclampsia is associated with a high risk for stroke and may be the underlying cause of severe postpartum headaches. 152 Transient elevations in BP are common post partum because of volume redistribution, iatro- genic administration of fluid, alterations in vascular tone, and use of nonsteroidal anti-inflammatory drugs, 153–155 but persis- tently elevated BP should be categorized and treated accord- ing to the adult guidelines. 140 A 2010 Cochrane (...) risk for preeclampsia, 158 but there are insufficient data to support a recommendation. Treatment of Elevated BP During Pregnancy, Including Preeclampsia The central autoregulatory plateau in pregnancy is estimated at 120 mm Hg, and women with moderate to severe high BP in pregnancy, especially those with preeclampsia, are at risk for loss of central cerebral vascular autoregulation. The association between high BP and stroke risk in women with preeclampsia is not linear, such that stroke can occur

2014 Congress of Neurological Surgeons

60. Multisociety Consensus Quality Improvement Revised Consensus Statement for Endovascular Therapy of Acute Ischemic Stroke

imaging and highly trained multidisciplinary hospital teams rapidly responding to emergency activation. Despite the previous acceptance of intravenous ?brinolysis for acute ischemic stroke and the development of designated stroke centers (1), ischemic stroke remains a leading cause of adult death and disability (2). Many patients are not can- didates for ?brinolysis, and intravenous therapy is relatively ineffective for severe strokes as a result of large cerebral artery occlusions. Moreover (...) in Acute Ischemic Stroke (THRACE) (8) trials reported 38% and 53% rates of mRS score 0–2 at 90 days, respectively, and, in the per- protocol population of the Pragmatic Ischaemic Thrombectomy Evalua- tion (PISTE) trial (129), 57% of the endovascular group reached an mRS score of 0–2 at 90 days. The major trials focused on stroke patients with large artery occlu- sions, speci?cally internal carotid terminus or proximal middle cerebral (ie, M1) arteries. However, some patients with severe stroke have

2018 Society of Interventional Radiology

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