SMJ articles in the category "Stroke"

Original Article

Empowering the Community Health Worker Role in the Stroke Continuum of Care: Development of the Florida Stroke Registry CHW Stroke Training Program

Objectives: Community health workers (CHWs) help patients navigate community resources and support healthier lifestyles. Although stroke transitions of care require navigating complex clinical services and behavioral changes, there is no established formal training for CHWs in stroke care across Florida. We describe the impact of a comprehensive stroke training course…

Posted in: community health worker 2 Stroke 16 transitions of care 5

Original Article

Community Socioeconomic and Urban–Rural Disparities in Prehospital Notification of Stroke by Emergency Medical Services in North Carolina

Objectives: Notification by emergency medical services (EMS) to the destination hospital of an incoming suspected stroke patient is associated with timelier in-hospital evaluation and treatment. Current data on adherence to this evidence-based best practice are limited, however. We examined the frequency of EMS stroke prenotification in North Carolina by community…

Posted in: disparities 16 emergency medical services 6 Rural 17 Stroke 16

Original Article

Evaluation of an Electronic Health Record Alert to Improve Screening and Management of Cardiovascular Disease and Stroke Factors in a High-Risk Population

Objectives: Cardiovascular disease and stroke risk factor screening and management by primary care providers (PCPs) have a significant impact on their patients’ health. The objective of this study was to investigate the effectiveness of an electronic health record (EHR) cardiovascular disease and stroke risk alert in improving the ability of…

Posted in: cardiovascular diseases 5 electronic health records 6 primary care 64 Stroke 16

Original Article

CME Article: Dural Venous Sinus Diameters in Children with Sickle Cell Disease: Correlation with History of Stroke in a Case–Control Study

Objectives: The purpose of this study was to compare the diameters of the dural venous sinuses (DVSs) in children with sickle cell disease (SCD) with healthy controls and determine whether the size has any correlation to history of cerebral infarct among children with SCD. Methods: A retrospective review compared demographics,…

Posted in: magnetic resonance imaging 13 sickle cell disease 28 Stroke 16

Original Article

CME Article: Personalized Reminders Increase Screening for Stroke Risk in Children with Sickle Cell Anemia

Objectives: Transcranial Doppler ultrasound (TCD) effectively identifies children with sickle cell anemia (SCA) who are at increased risk of stroke. We evaluated a low-cost quality improvement (QI) intervention to increase the proportion of children screened by TCD. Methods: We measured the proportion of children with SCA receiving appropriate TCD screening…

Posted in: quality improvement 22 screening 33 sickle cell anemia 6 Stroke 16

Review Article

Endovascular (Intraarterial) Treatment of Acute Ischemic Stroke: Efficacy Not Supported by Clinical Trials

Intravenous tissue plasminogen activator (IV tPA, alteplase) provides a statistically and clinically significant improvement in clinical outcome for carefully selected patients with acute ischemic stroke when administered within 4.5 hours of onset; however, even within the 4.5-hour window, outcome is poor for some eligible patients, including those with occlusions of…

Posted in: Stroke 16 thrombolysis 7

Original Article

Inpatient Rehabilitation Centers and Concern for Increasing Volume of Ischemic Stroke Patients Requiring Rehabilitation

Objectives: To determine whether prolonged length of stay (pLOS) in ischemic stroke is related to delays in discharge disposition arrangement. Methods: We designed a retrospective study to compare patients with acute ischemic stroke who experienced pLOS to those who did not experience pLOS. Patients who have had acute ischemic stroke…

Posted in: complications 13 length of stay 14 Stroke 16

Original Article

Safety Profile of High-Dose Statin Therapy in Geriatric Patients with Stroke

Objectives: Use of high-dose statin therapy (HDST) in patients with stroke became standard clinical practice after the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) study, in which the mean age of the study population was approximately 63 years. Little data are available on the adverse effects of statins…

Posted in: Geriatrics 10 myalgias 2 Stroke 16

Original Article

Association of Chlamydia pneumoniae Serology and Ischemic Stroke

Background: Stroke is one of the major causes of morbidity and mortality throughout the world. Reports about the role of Chlamydia pneumoniae infection in the development of atherosclerosis have been reported in many studies. The aim of the study was to evaluate the association between Chlamydia pneumoniae infection and ischemic…

Posted in: atherosclerosis 13 Chlamydia pneumoniae 2 risk factors 23 Stroke 16

Case Report

Starvation Causes Acute Psychosis Due to Anterior Thalamic Infarction

A 19-year-old female presented with acute onset of bizarre behavior, confusion, auditory hallucinations, and delusions after two weeks on a 100 kcal/day diet. She had a normal neurological examination. Urinalysis showed ketones 4+. She had elevated antinuclear antibody (ANA) (320) and positive heterozygous factor V Leiden mutation. Magnetic resonance imaging…

Posted in: acute 7 deficiency 3 psychosis 8 Stroke 16

CME Topic

Diffusion-Weighted Imaging: Not All That Glitters Is Gold

Abstract:Diffusion-weighted imaging (DWI) is a sophisticated magnetic resonance imaging (MRI) technique with rapid acquisition time and high sensitivity for depicting acute cerebral ischemia. It is currently part of the routine workup in most medical centers when ischemic stroke is in the differential diagnosis. DWI helps establish a diagnosis of acute…

Posted in: magnetic resonance imaging 13 Stroke 16

Case Report

Cervical Spine Manipulation: An Alternative Medical Procedure with Potentially Fatal Complications

There are multiple reports in the literature of serious and at times fatal complications after cervical spine manipulation therapy (CSMT), even though CSMT is considered by some health providers to be an effective and safe therapeutic procedure for head and neck pain syndromes. We report a case of a young…

Posted in: neurologic complications 2 Stroke 16

Review Article

Trigeminal Trophic Syndrome

Ulceration of the nose may be inadvertently induced by the patient. Although trigeminal trophic syndrome is an uncommon cause of chronic ulcers, healthcare providers should consider the possibility of this disorder when encountering a patient with nasal ulcerations. Trigeminal trophic syndrome most commonly occurs in older women following therapy for…

Posted in: basal 2 Cancer 19 carcinoma 5 cutaneous 4 dementia 3 nasal 2 skin 5 squamous 2 Stroke 16

Case Report

An Unrecognized Cause of Recurrent Hypercalcemia: Immobilization

Abstract:We report a 66-year-old Chinese man with chronic renal insufficiency (creatinine 1.7 mg/dL) and gout suffering from slurred speech and right hemiplegia for 3 days. Acute cerebral infarction was confirmed by computed tomography. Conscious disturbance occurred on the tenth hospital day without significant changes on imaging study when compared with…

Posted in: hypercalcemia 10 renal failure 10 Stroke 16

Case Report

Carotid Dissection Associated with a Handheld Electric Massager

The extracranial internal carotid artery (ICA) is susceptible to injury and dissection from external shear forces applied to the neck. Traumatic ICA dissection usually occurs in the setting of a sudden, high amplitude force causing significant distortion of surrounding soft tissues. Weaker, repetitive forces applied for longer intervals may also…

Posted in: Stroke 16 trauma 24

Original Article

Clinical Correlation Between Effective Anticoagulants and Risk of Stroke: Are We Using Evidence-based Strategies?

Objectives: Despite evidence supporting anticoagulant use in atrial fibrillation, this modality is not fully utilized. Methods: Retrospective chart review of 297 patients with nonvalvular atrial fibrillation between 1997 to 2000. 124 patients received warfarin and 166 did not; 91 patients suffered stroke. Results: Age (P = 0.232) and gender (P…

Posted in: Atrial Fibrillation 13 primary prevention 3 Stroke 16 Warfarin 10
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