keyword
https://read.qxmd.com/read/38531544/application-of-bedside-hints-abcd-2-score-and-truncal-ataxia-to-differentiate-cerebellar-brainstem-stroke-from-vestibular-neuritis-in-the-emergency-room
#1
JOURNAL ARTICLE
Xinmin Liu, Zhaoxia Li, Yi Ju, Xingquan Zhao
BACKGROUND AND PURPOSE: Acute vestibular syndrome (AVS) typically manifests as isolated dizziness or vertigo with no apparent neurological impairments. However, distinguishing life-threatening stroke from innocuous peripheral vestibular lesions in the emergency room (ER) remains challenging. This study aimed to explore the ability of the head impulse-nystagmus-test of skew (HINTS) combined with truncal ataxia or ABCD2 score to differentiate stroke from peripheral vestibular disease in patients with AVS in the ER...
March 25, 2024: Stroke and Vascular Neurology
https://read.qxmd.com/read/38134562/no-association-between-sars-cov-2-vaccination-and-ischaemic-stroke-or-high-risk-transient-ischaemic-attack
#2
JOURNAL ARTICLE
Silvia Komarek, Benjamin Dejakum, Kurt Moelgg, Christian Boehme, Anel Karisik, Thomas Toell, Stefan Kiechl, Michael Knoflach, Raimund Pechlaner, Lukas Mayer-Suess
BACKGROUND: Initiation of SARS-CoV-2 (Severe acute respiratory syndrome coronavirus type 2) vaccinations aroused scepticism within the general-public about risks including stroke. Our aim was to explore temporal associations between vaccination and cerebrovascular events through an analysis of a prospective large-scale cohort of consecutive stroke and high-risk TIA (transitory ischaemic attack) patients. METHODS: We prospectively recruited a cohort of consecutive ischaemic stroke and high-risk TIA (ABCD2-Score ≥ 4) patients treated at the Innsbruck University Hospital (STROKE-CARD Registry Study, NCT04582825) from December 2020 until February 2022...
October 11, 2023: Journal of the Neurological Sciences
https://read.qxmd.com/read/38020628/appropriate-use-of-antiplatelet-medications-following-transient-ischemic-attacks-and-stroke-a-9-year-study-from-the-middle-east
#3
JOURNAL ARTICLE
Hiba Naveed, Naveed Akhtar, Salman Al-Jerdi, Ryan Ty Uy, Sujatha Joseph, Deborah Morgan, Blessy Babu, Shobana Shanthi, Ashfaq Shuaib
BACKGROUND AND PURPOSE: Guidelines recommend that patients with high-risk TIAs and minor strokes presenting within 1-3 days from onset should be offered dual antiplatelet therapy (DAPT). There are little data on real-world adherence to these recommendations. We evaluated the appropriateness of DAPT use in TIA and stroke patients in a prospective database. METHODS: The Qatar Stroke Database began the enrollment of patients with TIAs and acute stroke in 2014 and currently has ~16,000 patients...
2023: Frontiers in Neurology
https://read.qxmd.com/read/37840913/multimodal-mri-study-of-the-relationship-between-plaque-characteristics-and-hypoperfusion-in-patients-with-transient-ischemic-attack
#4
JOURNAL ARTICLE
Ying Sui, Jiali Sun, Yue Chen, Wei Wang
OBJECTIVE: Transient ischemic attack is a significant risk factor for acute cerebral infarction. Previous studies have demonstrated that hypoperfusion in patients with transient ischemic attack was associated with the recurrence of transient ischemic attack, stroke, and persistent worsening of neurological symptoms. Moreover, transient ischemic attack patients classified as high-risk group according to the ABCD2 score have a higher incidence of stroke. Therefore, the objective of this study was to investigate the plaque characteristics of transient ischemic attack patients with concomitant cerebral hypoperfusion using multimodal MRI, as well as hemodynamic changes in the high-risk group with transient ischemic attack patients...
2023: Frontiers in Neurology
https://read.qxmd.com/read/37829551/safety-and-feasibility-of-an-emergency-department-to-outpatient-pathway-for-patients-with-tia-and-nondisabling-stroke
#5
JOURNAL ARTICLE
Alexis Roy, Anirudh Sreekrishnan, Erica Camargo Faye, Scott Silverman, Kori S Zachrison, Andrea M Harriott, Marcelo Matiello, Giovanna S Manzano, Mrinalini Prasanna, Simona Nedelcu, Aneesh B Singhal
BACKGROUND AND OBJECTIVES: Evaluation of transient ischemic attack/nondisabling ischemic strokes (TIA/NDS) in the emergency department (ED) contributes to capacity issues and increasing health care expenditures, especially high-cost duplicative imaging. METHODS: As an institutional quality improvement project, we developed a novel pathway to evaluate patients with TIA/NDS in the ED using a core set of laboratory tests and CT-based neuroimaging. Patients identified as 'low risk' through a safety checklist were discharged and scheduled for prompt outpatient tests and stroke clinic follow-up...
December 2023: Neurology. Clinical Practice
https://read.qxmd.com/read/37736940/bedside-testing-in-acute-vestibular-syndrome-evaluating-hints-plus-and-beyond-a-critical-review
#6
REVIEW
Alexander A Tarnutzer, Jonathan A Edlow
Acute vertigo and dizziness are frequent presenting symptoms in patients in the emergency department. These symptoms, which can be subtle and transient, present diagnostic challenges because they can be caused by a broad range of conditions that cut across many specialties and organ systems. Previous work has emphasized the value of combining structured history taking and a targeted examination focusing on subtle oculomotor signs. In this review, we discuss various diagnostic bedside algorithms proposed for the acutely dizzy patient...
September 1, 2023: Audiology Research
https://read.qxmd.com/read/37723115/soluble-c-type-lectin-like-receptor-2-in-stroke-clecstro-study-protocol-of-a-multicentre-prospective-cohort-of-a-novel-platelet-activation-marker-in-acute-ischaemic-stroke-and-transient-ischaemic-attack
#7
JOURNAL ARTICLE
Shinichiro Uchiyama, Katsue Suzuki-Inoue, Hideo Wada, Yasushi Okada, Teruyuki Hirano, Takehiko Nagao, Hiroyuki Kinouchi, Ryo Itabashi, Haruhiko Hoshino, Koichi Oki, Yutaka Honma, Nobuo Ito, Hiroshi Sugimori, Masahide Kawamura
INTRODUCTION: Soluble C-type lectin-like receptor 2 (sCLEC-2) is a new biomarker for platelet activation, which can be easily measured by usual blood collection. We conducted the CLECSTRO, a prospective, observational cohort study, to evaluate the clinical implications of sCLEC-2 in patients with acute ischaemic stroke (AIS) and transient ischaemic attack (TIA). METHODS AND ANALYSIS: The participants are patients with AIS/TIA and control patients required for differentiation from AIS/TIA...
September 18, 2023: BMJ Open
https://read.qxmd.com/read/37634045/abcd2-score-has-equivalent-stroke-risk-prediction-for-anterior-circulation-tia-and-posterior-circulation-tia
#8
JOURNAL ARTICLE
Shuang Cao, Lu Zhao, Lulu Pei, Yuan Gao, Hui Fang, Kai Liu, Hao Liu, Shuxiang Yang, Shilei Sun, Jun Wu, Bo Song, Yuming Xu
Transient ischemic attack (TIA) was clinically divided into anterior circulation (AC) or posterior circulation (PC). Previous study reported that ABCD2 score could predict the stroke risk after AC-TIA but might have limitation for PC-TIA. We aimed to classify TIA depending on neuroimaging and assess the value of ABCD2 score for predicting stroke risk in different territories. Research data was from TIA database of the First Affiliated Hospital of Zhengzhou University. TIA patients with acute infarction on diffuse weighted imaging [that is, transient symptoms with infarction (TSI)] were divided into anterior and posterior circulation groups according to the location of infarction...
August 26, 2023: Scientific Reports
https://read.qxmd.com/read/37344364/evaluating-the-use-of-the-abcd2-score-as-a-clinical-decision-aid-in-the-emergency-department-retrospective-observational-study
#9
JOURNAL ARTICLE
Siddhant Wahi, Zoe A Michaleff, Paige Lomax, Adam Brand, Madeleen van der Merwe, Mark Jones, Paul Glasziou, Gerben Keijzers
OBJECTIVE: Clinical decision aids (CDAs) can help clinicians with patient risk assessment. However, there is little data on CDA calculation, interpretation and documentation in real-world ED settings. The ABCD2 score (range 0-7) is a CDA used for patients with transient ischaemic attack (TIA) and assesses risk of stroke, with a score of 0-3 being low risk. The aim of this study was to describe ABCD2 score documentation in patients with an ED diagnosis of TIA. METHODS: Retrospective observational study of patients with a working diagnosis of a TIA in two Australian EDs...
June 21, 2023: Emergency Medicine Australasia: EMA
https://read.qxmd.com/read/37095950/development-of-a-model-to-predict-the-risk-of-cerebral-infarction-in-acute-vestibular-syndrome
#10
JOURNAL ARTICLE
Guiming Lin, Fangfang Liu, Hengshi Xu, Guanshui Bao
OBJECTIVES: This study aimed to develop a model to predict the risk of cerebral infarction in acute vestibular syndrome and assist emergency physicians in quickly identifying patients with cerebral infarction. MATERIALS AND METHODS: We looked at 262 patients who were split into cerebral infarction and peripheral vertigo groups. Stepwise regression and Lasso's approach were used to screen for variables, and Boothstrap's method was used to evaluate the model's discrimination and calibration...
April 2023: Heliyon
https://read.qxmd.com/read/37060288/colchicine-in-high-risk-patients-with-acute-minor-to-moderate-ischemic-stroke-or-transient-ischemic-attack-chance-3-rationale-and-design-of-a-multicenter-randomized-placebo-controlled-trial
#11
RANDOMIZED CONTROLLED TRIAL
Yongjun Wang, Jiejie Li, S Claiborne Johnston, Graeme J Hankey, J Donald Easton, Xia Meng, Fu-Dong Shi, Yilong Wang, Xingquan Zhao, Zixiao Li, Liping Liu, Hongqiu Gu, Yong Jiang, Anxin Wang, Yuesong Pan, Jing Jing, Siying Niu, Hao Li
BACKGROUND: Anti-inflammatory therapy using colchicine has reduced recurrent vascular events in patients with coronary heart disease. DESIGN: Colchicine in High-risk Patients with Acute Minor-to-moderate Ischemic Stroke or Transient Ischemic Attack (CHANCE-3) is a randomized, double-blind, placebo-controlled multicenter trial, in which 8,238 patients with acute minor-to-moderate ischemic stroke (NIHSS ⩽ 5) or high-risk transient ischemic attack (TIA) (ABCD2 score ⩾4) and a high-sensitivity CRP (hsCRP) level of ⩾2 mg/L will be randomly assigned within 24 h of symptom onset to colchicine (1 mg daily on days 1-3, followed by 0...
August 2023: International Journal of Stroke: Official Journal of the International Stroke Society
https://read.qxmd.com/read/36789535/association-between-plasma-trimethylamine-n-oxide-and-cognitive-impairment-in-patients-with-transient-ischemic-attack
#12
JOURNAL ARTICLE
Lufeng Wang, Xiaopeng Zhan, Li Jiang, Guangyu Xu, Yiwen Bao, Junlang Wang, Shaohua Qv, Jie Yang, Dongya Huang
BACKGROUND: There is increasing evidence for the association of trimethylamine-N-oxide (TMAO) with cognitive impairment after minor stroke or transient ischemic attack (TIA). However, how TMAO affects cognitive function in TIA patients has seldom been studied. METHODS: A total of 310 TIA participants were retrospectively collected from our stroke register between January 2020 and July 2021. Plasma TMAO was measured by liquid chromatography‒mass spectrometry at baseline...
February 15, 2023: Neurological Research
https://read.qxmd.com/read/36634579/the-combination-of-heart-rate-variability-and-abcd-2-score-portends-adverse-outcomes-after-minor-stroke-or-transient-ischemic-attack
#13
JOURNAL ARTICLE
Yu Tian, Yuesong Pan, Mengxing Wang, Xia Meng, Xingquan Zhao, Liping Liu, Yongjun Wang, Yilong Wang
BACKGROUND AND PURPOSE: The residual recurrent risk of stroke, which cannot be entirely explained by the traditional ABCD2 score, still existed. Heart rate variability (HRV), a method for reflecting the function of automatic nervous system (ANS), was a novel predictor of secondary stroke events. We aimed to investigate the relationships of combined HRV and ABCD2 score with adverse outcomes after acute minor stroke (MS) or transient ischemic attack (TIA), and further investigate the independent associations between HRV and adverse outcomes after MS/TIA stratified by ABCD2 score...
February 15, 2023: Journal of the Neurological Sciences
https://read.qxmd.com/read/36621122/evaluation-of-abcd2-score-during-the-development-of-stroke-in-covid-19-patients-diagnosed-with-transient-ischemic-attack-in-the-emergency-department
#14
JOURNAL ARTICLE
Güner Yurtsever, Rezan Karaali, Ejder Saylav Bora
BACKGROUND: The aim of the present study is to reveal the association between the risk of stroke using ABCD2 score and COVID-19 in patients who presented to our emergency department during the pandemic and were diagnosed with TIA. METHODS: According to the recommendations of the European Stroke Association, patients with an ABCD2 score of <4 were classified as low-risk, and patients with an ABCD2 score of ≥4 were classified as high-risk. Within 90 days of the patient's admission to the emergency room, the development of stroke was tracked and recorded on the system...
December 2, 2022: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://read.qxmd.com/read/36493551/posterior-circulation-stroke-diagnosis-in-unselected-group-of-acutely-dizzy-patients
#15
JOURNAL ARTICLE
S Kmetonyova, J Paulasova Schwabova, T Sramkova, M Dankova, A Olserova, M Petrzalka, A Tomek, J Jerabek
BACKGROUNDS: Diagnostics of a posterior circulation ischemia (POCI) in patients with acute vertigo is a challenging task. Recently, the combination of HINTS (Head Impulse, Nystagmus and Test of Skew) exam and ABCD2 has been recommended to identify stroke in these patients. Until now, studies regarding HINTS have mostly been tested on preselected patient groups and their results are only partially applicable to real clinical practice. AIMS: To compare the sensitivity and specificity of HINTS and ABCD2 and their combination in unselected acutely dizzy patients in the emergency department (ED) toward posterior circulation stroke detection...
January 2023: Clinical Neurology and Neurosurgery
https://read.qxmd.com/read/36478753/external-validation-of-abcd-series-scores-for-predicting-early-stroke-events-following-transient-ischemic-attack-in-a-large-nationwide-registry
#16
JOURNAL ARTICLE
Jia-Xu Weng, Hong-Qiu Gu, Shang Wang, Kai-Xuan Yang, Xin Yang, Chun-Juan Wang, Xia Meng, Xing-Quan Zhao, Yong-Jun Wang, Zi-Xiao Li
INTRODUCTION: In the context of modern guideline-based strategies, new validations of prognostic scores for predicting early stroke risk are needed. We aimed to compare the validity of the ABCD series scores and assess the incremental values of risk components for predicting in-hospital stroke events in patients with transient ischemic attack (TIA). PATIENTS AND METHODS: We abstracted data from the Chinese Stroke Center Alliance (CSCA), a nationwide registry with 68,433 TIA patients admitted within 7 days of symptom onset from 1476 hospitals...
December 2022: European Stroke Journal
https://read.qxmd.com/read/36233554/when-can-an-emergency-cta-be-dispensed-with-for-tia-patients
#17
JOURNAL ARTICLE
Jens-Christian Altenbernd, Razvan Gramada, Eugen Kessler, Jakob Skatulla, Eduard Geppert, Jens Eyding, Hannes Nordmeyer
BACKGROUND: Transient ischemic attacks (TIAs) and minor strokes are often precursors of a major stroke. Therefore, diagnostic work-up of the TIA is essential to reduce the patient's risk of further ischemic events. PURPOSE: With the help of this retrospective study, we aim to determine for which TIA patients a CT angiography (CTA) is not immediately necessary in order to reduce radiation exposure and nephrotoxicity. MATERIAL AND METHODS: Clinical and imaging data from patients who presented as an emergency case with a suspected diagnosis of TIA at a teaching hospital between January 2016 and December 2021 were evaluated...
September 26, 2022: Journal of Clinical Medicine
https://read.qxmd.com/read/36181073/the-efficacy-of-transitional-care-services-in-patients-with-transient-ischemic-attack-a-retrospective-cohort-study
#18
JOURNAL ARTICLE
Jing Lin, Meiling Jiang, Jinmiao Liu, Lan Yao
Transient ischemic attack (TIA) carries a particularly high short-term risk of stroke, which is associated with brain dysfunction caused by a regional reduction in blood flow. Transitional care services present benefits in improving ischemic neurological function and decreasing the recurrence in patients with TIA. The purpose of this study was to investigate the effects of transitional care on clinical outcomes in patients hospitalized for TIA. We retrospectively collected data about 1288 patients with TIA from May 2017 to June 2019...
September 30, 2022: Medicine (Baltimore)
https://read.qxmd.com/read/36179660/low-to-moderate-risk-transient-ischemic-attack-patients-can-be-safely-discharged-from-the-emergency-department-to-a-nurse-practitioner-led-clinic
#19
JOURNAL ARTICLE
Fnu Alfandy, Mary-Lynn Brecht, Suzette Cardin, Holli A DeVon
BACKGROUND: Unnecessary admissions fuel rising healthcare costs and take away resources from higher acuity patients without evidence of increased safety. The purpose of this quality improvement project was to determine whether the care diversion for transient ischemic attack (TIA), from inpatient to a nurse practitioner (NP)-led specialty clinic, resulted in no increase in stroke incidence at 90 days. METHODS: The sample included all adults presenting to the emergency department with TIA at a low-to-moderate risk for stroke...
September 26, 2022: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://read.qxmd.com/read/36159351/a-stroke-of-vision-as-one-and-a-half-syndrome-is-it-time-to-update-the-fast-criteria-and-abcd2-score
#20
Mansoor Zafar, Yasmin McCafferty, Awais Sarwar, Lieze Thielemans, Bethan Davies
FAST (Face, Arm, Speech, Time) is the most commonly used acronym to identify a possible acute stroke. However, it fails to include visual or vestibular changes as potential hallmarks of an acute event. In this case report, we discuss a patient presenting with visual disturbances and internuclear ophthalmoplegia, with a resulting diagnosis of acute ischaemia. We discuss the associated causes, syndromes, and acute management. Though FAST is an important tool for early recognition of a possible stroke, we want to highlight the consideration of visual changes as an increasing phenomenon in an acute cerebrovascular event...
September 2022: Curēus
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