Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
  1. Home
  2. Search

Refine search

Refine search

Access:
Content type:
Publication date:
Apply   From and To filters
Subject: Show more
Journals Show more
Publishers: Show more
Societies Show more
Series: Show more
Collections: Show more

Actions for selected content:

Select all | Deselect all
  • View selected items
  • Export citations
  • Download PDF (zip)
  • Save to Kindle
  • Save to Dropbox
  • Save to Google Drive

Save Search

You can save your searches here and later view and run them again in "My saved searches".

Please provide a title, maximum of 40 characters.
Cancel
×

3 results

  • Chapter 11 - Ischemic Stroke and Transient Ischemic Attack

  • from Section 3 - Specific Neurological Disorders in Emergency Medicine
  • Edited by Thomas P. Campbell, Allegheny Health Network, Pittsburgh, Kevin M. Kelly, Allegheny Health Network, Pittsburgh
  • Book:
    Handbook of Emergency Neurology
    Published online:
    10 January 2024
    Print publication:
    17 August 2023, pp 137-172

  • Summary

    In the United States, one stroke occurs every 40 seconds on average. Ischemic stroke is a leading cause of serious long-term disability and the fifth leading cause of death. Every year, 795,000 people experience a new or recurrent stroke. In 2018, stroke accounted for 1 of every 19 deaths. Stroke typically occurs suddenly, with symptoms of motor weakness, impaired speech, vision loss, or numbness, and can lead to significant disability. The financial burden of stroke, including direct medical costs and potential wages lost, is greater than $30 billion per year. Time-based acute stroke treatments improve functional outcome and reduce mortality, which makes rapid recognition of stroke of utmost importance.

  • Thrombolysis in Stroke Mimics: Comprehensive Stroke Centers vs Telestroke Sites

  • Radhika Nair, Khurshid Khan, Jillian M. Stang, Mary-Lou Halabi, Erik Youngson, Anas Alrohimi, Ashfaq Shuaib
  • Journal:
    Canadian Journal of Neurological Sciences / Volume 50 / Issue 6 / November 2023
    Published online by Cambridge University Press:
    01 December 2022, pp. 838-844
    • Article
      • You have access
      • Open access
    • PDF
    • HTML
    • Export citation
  • Background:

    Hyperacute treatment of acute stroke may lead to thrombolysis in stroke mimics (SM). Our aim was to determine the frequency of thrombolysis in SM in primary stroke centers (PSC) dependent on telestroke versus comprehensive stroke centers (CSC).

    Method:

    Retrospective review of prospectively collected data from the Quality improvement and Clinical Research (QuICR) registry, the Discharge Abstract Database (DAD), and The National Ambulatory Care Reporting System (NACRS) of consecutive patients treated with intravenous thrombolysis for acute ischemic stroke in Alberta (Canada) from April 2016 to March 2021.

    Result:

    A total of 2471 patients who received thrombolysis were included. Linking the QuICR registry to DAD 169 (6.83%) patients were identified as SM; however, on our review of the records, only 112 (4.53%) were actual SM. SMs were younger with a mean age of 61.66 (±16.15) vs 71.08 (±14.55) in stroke. National Institute of Health Stroke Scale was higher in stroke with a median (IQR) of 10 (5–17) vs 7 (5–10) in SM. Only one patient (0.89 %) in SM groups had a small parenchymal hemorrhage versus 155 (6.57%) stroke patients had a parenchymal hemorrhage. There was no death among patients of thrombolysed SM during hospitalization versus 276 (11.69%) in stroke. There was no significant difference in the rate of SM among thrombolysed patients between PSC 27 (5.36%) versus CSC 85 (4.3%) (P = 0.312). The most responsible diagnosis of SM was migraine/migraine equivalent, functional disorder, seizure, and delirium.

    Conclusion:

    The diagnosis of SM may not always be correct when the information is extracted from databases. The rate of thrombolysis in SM via telestroke is similar to treatment in person at CSC.