			Home About us Contact

Stroke Symptoms (stroke + symptom)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Stroke education: discrepancies among factors influencing prehospital delay and stroke knowledge

INTERNATIONAL JOURNAL OF STROKE, Issue 3 2010
Yvonne Teuschl
Background Time is essential for the treatment of acute stroke. Much time is lost outside the hospital, either due to failure in identifying stroke symptoms or due to a delay in notification or transport. We review studies reporting factors associated with better stroke knowledge and shorter time delays. We summarise the evidences for the effect of stroke knowledge and education on people's reaction in the acute situation of stroke. Methods We searched MEDLINE for studies reporting factors associated with prehospital time of stroke patients, or knowledge of stroke symptoms. Further, we searched for studies reporting educational interventions aimed at increasing stroke symptom knowledge in the population. Findings We included a total of 182 studies. Surprisingly, those factors associated with better stroke knowledge such as education and sociodemographic variables were not related to shorter time delays. Few studies report shorter time delays or better stroke knowledge in persons having suffered a previous stroke. Factors associated with shorter time delays were more severe stroke and symptoms regarded as serious, but not better knowledge about the most frequent symptoms such as hemiparesis or disorders of speech. Only 25,56% of patients recognised their own symptoms as stroke. While stroke education increases the knowledge of warning signs, a few population studies measured the impact of education on time delays; in such studies, time delays decreased after education. This may partly be mediated by better organisation of EMS and hospitals. Interpretation There is a discrepancy between theoretical stroke knowledge and the reaction in an acute situation. Help-seeking behaviour is more dependent on the perceived severity of symptoms than on symptom knowledge. Bystanders play an important role in the decision to call for help and should be included in stroke education. Education is effective and should be culturally adapted and presented in a social context. It is unclear which educational concept is best suited to enhance symptom recognition in the acute situation of stroke, especially in view of discrepancies between knowledge and action. [source]

Aortic Dissection Presenting as an Acute Ischemic Stroke for Thrombolysis

JOURNAL OF NEUROIMAGING, Issue 3 2005
Ken Uchino MD
ABSTRACT Thrombolysis for the treatment of acute ischemic stroke requires careful selection of patients. The authors report a case of aortic dissection presenting with acute ischemic stroke for which emergent ultrasonographic evaluation was helpful in the diagnosis and subsequent treatment. The patient presented with acute middle cerebral artery ischemic stroke symptoms and complained of bilateral ear and chest pain. Chest x-ray, cardiac enzymes, and transthoracic echocardiogram were normal, and she was considered for thrombolytic therapy. Carotid ultrasound revealed right common carotid occlusion that led to the diagnosis of aortic dissection, confirmed by chest computed tomography. An experienced sonographer with skills to perform rapid intra- and extracranial examinations may help to change the treatment plan for acute stroke patients. [source]

Thrombolytic treatment for stroke in the Scandinavian countries

ACTA NEUROLOGICA SCANDINAVICA, Issue 4 2009
K. Bruins Slot
Objective,,, We wanted to describe the use of thrombolytic treatment for stroke in Scandinavia, to assess stroke doctors' opinions on this treatment, to identify barriers against treatment, and to suggest improvements to overcome these barriers. Methods,,, We sent questionnaires to 493 Scandinavian doctors, who were involved in acute stroke care. Results,,, We received 453 (92%) completed questionnaires. Overall, 1.9% (range per hospital 0,13.9%) of patients received thrombolytic treatment. A majority (94%) of the respondents was convinced of the beneficial effects of thrombolytic treatment and many (85%) felt that its risks were acceptable. Main barriers were: unawareness of stroke symptoms among patients (82%) and their failure to respond adequately (54%); ambulance services not triaging acute stroke as urgent (23%); and insufficient in-hospital routines (15%). The respondents suggested that the following measures should be prioritized to increase the treatment's use: educational programmes to improve public awareness on stroke and how to respond (96%); education of in-hospital (88%) and prehospital (76%) medical staff. Conclusions,,, A large majority of Scandinavian doctors regard thrombolytic treatment for stroke as beneficial, yet its implementation in clinical practice has so far been poor. Our survey identified important barriers and potential measures that could increase its future use. [source]

The yield of expanding the therapeutic time window for tPA

ACTA NEUROLOGICA SCANDINAVICA, Issue 5 2006
J. F. Owe
Objectives,,, Intravenous thrombolysis with recombinant tissue plasminogen activator (tPA) for acute ischemic stroke has been proved to be effective when given within 3 h of onset of stroke symptoms. Partly due to this time limit, less than 10% of stroke patients are treated with tPA. This study assessed the potential for increased tPA utilization with a theoretical time limit of 6 h. Materials and methods,,, A total of 117 patients admitted with a diagnosis of acute cerebrovascular disease were prospectively registered over a 3-month period, with emphasis on timing and criteria for tPA treatment. Results,,, Eighty-eight of 117 patients (75%) had an acute ischemic stroke. Of these, 23% arrived within 3 h, 8% within 3,6 h, and 69% later than 6 h after symptom onset. Of the seven patients in the 3,6 h group, only one had time delay as the only contraindication to tPA. Conclusions,,, This study suggests that reducing patient delay, rather than increasing the time limit for thrombolytic treatment, may increase the frequency of tPA utilization. Changing time limits for thrombolysis may reduce time delay from stroke onset to arrival in hospital due to more rapid handling of patients by the emergency medical services. [source]