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Introduction:Current guidelines recommend 24-hours of high-intensity monitoring (HIM) for acute ischemic stroke patients post-intravenous thrombolysis (IVT) due to risk of bleeding complications including symptomatic intracranial hemorrhage (sICH). The mean length of ICU-stay for the HIM group was 32.8
Background and Purpose:Whether imaging markers of cerebral small vessel disease on computed tomography (CT-CSVD) relates to early clinical outcomes after intravenous thrombolysis for acute ischemic stroke remains not well understood. Stroke, Volume 56, Issue Suppl_1 , Page AWP6-AWP6, February 1, 2025. 1.02; score 2: OR 0.46, 95%CI 0.26-0.83;
She presented with presyncope and an initial bloodpressure of 77/63 mmHg. Catheter-directed thrombolysis and a temporary pacemaker insertion were carried out sequentially. Echocardiography confirmed signs of right ventricular dysfunction.
Recent landmark trials BEST-MSU and B_PROUD have proven that MSUs facilitate quicker thrombolysis times and improved functional outcomes at 90 days when compared to conventional emergency medical services (EMS) for acute ischemic stroke patients. Goal bloodpressure was defined as systolic bloodpressure <160.
Further exploration of moderate BP parameters deserve further study post thrombolysis, like the BEST II study in post thrombectomy patients. sICH had a similar but weaker association: excessive SBP (7.7% vs 4.9%; p=0.3) and excessive DBP (3.8% vs 1.4%; p=0.2).Conclusion:Our
We derived benefit per hundred treated (BPH, same as absolute risk reduction) and NNT using four Permutation Methods (CMH test with tied pairs ignored, divided in half, assigned by NIHSS outcome, and by better than model expectations) and three Joint Outcome Table Methods (Multi-sampling, Min-Max, and Expert Panel).Results:The
MY Thoughts on this CASE: Not being there — I am unaware of physical exam parameters ( bloodpressure, respiratory rate; oxygen saturation; heart and lung auscultation, etc. ). When it is — this may greatly expedite clinical decision-making for anticoagulation and/or thrombolysis. Figure-1: The initial ECG in today's case. (
Median age was 64 (51-75) years, 11 (46%) patients were randomized to receive intravenous thrombolysis (IVT) prior to EVT, and 19 (79%) patients had an MCA occlusion. Functional independence (mRS 0-2) at 90 days (21 (88%) patients) and long term (20 (83%) patients) was comparable. respectively).
EMS obtained the following vital signs: pulse 50, respiratory rate 16, bloodpressure 96/49. [link] A 62 year old man with a history of hypertension, type 2 diabetes mellitus, and carotid artery stenosis called 911 at 9:30 in the morning with complaint of chest pain.
The new analysis of the trial results, led by UVA Health’s Andrew Southerland , MD, found that high blood sugar shortly after thrombolysis – opening blocked arteries in the brain with a clot-busting drug – was associated with greater risk for potentially deadly brain bleeds, particularly in older patients with more severe strokes.
of respondents work in facilities equipped with intravenous thrombolysis and mechanical thrombectomy respectively. demonstrated poor knowledge of bloodpressure control in patients with acute stroke.Working in Primary Healthcare Centre (PHCs) and Government Hospital was a significant predictor of overall poor knowledge of stroke.
Be ready with prudent administration of IV fluids if bloodpressure drops ( See ECG Blog #190 for more on RV MI, and its different hemodynamics ). Comparable benefit from acute reperfusion ( by PCI or thrombolysis ) is seen in patients with acute coronary occlusion from an OMI, as from a STEMI.
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