Remove 2019 Remove Outcomes Remove Stroke
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Don’t Use Lytics in Mild Stroke, Part 3

EM Literature of Note

MARISS tried to ascertain predictors of poor outcome in mild stroke, and intravenous thrombolysis was not associated with an effect on the primary outcome. Now, again, we examine thrombolysis in “mild” stroke, in this case, NIHSS ≤3 – and fail. Well, PRISMS demonstrated unfavorable results.

Stroke 112
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What's the ideal blood pressure target after ischemic stroke?

PulmCCM

Blood pressure often rises during acute ischemic strokes, in what is widely held to be a natural protective mechanism: increased blood pressure pushes more blood through and around stenotic blood vessels into areas of injured, oxygen-starved brain.

Stroke 105
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EM@3AM: Brainstem Strokes

EMDocs

Answer : Brainstem stroke specifically in the pons resulting in locked in syndrome. CT head without contrast 1 is performed and reveals the following: Question: What is the diagnosis?

Stroke 90
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Glasgow Coma Scale in Children

Pediatric EM Morsels

Motor Fingernail bed pressure with a pencil first If flexion outcome, then apply painful stimulus to neck or head (trapezius or supraorbital notch) to look for localization Spinal reflex can result in a falsely elevated score if lower extremity pain induced Verbal Orientated- Able to answer all questions. Fun fact for animal lovers!-

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Unpacking the PEACH Trial: What is Levetiracetam’s Role in Spontaneous Intracerebral Hemorrhage?

RebelEM

BACKGROUND: intracerebral hemorrhage (ICH) makes up 10-15% of all strokes and significantly contributes to overall stroke-related morbidity and mortality ( Hostettler 2019 ). About 30% of patients experience early seizures within seven days following the onset of a stroke ( Peter-Derex 2022 ).

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52 in 52 – #38: Thrombolysis Guided by Perfusion Imaging up to 9 Hours after Onset of Stroke

EMDocs

This week we cover the EXTEND trial looking at thrombolysis up to 9 hours after stroke onset. and 9 hours after onset of symptoms, with non-infarcted brain tissue, does the administration of alteplase improve functional outcome at 90 days? Intervention: Alteplase 0.9 in alteplase group versus 0.9% to 53.54, p=0.053).

Stroke 79
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SGEM#269: Pre-Hospital Nitroglycerin for Acute Stroke Patients?

The Skeptics' Guide to EM

Date: September 25th, 2019 Reference: Bath PM et al. Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomized, sham-controlled, blinded, phase 3 trial. The Lancet March 2019. Date: September 25th, 2019 Reference: Bath PM et al.

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