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Should thrombolytics be given >4.5 hours after stroke onset?

PulmCCM

Patients who present with ischemic stroke more than 4.5 A new meta-analysis challenges that dogma , and makes an already challenging decision-making process even thornier for neurologists answering “code strokes” At least 8 randomized trials have been published testing IV thrombolytics given more than 4.5

Stroke 101
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Trauma Activation Vs. Stroke Code

The Trauma Pro

Medics call the receiving trauma center in advance to advise them that they have a stroke code. Stroke centers pride themselves on the speed of their stroke teams in assessing, scanning, and when appropriate, administering thrombolytics to resolve the problem. Trauma team or stroke team? Is this a reasonable request?

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Posterior Circulation Strokes

EM Ottawa

Posterior circulation ischemia accounts for approximately 20-25% of all ischemic strokes and is a significant cause of patient disability. Posterior strokes are misdiagnosed more than 3x more often than anterior circulation strokes.1 Posterior strokes are misdiagnosed more than 3x more often than anterior circulation strokes.1

Stroke 140
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Sickle Cell Disease and Stroke

Pediatric EM Morsels

Impact of the New American Heart Association/American Stroke Association Definition of Stroke on the Results of the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis Trial. J Stroke Cerebrovasc Dis. 2017 Jan;26(1):108-115. doi: 10.1016/j.jstrokecerebrovasdis.2016.08.038.

Stroke 130
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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 111
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Paediatric stroke

Life in the Fast Lane

Oliver Flower Paediatric stroke Stuart Browne is a Neuro Rehabilitation specialist from Sydney. He discusses what “severe disability” really means.

Stroke 111
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Endovascular Treatment of Stroke Due to Medium-Vessel Occlusion

EM Ottawa

Question and Methods:This multi-center, open label RCT of 530 patients presenting with medium-sized vessel stroke within 12h of last seen well compared functional outcomes at 90-days between EVT with standard medical care and standard medical care alone.

Stroke 52