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By Arthur Cronwright Aspiring to best practice always
Joseph Miller, Harish Kinni, Christopher Lewandowski, Richard Nowak, Phillip Levy
Elevated blood pressure is present in more than 60% of patients with acute stroke. Moderate to severe hypertension affects stroke outcomes, yet the optimal management has been a gray area in the care of such patients. Although new data are changing the approach, particularly for hemorrhagic events, significant questions remain. This article presents the latest evidence on hypertension in the setting of ischemic and hemorrhagic stroke and highlights management considerations that are relevant to emergency medicine...
September 2014: Annals of Emergency Medicine
Chun-Hsiang Tseng, Wen-Yi Chiu
The medulla contains complex nervous structures related to motor, sensory, coordination, and visceral autonomic functions. The medullary infarctions cause various symptoms and signs depending on the location of the lesion. Lateral medullary infarction is caused by a vascular event in the territory of the posterior inferior cerebellar artery or the vertebral artery. We report a case of a patient with falling tendency and whirling sensation. He reported no facial drop, arm drift, slurred speech, difficulty of swallowing, or weakness of his limbs...
July 2014: American Journal of Emergency Medicine
Jeffrey J Perry, Mukul Sharma, Marco L A Sivilotti, Jane Sutherland, Cheryl Symington, Andrew Worster, Marcel Émond, Grant Stotts, Albert Y Jin, Weislaw J Oczkowski, Demetrios J Sahlas, Heather E Murray, Ariane MacKey, Steve Verreault, George A Wells, Ian G Stiell
BACKGROUND: The ABCD2 score (Age, Blood pressure, Clinical features, Duration of symptoms and Diabetes) is used to identify patients having a transient ischemic attack who are at high risk for imminent stroke. However, despite its widespread implementation, the ABCD2 score has not yet been prospectively validated. We assessed the accuracy of the ABCD2 score for predicting stroke at 7 (primary outcome) and 90 days. METHODS: This prospective cohort study enrolled adults from eight Canadian emergency departments who had received a diagnosis of transient ischemic attack...
July 12, 2011: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
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