Safety and feasibility of collateral blood flow augmentation after intravenous thrombolysis.

Background And Purpose: Collateral flow augmentation using partial aortic occlusion may improve cerebral perfusion in acute stroke. We assessed the safety and feasibility of partial aortic occlusion immediately after intravenous tissue plasminogen activator.

Methods: We conducted an open-label pilot study of partial aortic occlusion after thrombolysis.

Titrated initiation of acetylsalicylic acid-dipyridamole therapy reduces adverse effects and improves tolerance in patients with stroke.

Background: Standard aspirin (acetylsalicylic acid [ASA])-dipyridamole therapy twice daily is associated with high rates of discontinuation in large part because of headache and gastrointestinal side effects. Attempts to address dipyridamole-induced headache through reduced dose initiation have produced variable results. Moreover, it has been suggested that migraineurs are more likely to have a dipyridamole-induced headache.

Thrombus detection by echocardiography in patients with acute ischemic stroke and chronic or new-onset atrial fibrillation.

Introduction: Recent articles have promoted anticoagulation for potential sources of embolism detected on echocardiography, despite lack of data regarding risk/benefit ratio for anticoagulating many of these abnormalities. Conversely, we have found echocardiography use in ambulatory stroke care to be of low yield. However, direct visualization of a thrombus might be considered a reasonable indication for anticoagulation.

Serial electrocardiographic assessments significantly improve detection of atrial fibrillation 2.6-fold in patients with acute stroke.

Background And Purpose: Previous studies have reported a low, approximately 1% to 3%, rate of detection of occult atrial fibrillation (AF) with Holter monitor in patients with acute stroke. Furthermore, at least one study has reported that Holter monitoring could not always corroborate initial electrocardiographic (ECG) detection of AF suggesting underestimation of AF by Holter. We compare the detection of new-onset AF by serial ECG assessments and Holter after acute ischemic stroke.

Blood pressure management in acute stroke: comparison of current guidelines with prescribing patterns.

Objective: Current recommendations for treating elevated blood pressure (BP) in the acute stroke are based largely on expert opinion and vary with regard to treatment thresholds and choice of antihypertensive agents. In this study we investigate the influence of these recommendations by comparing the management of hypertension in acute stroke at a tertiary care hospital with current guidelines.

Method: Retrospective chart review of patients admitted with acute stroke at The Ottawa Hospital-General Campus over six consecutive months.

Severe amnesia associated with human herpesvirus 6 encephalitis after bone marrow transplantation.

Background: Human herpesvirus 6 (HHV-6) appears to have a predilection for immunocompromised patients and has been implicated as a cause of posttransplant encephalitis. However, the pathogenesis, as well as the appropriate means of diagnosis and treatment of HHV-6 encephalitis is unclear.

Method: We describe a case of a 20-year-old male university student with anemia who presented with an acute, severe amnesia 1 month after bone marrow transplantation.