Background and objective The rate of intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) is still low due to several absolute and relative contraindications, including admission time delay, which remains the main reason for exclusion from thrombolysis. In this study, we aimed to identify reasons for non-thrombolysis at our stroke center. Methods This retrospective study included all patients with a final diagnosis of AIS as per our stroke prospective register from 2014 to 2019.
View Article and Find Full Text PDFObjective: Intravenous thrombolysis (IVT) with tenecteplase has been associated with better clinical outcomes in acute ischemic stroke (AIS) patients with confirmed large vessel occlusions compared to IVT with alteplase. However, the utility of tenecteplase for the treatment of all AIS patients eligible for IVT has not been established.
Methods: We compared the safety and efficacy of tenecteplase versus alteplase in AIS patients by analyzing propensity score matched data from 20 centers participating in the Safe Implementation of Treatments in Stroke-International Stroke Thrombolysis Register.
Spinal cord infarction is an uncommon but devastating disorder caused by various conditions. It remains however a rare neurological complication in acute aortic injuries. In this context, aortic dissection is the most frequent etiological factor.
View Article and Find Full Text PDFIntravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) is the first effective approved treatment for reducing ischemic stroke disability, and having a stroke within 3 months is usually a contraindication to thrombolysis. In this paper, we describe the case of a 58-year-old patient who received repeated intravenous thrombolysis at 10 days interval for a recurrent ischemic stroke, with dramatic improvement. The carotid diaphragm was behind this recurrent stroke and it was treated by stenting.
View Article and Find Full Text PDFCoronavirus disease 2019 (COVID-19) is an emerged pandemic disease caused by a new coronavirus known as SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2). Initially the mortality of this infection are related to severe acute respiratory distress syndrome, but several publications also showed that this infection caused an inflammatory response with severe systemic complications [1]. Venous thromboembolism has been shown to be an important cause of morbidity and mortality in patients with COVID-19, both in the general inpatient and in the intensive care unit (ICU) setting, and even in patients receiving therapeutic anticoagulation [2].
View Article and Find Full Text PDFGayet Wernicke encephalopathy (EGW) is a neurological emergency secondary to thiamine deficiency (vitamin B1). This is more often secondary to chronic alcoholism. The purpose of this study is to remind clinicians of some clinical signs different from ethylism, suggesting EGW as well as to report four cases characterized by different types of anomalies shown by MRI.
View Article and Find Full Text PDFBackground: Parkinson's disease (PD) affects millions of people worldwide, and it is predicted that this pathology will gravely increase in the next few years. Unfortunately, there's currently no cure for this disease, indeed an early diagnosis of Parkinson's disease can help to better manage its symptoms and its evolution. One of the most frequent abilities and usually also the first manifestation of Parkinson's disease is alteration of handwriting.
View Article and Find Full Text PDFParkinson's disease (PD) is the second most common neurodegenerative disease affecting significant portion of elderly population. One of the most frequent hallmarks and the first manifestation of PD is deterioration of handwriting. Since the diagnosis of Parkinson's disease is difficult, researchers have worked to develop a support tool based on algorithms to separate healthy controls from PD patients.
View Article and Find Full Text PDFBackground And Methods: Stroke incidence and mortality are reported to have increased in the Middle-East and North African (MENA) countries during the last decade. This was a prospective observational study to examine the baseline characteristics of stroke patients in the MENA region and to compare the MENA vs. the non-MENA stroke cohort in the Safe Implementation of Treatments in Stroke (SITS) International Registry.
View Article and Find Full Text PDFBackground: Thrombolysis alert (TA) is a procedure triggered every time a patient consults for sudden focal neurological deficit within 4.5 hours.
Objective: We aimed to determine firstly the etiological profile of TA and secondly to evaluate the delays in the management not only of thrombolyzed patients but also of nonthrombolyzed patients to determine the intrahospital delays to optimize.
Cerebral venous thrombosis (CVT) is a rare origin of stroke, the clinical presentation and etiologies vary. The prognosis is shown to be better than arterial thrombosis. Magnetic Resonance Imaging (MRI) and MR Venograpgy (MRV) are currently important tools for the diagnosis.
View Article and Find Full Text PDFMarfan syndrome is a systematic genetic disease of the connective tissue. The cardiac affection would predict the prognosis and ischemic stroke might complicate it. The purpose of this work is to discuss the mechanisms of the ischemic stroke in Marfan syndrome which have to be considered in all young patients of ischemic strokes.
View Article and Find Full Text PDFBackground. Few studies have analysed the natural course of cerebral ischaemia for predicting outcome. We aimed to determine the early clinical findings and the thresholds for deficit severity and symptom duration that make it possible to stratify outcome.
View Article and Find Full Text PDFThe choice of imaging parameters for functional MRI can have an impact on the accuracy of functional localization by affecting the image quality and the degree of blood oxygenation-dependent (BOLD) contrast achieved. By improving sampling efficiency, parallel acquisition techniques such as sensitivity encoding (SENSE) have been used to shorten readout trains in single-shot (SS) echo planar imaging (EPI). This has been applied to susceptibility artifact reduction and improving spatial resolution.
View Article and Find Full Text PDFUnlabelled: The frequency and impact of in-patient assessment by a neurologist in the emergency room (ER) setting remain largely underestimated. The objective of our study was to analyse the impact of neurologist in-patient management.
Methods: Over a period of 12 months, we prospectively recorded the demographics of patients requiring examination in the ER, the ER team's tentative neurological diagnosis, the neurology team's final diagnosis and patient outcomes.