Publications by authors named "Juhani Ritvonen"
Introduction: After severe ischemic stroke (IS), circulating levels of symmetric dimethylarginine (SDMA) increase. We investigated the early dynamics of SDMA in stroke to potentially aid with prehospital identification of severe IS from hemorrhagic stroke (HS).
Methods: We performed targeted mass spectrometry (MS) measurements of SDMA in two sequential acute plasma samples (early and secondary) of 50 IS patients with LVO and 49 HS patients.
Article Synopsis
- - The study examines the outcomes of intravenous thrombolysis (IVT) in patients with basilar artery occlusion (BAO) and compares it to endovascular thrombectomy (EVT), noting that IVT has often been underrepresented in prior studies despite being effective beyond the usual treatment window.
- - Data from a cohort of 376 patients treated between 1995-2022 reveals that 65.2% received only IVT, with about 46.5% achieving favorable outcomes at 3 months, although there was a notable mortality rate of 35.9%.
- - Factors like younger age and less severe symptoms were linked to better outcomes for those treated solely with IVT, and the research used advanced
Background: Plasma glial fibrillary acidic protein (GFAP) and tau are promising markers for differentiating acute cerebral ischemia (ACI) and hemorrhagic stroke (HS), but their prehospital dynamics and usefulness are unknown.
Methods: We performed ultra-sensitivite single-molecule array (Simoa®) measurements of plasma GFAP and total tau in a stroke code patient cohort with cardinal stroke symptoms [National Institutes of Health Stroke Scale (NIHSS) ≥3]. Sequential sampling included 2 ultra-early samples, and a follow-up sample on the next morning.
Around 30-60% of patients with basilar artery occlusion (BAO) present with coma, which is often considered as a hallmark of poor prognosis. To examine factors that will help predict outcomes in patients with BAO comatose on admission. A total of 312 patients with angiography-proven BAO were analyzed.
View Article and Find Full Text PDFBackground: The data on long-term outcome after basilar artery occlusion (BAO) are scarce. Little is known about BAO survivors´ outcome over decades.
Aim: We set out to investigate long-term survival and causes of death in BAO patients with up to two decades of follow-up.
Background: Accurate identification of acute stroke by Emergency Medical Dispatchers (EMD) is essential for timely and purposeful deployment of Emergency Medical Services (EMS), and a prerequisite for operating mobile stroke units. However, precision of EMD stroke recognition is currently modest.
Aims: We sought to identify targets for improving dispatcher stroke identification.
Should we thrombolyse prior to endovascular treatment in acute stroke?
Clin Neurol Neurosurg
February 2019
The superiority of endovascular treatment (EVT) in acute stroke due to large vessel occlusion has been proven in recent randomized trials. Yet, there are no randomized trials which have tested the additive effect of standard treatment with intravenous thrombolysis (IVT) as pretreatment to EVT over EVT treatment alone. So far, the EVT treatment groups of RCTs most often had pretreatment with IVT.
View Article and Find Full Text PDFObjectives: To clarify diagnostic accuracy and consequences of misdiagnosis in the admission evaluation of stroke-code patients in a neurologic emergency department with less than 20-minute door-to-thrombolysis times.
Methods: Accuracy of admission diagnostics was studied in an observational cohort of 1,015 stroke-code patients arriving by ambulance as candidates for recanalization therapy between May 2013 and November 2015. Immediate admission evaluation was performed by a stroke neurologist or a neurology resident with dedicated stroke training, primarily utilizing CT-based imaging.