Prehospital neurologic deterioration in patients with intracerebral hemorrhage.

Objective: Early neurologic deterioration has been studied in patients with intracerebral hemorrhage during hospitalization, but rates and factors associated with prehospital neurologic deterioration (PND) are unknown. We sought to determine the prevalence of PND among patients with intracerebral hemorrhage during Emergency Medical Services transportation to the hospital.

Design: Historical cohort study.

Treatment of acute hypertension in patients with intracerebral hemorrhage using American Heart Association guidelines.

Objective: To determine the feasibility and safety of treatment of acute hypertension in patients with intracerebral hemorrhage within 24 hrs of symptom onset. Elevated blood pressure, observed in up to 56% of patients with intracerebral hemorrhage, may predispose to hematoma expansion; on the other hand, reduction of blood pressure may reduce hematoma expansion and subsequent death and disability.

Design: Single-center prospective registry supplemented by retrospective chart review.

High prevalence of previous antiplatelet drug use in patients with new or recurrent ischemic stroke: Buffalo metropolitan area and Erie County stroke study.

Study Objective: To determine the proportion of patients in a large metropolitan population who developed ischemic stroke despite having received antiplatelet drug therapy, and their associated characteristics and in-hospital outcomes.

Design: Retrospective, cross-sectional study.

Setting: Eleven hospitals in western New York State.

Endovascular treatment of subarachnoid hemorrhage.

Aneurysmal subarachnoid hemorrhage (aSAH) is a common and devastating form of stroke. A large number of patients with aSAH develop angiographic or clinical vasospasm responsible for high morbidity and mortality. Rapid advances in the field of interventional neurology and the development of minimally invasive techniques have resulted in expansion of potential therapeutic applications.

Advances in thrombolytics and mechanical devices for treatment of acute ischemic stroke.

Stroke is a leading cause of death and disability. Recently, there have been advances in the treatment of acute ischemic stroke aimed at re-establishing blood flow to the affected area in an effort to save the ischemic penumbra surrounding the area of infarction. This is achieved by the use of thrombolytics intravenously or intra-arterially.

Therapeutic advances in interventional neurology.

Rapid advances in the field of interventional neurology and the development of minimally invasive techniques have resulted in a great expansion of potential therapeutic applications. We discuss therapeutic interventional neurology as applied in clinical practice in one of the two possible ways: 1) embolization leading to occlusion of blood vessels; and 2) revascularization leading to reopening of blood vessels. These procedures can be applied to a broad range of cerebrovascular diseases.

An Update on Myasthenic Crisis.

Myasthenia gravis (MG) is the most common disorder of the neuromuscular junction. Myasthenia crisis, defined as respiratory failure requiring mechanical ventilation in MG, is a common life-threatening complication that occurs in approximately 15% to 20% of patients with MG during their life time. The advent of effective mechanical ventilation, specialized neurointensive care units and the widespread use of immunotherapies have substantially altered the prognosis of myasthenic crisis.

Buffalo metropolitan area and Erie County stroke study: rationale, design, and methods.

Objectives: The primary objective of this study was to define the incidence, disability, and death associated with stroke in the Buffalo metropolitan area and Erie County. This area has the highest stroke rate in New York State and therefore represents an ideal site to develop a successful model for prevention and management of stroke.

Design: A cross-sectional design to study all new and recurrent strokes that occurred in the calendar year 2000 in the geographical location of Buffalo metropolitan area and Erie County.