Publications by authors named "Simone Tonello"
Article Synopsis
- The study assesses the availability and effectiveness of treatments like intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) for acute ischemic stroke patients in the Veneto region of Italy from 2017 to 2021, using a "hub-and-spoke" model.
- Data from 23 stroke units showed a total of 6093 IVT treatments, 1114 combined IVT and MT treatments, and 921 MT-only treatments, revealing variation in treatment rates across regions and differences in access based on the unit's classification as a hub or spoke.
- Results indicate that while overall treatment goals set by the Action Plan for Stroke in Europe have been exceeded, there is still significant variability in access to MT treatments across
Background: Spontaneous intracranial hypotension (SIH) is a syndrome characterized by low cerebrospinal fluid (CSF) pressure and postural headaches, and affects 1 per 20,000 individuals every year.
Case Report: We report an otherwise healthy 38-year-old man admitted to the hospital with orthostatic headache that developed 48 h after a short-haul flight during which he sustained a neck injury due to turbulence. Neurological examination, blood analysis and computed tomography scan performed at the emergency service were normal.
Background: Efficiency of care chain response and hospital reactivity were and are challenged for stroke acute care management during the pandemic period of coronavirus disease 2019 (COVID-19) in North-Eastern Italy (Veneto, Friuli-Venezia-Giulia, Trentino-Alto-Adige), counting 7,193,880 inhabitants (ISTAT), with consequences in acute treatment for patients with ischemic stroke.
Methods: We conducted a retrospective data collection of patients admitted to stroke units eventually treated with thrombolysis and thrombectomy, ranging from January to May 2020 from the beginning to the end of the main first pandemic period of COVID-19 in Italy. The primary endpoint was the number of patients arriving to these stroke units, and secondary endpoints were the number of thrombolysis and/or thrombectomy.
Article Synopsis
- The study investigates how the time to treatment for ischemic stroke affects patient outcomes, comparing different types of stroke care facilities in Northeastern Italy.
- It analyzes data from 512 stroke patients treated in 25 Stroke Units, focusing on the effectiveness of treatments like intravenous thrombolysis and thrombectomy.
- Results show variations in treatment methods and outcomes between level 1 and level 2 Stroke Units, indicating that these differences may impact recovery rates and overall patient health after three months.
Intravenous thrombolysis (IVT) is the treatment of choice for most patients with acute ischemic stroke. According to the recently updated guidelines, IVT should be administered in absence of absolute exclusion criteria. We aimed to assess the proportion of ischemic strokes potentially eligible and actually treated with IVT, and to explore the reasons for not administering IVT.
View Article and Find Full Text PDFOver 10 years after European approval, thrombolysis is still limited by a restricted time window and non-optimal territorial coverage. Implementation of telestroke can give a growing number of patients access to treatment. We hereby present the first Italian telemedicine study applied to both the acute and the monitoring phase of stroke care.
View Article and Find Full Text PDFBackground And Purpose: Transient global amnesia (TGA) has been associated with an increased prevalence of internal jugular valve insufficiency and many patients report Valsalva-associated maneuvers before TGA onset. These findings have led to the assumption of hemodynamic alterations in intracranial veins inducing focal hippocampal ischemia. We investigated this hypothesis in patients with TGA and control subjects.
View Article and Find Full Text PDFBackground And Purpose: Internal carotid artery (ICA) elongation (coiling and kinking) has been suggested as a risk factor for carotid dissection. Since vasomotion is known to be impaired in spontaneous cervical vessel dissection, we investigated whether endothelial-dependent vasodilation in subjects with carotid coiling and kinking is compromised.
Methods: We undertook a case-control study using high-resolution ultrasound and measured flow-mediated dilation (FMD) of the brachial artery in 80 subjects with carotid elongation and in 80 age- and sex-matched healthy controls (HC).
Objective: To monitor the sonographic course of spontaneous cervical artery dissections (sCADs) and investigate their recanalization and recurrence rates.
Methods: All consecutive patients with an MRI-proven sCAD were prospectively evaluated by neurovascular ultrasound (nUS) daily while in hospital, then monthly for the first 6 months after discharge and every 6 months thereafter, for a mean follow-up period of 58 months (range, 28-96 months).
Results: A total of 105 sCADs were detected in 76 patients: 61 (58.
Background And Purpose: The etiology of spontaneous cervical artery dissection (sCAD) is still unknown, even though an underlying arteriopathy impairing vasomotion has often been suspected. This study was undertaken to investigate: (1) spontaneous, (2) endothelial-dependent, and (3) endothelial-independent vasodilation in patients with multiple sCAD.
Methods: In 19 consecutive patients with multiple carotid or vertebral artery dissections high-resolution ultrasound was used to assess spontaneous and endothelial-independent dilations (isosorbide dinitrate-mediated) in the common carotid, vertebral and brachial arteries, and endothelial-dependent dilation (flow-mediated arterial dilation) in the brachial arteries alone.