Subjects -> MEDICAL SCIENCES (Total: 8196 journals)
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EMERGENCY AND INTENSIVE CRITICAL CARE (121 journals)                     

Showing 1 - 124 of 124 Journals sorted alphabetically
AACN Advanced Critical Care     Full-text available via subscription   (Followers: 36)
Academic Emergency Medicine     Hybrid Journal   (Followers: 90)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
Acute and Critical Care     Open Access   (Followers: 9)
Acute Cardiac Care     Hybrid Journal   (Followers: 11)
Acute Medicine     Full-text available via subscription   (Followers: 8)
Advances in Emergency Medicine     Open Access   (Followers: 16)
Advances in Neonatal Care     Hybrid Journal   (Followers: 43)
African Journal of Anaesthesia and Intensive Care     Full-text available via subscription   (Followers: 7)
African Journal of Emergency Medicine     Open Access   (Followers: 7)
AINS - Anasthesiologie - Intensivmedizin - Notfallmedizin - Schmerztherapie     Hybrid Journal   (Followers: 5)
American Journal of Emergency Medicine     Hybrid Journal   (Followers: 54)
Annals of Emergency Medicine     Hybrid Journal   (Followers: 126)
Annals of Intensive Care     Open Access   (Followers: 37)
Annals of the American Thoracic Society     Full-text available via subscription   (Followers: 15)
Archives of Academic Emergency Medicine     Open Access   (Followers: 6)
Archives of Trauma Research     Open Access   (Followers: 4)
ASAIO Journal     Hybrid Journal   (Followers: 2)
Australasian Journal of Paramedicine     Open Access   (Followers: 7)
Australian Critical Care     Full-text available via subscription   (Followers: 21)
Bangladesh Critical Care Journal     Open Access   (Followers: 1)
BMC Emergency Medicine     Open Access   (Followers: 25)
BMJ Quality & Safety     Hybrid Journal   (Followers: 65)
Burns Open     Open Access  
Canadian Journal of Respiratory, Critical Care, and Sleep Medicine     Hybrid Journal   (Followers: 2)
Case Reports in Acute Medicine     Open Access   (Followers: 3)
Case Reports in Critical Care     Open Access   (Followers: 13)
Case Reports in Emergency Medicine     Open Access   (Followers: 19)
Chronic Wound Care Management and Research     Open Access   (Followers: 7)
Clinical and Applied Thrombosis/Hemostasis     Open Access   (Followers: 32)
Clinical Intensive Care     Hybrid Journal   (Followers: 6)
Clinical Medicine Insights : Trauma and Intensive Medicine     Open Access   (Followers: 3)
Clinical Risk     Hybrid Journal   (Followers: 5)
Crisis: The Journal of Crisis Intervention and Suicide Prevention     Hybrid Journal   (Followers: 15)
Critical Care     Open Access   (Followers: 74)
Critical Care and Resuscitation     Full-text available via subscription   (Followers: 29)
Critical Care Clinics     Full-text available via subscription   (Followers: 34)
Critical Care Explorations     Open Access   (Followers: 3)
Critical Care Medicine     Hybrid Journal   (Followers: 279)
Critical Care Research and Practice     Open Access   (Followers: 13)
Current Emergency and Hospital Medicine Reports     Hybrid Journal   (Followers: 5)
Current Opinion in Critical Care     Hybrid Journal   (Followers: 73)
Disaster and Emergency Medicine Journal     Open Access   (Followers: 12)
Egyptian Journal of Critical Care Medicine     Open Access   (Followers: 2)
EMC - Urgenze     Full-text available via subscription  
Emergency Care Journal     Open Access   (Followers: 7)
Emergency Medicine (Medicina neotložnyh sostoânij)     Open Access  
Emergency Medicine Australasia     Hybrid Journal   (Followers: 17)
Emergency Medicine Clinics of North America     Full-text available via subscription   (Followers: 19)
Emergency Medicine International     Open Access   (Followers: 8)
Emergency Medicine Journal     Hybrid Journal   (Followers: 53)
Emergency Medicine News     Full-text available via subscription   (Followers: 7)
Emergency Nurse     Full-text available via subscription   (Followers: 17)
Enfermería Intensiva (English ed.)     Full-text available via subscription  
European Burn Journal     Open Access   (Followers: 10)
European Journal of Emergency Medicine     Hybrid Journal   (Followers: 23)
Frontiers in Emergency Medicine     Open Access   (Followers: 8)
Global Journal of Transfusion Medicine     Open Access   (Followers: 1)
Hong Kong Journal of Emergency Medicine     Full-text available via subscription   (Followers: 5)
Indian Journal of Burns     Open Access   (Followers: 2)
Injury     Hybrid Journal   (Followers: 20)
Intensive Care Medicine     Hybrid Journal   (Followers: 82)
Intensive Care Medicine Experimental     Open Access   (Followers: 2)
Intensivmedizin up2date     Hybrid Journal   (Followers: 4)
International Journal of Critical Illness and Injury Science     Open Access   (Followers: 1)
International Journal of Emergency Medicine     Open Access   (Followers: 9)
International Journal of Emergency Mental Health and Human Resilience     Open Access   (Followers: 2)
International Paramedic Practice     Full-text available via subscription   (Followers: 14)
Iranian Journal of Emergency Medicine     Open Access  
Irish Journal of Paramedicine     Open Access   (Followers: 2)
Journal Européen des Urgences et de Réanimation     Hybrid Journal   (Followers: 1)
Journal of Acute Care Physical Therapy     Hybrid Journal   (Followers: 3)
Journal of Cardiac Critical Care TSS     Open Access   (Followers: 1)
Journal Of Cardiovascular Emergencies     Open Access  
Journal of Concussion     Open Access  
Journal of Critical Care     Hybrid Journal   (Followers: 48)
Journal of Critical Care Medicine     Open Access   (Followers: 18)
Journal of Education and Teaching in Emergency Medicine     Open Access   (Followers: 1)
Journal of Emergencies, Trauma and Shock     Open Access   (Followers: 13)
Journal of Emergency Medical Services     Full-text available via subscription   (Followers: 12)
Journal of Emergency Medicine     Hybrid Journal   (Followers: 53)
Journal of Emergency Medicine, Trauma and Acute Care     Open Access   (Followers: 25)
Journal of Emergency Practice and Trauma     Open Access   (Followers: 6)
Journal of Intensive Care     Open Access   (Followers: 9)
Journal of Intensive Care Medicine     Hybrid Journal   (Followers: 22)
Journal of Intensive Medicine     Open Access  
Journal of Neuroanaesthesiology and Critical Care     Open Access   (Followers: 3)
Journal of Stroke Medicine     Hybrid Journal  
Journal of the American College of Emergency Physicians Open     Open Access   (Followers: 1)
Journal of the Intensive Care Society     Hybrid Journal   (Followers: 4)
Journal of the Royal Army Medical Corps     Hybrid Journal   (Followers: 6)
Journal of Thrombosis and Haemostasis     Hybrid Journal   (Followers: 81)
Journal of Translational Critical Care Medicine     Open Access   (Followers: 5)
Journal of Trauma and Acute Care Surgery, The     Hybrid Journal   (Followers: 34)
La Presse Médicale Open     Open Access  
Médecine de Catastrophe - Urgences Collectives     Hybrid Journal  
Medicina Intensiva     Open Access   (Followers: 3)
Medicina Intensiva (English Edition)     Hybrid Journal   (Followers: 1)
Mediterranean Journal of Emergency Medicine & Acute Care : MedJEM     Open Access  
Notfall + Rettungsmedizin     Hybrid Journal   (Followers: 3)
OA Critical Care     Open Access   (Followers: 3)
OA Emergency Medicine     Open Access   (Followers: 2)
Open Access Emergency Medicine     Open Access   (Followers: 6)
Open Journal of Emergency Medicine     Open Access   (Followers: 2)
Palliative Care : Research and Treatment     Open Access   (Followers: 19)
Palliative Medicine     Hybrid Journal   (Followers: 54)
Prehospital Emergency Care     Hybrid Journal   (Followers: 19)
Regulatory Toxicology and Pharmacology     Hybrid Journal   (Followers: 41)
Research and Opinion in Anesthesia and Intensive Care     Open Access   (Followers: 3)
Resuscitation     Hybrid Journal   (Followers: 54)
Resuscitation Plus     Open Access   (Followers: 2)
Saudi Critical Care Journal     Open Access   (Followers: 2)
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine     Open Access   (Followers: 11)
Seminars in Thrombosis and Hemostasis     Hybrid Journal   (Followers: 46)
Shock : Injury, Inflammation, and Sepsis : Laboratory and Clinical Approaches     Hybrid Journal   (Followers: 10)
Sklifosovsky Journal Emergency Medical Care     Open Access  
The Journal of Trauma Injury Infection and Critical Care     Full-text available via subscription   (Followers: 24)
Therapeutics and Clinical Risk Management     Open Access   (Followers: 2)
Transplant Research and Risk Management     Open Access  
Trauma Case Reports     Open Access   (Followers: 1)
Trauma Monthly     Open Access   (Followers: 3)
Visual Journal of Emergency Medicine     Full-text available via subscription   (Followers: 1)
Western Journal of Emergency Medicine     Open Access   (Followers: 11)
 AEM Education and Training : A Global Journal of Emergency Care     Open Access   (Followers: 1)

           

Similar Journals
Journal Cover
Journal of Stroke Medicine
Number of Followers: 0  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 2516-6085 - ISSN (Online) 2516-6093
Published by Sage Publications Homepage  [1174 journals]
  • Effect of Decompression Craniectomy on Survival and Functional Outcome in
           Patients with COVID-19 and Malignant Infarct: A Retrospective Cohort Study
           and Review of Literature

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      Authors: Pachipala Sudheer, Saranya B. Gomathy, Ayush Agarwal, Venugopalan Y. Vishnu, Awadh K. Pandit, Vibha Deepti, Rohit Bhatia, Padma M. V. Srivastava
      Pages: 48 - 55
      Abstract: Journal of Stroke Medicine, Volume 5, Issue 1, Page 48-55, June 2022.
      Background and objectiveAmongst the varied neurological manifestations of COVID-19 infection, stroke is one of the common complications. A large portion of patients had large vessel occlusion (LVO) which increases the risk of malignant cerebral infarction requiring decompressive craniectomy. The impact of COVID-19, however, on decompressive craniectomy is not well described. Through this study, we aim to study the impact of decompressive craniectomy in COVID-19 patients presented to our tertiary care hospital.Material and methodsData of all acute ischemic stroke patients who tested COVID positive during the study period was collected. From among them, patients requiring decompressive craniectomy were included. The demographic, clinico-radiological parameters related to stroke, treatment received, outcome and complications were noted. In addition, data from all case reports and case series published on patients with COVID-19, who had developed ischemic stroke and underwent decompression craniectomy was collected and systematically reviewed.ResultsTwenty-seven stroke patients tested positive for COVID-19 infection, out of whom five patients underwent decompression hemicraniectomy in view of neurologic deterioration. The review of literature yielded 453 abstracts. After reading the full text of 69 articles, 12 studies on 15 patients finally met our inclusion criteria and were included in the systematic review. The mortality rate was 40% among stroke patients requiring decompressive craniectomy in COVID-19 patients. The mortality rate and functional outcomes of this cohort are comparable to the pre-pandemic period.ConclusionDecompressive craniectomy is a life-saving procedure in COVID-19 patients with malignant infarctions similar to patients in the pre-COVID-19 era.
      Citation: Journal of Stroke Medicine
      PubDate: 2022-06-29T04:48:29Z
      DOI: 10.1177/25166085221098914
      Issue No: Vol. 5, No. 1 (2022)
       
  • Bilateral Cerebral Infarctions Secondary to Unilateral ICA Stenosis

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      Authors: Dhananjay Gupta, Karan Sharma, Dhaval Thakkar, Nishchint Jain, Rajsrinivas Parthasarathy, Vipul Gupta
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      A 76-year-old diabetic man presented to us with complaints of sudden-onset right-sided weakness for the last 4 days. On evaluation, he was found to have right hemiparesis (Modified Medical Research Council grade 4-/5) along with left leg weakness (4+/5). Neuroimaging revealed acute infarcts in the right anterior cerebral artery (ACA) territory and left cerebral external watershed territory. Magnetic resonance (MR) angiogram of the brain showed a hypoplastic right A1-ACA with bilateral A2-ACA arising from the left A1-ACA (bi-hemispheric A1-ACA). MR angiogram of the neck revealed significant left internal carotid artery (ICA) origin stenosis. It was concluded that the origin of right A2-ACA from left ACA was the probable because of right ACA infarcts, along with left cerebral watershed infarcts (embolic phenomenon). This represents a very important variation, as in these cases, even a unilateral ICA stenosis can lead to bilateral ACA stroke and thus necessitates urgent revascularization.
      Citation: Journal of Stroke Medicine
      PubDate: 2022-07-13T12:07:56Z
      DOI: 10.1177/25166085221094667
       
  • Assessment of Outcomes After Decompressive Craniectomy—An
           Institutional-Based Study from India

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      Authors: Madhavi Karri, Balakrishnan Ramasamy, Angel P. Varghese
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      Background:Decompressive craniectomy (DC) is a life-saving treatment modality for acute malignant strokes. We aimed to identify the risk factors and assess the long-term functional outcome in patients with malignant stroke undergoing DC.Methods:We conducted an ambispective study on patients (>18 years) undergoing DC between January 2016 and January 2019. Demographic data, stroke risk factors, clinical characteristics, and serial imaging findings were collected. We measured the functional outcomes using the National Health Stroke Scale (NIHSS), Glasgow Coma Scale (GCS), modified Ranking Scale (mRS), and Barthel index (BI) at 3, 6, and 12 months postoperatively. We did univariate and multivariate regression analyses for the independent variables and outcomes.Results:On admission, the 93 patients (70 males) had a mean GCS of 11.77 (standard deviation [SD]: 2.90) and a mean NIHSS score of 13.65 (SD: 4.41). Diabetes (odds ratio [OR]: 1.76; 0.67-4.46, 95% confidence interval [CI]) and ischemic heart disease (OR: 4.50; 1.44-14.07, 95% CI) showed a positive correlation with the outcome. Forty patients underwent surgery within 48 h of stroke onset, while 53 patients were operated on after 48 h. Twenty-two (23.66%) patients died during the study period, and 55 patients (59.14%) had an mRS score
      Citation: Journal of Stroke Medicine
      PubDate: 2022-06-27T04:30:28Z
      DOI: 10.1177/25166085221104914
       
  • Role of Retinal Vessel Caliber Assessment in Predicting Hemorrhagic
           Stroke—Emerging Concepts

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      Authors: Sudha Menon, Girish Menon
      First page: 7
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      Retinal vessels provide an indirect window to the status of cerebral vasculature. Pathological changes in cerebral vessels secondary to hypertension and other predisposing conditions precede the onset of hemorrhagic stroke. Retinal vessel assessment may help in early detection of these changes and several studies have shown that retinal vessel caliber assessment can be a valuable tool in the primary prevention of hemorrhagic stroke. Technical considerations have been a limiting factor in the widespread use of this simple user friendly tool. However, recent technological and software advances especially in the realm of artificial intelligence and machine learning have simplified the procedure. This article explores the current status and future prospects of this extremely promising tool.
      Citation: Journal of Stroke Medicine
      PubDate: 2022-03-17T05:47:26Z
      DOI: 10.1177/25166085221082440
       
  • Statistical Analysis Plan for the Secondary Prevention by Structured
           Semi-Interactive Stroke Prevention Package in INDIA (SPRINT INDIA): A
           Randomized Controlled Trial

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      Authors: Himani Khatter, Jeyaraj D. Pandian, Mahesh Kate, Sankara Sarma, PN Sylaja, Dheeraj Khurana, Pamidimukkala Vijaya, Biman Kanti Ray, Vivek Nambiar, Sanjith Aaron, Tina George, Gaurav Mittal, Ivy Sebastian, Nagarjunakonda V. Sundarachary, Aparna R. Pai, Sankar Gorthi, Kumaravelu Somasundaram, Meenakshi Sharma, Rupinder Dhaliwal, Y. Muralidhar Reddy, Sunil Narayan, NC Borah, Rupjyoti Das, Girish B. Kulkarni, Vikram Huded, Thomas Mathew, Padma MV Srivastava, Rohit Bhatia, Pawan Ojha, Jayanta Roy, Sherly Abraham, Jemin Webster, Anand Vaishnav, Arvind Sharma, Shaik A. Jabeen, Abhishek Pathak, Sanjeev Bhoi, Sudheer Sharma, Sulena Sulena, Aralikatte Onkarappa Saroja, Neetu Ramrakhiani, Madhusudhan B. Kempegowda, Deepti Arora, Shweta J. Verma, Rahul Huilgol, Aneesh Dasan, Vishnu Renjith
      First page: 14
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      BackgroundRecurrent stroke is one of the major causes of death in stroke patients. Introducing stroke prevention education package to improve the lifestyle behavioral factors could reduce the vascular events. The Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package (SPRINT) study in India aims to assess the role of a stroke prevention education package to reduce recurrent strokes, myocardial infarction, and death in patients with stroke. The objective is to formulate the detailed statistical analysis plan for the SPRINT India prior to trial unblinding.MethodsThe plan was developed by trial statisticians with the help of principal investigator and management team of the SPRINT study. The chosen primary and secondary outcome measures and knowledge of critical baseline data were used to construct the statistical analysis plan. All collected data will be thoroughly reviewed. Patient baseline characteristics will be summarized with relevant descriptive statistics. The findings are planned and explained for the most appropriate statistical comparison between the groups.ResultsThe final statistical analysis plan corresponds to established criteria and will allow for transparent and efficient reporting.ConclusionsThe SPRINT trial statistical analysis plan is developed in order to avoid analysis bias arising from prior knowledge of findings and to explicitly summarize prespecified analyses.
      Citation: Journal of Stroke Medicine
      PubDate: 2022-06-01T08:42:50Z
      DOI: 10.1177/25166085221098928
       
  • Predictors of Recurrence in Symptomatic Large Artery Atherosclerosis and
           Cryptogenic Strokes—A Comparative Study

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      Authors: Radhika Sanjay Lotlikar, Karkala Saikiran, Jithin George, Narayanan Namboodiri, P. N. Sylaja, Sapna Erat Sreedharan
      First page: 21
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      Background and Purpose:Ischemic stroke has highest recurrence risk in the first-year, ranging from 5.7% to 14%, depending on etiology, with highest reported following cardioembolism and large artery atherosclerosis (LAA), while it is not negligible in cryptogenic strokes. We evaluated the utility of clinical, imaging parameters along with electrographic and echocardiographic biomarkers of atrial dysfunction in 2 etiological groups, namely LAA and cryptogenic strokes and compared the predictors of recurrence risk at 1 year.Methodology:All acute ischemic strokes admitted to Comprehensive Stroke Care Centre, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India for 1 year (July 2019 till June 2020) with 1 year completed follow-up were screened from electronic records. Strokes secondary to LAA and undetermined cause were compared for their clinical, imaging, and cardiac variables to predict risk of recurrence in the first year.Results:Of the 179 patients, 93 had strokes secondary to LAA and 86 had cryptogenic strokes (CS). Seventy-five patients had more than 1 event at presentation/follow-up. Recurrence risk did not differ between the 2 etiological subgroups at 1 year. Hypertension (P = .016), multiple territory strokes (P = .02), and dilated left ventricle (LA) chamber (P = .047) were independently associated with recurrence risk in the entire cohort as well as within the undetermined group. Early hospitalization within 48 h reduced the overall recurrence risk (P = .01), thus emphasizing the role of early etiological evaluation and initiation of secondary prevention in reducing future events, irrespective of etiology.Conclusion:In optimally managed LAA and cryptogenic strokes, presence of hypertension, multiterritorial infarcts, and dilated LA chambers increases the recurrence risk pointing to a likely cardiac substrate itself contributing to future stroke risk.
      Citation: Journal of Stroke Medicine
      PubDate: 2022-03-08T12:40:21Z
      DOI: 10.1177/25166085221082403
       
  • Treatment-Seeking Behavior of the Public During an Acute Stroke or Cardiac
           Event—Health-Care Expert’s Perspective From Kerala, India

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      Authors: Manesh Muraleedharan, Alaka Omprakash Chandak
      First page: 26
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      Early treatment seeking during a stroke or heart attack is critical to prevent mortality and disability. This study has aimed to understand the perceptions of health-care experts in the state regarding the “emergency healthcare-seeking behavior of Kerala population during an acute stroke or heart attack.” An interpretative phenomenological analysis (IPA) was utilized in the study. Semi-structured interviews with health-care experts were conducted, and the data were analyzed linguistically. Later, interpretations were made based on the themes and literature review. We interviewed 7 health experts, and data were analyzed using the IPA method. Major concerns raised by the health experts include health financing issues, the disparity in treatment-seeking response based on socioeconomic status, less awareness regarding stroke in public, and so on.
      Citation: Journal of Stroke Medicine
      PubDate: 2022-03-12T06:51:04Z
      DOI: 10.1177/25166085221082425
       
  • Cerebral Venous Sinus Thrombosis (CVST) as a Complication of SARS-COV2
           Infection

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      Authors: Shripad S. Pujari, Pawan K. Ojha, Rahul V. Kulkarni, Sumit Kharat, Dulari Gupta, Rakesh Lalla, Keyur Panchal, Priyanka S. Walzade, Nilesh Palasdeokar, Dattatraya Nadgir, Satish Nirhale, Pramod Dhonde, Nasli Ichaporia, Sujit A. Jagtap, Ameet Dravid, Bharat Purandare, Sameer Jog, Zafer Khan, Chandrashekhar Meshram
      First page: 32
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      Background and Purpose:Severe acute respiratory syndrome coronavirus 2 (SARS-COV2) infection induces a prothrombotic state frequently associated with arterial ischemic strokes. Cerebral venous sinus thrombosis (CVST) is also reported with corona virus disease-19 (COVID-19) but a large cohort study is lacking. Our aim was to study the characteristics, treatment response, and outcomes of CVST occurring in association with COVID-19 (COVID-CVST) and the causal relationship with COVID-19.Methods:Data of 34 patients admitted in COVID facility and suffering from CVST and SARS-COV2 infection was studied with respect to their clinic-radiological and lab features, predisposing factors, treatment, and outcome.Observations and Results:15 patients with CVST were detected positive for COVID but remained asymptomatic for the same. 14 patients had CVST along with symptoms of COVID, whereas 5 had CVST after recovery from COVID, at an average of 18 days after COVID-19. 4 patients were on aspirin as prophylaxis against thrombo-embolic events. The number of males exceeded females (22:12), conventional risk factors were seen in only 8 patients (postpartum state-3, alcohol abuse-2 and anemia-3), whereas the majority (26/34) showed none of them. The mean serum homocysteine level was normal and antiphospholipid antibody was tested normal in the assessed subjects. D-dimer and C reactive protein were elevated in all. 4 symptomatic patients who suffered from severe pneumonia died because of systemic complications.Conclusion:COVID-19 predisposes to CVST and the outcome is related to the severity of COVID pneumonia. CVST related to COVID occurs during or after a few weeks of COVID pneumonia and can also be seen in asymptomatic SARS-COV2 infection. COVID-19 can occur independently or in association with traditional thrombotic risk factors which increase the risk and severity of CVST in COVID. If recognized early, CVST associated with COVID can usually be treated effectively to achieve a very good outcome.
      Citation: Journal of Stroke Medicine
      PubDate: 2022-04-11T05:56:55Z
      DOI: 10.1177/25166085221089731
       
  • Evaluation of Neutrophil-to-Lymphocyte Ratio Among Ischemic Stroke
           Subtypes and Stroke Severity

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      Authors: Dhrumil Shah, Rajeswari Rajan, Anuradha Batra, Ish Anand, Amrita Saraf, Prahlad Sethi
      First page: 40
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      IntroductionRecently, neutrophil-to-lymphocyte ratio (NLR) has been proven to be useful in predicting severity, mortality, and morbidity of stroke. NLR is low cost and yet not used widely as a biomarker to predict prognosis.AimsWe evaluated the association of NLR in severity of stroke and ischemic stroke subtypes.MethodologyA total of 69 subjects with ischemic stroke onset within 24 h were included in the study and categorized according to TOAST classification. National Institutes of Health Stroke Scale was used to determine stroke severity at admission. Samples were obtained within 24 h of stroke onset and NLR measured which was later correlated with severity and subtypes of stroke.ResultsNLR and severity of stroke showed statistically significant association (P < .05). Median (interquartile range [IQR]) of NLR was significantly high in severe cases (7.1 [4.03-7.698]), as compared to others. The area under the receiver operating characteristic curve for NLR to predict the stroke severity was 6.07 [area under the curve 0.764; 95% confidence interval: 0.647 to 0.858). When NLR was more than 6.07, there was 90.90% chances of moderate-to-severe stroke and with milder stroke, 93.10% had NLR of less than equal to 6.07. NLR and stroke subtypes also showed statistically significant association (P < .05). Median (IQR) of NLR in embolic stroke was significantly high (4.75 [2.95-8.2]), as compared to other stroke subtypes.ConclusionNLR, at a cut-off 6, has moderate sensitivity and higher specificity in predicting stroke severity and NLR was high in embolic stroke among other stroke subtypes.
      Citation: Journal of Stroke Medicine
      PubDate: 2022-05-04T11:28:33Z
      DOI: 10.1177/25166085221095183
       
  • Tenecteplase for Thrombolysis in Acute Ischemic Stroke and Its
           Outcome—An Indian Experience

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      Authors: Madhavi Karri, Balakrishnan Ramasamy
      First page: 56
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      Background:Stroke has been a growing concern with increasing morbidity and mortality worldwide. Tenecteplase has been approved in India as a newer thrombolytic, in acute ischemic stroke, since 2016. Very few studies have been reported to know the efficacy of Tenecteplase in AIS compared to alteplase.Aim:This study was done to understand the efficacy and related complications of Tenecteplase in AIS.Methods:In this prospective study, we took 112 people with AIS who received Tenecteplase, admitted between August 2018 and August 2020. After obtaining ethical approval, we tabulated patients’ data and did the statistical analysis using an unpaired t test, Analysis of Variance, and chi-square test. A P value of
      Citation: Journal of Stroke Medicine
      PubDate: 2022-05-20T05:14:03Z
      DOI: 10.1177/25166085221098905
       
  • Reperfusion Injury in the Cord—Rare Case of Pediatric White Cord
           Syndrome

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      Authors: Geethanjali Sundaram, Rohit Balasubramanian, Navya Christopher, Shriram Varadharajan, Seetharaman Cannane
      First page: 62
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      Background:Postoperative neurological deficits following spinal decompression are often caused due to an expanding hematoma or other iatrogenic injuries. When a definitive etiology could not be identified, it may rarely be related to a reperfusion injury. Such unexplained neurological deficits are often associated with the presence of cord signal changes on imaging. It is assumed to result from ischemia-reperfusion injury and is often designated as “white cord syndrome” due to its imaging appearance. Such a diagnosis is made after excluding other differentials. Outcomes are variable based on the current literature. We report a patient with possible white cord syndrome following decompression and excision of cervicodorsal osteochondroma.Case Description:In this case report, we present a young patient who was admitted with slowly progressive paraplegia, and initial imaging showed C7-D1 pedunculated osteochondroma. He underwent an uneventful spinal laminectomy accompanied by tumor excision. In the immediate postoperative period, the patient became paraplegic and a follow-up magnetic resonance imaging was taken. It showed re-expansion of cord in the region of compression by the mass lesion at C7-D1 level with interval abnormal T2/IR hyper intensity extending from C6 to D1 levels.Conclusion:White cord syndrome is an extremely rare condition. It is postulated to be caused by reperfusion injury to the cord within areas of chronic ischemia due to compressive causes. We describe a child with white cord syndrome following decompression and excision of an osteochondroma.
      Citation: Journal of Stroke Medicine
      PubDate: 2022-05-12T07:55:02Z
      DOI: 10.1177/25166085221096509
       
  • Acute Revascularization Induced Reversed Robin Hood Syndrome

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      Authors: Mukesh Kumar, Dheeraj Khurana, Aditya Choudhary, Chirag Kamal Ahuja
      First page: 65
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      Paradoxical intracranial hemodynamic steal (IHS) is a contradictory reduction of cerebral blood flow volume in the territory of the impaired perfusion area occurring spontaneously or in response to vasodilatory stimuli, which can be recorded and evaluated on transcranial doppler (TCD). IHS followed by early neurological worsening (change in National Institute of Health Stroke Scale [NIHSS]> 2) in acute ischemic stroke patients has been described as reversed Robin Hood syndrome (RRHS). We describe two cases of RRHS following carotid artery stenting (CAS) in patients with contralateral carotid occlusion and its further management.Two patients with a history of anterior circulation strokes presented with recent complaints of dizziness and a sensation of being pulled back (patient 1), and episodic numbness of upper limbs (patient 2). On CT angiogram, both of the patients had severe extracranial internal carotid artery (ICA) stenosis on the symptomatic side associated with complete occlusion of the ICA on the contralateral side. In addition, both patients had impaired vasomotor reactivity (VMR) on TCD in the bilateral middle cerebral artery (MCA). Therefore, CAS on the symptomatic side was performed in both patients by femoral artery access without any periprocedural and postprocedural complications. However, on day 1 post CAS, complaints of transient upper limb tingling (patient 1) and limb shaking (patient 2) were reported corresponding to the completely occluded ICA, and TCD examinations confirmed RRHS in both patients. Patients were managed by decreasing the dose of antihypertensive medication to augment the blood pressure for 2 weeks. Normalization of the VMR on TCD was seen on follow-up, and both patients remain asymptomatic.
      Citation: Journal of Stroke Medicine
      PubDate: 2022-04-08T10:09:25Z
      DOI: 10.1177/25166085221082407
       
  • Bilateral Carotid Stenosis in a Patient with Previous Neck Surgery:
           Difficulties in Endarterectomy

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      Authors: Arunmozhimaran Elavarasi, Sunil K. Narayan, Sai Chandran, Durga Prasad Rath
      First page: 69
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      Carotid stenosis is an important cause of recurrent transient ischemic attacks and stroke. Carotid stenting and endarterectomy are considered equally effective in treating this condition. We report a patient with recurrent TIA and bilateral carotid stenosis who had undergone anterior cervical diskectomy and fusion and who was found to have fibrous bands encasing the right carotid artery. He was treated with endarterectomy on the left side and carotid stenting on the right side. With the widespread availability of procedures like carotid endarterectomy, more older people would undergo this surgery, who might have undergone anterior cervical surgery. Prior neck surgery and adhesions may lead to altered anatomy, risk of increased blood loss, and surgical complications. In such cases, carotid stenting could be an alternative to endarterectomy.
      Citation: Journal of Stroke Medicine
      PubDate: 2022-03-18T03:38:06Z
      DOI: 10.1177/25166085221082410
       
  • Isolated Oculomotor Nuclear Infarction: A Rare Clinical Scenario

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      Authors: Jomal Mathew
      First page: 71
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      Selective infarction of the oculomotor nuclear complex without accompanying long tract involvement is an exceedingly rare event with distinctive clinical features. The complicated topographical distribution of the various nuclei within the complex can result in diverse clinical presentation.
      Citation: Journal of Stroke Medicine
      PubDate: 2022-03-31T12:09:26Z
      DOI: 10.1177/25166085221082409
       
  • Neuroimaging in COVID-19 Patients on Mechanical Ventilation Receiving
           Sedation: Insight Beyond Diagnosis: A Case Series

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      Authors: Pachipala Sudheer, Ayush Agarwal, V. Y. Vishnu, Awadh Kishor Pandit, Deepti Vibha, Rohit Bhatia, M. V. Padma Srivastava
      First page: 73
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      Patients with severe COVID-19 are at risk of thrombotic complications such as deep vein thrombosis, pulmonary thromboembolism, myocardial infarction, and stroke. The incidence of strokes following COVID-19 is reported to be around 1.2%. There has been increased incidence with COVID-19 of large vessel strokes, especially in young patients without any known vascular risk factors. We reported four patients with severe COVID-19-associated acute respiratory distress syndrome where stroke was diagnosed following neuroimaging. All the patients were on ventilatory assistance and supportive treatment when stroke was diagnosed. They had received sedation and paralytics during mechanical ventilation. Poor response to stimulation and nonresponsiveness after wearing off sedation prompted neuroimaging in these patients, which revealed stroke. Incidentally, all these patients had hypernatremia when stroke was diagnosed. This case series suggests that stroke should be considered a possible cause in all COVID-19 patients presenting with abnormal or altered sensorium.
      Citation: Journal of Stroke Medicine
      PubDate: 2022-04-20T12:36:28Z
      DOI: 10.1177/25166085221085780
       
  • Posterior Reversible Encephalopathy Syndrome (PRES) Associated With
           COVID-19 Infection—A Case Report and Review

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      Authors: Shamik Shah, Urvish Patel, Neev Mehta, Pratik Shingru
      First page: 78
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      Coronavirus disease 2019 (COVID-19) has caused a large number of systemic complications including a variety of neurological complications. Some of the neurological complications are not known. Posterior reversible encephalopathy syndrome (PRES) is a known acute neurotoxic syndrome causing a wide range of neurological symptoms. If remains untreated, it can potentially become a life-threatening condition. However, it is not a known neurological complication of COVID-19. We describe a presentation of PRES in a patient with positive COVID-19 and presented with altered mental status. A 78-year-old male with history of idiopathic epilepsy was initially admitted with respiratory illness with negative COVID-19 test. Later during his hospitalization, his respiratory condition got worse and his repeat COVID-19 test came back positive. He had continued encephalopathy and was found to have status epilepticus afterward. Magnetic Resonance Imaging brain showed extensive PRES-related changes. His blood pressure remained overall within control without significant fluctuations. No other apparent etiology was identified for PRES except for possible correlation with COVID-19. Clinicians should consider PRES early in their differential diagnoses in patients with severe COVID-19 with continued encephalopathy.
      Citation: Journal of Stroke Medicine
      PubDate: 2022-01-13T05:56:40Z
      DOI: 10.1177/25166085211069861
       
  • Carotid Occlusion Associated With Eosinophilia and Proteinuria: Potential
           Diagnostic Clues or Red Herrings'

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      Authors: Arunmozhimaran Elavarasi, Sunil K. Narayan, Sreejith Parameswaran, Debasis Gocchait
      First page: 85
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      Nephrotic syndrome and hypereosinophilic syndrome both are uncommon causes of arterial stroke. We had a young patient with internal carotid artery occlusion, who had both these rare associations and was found to have membranous nephropathy. Idiopathic hypereosinophilia was treated with corticosteroids and conventional parasiticidal therapy with the intention of bringing down the eosinophil count. Nephrotic syndrome was also treated with corticosteroids and immunosuppression with cyclophosphamide. Hematologic abnormalities are an important cause of arterial thrombosis with effective secondary prevention strategies. Similarly, nephrotic syndrome is not to be missed as early treatment may prevent vascular complications. While cause-effect associations remained presumptive and a single diagnostic label elusive, the patient was recognized and treated early and had a good prognosis. However, other common causes of stroke should always be worked up for, and vigilant follow-up mandatory for prevention and treatment of recurrences which can have devastating sequelae such as total blindness and other vascular outcomes.
      Citation: Journal of Stroke Medicine
      PubDate: 2022-03-17T09:13:02Z
      DOI: 10.1177/25166085221082433
       
  • Transbrachial access for mechanical thrombectomy in a case of acute
           ischemic stroke with aortic bifurcation occlusion

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      Authors: Vikas Bhatia, Neha Choudhary, Anuj Prabhakar, Ajay Kumar, Dheeraj Khurana
      First page: 91
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      Objective:To report successful mechanical thrombectomy through transbrachial route in a patient with left middle cerebral artery (MCA) stroke and aortic bifurcation occlusion.Background:Mechanical thrombectomy is the standard therapeutic approach for eligible candidates of acute ischemic stroke according to American Heart Association/American Stroke Association guidelines. Mostly, a transfemoral approach is used to perform mechanical thrombectomy. Few studies have shown use of radial route for this procedure. Few reports have shown alternate access routes for performing mechanical thrombectomy when transfemoral or radial routes are not accessible.Design/Methods:Case report and literature review.Results:A 51-year-old female presented with left MCA stroke. Computed tomography angiography showed left internal carotid artery T occlusion extending into left MCA. Associated left atrial thrombus and occlusion at the aortic bifurcation were diagnosed in this patient. A transbrachial route was taken to perform mechanical thrombectomy in this patient resulting in complete recanalization.Conclusion:This case emphasizes the role of alternate access routes to perform mechanical thrombectomy in challenging situations.
      Citation: Journal of Stroke Medicine
      PubDate: 2022-04-11T05:52:16Z
      DOI: 10.1177/25166085221089745
       
  • Venous Sinus Thrombosis due to Vaccine-Induced Thrombotic Thrombocytopenia
           (VITT): A Case Report

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      Authors: Neetu Ramrakhiani, Palak Mamodia, Devang Sharma, Nitesh Agarwal
      First page: 96
      Abstract: Journal of Stroke Medicine, Ahead of Print.
      Patient, 19-year-old male, presented with fever, abdominal pain, headache, and vomiting presented after vaccination with ChAdOx1 CoV-19 (AstraZeneca, University of Oxford, and Serum Institute of India, and adenoviral-based vaccine) with alteration in sensorium and thrombocytopenia. He was diagnosed to have extensive venous sinus thrombosis with mass effect, midline shift, and underwent decompressive hemicraniotomy. He had a good outcome.
      Citation: Journal of Stroke Medicine
      PubDate: 2022-03-15T05:11:15Z
      DOI: 10.1177/25166085221082438
       
 
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