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Recognition of posterior circulation stroke.

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Title: Recognition of posterior circulation stroke.
Authors: Puustjärvi, V., Strbian, D., Tiainen, M., Curtze, S., Tatlisumak, T., Sairanen, T.
Source: Acta Neurologica Scandinavica. Jun2015, Vol. 131 Issue 6, p389-393. 5p.
Subjects: Stroke patients, Thrombolytic therapy, Ischemia, Hypertension, Patients, Blood circulation, Drug therapy, Warfarin
Abstract: Objectives Better identification and triage of acute posterior circulation ( PC) stroke patients is needed as the PC ischemic stroke ( IS) patients may be allowed longer thrombolysis window than anterior circulation ( AC) IS patients and PC patients with hemorrhagic stroke ( ICH) may require care in a neurosurgical unit possibly remote from stroke unit. Materials and methods Consecutive stroke patients treated at a tertiary center with thrombolysis (100% for IS) and/or comprehensive stroke unit care. Results Altogether, 1641 patients had AC (75%) and 553 PC strokes. The PC- IS patients were younger (65 vs 70), had less often prior hypertension (51 vs 61%), and were twice more often on warfarin. They presented 3.5 times more often with seizure, vomited five times more often, had headache twice as often, and required intubation 2 to 3 times more often despite equal NIHSS (9 vs 8) or GCS (15 both) scores with AC- IS patients. Among PC patients, IS (n = 190) associated with younger age, prior atrial fibrillation ( AF) in 25% and dyslipidemia in ~40%. One-third of PC- ICH patients (n = 363) had headache and vomited at the onset. PC- ICH patients had BP median of 177/92 mmHg and blood glucose 7.4 mmol/l on ER arrival. Warfarin use was twice as common in PC- ICH. Conclusions Despite being of typical age for multiple cardiovascular conditions the PC- ICH patients less often have a previous history of AF or dyslipidemia than IS patients do. The vomiting PC- ICH patient with hypertensive BP values often has headache and a red flag for hemorrhage is warfarin treatment. [ABSTRACT FROM AUTHOR]
Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Recognition of posterior circulation stroke.
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  Data: <searchLink fieldCode="JN" term="%22Acta+Neurologica+Scandinavica%22">Acta Neurologica Scandinavica</searchLink>. Jun2015, Vol. 131 Issue 6, p389-393. 5p.
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  Data: <searchLink fieldCode="DE" term="%22Stroke+patients%22">Stroke patients</searchLink><br /><searchLink fieldCode="DE" term="%22Thrombolytic+therapy%22">Thrombolytic therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Ischemia%22">Ischemia</searchLink><br /><searchLink fieldCode="DE" term="%22Hypertension%22">Hypertension</searchLink><br /><searchLink fieldCode="DE" term="%22Patients%22">Patients</searchLink><br /><searchLink fieldCode="DE" term="%22Blood+circulation%22">Blood circulation</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+therapy%22">Drug therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Warfarin%22">Warfarin</searchLink>
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  Data: Objectives Better identification and triage of acute posterior circulation ( PC) stroke patients is needed as the PC ischemic stroke ( IS) patients may be allowed longer thrombolysis window than anterior circulation ( AC) IS patients and PC patients with hemorrhagic stroke ( ICH) may require care in a neurosurgical unit possibly remote from stroke unit. Materials and methods Consecutive stroke patients treated at a tertiary center with thrombolysis (100% for IS) and/or comprehensive stroke unit care. Results Altogether, 1641 patients had AC (75%) and 553 PC strokes. The PC- IS patients were younger (65 vs 70), had less often prior hypertension (51 vs 61%), and were twice more often on warfarin. They presented 3.5 times more often with seizure, vomited five times more often, had headache twice as often, and required intubation 2 to 3 times more often despite equal NIHSS (9 vs 8) or GCS (15 both) scores with AC- IS patients. Among PC patients, IS (n = 190) associated with younger age, prior atrial fibrillation ( AF) in 25% and dyslipidemia in ~40%. One-third of PC- ICH patients (n = 363) had headache and vomited at the onset. PC- ICH patients had BP median of 177/92 mmHg and blood glucose 7.4 mmol/l on ER arrival. Warfarin use was twice as common in PC- ICH. Conclusions Despite being of typical age for multiple cardiovascular conditions the PC- ICH patients less often have a previous history of AF or dyslipidemia than IS patients do. The vomiting PC- ICH patient with hypertensive BP values often has headache and a red flag for hemorrhage is warfarin treatment. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/ane.12351
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        Text: English
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        Type: general
      – SubjectFull: Thrombolytic therapy
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      – SubjectFull: Ischemia
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      – SubjectFull: Hypertension
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      – SubjectFull: Warfarin
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      – TitleFull: Recognition of posterior circulation stroke.
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              Text: Jun2015
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