Early Signs Of Stroke Research Articles

Prehospital Factors Associated with Delayed Hospital Arrival of Stroke Patients: A Regional Single-Center Study from India.

Only a small percentage of patients with acute stroke are currently eligible for thrombolysis, partly due to severe delays in hospital arrival. We had previously conducted the first regional study to assess the factors delaying acute stroke care in India. The present study aims to understand and describe in depth the variables associated with prehospital delay among patients admitted with an acute ischemic stroke. Data were prospectively collected by conducting an in-depth interview of 470 acute ischemic stroke patients and their bystanders, aged above 18 years, presenting to the Department of Emergency Medicine, Jubilee Mission Medical College and Research Institute, Thrissur. Patients who arrived within 4.5 h of symptom onset were considered as "early arrival" and those who arrived after 4.5 h were considered as "delayed arrival." Univariate and multivariate analyses were undertaken to determine associations between variables of interest and delays to hospital presentation. Of the 470 patients who met the inclusion criteria, 73 patients reached within 4.5 h (15.5%), whereas 397 patients arrived after 4.5 h. The mean age of acute stroke patients who reached within 4.5 h was 63 ± 13.7 years, whereas the mean age of those who reached after 4.5 h was 63 ± 12.1 years. Binary logistic regression performed to quantify the associations of prehospital factors showed an increased risk of prehospital delay among individuals with lack of awareness (odds ratio [OR] = 5.16 [3.040-8.757], P < 0.001), followed by those for whom a vehicle was not available at the site of event (OR = 3.745 [1.864-7.522], P < 0.001). Within the predefined socioeconomic strata, compared to lower class, upper middle class had less risk (OR = 0.135 [0.018-1.035], P = 0.054), whereas the distance from first medical contact to emergency department contributed moderate risk (OR = 1.071 [1.028-1.116], P < 0.001) for prehospital delay. Health promotion techniques that increase public knowledge about the early signs of stroke, transferring patients directly to hospitals with thrombolysis capabilities, and making ambulance services more widely available are appropriate measures to reduce prehospital delay.

Abstract Number ‐ 123: Retained microvascular wire during acute stroke thrombectomy and stenting.

Introduction There is limited information on retained wires during neuro interventional ischemic cases, although there is a wealth of information on cardiac cases. Retained wires can present with thrombosis, perforation, or may be followed for longer period of time, with no complications. Changes in outcome vary on the ability of the wire to migrate, the size of the vessel adjacent to the wire, and the difficulty in retrieving the retained item. Methods We present a case report on a 56‐year‐old man who presented in 2018 with a left internal carotid occlusion horizontal petrous level, with no early signs of stroke on CT, and 106 mL penumbra on CT perfusion (CTP), with dense expressive and receptive aphasia. Results Patient developed hemiparesis while sitting sitting up, and drops in blood pressure, below the presenting blood pressure of 200 over 100 mmHg. The patient was taken for emergent thrombectomy. Patient underwent petrous thrombectomy with a residual high grade stenosis. This was followed by cavernous angioplasty, and Wingspan stenting. We attempted to cross the stenosis with a Gateway balloon and Synchro2 microwire. The wire tip was trapped and separated after extensive rotation, with a retained 5 mm tip. After inspecting the wire, there is no clear evidence of any a retained product. The tip was secured with a Wingspan stent. After thrombectomy and stenting aphasia improved. Four days later the patient developed worsening aphasia, and was found to have stent reocclusion. During CT angiography (CTA) it became apparent that a small wire extended from the left internal carotid petrous segment at the level of the wingspan stent down to the descending aorta. CT angiography of the chest and abdomen after reperfusion found that the wire was anchored in the left internal carotid, and extended down to the renal artery. Thrombus was aspirated, and ICA reconstructed with coronary stents in the petrous, and self‐expanding stents in the cervical segments, with TICI 3 reperfusion. Follow‐up imaging with CT chest and abdomen at six months, one year, and four years found the wire to be still anchored to the left internal carotid stent, and stable in the superior mesenteric artery. There is no evidence of thrombus formation, or distal embolization. We examined a Synchro2 microwire ex vivo were able to detach the tip, and have the inner core unravel up to a meter in length. Given that the wire shaft did not appear to be altered, the retained product was likely an unraveled inner core. Conclusions Retained neurovascular products can predispose to reocclusion, and should be secured. Once secured the course can be benign. When a wire with a wound core is fractured, unwound core can remain behind with the wire appearing as if it has been fully retrieved.

Awareness of risk factors and early signs of stroke in high risk population of Pune region

Background: Knowledge about risk factors and early signs of stroke helps in early intervention and may lead to a better functional outcome for the patient. This study was conducted to assess awareness about stroke in the high risk population of Pune region.Methods: Ethical committee clearance was taken. A total of 180 samples were recruited and written consent was obtained. Data was collected using a close-ended, self made questionnaire, which was face validated, in an interview based format. Collected data was analysed using descriptive statistics.Results: 43.3% participants were fully aware about stroke. 24.2% participants couldn’t identify a single risk factor.79% participants did not have self risk perception about stroke. Only 2.2% participants identified all the signs and symptoms of stroke correctly. 85.4% participants believed that early treatment of stroke increases chances of recovery. Only 32.5% participants would call the ambulance on occurrence of stroke. Awareness about risk factors and early signs of stroke seems to be higher among high risk population belonging to urban areas of Pune region, with higher literacy levels.Conclusions: There is significant lack of awareness about risk factors and early signs of stroke. Public health education seminars should be conducted to increase awareness, especially targeting population at high risk. Outreach to the rural population should be improved.

An ecological approach to understanding stroke experience and access to rehabilitation services in Ghana: A cross-sectional study.

Despite a growing burden of stroke in low-middle-income countries, research on patient's experiences and access to rehabilitation services remains limited. This study explores the experiences of stroke patients in relation to access and use of stroke rehabilitation services, coping strategies and strategies to improve care in Ghana. A cross-sectional study was conducted. A total of 136 adult stroke patients hospitalised and subsequently discharged in three major referral hospitals in Ghana participated in the study. A paper-based questionnaire was used to collect data. Data were inputted into STATA version 12, cleaned and analysed using descriptive statistics and Chi-Square tests. Findings showed that stroke patients experience stroke differently. Early detection (awareness) of stroke symptoms at onset was low (29.4%). Hypertension was the major (58.1%) predisposing risk factor for stroke, followed by diabetes (14.7%). Multiple barriers impede access to outpatient rehabilitation services: high cost of medications (43.4%), transportation constraints (10.3%), long waiting time (6.6%), forgetfulness about appointment (4.4%), limited education on rehabilitation (20.6%), lack of community support (12.5%) and ineffective communication with healthcare providers (5.2%). Recommended strategies to improve access to rehabilitation care included public education on stroke and its associated risk, reduction in the cost of drugs and increased stroke rehabilitation funding by the NHIS, especially for physiotherapy consultation and training support to caregivers on patient care. Given the difference in stroke experience and barriers in accessing rehabilitation care, multi-level health policy and service delivery reforms are needed to improve access to rehabilitation care, including national public awareness campaigns on early signs of stroke and subsidised cost of stroke rehabilitation.

Early signs of stroke: How your body warns you

Stroke, or cerebrovascular accident (CVA), remains one of the leading causes of mortality and long-term neurological disability worldwide. It is generally characterised by the sudden loss of blood flow to the brain and results in irreversible brain damage if not treated promptly. Early recognition of stroke symptoms is paramount, as timely medical intervention can drastically reduce complications and improve recovery outcomes. The widely known F.A.S.T. acronym (Face drooping, Arm weakness, Speech difficulty, and Time to act) aids in identifying common signs, but subtler symptoms like numbness, dizziness, and vision changes may also serve as critical early warnings. This paper explores the various types of strokes—ischemic, hemorrhagic, and transient ischemic attacks (TIA)—and discusses their underlying causes, risk factors, and prevention strategies. Emphasis is placed on the importance of managing risk factors such as hypertension, diabetes, and smoking, alongside lifestyle modifications for stroke prevention. This paper concludes with recommendations emphasising public awareness and encouraging immediate action upon recognising symptoms, underscoring the potential to reduce the global burden of strokes and improve patient outcomes.

Edukasi Deteksi Dini Stroke Pada Komunitas Diabetes Di Kota Mataram

Stroke remains one of the major causes of death and disability in Indonesia with a mortality and disability rate of 15% and 65%, respectively. Diabetes is known as a modifiable risk fator on stroke. Promptly identifying the symptoms of stroke is crucial as it leads to faster treatment and minimize brain damage. However, most patients are unaware of the early warning signs and symptoms of stroke. Therefore, providing education on early detection of stroke for patients with diabetes is essential as it may improve awareness on early signs of stroke hence allow patients to seek early treatment and later reduce the impact of the disease. The aim of this community education is to increase awareness of stroke and provide information on early signs and prevention of stroke among patients with diabetes.To achieve the aim of this community education include provide a talk/presentation on early sign of stroke and healthy life style for diabetes patient and evaluation of process. Evaluation of the community education was conducted through a pre and posttest to all participant on the related issue. Approximately 18 diabetes patients took part in this community education. The pre-test average score of participants was 73.33%. After providing education on stroke early detection, the participants' average score increased to 86.67 or increased by 18%. Education for early detection of stroke among Diabetes patients increased participants' understanding of the symptoms and early signs of stroke

Epidemiology, Risk Factors, Type and Outcome of Stroke in Health Care Facilities of Lomé, Togo: A Prospective Study

Background: Stroke is the leading cause of permanent disability acquired in the world. Aim: To study the epidemiological indices, risk factors and outcome of stroke. Subjects and Methods: It was a prospective study to collect epidemiological data, clinical presentation and outcome of stroke patients in 28 public and private health facilities in our largest health region. It had covered the period from January to December 2013. Results: A total of 43,558 inpatients were enrolled. Among them, 986 patients had a stroke which frequency was 2.26 %. The incidence rate has been estimated to 79.58/ 100,000 inhabitants/year. Male subjects were observed in 50.8% and 49.2% of females. The mean age was 59 ± 13.2 years. Concerning the stroke subtype, ischemic stroke was found with 54.9% and 45.1% of hemorrhagic including 10.8 % of subarachnoid hemorrhage. The traditional main risk factors were hypertension (87.3 %) and diabetes (17.5 %). The mean time of admission was 55 ± 20.75 hours. The average time before beginning first care was 56 ± 20.74 hours. Only 44% of patients had received first aids within 24 hours. The average length of stay was 17 ± 8.5 days. The mean modified Rankin scale score at the exit time was 2.3 ± 0.8. At discharge, 58.9% of patient had partial motor deficits and 27.5% of them died. Conclusion: A good knowledge of risk factors and early signs of stroke by the population will reduce stroke mortality and its functional sequel. All these lacks of assessment increase the delay in the management of patient and lead to permanent deficits.

To FAST or Not to FAST?

See related article, pages 2864–2868. In this issue of Stroke , Kleindorfer and colleagues1 report on a chart review comparing the traditional 5 “sudden” warning signs of stroke and the FAST system. FAST is based on the Cincinnati Prehospital Stroke Scale (CPSS) and focuses on 3 symptoms: facial droop (F), arm drift (A) and speech problems (S), with “T” for “time” rounding out the acronym. As Kleindorfer and colleagues point out, the standard list of 5 warning signs was created by a committee (the Brain Attack Coalition). Although it may be neurologically sound, Kleindorfer et al suspect it does not represent best practices when talking to the general public. But what does make for effective public education messaging? If we look at the world of advertising, there appears to be 3 underlying principles for getting messages out to people—and ensuring they are remembered. They are: (1) consistency, (2) simplicity, and (3) repetition. Looking at public-oriented websites of some of the major English-language stroke organizations suggests that common messaging on the warning signs of stroke follows national boundaries. The American Stroke Association (ASA),2 National Stroke Association (NSA)3 and National Institute of Neurological Disorders and Stroke (NINDS)4 all list the same 5 warning signs. The Heart and Stroke Foundation of Canada lists five,5 as does the Stroke …

Preclinical treatment of patients with stroke

Stroke is the third leading cause of death and number one cause of disability in industrialised countries. Studies into the pathophysiology of acute ischaemic stroke have indicated that treatment options are likely to be optimized when early signs of stroke are recognized and treatment is initiated within 3 hours from symptom onset. Therefore, new conceptions heading towards early diagnosis, fast preclinical treatment, structured diagnostics, immediate initiation of acute therapy as well as early initiation of rehabilitation are required. It is well known that, for most patients, there is a long delay between the onset of symptoms and the start of therapy. Many factors are responsible for the time delay:signs and symptoms often go unrecognized and/or are minimized by patients, relatives and bystanders. Unlike trauma or myocardial infarction, stroke is not given a high priority by medical staff and/or emergency medical services (EMS). Although a small number of stroke patients is treated as emergency and attended to by the emergency medical services within this time window, this number could easily be increased by intensified public and emergency personnel education. At present the standard of care by the EMS personnel includes adequate cerebral oxygenation, treatment of cardiac arrhythmia, management of hypertension as well as therapy of hyperglycemia and hyperthermia. For the future, we hope that emergency medical services will be able to initiate therapies which must be administered within the first few hours of acute stroke after onset of symptoms. Early notification of hospitals would enable a particular stroke team to be present at the patient's admission.

Der Schlaganfall als medizinischer Notfall

Studies into the pathophysiology of acute ischaemic stroke have indicated that treatment options are likely to be optimised when early signs of stroke are recognised and treatment is initiated within 3 hours from symptom onset. For most patients there is a long delay between the onset of symptoms and the start of therapy. Many factors are responsible for this time delay: signs and symptoms often go unrecognised by patients, relatives and bystanders and stroke is not given a high priority by medical staff. Although a small number of stroke patients is treated as emergency and attended to by the emergency medical services within this time window, this number could easily be increased by intensified public and emergency personnel education. For the future, we hope that emergency medical services (EMS) will be able to initiate therapies which must be administered within the first few hours of acute stroke. Standard of care by the EMS personnel includes maintenance of oxygenation, treatment of cardiac arrhythmia and hypertension as well as hyperglycemia and hyperthermia. Early notification by the emergency medical services about stroke patients would enable stroke teams to be present at admission, thus improving the likelihood of a better outcome for patients.

Stroke--a medical emergency.

Stroke is the third leading cause of death and number one cause of disability in industrialised countries. A number of new therapeutic approaches are currently in development for use in...

Early Signs of Stroke detected by SPM of EEG Source Spectra

Early Signs of Stroke detected by SPM of EEG Source Spectra