Tags
Blog

'stroke' posts

Advances in thrombolysis

 Washington State has one of the high est stroke mortality rates in the nation. To improve this situation, acute intervention al therapies for stroke are being employed to restore circulation to ischemic brain tissue that surrounds areas of completed infraction, while avoiding risk of hemor rhage due to reperfusion of large areas of infracted brain tissue.

Urgent thrombolysis with intrave nous alteplase is the only therapy known to improve clinical outcomes following acute stroke. Unfortunately, alteplase has had limited usage because many patients arrive in an emergency department after the three-hour treatment window. The FDA has also approved two clot removal devices based on the ability to restore circulation. These devices are used up to eight hours after symptom onset. Several approaches to improved acute stroke care are now under way, including extension of the thrombolysis window to 4.5 hours, identification of safer thrombolytic agents and research identifying brain at risk of in farction following a stroke.

A recent European study demonstrat ed the efficacy of alteplase up to 4.5 hours after ischemic stroke in patients younger than age 80 years who have neither dia betes mellitus or prior stroke. The safety profile during this longer window for these patients appears similar to that at three hours.

Another promising advance employs a new thrombolytic agent called des moteplase.

Detection of Cerebral Microemboli by Transcranial Doppler

FROM BRAINWAVES: Since its introduction in 1982, transcranial doppler ultrasound (TCD) has evolved into a portable, multimodality, noninvasive method for real-time imaging of intracranial vasculature. The detection of cerebral microemboli is among the more remarkable capabilities of TCD. Emboli create countable signals in the ultrasound display due to the higher reflection of sound waves compared to the blood cells. Experimental models have shown a high sensitivity and specificity for detection of a variety of substrates, including thrombotic, platelet and atheromatous emboli.

Microembolic signals (MES) within the intracranial vasculature are most frequently identified in patients with large-vessel atherosclerotic disease, such as carotid stenosis. They have also been reported in intracranial arterial stenosis, arterial dissection, cardiac disease and atheroaortic plaque. Additionally, they have been seen in arteries distal to coiled aneurysms.

There is strong evidence that MES detection predicts future ipsilateral stroke risk in patients with symptomatic carotid stenosis (Markus HS, et al.; King A, et al.). A recent study of patients with asymptomatic carotid stenosis demonstrated that MES predicted subsequent ipsilateral stroke and TIA, and also ipsilateral stroke alone, and that it is helpful in selecting patients who will benefit from carotid endarterectomy.

Sequim Gazette - Long Distance Diagnosis

Sequim, Nov. 3, 2010 - Clallam County residents facing a potential or actual ischemic stroke now will benefit from a recently formed partnership between the Swedish Neuroscience Institute TeleStroke Program and Olympic Medical Center.

Staying Fit to Prevent Stroke

A brisk walk for as little as 30 minutes a day can improve your health in many ways and may reduce your risk for stroke. Join me, and one of our exercise physiologists to learn how to stay fit and reduce your risk for stroke. Free blood pressure screening will also be available.

Cherry Hill - Pinard Foyer

Tuesday, Oct. 12, 11 a.m.-1 p.m

For more information, please contact Sherene Schlegel:

sherene.schlegel@swedish.org

Office: 206-320-3484

Swedish Adds Seven New Doctors to its Medical Staff

 

Perspectives on Healthcare - Spring 2010

Welcome to the latest installment of Perspectives. Since we started this series 18 months ago, we’ve examined a number of issues that impact the future of health care. But one topic we have not yet addressed is the severe shortage of physicians in this country.

About 60 million Americans are affected by the shortage in that they live in one of 3,000 U.S. communities designated as medically underserved, meaning there are not enough doctors to meet the needs of the local population. Our state has a higher rate of physicians than most, but even still, there are 147 communities right here in Washington that carry the medically underserved designation.

The physician shortage dates back, largely, to the mid-1990s when experts predicted the country was headed for a surplus of physicians. As a result, medical schools froze enrollment and began graduating fewer and fewer doctors.

The shortage has been exacerbated by aging baby boomers, who require more medical attention as they grow older. And now that health-care reform has passed and 30 million more Americans will have access to health insurance, the demand for doctors will continue to outpace the supply – by a large margin.

Addressing the shortage

Groundbreaking Study Using Ultrasound for Treatment of Intracerebral, Intraventricular Hemorrhage Stroke Shows Promise

 
Results 22-28 of 37