CONTEXT Intravenous tissue-type plasminogen activator (tPA) therapy using the National Institute of Neurological Disorders and Stroke criteria has been given with variable safety to less than 5% of the patients who have ischemic strokes nationwide. Our center is experienced in treating large numbers of stroke patients with intravenous tPA. OBJECTIVE To report our total 4-year experience in th...

BACKGROUND An Early Supported Discharge (ESD) and rehabilitation from a coordinated team in the home environment is recommended in several high-income countries for patients with mild to moderate symptoms after stroke. Returning home from the hospital takes place very early in Sweden today (12 days post stroke), thus the term Very Early Supported Discharge (VESD) is used in the current study. T...

BACKGROUND AND PURPOSE The benefits of intravenous tissue-type plasminogen activator (tPA) in acute ischemic stroke are time-dependent, and guidelines recommend a door-to-needle time of ≤60 minutes. However, fewer than one third of acute ischemic stroke patients who receive tPA are treated within guideline-recommended door-to-needle times. This article describes the design and rationale of TA...

BACKGROUND Emergency medical services (EMS) prenotification to hospitals regarding the arrival of patients who have had a stroke is recommended to facilitate the workup once the patient arrives. Most hospitals have the patient enter the emergency department (ED) before obtaining a head computed tomography (CT) scan. At Capital Health, prehospital stroke-alert patients are delivered directly to ...

Dysphagia and aspiration are fairly common sequelae of stroke, particularly of the brain stem variety. The authors present an actual case study of a patient who developed dysphagia, aspiration, and feeding problems subsequent to experiencing a lateral medullary stroke. This article follows the patient along as his post-stroke swallowing status changed and various feeding decisions were made. Th...

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INTRODUCTION According to the American Heart Association’s 2015 Heart Disease and Stroke Statistics Update, stroke is the fourth leading cause of death in the United States (129,000 people per year) as well as a major cause of long term disability.1 In addition to the physical impairments caused by stroke, many individuals may experience changes in their cognitive, communication, and swallowing...

OBJECTIVE Effective stroke care does not end with acute treatment during hospitalization, but extends through rehabilitation and secondary stroke prevention. In transitions across care environments, stroke patients are vulnerable to errors in communication of diagnosis and treatment. This study aimed to demonstrate that formalized communication between the neurology team and the rehabilitation ...