Navegando por Palavras-chave "Ischemic stroke"
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- ItemSomente MetadadadosAcute Foot Drop Syndrome Mimicking Peroneal Nerve Injury: An Atypical Presentation of Ischemic Stroke(Elsevier B.V., 2014-05-01) Ricarte, Irapua Ferreira [UNIFESP]; Figueiredo, Marcelo Marinho de [UNIFESP]; Fukuda, Thiago Goncalves [UNIFESP]; Pedroso, Jose Luiz [UNIFESP]; Silva, Gisele Sampaio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hosp Israelita Albert EinsteinFoot drop syndrome is a frequent neurologic condition usually caused by peroneal nerve damage. On rare occasions, foot drop may present as the single neurologic manifestation of intracranial lesions. We presented a 43-year-old man admitted to our hospital with acute weakness in the dorsiflexion of his right foot that appeared 3 days before admission. Brain magnetic resonance imaging diffusion-weighted sequence revealed a small area of restricted diffusion in the left frontal cortex. Three months later, his motor deficit had completely improved (modified Rankin scale score = 0). To our knowledge, this is the second report of sudden isolated foot drop caused by a cortical infarction.
- ItemSomente MetadadadosAcute Treatment Costs of Stroke in Brazil(Karger, 2009-01-01) Christensen, Michael C.; Valiente, Raul; Silva, Gisele Sampaio [UNIFESP]; Lee, Won Chan; Dutcher, Sarah; Guimaraes Rocha, Maria Sheila; Massaro, Ayrton [UNIFESP]; Novo Nordisk AS; Hosp Santa Marcelina; Universidade Federal de São Paulo (UNIFESP); Abt Biopharma Solut IncBackground and Purpose: Although stroke is the leading cause of death in Brazil, little information exist on the acute treatment provided for stroke and its associated costs. This study addresses this gap by both clinically and economically characterizing the acute treatment of first-ever intracerebral hemorrhage (ICH) and ischemic stroke ( IS) in Brazil. Methods: Retrospective medical chart review using data from two high-volume stroke centers in São Paulo, Brazil. Clinical and resource utilization data for all patients admitted to the stroke centers with a first-ever stroke between January 1, 2006 and May 31, 2007 were collected and the mean acute treatment costs per person were calculated by assigning appropriate unit cost data to all resource use. Cost estimates in Brazilian reals (BRL) were converted to US dollars (USD) using the 2005 purchasing power parity index. National costs of acute treatment for incident strokes were estimated by extrapolation of mean cost estimate per person to national incidence data for the two types of stroke. the mean costs of acute treatment on a national scale were examined in sensitivity analysis. Results: A total of 316 stroke patients were identified and their demographic and clinical characteristics, patterns of care, and outcomes were examined. Mean length of hospital stay was 12.0 8 +/- 8.8 days for ICH and 13.3 +/- 8 23.4 days for IS. Ninety-one percent of the ICH patients and 68% of the IS patients were admitted to an intensive care unit (ICU). Mean total costs of initial hospitalization were USD 4,101 (SD +/- 4,254) for ICH and USD 1,902 (SD +/- 1,426) for IS. in multivariate analysis, hemorrhagic stroke, development of pneumonia, neurosurgical intervention, stay in ICU, and physical therapy were all significant independent predictors of acute treatment costs. Aggregate national health care expenditures for acute treatment of incident ICH were USD 122.4 million (range 30.8-274.2) and USD 326.9 million for IS (range 82.4-732.2). Conclusion: Acute treatment costs of incident ICH and IS in Brazil are substantial and primarily driven by the intensity of hospital treatment and in-hospital complications. With the expected increase in the incidence of stroke in Brazil over the coming decades, these results emphasize the need for effective preventive and acute medical care. Copyright (C) 2008 S. Karger AG, Basel
- ItemSomente MetadadadosGender Differences in Outcomes after Ischemic Stroke: Role of Ischemic Lesion Volume and Intracranial Large-Artery Occlusion(Karger, 2010-01-01) Silva, Gisele Sampaio [UNIFESP]; Lima, Fabricio O.; Camargo, Erica C. S.; Smith, Wade S.; Lev, Michael H.; Harris, Gordon J.; Halpern, Elkan F.; Koroshetz, Walter; Furie, Karen L.; Massachusetts Gen Hosp; Harvard Univ; Univ Calif San Francisco; Natl Inst Neurol Disorders & Stroke; Universidade Federal de São Paulo (UNIFESP)Background: the reasons for gender disparities in stroke outcome remain unclear, and little is known about the value of acute neuroimaging characteristics in elucidating differential stroke outcomes between the sexes. Methods: We prospectively evaluated consecutive patients with acute ischemic stroke. CT angiography (CTA) was performed in all patients within 24 h of symptom onset. CTA source images were used to evaluate lesion volume. the primary outcome measure was a modified Rankin scale (mRS) score >= 3 at 6 months. Results: We evaluated 676 consecutive patients (322 women). Women were older than men (p < 0.01), more frequently had a prestroke mRS >0 (p < 0.01), and had higher admission National Institutes of Health Stroke scale scores (p = 0.01). More women had intracranial artery occlusions than men (46 vs. 33.1%, p = 0.01), but there was no significant difference between ischemic lesion volumes (p = 0.21). Using multiple regression, female gender remained an independent predictor of poor mRS scores at 6 months (odds ratio 1.57; 95% confidence interval 1.02-2.36) after adjustment for clinical and imaging covariates. Conclusion: Compared with men, women are less likely to achieve independence after acute ischemic stroke. the disparity in stroke outcome is not explained by differences in ischemic lesion volume or the presence of intracranial artery occlusions. Copyright (C) 2010 S. Karger AG, Basel