Article
Clinical Neurology
Hisham Alhajala, Melinda Hendricks-Jones, Julie Shawver, Abdelaziz Amllay, John Tuhao Chen, Monica Hajjar, Sarah Robbins, Trisha Dwyer, Emily Sedlak, Christopher Crayne, Brian Miller, Vieh Kung, Richard Burgess, Mouhammad Jumaa, Syed F. Zaidi
Summary: Expanding telestroke service to inpatient units helps decrease transfers and retain patients in their communities, increases stroke and TIA diagnosis accuracy, and does not compromise patients' hospitalization or outcome.
ANNALS OF NEUROLOGY
(2023)
Article
Clinical Neurology
Michael J. Lyerly, Joanne Daggy, Michelle LaPradd, Holly Martin, Brandon Edwards, Glenn Graham, Sharyl Martini, Jane Anderson, Linda S. Williams
Summary: The implementation of the VA National Telestroke Program resulted in a significant reduction in interhospital transfer rates among Veterans with acute ischemic stroke. Younger age, higher stroke severity, and shorter duration from symptom onset were associated with transfer.
Article
Medicine, General & Internal
Christina Tsou, Suzanne Robinson, James Boyd, Shruthi Kamath, Justin Yeung, Stephanie Waters, Karen Gifford, Andrew Jamieson, Delia Hendrie
Summary: The study aims to examine the impact of consultation with a stroke specialist via telehealth on the effectiveness and cost-effectiveness of stroke and transient ischaemic attack care using a mixed methods approach. A decision tree model will be constructed with input from clinicians and programme managers, with a before and after comparison using state-wide administrative datasets. The drivers of cost-effectiveness will be explored through stakeholder interviews.
Article
Health Care Sciences & Services
Priya Arumuganathan, Amelia K. Adcock, Cristal Espinosa, Scott Findley
Summary: This study provides novel characterization of stroke presentations and telestroke in rural critical access hospitals. The EMR-derived report is a reasonable tool to concentrate potential stroke cases for review and resource allocation but is not sensitive enough to detect stroke as a stand-alone tool. Further studies are critical to understand reasons contributing to the low utilization of telestroke.
TELEMEDICINE AND E-HEALTH
(2023)
Article
Clinical Neurology
Andrew D. Wilcock, Lee H. Schwamm, Jose R. Zubizarreta, Kori S. Zachrison, Lori Uscher-Pines, Jessica V. Richard, Ateev Mehrotra
Summary: This study found that patients with acute ischemic stroke treated at hospitals with telestroke capacity were more likely to receive reperfusion treatment and had lower 30-day mortality. There were no differences in days spent living in the community following discharge or in spending.
Article
Health Care Sciences & Services
Mark McDonald, Theresa Sevilis, Michelle Boudreau, Hsiong Chen, Caitlyn Boyd, Amanda Avila, Mohammed Zaman, Gregory Heath, Lan Gao, Thomas Devlin
Summary: This study found no significant differences in acute stroke treatment rates and door-to-needle (DTN) times by race or ethnicity within a multi-state telestroke program. These findings suggest that telestroke may help mitigate racial and ethnic disparities in stroke care.
JOURNAL OF TELEMEDICINE AND TELECARE
(2023)
Article
Clinical Neurology
Erik Simon, Matin Forghani, Andrij Abramyuk, Simon Winzer, Claudia Wojciechowski, Lars-Peder Pallesen, Timo Siepmann, Heinz Reichmann, Volker Puetz, Kristian Barlinn, Jessica Barlinn
Summary: This study evaluated the safety and short-term efficacy of intravenous thrombolysis (IVT) in acute ischemic stroke within an expanded time window delivered through a hub-and-spoke telestroke network. The results showed that IVT delivered through the telestroke network in the expanded time window was safe with equivalent short-term functional outcomes for patients admitted to spoke and hub centers.
FRONTIERS IN NEUROLOGY
(2021)
Article
Health Care Sciences & Services
Kori S. Zachrison, Rebecca E. Cash, Krislyn M. Boggs, Emily M. Hayden, Ashley F. Sullivan, Carlos A. Camargo Jr
Summary: This study aimed to examine the use of telehealth by US emergency departments (EDs) during COVID-19 and whether existing telehealth infrastructure or increased system integration were associated with increased likelihood of use. The results showed that telehealth use by US EDs in 2020 exceeded expectations and preexisting telehealth infrastructure was associated with increased innovation in its use.
TELEMEDICINE AND E-HEALTH
(2023)
Article
Clinical Neurology
Justin Choi, Ashley Petrone, Amelia Adcock
Summary: The study found that there was no significant difference in care provided by emergency medicine physicians and neurologists during telestroke consultations, suggesting that the lack of formally trained neurologists may not impede the development of an effective telestroke network. Future efforts should focus on identifying strategies that facilitate sustainable telestroke implementation.
FRONTIERS IN NEUROLOGY
(2021)
Article
Health Care Sciences & Services
Andrew D. Wilcock, Lee H. Schwamm, Jose R. Zubizarreta, Kori S. Zachrison, Lori Uscher-Pines, Jennifer J. Majersik, Jessica Richard, Ateev Mehrotra
Summary: Based on our study, the implementation of the FAST Act resulted in a substantial increase in Medicare telestroke billing. However, at the time, only a small number of hospitals with telestroke capacity had billed Medicare, and there was a significant amount of non-compliant billing. Therefore, simplified payment rules are crucial to ensure the intended impact of expanded reimbursement.
Article
Computer Science, Interdisciplinary Applications
Kimiyo Kikuchi, Yoko Sato, Rieko Izukura, Mariko Nishikitani, Kiyoko Kato, Seiichi Morokuma, Meherun Nessa, Yasunobu Nohara, Fumihiko Yokota, Ashir Ahmed, Rafiqul Islam-Maruf, Naoki Nakashima
Summary: The intervention study on the portable health clinic (PHC) for maternal and child health in a rural area of Bangladesh showed that introducing this system can increase the proportion of pregnant and postpartum women receiving antenatal and postnatal care, detect health problems promptly, and improve the health of mothers and newborns.
COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE
(2021)
Article
Health Care Sciences & Services
Haidar Moustafa, Kristian Barlinn, Alexandra Prakapenia, Simon Winzer, Johannes Gerber, Lars-Peder Pallesen, Timo Siepmann, Kevin Haedrich, Claudia Wojciechowski, Heinz Reichmann, Jennifer Linn, Volker Puetz, Jessica Barlinn
Summary: Recent exploratory analysis found comparable outcomes among stroke patients selected via telestroke network and those directly admitted and treated with endovascular therapy (EVT). Telemedicine plays an important role in identifying acute ischemic stroke patients without immediate access to EVT-capable stroke centers. Patients selected through telemedicine had similar chances of favorable outcomes after EVT for large vessel occlusion as those directly admitted.
JOURNAL OF TELEMEDICINE AND TELECARE
(2021)
Article
Clinical Neurology
Nirav R. Bhatt, Michael R. Frankel, Raul G. Nogueira, Carol Fleming, Nicolas A. Bianchi, Olivia Morgan, Katleen Chester, Stephen W. English, Nicholas Janocko, Digvijaya Navalkele, Diogo C. Haussen
Summary: This study aimed to test the reliability of the FAST-ED scale used by paramedics in a mobile stroke unit, showing excellent agreement between paramedics and vascular neurologists in scoring. The results indicate that paramedics can accurately perform the FAST-ED scale in the prehospital setting.
Review
Health Care Sciences & Services
Christina Tsou, Suzanne Robinson, James Boyd, Andrew Jamieson, Robert Blakeman, Justin Yeung, Josephine McDonnell, Stephanie Waters, Kylie Bosich, Delia Hendrie
Summary: The study analyzed the effectiveness of emergency telehealth in rural and remote emergency departments, finding positive impacts on clinical effectiveness and care processes. Different clinical contexts and severity of patient presentation may influence the interpretation of these findings, with the acuity of patient presentation being a key consideration in various outcome measures.
JOURNAL OF MEDICAL INTERNET RESEARCH
(2021)
Article
Neurosciences
Carter H. Nakamoto, Andrew D. Wilcock, Lee H. Schwamm, Kori S. Zachrison, Lori Uscher-Pines, Ateev Mehrotra
Summary: This study compared hospitals that adopted telestroke before and during the pandemic, and found no significant differences in characteristics and usage of telestroke between the two groups.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2023)
Article
Neurosciences
Christopher M. Shea, Amir Alishahi Tabriz, Kea Turner, Steve North, Kristin L. Reiter
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2018)
Review
Health Care Sciences & Services
Oliver T. Nguyen, Amir Alishahi Tabriz, Jinhai Huo, Karim Hanna, Christopher M. Shea, Kea Turner
Summary: E-visits have shown potential for improving or maintaining comparable clinical outcomes for chronic disease management, but the impact on quality of care varies depending on the condition, especially in infection management. Additionally, e-visits have the potential to reduce health care costs compared to in-person visits for certain conditions. Further research is needed to understand the full impact of e-visits on health care delivery.
JOURNAL OF MEDICAL INTERNET RESEARCH
(2021)
Article
Health Care Sciences & Services
Amir Alishahi Tabriz, Kea Turner, Dunc Williams, Nimmy Babu, Steve North, Christopher M. Shea
Summary: Telemedicine adoption for cardiac and stroke care has significantly increased in recent years in US hospitals. Financial indicators may have a greater impact on adoption for urban hospitals compared to rural hospitals.
TELEMEDICINE AND E-HEALTH
(2022)
Article
Health Care Sciences & Services
Christopher M. Shea, Kea Turner, Josh Weinstein, Amir Alishahi Tabriz, Nimmy Babu, Jessica Link Reeve, Steve North
Summary: This study surveyed hospitals in five states to examine telestroke programs and identified challenges hospitals face in implementing and sustaining telestroke services. Key issues include difficulties in monitoring process measures, using performance indicators for improvement, and sharing data with physicians.
TELEMEDICINE AND E-HEALTH
(2022)
Article
Substance Abuse
Alex K. Gertner, Hannah Margaret Clare, Byron J. Powell, Allison R. Gilbert, Hendree E. Jones, Pam Silberman, Christopher M. Shea, Marisa Elena Domino
Summary: This study aimed to identify provider factors that could drive differences in treatment retention for opioid use disorder (OUD) while considering patient characteristics. The findings suggest that providers who adopt low-threshold approaches to treatment may achieve higher retention rates than those who adopt high-threshold approaches.
INTERNATIONAL JOURNAL OF DRUG POLICY
(2022)
Article
Health Care Sciences & Services
Ashley M. Hughes, Karen Riska, Mary Jo S. Farmer, Divya Krishnakumar, Christopher M. Shea, Dean R. Hess, Peter K. Lindenauer, Mihaela S. Stefan
Summary: Interprofessional teamwork is crucial in utilizing noninvasive ventilation (NIV) for patients with exacerbated COPD. A cognitive task analysis was conducted to identify the shared cognitive tasks in interprofessional teams. The study found that conducting thorough assessments, formulating care plans, and continuously monitoring patient status were the shared cognitive tasks. Access to up-to-date information and expertise, as well as shared understanding of care plans, played important roles in the execution of NIV treatment.
JOURNAL OF INTERPROFESSIONAL CARE
(2023)
Article
Health Care Sciences & Services
Arrianna Marie Planey, Burcu Bozkurt, Monisa Aijaz, Josh Weinstein, Saif Khairat, Christopher M. Shea
Summary: This study examines the utilization of telehealth in maternal health services among commercially insured patients during the antenatal, delivery, and postpartum phases. The results show that 3.5% of visits were conducted through telehealth, with higher usage in the antenatal and postpartum periods. Additionally, the proportion of telehealth services increases in areas with a higher share of Black and Latinx residents.
TELEMEDICINE AND E-HEALTH
(2023)
Article
Neurosciences
Adam Vacek, Grant Mair, Philip White, Philip M. Bath, Keith W. Muir, Rustam Al-Shahi Salman, Chloe Martin, David Dye, Francesca M. Chappell, Ruediger von Kummer, Malcolm Macleod, Nikola Sprigg, Joanna M. Wardlaw
Summary: This study evaluated the performance of e-ASPECTS software in delineating the extent of intracranial hemorrhage (ICH) on brain CT scans. The results showed that the software achieved excellent or good delineation of ICH extent in 71% of cases. However, it was more likely to over- or under-estimate the extent when ICH was more extensive, intraventricular, or extra-axial.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2024)
Article
Neurosciences
Mathias Jacobsen Bach, Audrone Jakubauskaite, Ian Law, Otto Molby Henriksen, Inger Havsteen, Alexander Cuculiza Henriksen, Sverre Rosenbaum, Lisbeth Marner
Summary: This study found that the rCBFacz value after ACZ challenge can serve as an important indicator for predicting future cerebrovascular events, with high accuracy and prognostic value.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2024)
Article
Neurosciences
Tak Kyu Oh, Saeyeon Kim, In-Ae Song
Summary: The study found that many survivors of nontraumatic intracranial hemorrhage in South Korea experience unemployment, decreased household income, and newly acquired disability after intensive care unit admission. However, these changes are not associated with 2-year all-cause mortality.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2024)
Article
Neurosciences
Eduardo Sousa de Melo, Rodrigo de Paiva Bezerra, Arthur Cesario de Holanda, Maria Junia Lira e Silva, Paloma Peter Travassos, Tayne Fernanda Lemos da Silva, Genova Maria de Azevedo Oliveira, Silvia Marinho Martins Alves, Carolina de Araujo Medeiros, Maria das Neves Dantas da Silveira Barros, Wilson Alves de Oliveira, Gisele Sampaio Silva, Luciana Patrizia Alves de Andrade Valenca
Summary: Cardiac involvement has been found to be the predominant factor correlated with stroke in Chagas disease. While atherosclerosis-related risk factors are prevalent, their influence on ischemic stroke in Chagas disease appears limited.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2024)
Article
Neurosciences
Pingping Zheng, Ning Zhang, Zixi Chen
Summary: This case presents a rare infectious cause of stroke and air embolism involving a pulmonary abscess and pulmonary vein thrombosis. Early detection, diagnosis, and appropriate treatment of infected systemic embolism in young patients are crucial to prevent serious complications.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2024)
Article
Neurosciences
Filippo Luca Gurgoglione, Luigi Vignali, Maria Alberta Cattabiani, Emilia Solinas, Giorgio Benatti, Iacopo Tadonio, Federico Barocelli, Chiara Dizdari, Domenico Tuttolomondo, Diego Ardissino, Francesco Nicolini, Giampaolo Niccoli
Summary: The incidence of recurrent ischemic neurological events after transcatheter patent foramen ovale closure is relatively low. Obesity, Risk of Paradoxical Embolism score < 7, and migraine are independent positive predictors of recurrent stroke or transient ischemic attack.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2024)
Article
Neurosciences
Angelo Cascio Rizzo, Ghil Schwarz, Amedeo Cervo, Giuditta Giussani, Chiara Ceresa, Antonella Gatti, Fausto De Angeli, Cristina Motto, Angelo Guccione, Rachele Tortorella, Giuseppe Granata, Claudia Rollo, Antonio Macera, Mariangela Piano, Guglielmo Pero, Elio Clemente Agostoni
Summary: This study aimed to evaluate the efficacy and safety of endovascular treatment (EVT) in primary and EVT-induced secondary medium-vessel occlusions (MeVO). The results showed that primary MeVO had poorer outcomes in terms of complications, EVT efficacy, and the proportion of patients with a modified Rankin Scale (mRS) of 0-2 at 3 months compared to exclusive large-vessel occlusion (LVO). However, EVT-induced secondary MeVO showed similar safety and efficacy outcomes as exclusive LVO and had better outcomes in terms of mRS 0-2 compared to primary MeVO.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2024)
Article
Neurosciences
Jing Zhang, Chenming Wei, Jian Wu
Summary: This case report describes a patient with Bloom syndrome who developed acute cerebral infarction along with elevated antiphospholipid antibodies, suggesting a possible association between immune and coagulation abnormalities caused by Bloom syndrome and the development of acute cerebral infarction.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2024)
Article
Neurosciences
Yunxia Zhou, Shenglan He, Yanhong Hu
Summary: Compared with clopidogrel, DAPT with ticagrelor plus aspirin was associated with significantly lower thromboembolic events without an increase in hemorrhagic events in the treatment of intracranial aneurysms, according to the one-year clinical outcome analysis. However, larger upcoming trials are needed to confirm the effectiveness and safety of ticagrelor-associated DAPT.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2024)
Article
Neurosciences
Edvania Andrade de Moura Silva, Ludmilla Ribeiro Batista, Marcela Aline Fernandes Braga, Luci Fuscaldi Teixeira-Salmela, Christina Danielli Coelho de Morais Faria, Iza Faria-Fortini
Summary: The study found that stroke severity is the best predictor of self-perceived manual ability at both three and six months after stroke. Age, although significant, contributes little to the prediction of manual ability.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2024)
Article
Neurosciences
Sidarrth Prasad, Erica M. Jones, Mehari Gebreyohanns, Veronica Aguilera, DaiWai M. Olson, Jane A. Anderson, Sean I. Savitz, Salvador C. Flores, Steven J. Warach, Charlotte E. Rhodes, Mark P. Goldberg, Nneka L. Ifejika
Summary: This study identified the barriers and facilitators to adopting tenecteplase (TNK) as a thrombolytic treatment for acute ischemic stroke (AIS) by conducting qualitative research with stroke clinicians in Texas. The findings suggest that providing evidence and identifying key change processes can help clinicians achieve consensus on adopting TNK for AIS treatment.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2024)
Article
Neurosciences
Jeshma Jayan, Sunil K. Narayan, Yasmin Nesha Haniffa, Navin Kumar
Summary: This study investigated the effects of transcranial electrical and magnetic stimulation on somatosensory evoked potentials in chronic ischemic stroke patients, finding that the real tDCS and rTMS combination results in significant improvement and is safe for use.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2024)
Article
Neurosciences
Phoebe M. Tran, Cenjing Zhu, William T. Harris II, Sajeesh K. Kamala Raghavan, Agricola Odoi, Liem Tran
Summary: This study assessed the geographic accessibility of stroke rehabilitation facilities in Tennessee. The study found that rural counties had significantly longer travel distances and times compared to urban counties. Counties with high and medium stroke prevalence also had higher travel times and distances compared to low stroke prevalence counties. Therefore, addressing transportation barriers and implementing tele-rehabilitation are crucial for improving access to stroke aftercare in these areas.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2024)
Article
Neurosciences
Lili Xu, Shuaiyu Chen, Jing Xu, Yanyan Shi, Zhihang Huang, Meng Wang, Ziqiao Wei, Hui Cao, Junshan Zhou, Wei Wang, Mingyang Du
Summary: This study found that the Chinese Visceral Adiposity Index (CVAI) is positively correlated with 90-day poor outcome in Chinese ischemic stroke patients after endovascular thrombectomy (EVT).
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2024)
Article
Neurosciences
Guangying Wu, Shuhua Li, Min Luo, Xiaotian Li, Xinghua Zhu, Junhuai Zhang, Qian He, Qian Yang, Guojiang Zhao, Shasha Luo, Zhijie Yang
Summary: The study aimed to investigate the relationship between serum alkaline phosphatase (ALP) levels and the severity and prognosis of intracerebral hemorrhage (ICH). The results showed that serum ALP levels in ICH patients were significantly elevated and correlated with hematoma volume and Glasgow coma scale (GCS) score. High serum ALP levels may serve as a potential predictor for the severity and unfavorable prognosis of ICH.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2024)