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Browsing NEU - Artigos by Subject "Acidente Vascular Cerebral"
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- Diferenças de Género no Tratamento de Fase Aguda do Acidente Vascular Cerebral IsquémicoPublication . Taulaigo, A; Pedro, B; Mariano, M; Paiva Nunes, AIntroduction: In order to personalize stroke treatment, it is important to know if there are differences between genders in clinical features, acute phase treatment and outcomes. Material and Methods: Longitudinal retrospective study that included patients with ischemic stroke, admitted in a stroke unit during a 30 months period and treated with throm bectomy with or without thrombolysis. The objective was to assess gender differences. Results: Of 594 patients included, 50% were women. At admission, women had higher median age (78 vs 73 years), higher modified Rankin Score (mRS) and higher median Na tional Institutes of Health Stroke Scale (NIHSS). No gender differences were found in treatment type, median time be tween symptoms onset and computed tomography, between computed tomography and thrombolysis and with respect to revascularization success. Disability expressed by mRS and mortality at 3 months were similar between genders. More women had atrial fibrillation (AF) (51% vs 35%), nevertheless, less women with known AF were receiving anticoagulant ther apy before the event, compared to men (38% vs 52%). Discussion: Even if women were older and had worse pre morbid functional status, no gender differences were evident with regard to acute phase treatment efficacy and medium term outcomes. Conclusion: In women, age should not limit acute phase treatment of stroke and decisions should be individualized
- Prevalência de Doença Carotídea na Patologia Cérebro-Vascular Isquémica. O Papel do Eco-DopplerPublication . Fragata, I; Galo, S; Manita, M; Ferreira, S; Reis, JBACKGROUND: Atherosclerotic carotid disease represents approximately 20% of the causes of ischemic stroke. Effective treatment options, such as endovascular or surgical revascularization procedures, are available. Doppler Ultrasound (DUS) is a non-invasive, inexpensive, routine exam used to evaluate the presence of internal carotid artery (ICA) stenosis. We retrospectively analysed the prevalence of severe atherosclerotic carotid disease in a population of patients with acute ischemic stroke/transitory ischemic attacks (TIAs), and the role of DUS in the detection of ICA stenosis and treatment decisions in these patients. METHODS: A total of 318 patients with ischemic stroke or TIAs was admitted to our stroke unit, and 260 patients were studied by DUS. ICA stenosis was evaluated by DUS according to peak systolic velocity. All DUS exams were performed by the same operator. ICA stenosis was further assessed in 43 patients by digital subtraction angiography (DSA) using NASCET criteria. RESULTS: Of the total 318 patients, 260 (82%) had DUS evaluation. Of the total 520 ICAs studied by DUS, degrees of ICA stenosis were: 0-29% n= 438 (84%); 30-49% n= 8 (2%); 50-69% n= 27 (5%); 70-89% n= 15 (3%); 90-99% n= 20 (4%); oclusão n= 14 (2%). Of the total 260 patients studied, 43 (16.5%) underwent DSA. Sensibility and specificity of DUS in the diagnosis of carotid stenosis over 70% were, respectively, 91% e 84%. Of the total 31 patients with significant carotid stenosis (70-99%), 23 (74%) underwent subsequent carotid revascularization procedures. DISCUSSION: DUS is an important screening test in our stroke unit, justifying its use as a routine exam for all patients with ischemic stroke/TIAs. Moreover, our results show the relevance of severe carotid disease in a population with acute ischemic stroke/TIAs (16.5%), with a total of 9% of patients being submitted to carotid revascularization procedures.