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Subject = STROKE AND TIA;
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Displaying Results 1 - 21 of 21 on page 1 of 1
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A rare case of cryptogenic stroke with an incidental finding of patent foramen ovale.
(2015)
Anglim, B; Maher, N; Cunningham, O; Mulcahy, D; Harbison, J; O'Connell, M
A rare case of cryptogenic stroke with an incidental finding of patent foramen ovale.
(2015)
Anglim, B; Maher, N; Cunningham, O; Mulcahy, D; Harbison, J; O'Connell, M
Abstract:
Patent foramen ovale (PFO) occurs in 25-30% of the general population. Stroke in the puerperium is a rare phenomenon, 34 per 100,000 women. A 32 year old lady, Para3+2 presented eight days postnatally with symptoms of a transient episode of left sided facial and limb parathesia and dysphasia. She had a CT brain which was normal, however a subsequent MRI brain showed a small right parietal lobe infarct. An echocardiogram was performed which showed a small PFO, with an ejection fraction of 60-65%. A bubble study was performed which was positive with valsalva. She was started on aspirin 300mg once daily for 2 weeks, and shall remain on life-long aspirin 75mg.
http://hdl.handle.net/10147/559204
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Access to in-patient stroke services and multidisciplinary team (MDT) rehabilitation: current demands and capacity
(2014)
O’Sullivan, EJ; Williams, DJ; Shanahan-O’Connell, J; Kirrane, K; Armitage, D; Leahy, W;...
Access to in-patient stroke services and multidisciplinary team (MDT) rehabilitation: current demands and capacity
(2014)
O’Sullivan, EJ; Williams, DJ; Shanahan-O’Connell, J; Kirrane, K; Armitage, D; Leahy, W; O’Flaherty, E; Horgan, NF
Abstract:
The objective of this project was to analyse the current access to in-patient stroke services and MDT rehabilitation in an acute stroke centre and to compare these services to the recommended â National Clinical Guidelines and Recommendations for the Care of People with Stroke and TIAâ (IHF 2010). A retrospective chart review was carried out, recording activity statistics of all patients admitted with acute stroke over a three-month period. 73 patients (male=40, 54.8%) were included. Patients were discharged from the stroke service after a mean stay of 20.2 days (SD.= 19.3). 76.7% (N=56) of patients were admitted to the acute stroke unit (ASU). The mean length of time from admission to first assessment 3.4 days (SD.=2.68), with an average of 138 minutes of treatment received per day across all disciplines. This is compared to the IHFâ s recommendation of patients being assessed within 24-48 hours of admission and receiving 180 minutes of treatment across all disciplines. As dema...
http://hdl.handle.net/10147/322916
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Acute hospital, community, and indirect costs of stroke associated with atrial fibrillation: population-based study.
(2014)
Hannon, Niamh; Daly, Leslie; Murphy, Sean; Smith, Samantha; Hayden, Derek; Ní Chróinín,...
Acute hospital, community, and indirect costs of stroke associated with atrial fibrillation: population-based study.
(2014)
Hannon, Niamh; Daly, Leslie; Murphy, Sean; Smith, Samantha; Hayden, Derek; Ní Chróinín, Danielle; Callaly, Elizabeth; Horgan, Gillian; Sheehan, Orla; Honari, Bahman; Duggan, Joseph; Kyne, Lorraine; Dolan, Eamon; Williams, David; Wiley, Miriam; Kelly, Peter J
Abstract:
No economic data from population-based studies exist on acute or late hospital, community, and indirect costs of stroke associated with atrial fibrillation (AF-stroke). Such data are essential for policy development, service planning, and cost-effectiveness analysis of new therapeutic agents.
http://hdl.handle.net/10147/336175
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An exploration of EEG features during recovery following stroke - implications for BCI-mediated neurorehabilitation therapy
(2014)
Leamy, Darren J; Kocijan, Juš; Domijan, Katarina; Duffin, Joseph; Roche, Richard AP; Co...
An exploration of EEG features during recovery following stroke - implications for BCI-mediated neurorehabilitation therapy
(2014)
Leamy, Darren J; Kocijan, Juš; Domijan, Katarina; Duffin, Joseph; Roche, Richard AP; Commins, Sean; Collins R; Ward, Tomas E
Abstract:
Abstract Background Brain-Computer Interfaces (BCI) can potentially be used to aid in the recovery of lost motor control in a limb following stroke. BCIs are typically used by subjects with no damage to the brain therefore relatively little is known about the technical requirements for the design of a rehabilitative BCI for stroke. Methods 32-channel electroencephalogram (EEG) was recorded during a finger-tapping task from 10 healthy subjects for one session and 5 stroke patients for two sessions approximately 6 months apart. An off-line BCI design based on Filter Bank Common Spatial Patterns (FBCSP) was implemented to test and compare the efficacy and accuracy of training a rehabilitative BCI with both stroke-affected and healthy data. Results Stroke-affected EEG datasets have lower 10-fold cross validation results than healthy EEG datasets. When training a BCI with healthy EEG, average classification ...
http://dx.doi.org/10.1186/1743-0003-11-9
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Delays in the stroke thrombolysis pathway - Identifying areas for improvement
(2014)
Brewer, L; Arize, C; Williams, D
Delays in the stroke thrombolysis pathway - Identifying areas for improvement
(2014)
Brewer, L; Arize, C; Williams, D
Abstract:
Despite international consensus on the benefits of thrombolysis for ischaemic stroke (IS), it remains underused. Guidelines now recommend a door-to-needle time of d60 minutes. We reviewed the rate and timeliness of thrombolysis for IS at our hospital. 323 stroke patients presented between January 2011 and April 2012.Thirty patients (10.6% of IS) were thrombolysed, mean age was 68.5 years (42 to 88) and 19 patients (63%) were male. Thirty-six patients (12.7% of IS) were not thrombolysed despite arriving within the time-window and symptom resolution was the commonest reason (15 patients; 42%). Despite most thrombolysed patients (42%) presenting to the Emergency Department during daytime working hours, there were delays at each step of the acute care pathway. The mean time for stroke team review was 23 minutes (5-50). The mean door-to-CT and the door-to-needle times were 60 minutes (25-95) and 92 minutes (46-130) respectively. In parallel with national stroke incentives, local audit ca...
http://hdl.handle.net/10147/316726
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Evolution of carotid surgical practice in the last decade
(2015)
Hanrahan, L; Canning, C; Abdulrahim, O; Fitzgerald, L; O’Neill, S; Madhavan, P; Harbiso...
Evolution of carotid surgical practice in the last decade
(2015)
Hanrahan, L; Canning, C; Abdulrahim, O; Fitzgerald, L; O’Neill, S; Madhavan, P; Harbison, J; Colgan, MP; Martin, Z
Abstract:
Stroke units provide immediate care and appropriate intervention in the evolving stroke. The aims of this study were to review the practice of carotid endarterectomy (CEA) before and after the establishment of a Stroke Unit in St. James’s Hospital. Prior to the introduction of the Stroke Unit, 263 CEA’s were performed over a five-year period. 139/263 (53%) of these were for symptomatic disease. 229 were performed in the five years since. 179/229 (78%) of these were for symptomatic disease. The 30-day stroke and death rates were <2% before the introduction of the Stroke Unit, and have remained unchanged. Since the introduction of the Stroke Unit, there has been a slight decrease in the overall number of CEA’s performed with a 25% increase in the proportion of endarterectomies performed for symptomatic disease. Despite the reduction in surgery for asymptomatic disease the overall 30-day stroke and death rate remains excellent at 2/229 (2%).
http://hdl.handle.net/10147/578371
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Guidelines for the management of a patient with a subarachnoid haemorrhage
(2010)
Health Service Executive (HSE)
Guidelines for the management of a patient with a subarachnoid haemorrhage
(2010)
Health Service Executive (HSE)
http://hdl.handle.net/10147/315834
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Hospital-based stroke care in Ireland: results from one regional register.
(2000)
Fan, C W; McDonnell, R; Johnson, Z; O'Keeffe, S; Crowe, M J
Hospital-based stroke care in Ireland: results from one regional register.
(2000)
Fan, C W; McDonnell, R; Johnson, Z; O'Keeffe, S; Crowe, M J
Abstract:
BACKGROUND: Most patients with acute stroke are admitted to hospital. If stroke services in this country are to be improved, we need accurate and reliable information about the types of stroke patients being admitted, their present management and outcome. AIMS: To examine the demography, severity, level of investigation, length of stay, mortality and discharge location of prospectively identified consecutive stroke admissions to three general hospitals in South East Dublin. RESULTS: Three hundred and twenty nine consecutive stroke admissions to three general hospitals in South East Dublin were registered using the European Stroke Database over 50 weeks. The mean age was 73.3 years, whilst 20.1% patients were under 65 years. Prior to admission, 90% of patients were community dwelling with 14.9% of patients being dependent in activities of daily living. 22.4% of patients had some depression in level of consciousness on admission. The overall mortality rate was 26.1% whilst 136 (41.3...
http://hdl.handle.net/10147/323796
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Images in clinical medicine. Pronator drift.
(2013)
Darcy, Philip; Moughty, Adrian M
Images in clinical medicine. Pronator drift.
(2013)
Darcy, Philip; Moughty, Adrian M
http://hdl.handle.net/10147/305335
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Improving stroke care for patients at Cavan hospital [poster]
(2013)
Murugasu, G Dr.; O’Callaghan, Su-Zann; Smith, Collette; Young, Maeve
Improving stroke care for patients at Cavan hospital [poster]
(2013)
Murugasu, G Dr.; O’Callaghan, Su-Zann; Smith, Collette; Young, Maeve
Abstract:
Under the Quality and Continuing Care Directorate (QCCD) in stroke care Cavan General Hospital was identified as a hospital that received a large number of stroke and TIA patients. A programme was established to improve services to this population.
http://hdl.handle.net/10147/305270
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Investigation and diagnostic formulation in patients admitted with transient loss of consciousness
(2017)
Briggs, R; Coughlan, T; Doherty, J; Collins, DR; O’Neill, D; Kennelly, SP
Investigation and diagnostic formulation in patients admitted with transient loss of consciousness
(2017)
Briggs, R; Coughlan, T; Doherty, J; Collins, DR; O’Neill, D; Kennelly, SP
Abstract:
Several commonly completed tests have low diagnostic yield in the setting of transient loss of consciousness (T-LOC). We estimated the use and cost of inappropriate investigations in patients admitted with T-LOC and assessed if these patients were given a definitive diagnosis for their presentation. We identified 80 consecutive patients admitted with T-LOC to a university teaching hospital. Eighty-eight percent (70/80) had a computerized topography (CT) brain scan and 49% (34/70) of these scans were inappropriate based on standard guidelines. Almost half (17/80) of electroencephalograms (EEG) and 82% (9/11) of carotid doppler ultrasound performed were not based on clinical evidence of seizure or stroke respectively. Forty-four percent (35/80) of patients had no formal diagnosis documented for their presentation. Inappropriate investigation in T-LOC is very prevalent in the acute hospital, increasing cost of patient care. In addition, there is poor diagnostic formulation for T-LOC ma...
http://hdl.handle.net/10147/621370
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Irish Heart Foundation national audit of stroke care
(2008)
Irish Heart Foundation (IHF)
Irish Heart Foundation national audit of stroke care
(2008)
Irish Heart Foundation (IHF)
Abstract:
Stroke is the third leading cause of death and disability worldwide. It constitutes a formidable burden of disability for patients, their families, health professionals and the wider community. It combines aspects of both acute and chronic disease, and there is increasing evidence that those affected by stroke can benefit to a very significant extent from organised stroke care throughout the course of the illness. Delivering this care requires a unique combination of skills, drawing on neurosciences, cardiovascular medicine, general medicine, the science of ageing, rehabilitation, vascular surgery, and public health. Local and timely evidence on the service performance is essential to assess quality of care and to improve services. This has not been available to date in Ireland. The aim of this project was to conduct a national audit of stroke care in hospital and the community in the Republic of Ireland. This was achieved by completing six separate surveys and by drawing conclusion...
http://hdl.handle.net/10147/310920
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Long-term risk of stroke after transient ischaemic attack: a hospital-based validation of the ABCD2 rule
(2014)
Galvin, Rose; Atanassova, Penka A; Motterlini, Nicola; Fahey, Tom; Dimitrov, Borislav D
Long-term risk of stroke after transient ischaemic attack: a hospital-based validation of the ABCD2 rule
(2014)
Galvin, Rose; Atanassova, Penka A; Motterlini, Nicola; Fahey, Tom; Dimitrov, Borislav D
Abstract:
Abstract Background The ABCD2 clinical prediction rule is a seven point summation of clinical factors independently predictive of stroke risk. The purpose of this cohort study is to validate the ABCD2 rule in a Bulgarian hospital up to three years after TIA. Methods All consecutive admissions to an emergency department with symptoms of a first TIA were included. Baseline data and clinical examinations including the ABCD2 scores were documented by neurologists. Discrimination and calibration performance was examined using ABCD2 cut-off scores of ≥3, ≥4 and ≥5 points, consistent with the international guidelines. The Hosmer-Lemeshow test was used to examine calibration between the observed and expected outcomes as predicted by ABCD2 score within the logistic regression analysis. Results Eighty-nine patients were enrolled to the study with a mean age of 63 years (+/- ...
http://dx.doi.org/10.1186/1756-0500-7-281
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Plaque inflammation and unstable morphology are associated with early stroke recurrence in symptomatic carotid stenosis.
(2014)
Marnane, Michael; Prendeville, Susan; McDonnell, Ciaran; Noone, Imelda; Barry, Mary; Cr...
Plaque inflammation and unstable morphology are associated with early stroke recurrence in symptomatic carotid stenosis.
(2014)
Marnane, Michael; Prendeville, Susan; McDonnell, Ciaran; Noone, Imelda; Barry, Mary; Crowe, Morgan; Mulligan, Niall; Kelly, Peter J
Abstract:
Although symptomatic carotid stenosis is associated with 3-fold increased risk of early stroke recurrence, the pathophysiologic mechanisms of high early stroke risk have not been established. We aimed to investigate the relationship between early stroke recurrence after initial symptoms and histological features of plaque inflammation and instability in resected carotid plaque.
http://hdl.handle.net/10147/314723
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Prevalence of risk factors for ischaemic stroke and their treatment among a cohort of stroke patients in Dublin.
(2000)
McDonnell, R; Fan, C W; Johnson, Z; Crowe, M
Prevalence of risk factors for ischaemic stroke and their treatment among a cohort of stroke patients in Dublin.
(2000)
McDonnell, R; Fan, C W; Johnson, Z; Crowe, M
Abstract:
BACKGROUND: The majority of strokes are due to ischaemia. Risk factors include atrial fibrillation, hypertension and smoking. The incidence can be reduced by addressing these risk factors. This study examines the prevalence of risk factors and their treatment in a cohort of patients with ischaemic stroke registered on a Dublin stroke database. METHODS: Patients admitted to any of three acute hospitals with a diagnosis of stroke during a one-year period in 1997/98 were registered on a database using the European Stroke Database format. Data relating to common risk factors were analysed. RESULTS: There were 238 ischaemic stroke cases registered. The most frequent medical risk factors were: hypertension (45%), atrial fibrillation (27.3%), and previous disabling or non-disabling stroke (33.2%). There was an increasing trend with advancing age for atrial fibrillation (p < 0.001). Some 23% (54/233) were current smokers. A significantly higher proportion of patients with no medical ri...
http://hdl.handle.net/10147/324323
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Stroke care: towards excellence in stroke care in Ireland
(2001)
Council on Stroke, Irish Heart Foundation
Stroke care: towards excellence in stroke care in Ireland
(2001)
Council on Stroke, Irish Heart Foundation
Abstract:
Stroke is an illness with a huge personal and societal impact. It is the most common cause of acquired physical disability and is the cause of the second most common form of dementia, vascular dementia. There were 8,584 acute strokes admitted to hospital in the Republic of Ireland in 1997 and the inhospital mortality is 21% in general hospitals in the EHB region. There are 30,000 people with residual disability from stroke, including hemiparesis (48%), inability to walk (22%), needing help with activities of daily living (24- 53%), clinical depression (32%), and cognitive impairment (33%). This report arose from the realisation of the many groups (patient-advocacy and professional) on the IHF Council on Stroke that strategies for prevention and treatment for this devastating disease are randomly organised, incomplete and under-funded. There is no clearly stated outline of best practice and policy which is relevant to the Republic of Ireland. Focussed prevention and treatment strateg...
http://hdl.handle.net/10147/310942
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Stroke clinical care programme: model of care
(2012)
HSE Quality and Clinical Care Directorate
Stroke clinical care programme: model of care
(2012)
HSE Quality and Clinical Care Directorate
Abstract:
In recent years new techniques and strategies for improving the care of people with stroke have emerged. For example, the benefits of organised clinical services for stroke care have been clearly established. Hospital-based Stroke Units for acute and initial rehabilitation of patients with stroke and TIA are associated with a reduction in death and institutional care of around 20%, with one additional patient returned to community living for every 20 patients treated. Following emergency admission to hospital with stroke, administration of ‘clot-busting’ thrombolysis therapy can reverse or substantially reduce disability in one-third of patients treated within 90 minutes of stroke onset. However, strict administration guidelines mean that only 8-15% of confirmed ischaemic stroke patients are eligible for such treatment. Because of the potential for catastrophic brain haemorrhage associated with thrombolysis given inappropriately and the brief time-window for treatment, substantial o...
http://hdl.handle.net/10147/325086
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Stroke knowledge in an Irish semi-rural community-dwelling cohort and impact of a brief education session.
(2012)
O'Callaghan, Geraldine; Murphy, Sean; Loane, Dorothy; Farrelly, Evelyn; Horgan, Fr...
Stroke knowledge in an Irish semi-rural community-dwelling cohort and impact of a brief education session.
(2012)
O'Callaghan, Geraldine; Murphy, Sean; Loane, Dorothy; Farrelly, Evelyn; Horgan, Frances
Abstract:
Poor knowledge of stroke risk factors and failure to recognize and act on acute symptoms hinders efforts to prevent stroke and improve clinical outcomes. Levels of stroke knowledge are poorly established within Ireland. This study was conducted to establish levels of knowledge among men and women aged >40 years in an Irish community, and also to determine the impact of a single education session on stroke knowledge. Subjects from 2 separate geographical locations were allocated to an intervention group (n = 200), who received stroke information over a 90-minute session, or a control group (n = 200). Both groups completed a stroke knowledge questionnaire at baseline and at 4 weeks after the educational session. Overall, the initial response rate was 70% (280/400); 52% of the respondents knew that the brain is affected by stroke, 58% could list 2 or more risk factors but only 27% could list 2 or more warning signs, 50% would call 999 (emergency number in Ireland) in response to str...
http://hdl.handle.net/10147/285652
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The Cork and Kerry Diabetes and Heart Disease study: a report to the Department of Health and Children and the Southern Health Board.
(1997)
Department of Health (DoH); Creagh, Don; Neilson, Stuart
The Cork and Kerry Diabetes and Heart Disease study: a report to the Department of Health and Children and the Southern Health Board.
(1997)
Department of Health (DoH); Creagh, Don; Neilson, Stuart
Abstract:
The primary aims of the study were: I. To estimate the prevalence of major card iovascular disease (CVD) risk factors, including Type 2 Diabetes Mellitus, in the general population of males and females between the ages of 50-69 years. 2. To estimate the proportion of individuals in this age group at high absolute risk of cardiovascular disease events (Heart Attack and Stroke!. defined on the basis of pre-existing cardiovascular disease or as defined by the framingham CVO risk equations [lJ [2]. 3. To assess the perlormance of two widely used Coronary Heart Disease (CHD) risk-scoring charts in this population (The Sheffield Table [3) and The Cardiac Risk Assessor Chart [4]).
http://hdl.handle.net/10147/575344
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Towards earlier discharge, better outcomes, lower cost: stroke rehabilitation in Ireland
(2014)
Wren, Maev-Ann; Gillespie, Paddy; Smith, Samantha; Kearns, Karen; Wolfe, Charles; Royal...
Towards earlier discharge, better outcomes, lower cost: stroke rehabilitation in Ireland
(2014)
Wren, Maev-Ann; Gillespie, Paddy; Smith, Samantha; Kearns, Karen; Wolfe, Charles; Royal College of Surgeons in Ireland
Abstract:
This report describes the analysis and findings of the Stroke Rehabilitation in Ireland (SRI) study . This study was undertaken with the overall aim of examining rehabilitation services for stroke patients in the Irish healthcare system, identifying patterns of use, an d assessing implications ( in terms of e conomic and health outcomes) of existing and new models of care. The SRI study ha d four main objectives: • to describe current rehabilitation provision for stroke patients in Ireland; • to analyse best practice path way s of stroke rehabilitation; • to compare cost s, outcome s and cost - effectiveness implications of actual and best practice path ways of rehabilitation in Ireland; • to recommend how best to deliver stroke rehabilita tion after the inpatient phase.
http://hdl.handle.net/10147/331957
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What happens to stroke patients after hospital discharge?
(2001)
Noone, I; Fan, C W; Tarrant, H; O'Keeffe, S; McDonnell, R; Crowe, M
What happens to stroke patients after hospital discharge?
(2001)
Noone, I; Fan, C W; Tarrant, H; O'Keeffe, S; McDonnell, R; Crowe, M
Abstract:
Of 231 stroke patients discharged from hospital, 34 patients (14.7%) had died when reviewed 6 months later. Of 195 survivors, 115 (58%) were independent and living in the community. The remaining 80 (42%) patients were dependent. The majority of dependent patients were in institutional care but 29 (36%) were residing in the community of whom a substantial number were not receiving physiotherapy, occupational therapy or day care. Patients who were dependent in nursing homes were less likely to have received physiotherapy (48% versus 70%) or occupational therapy (28% versus 60%) compared to disabled patients in hospital based extended nursing care. 45 patients (24%) had been re-admitted to hospital although only 48% of patients had been reviewed in hospital outpatients since discharge. 64% of patients were on anti-thrombotic treatment. This survey suggests that 6 months after hospital discharge, most stroke patients are still alive and living in the community. Many of the dependent su...
http://hdl.handle.net/10147/323800
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