Putra Acute Stroke protocol

Muda, Ahmad Sobri; Kamis, Mohd Fandi Al Khafiz; Yaakob, Mohd Naim Mohd; Rahim, Ezamin Abdul; Mahmood, Mohamad Khairi; Noh, Mohamad Syafeeq Faeez Md; Arshad, Nabila Hanem; Hassan, Hasyma Abu

doi:10.32896/cvns.v3n4.12-14

Cited by 4 publications

(3 citation statements)

References 4 publications

(7 reference statements)

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“… 4 In the field of AIS, a huge interest in intracranial atherosclerotic disease has meant a wider usage of VWI. 5 Our institution's stroke protocol 6 routinely incorporates VWI for the imaging of patients clinically presenting with acute stroke, with the scan parameters presented in Table 1 .…”

Section: Discussionmentioning

confidence: 99%

The Utility of Vessel Wall Imaging in the Postulation of Acute Ischemic Stroke With Spontaneous Recanalization Pathophysiology

Noh

Rashid

Hoo

et al. 2022

Topics in Magnetic Resonance Imaging

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:Recent advances in technology, particularly in the field of magnetic resonance imaging, have brought forth new sequences, including vessel wall imaging (VWI). Traditionally, the workup for intracranial vascular pathology has always turned to luminal imaging using computed tomography angiography, magnetic resonance angiography, or digital subtraction angiography. Since its introduction, VWI has enabled researchers and practicing clinicians to better understand disease processes and manage patients to the best standard of care possible. Spontaneous recanalization in acute ischemic stroke (AIS) is a known but understudied phenomenon. Available literature has looked at this phenomenon and postulated the occurrence based on conventional cross-sectional imaging and angiography; however, objective evidence pointing to the occurrence of this phenomenon is scarce. We would like to share our experience using VWI in a patient who was clinically suspected to have a middle cerebral artery syndrome at onset, with resolution of the symptoms 3 hours after initial presentation. VWI showed vessel wall enhancement at the suspected vessel involved, with evidence of acute infarcts at the vascular territory supplied. A presumptive diagnosis of AIS with spontaneous recanalization was made. Our experience could potentially aid in the understanding of spontaneous recanalization in patients with AIS, particularly in the postulation of the pathophysiology.

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Section: Discussionmentioning

confidence: 99%

The Utility of Vessel Wall Imaging in the Postulation of Acute Ischemic Stroke With Spontaneous Recanalization Pathophysiology

Noh

Rashid

Hoo

et al. 2022

Topics in Magnetic Resonance Imaging

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“…Although many centers utilize computed tomography (CT), early infarct signs on CT can be subtle and advanced information such as infarct core and volume cannot be determined from CT alone. Thus, we have adopted the Putra Acute Stroke Protocol, where the first three MRI sequences are completed within 8 min, consisting of diffusion-weighted imaging (DWI), fluid attenuation inversion recovery (FLAIR) and magnetic resonance angiography (MRA) [ 12 ]. Using data from these three sequences is adequate to determine eligibility for IVT, followed by delivery of IVT in the MRI suite.…”

Section: Methodsmentioning

confidence: 99%

Establishing a hyperacute stroke service during the COVID-19 pandemic: our institution’s one year experience

et al. 2023

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Background and aims The corononavirus 2019 (COVID-19) pandemic resulted in modifications in the workflow and redistribution of human resources, causing challenges in setting up of an acute stroke service. We would like to share our preliminary outcome amid this pandemic, to determine if the implementation of COVID-19 standard operating procedures (SOPs) affected the delivery of our hyperacute stroke service. Methods We retrospectively analyzed one-year data from our stroke registry that began with the establishment of our hyperacute stroke service at Universiti Putra Malaysia Teaching Hospital from April 2020 until May 2021. Results Setting up acute stroke services during the pandemic with constrained manpower and implementation of COVID-19 SOPs, was challenging. There was a significant dip of stroke admission from April to June 2020 due to the Movement Control Order (MCO) implemented by the government to curb the spread of COVID-19. However, the numbers of stroke admission steadily rose approaching 2021, after the implementation of recovery MCO. We managed to treat 75 patients with hyperacute stroke interventions i.e. intravenous thrombolysis (IVT), mechanical thrombectomy (MT) or both. Despite implementing COVID-19 SOPs and using magnetic resonance imaging (MRI) as our first line acute stroke imaging modality, clinical outcomes in our cohort were encouraging; almost 40% of patients who underwent hyperacute stroke treatment had early neurological recovery (ENR), and only 33% of patients had early neurological stability (ENS). In addition, we were able to maintain our door-to-imaging (DTI) and door-to-needle (DTN) time in line with international recommendations. Conclusions Our data reflects that COVID-19 SOPs did not deter successful delivery of hyperacute stroke services in our center. However, bigger and multi center studies are required to support our findings.

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“…We describe a patient with COVID-19 associated carotid atherothrombosis and stroke, whom was managed in our institution, as well as the vessel wall imaging (VWI) findings via magnetic resonance imaging (MRI) using our protocol. 3 …”

Section: Introductionmentioning

confidence: 99%

Vessel wall imaging in COVID-19 associated carotid atherothrombosis and stroke: a case report and literature review

Noh

Khan

Sabri

et al. 2022

J Cent Nerv Syst Dis

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COVID-19 associated neurological syndromes, including acute ischemic stroke, pose a challenge to treating physicians. The role of MRI in aiding diagnosis and further management is indispensable. The advent of new MRI sequences such as vessel wall imaging (VWI) allows an avenue in which these patients could be better investigated and treated. We describe our experience in managing a patient with COVID-19 associated atherothrombosis and stroke, focusing on the VWI imaging findings.

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Putra Acute Stroke protocol

Abstract: Putra Acute Stroke protocol

Cited by 4 publications

References 4 publications

The Utility of Vessel Wall Imaging in the Postulation of Acute Ischemic Stroke With Spontaneous Recanalization Pathophysiology

The Utility of Vessel Wall Imaging in the Postulation of Acute Ischemic Stroke With Spontaneous Recanalization Pathophysiology

Establishing a hyperacute stroke service during the COVID-19 pandemic: our institution’s one year experience

Vessel wall imaging in COVID-19 associated carotid atherothrombosis and stroke: a case report and literature review

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