Use of a computerized information system in the management of patients with transient cerebral ischemia

Abstract

A computerized information system has been developed for storing and retrieving the clinical, demographic and laboratory data on 267 patients with transient cerebral ischemia admitted to Duke University Hospital during the past 4 years. The major objective of this computer system is to improve patient care by providing the clinician with immediate information for decision-making and prognostication, based on experience with prior patients with cerebral ischemia similar to those under the clinician's care. The data bank also provides a resource for clinical investigation for transient cerebral ischemia, and represents a repository of detailed information not available in the usual printed sources of medical instruction.

Short-Term Outcome of Medically Treated Patients with Transient Ischemic Attacks, Reversible Ischemic Neurologic Deficits and Strokes with Minimum Residuum

“…The few stud ies available suggest an incidence of about 7% in the first 3 months [5] in nontreated patients and of about 1.5% in medically treated patients [6]. In other series the period between the initial ischemic event and the beginning of the follow-up is variable or too long [22][23][24][25], In our series (which, although retrospective, is illustrative since all the pa-ticnts entered the study within the 1st week after the ischemic event and none was lost to follow-up) 2.5% of strokes with moderate or severe disability were found in the first 3 months. An additional 2.5% suffered from TIA, RIND or SMR during that period.…”

Neural Networks for Ischemic Stroke

“…The response to each symptom section was processed using a computer algorithm that simulated clinical judgment by related to laterality and distribution of the TIA/stroke in a manner similar to that used by a clinician. 16 As an example, the network for double vision is presented in Figure 1, and its architecture, training process, and application are described in the Appendix.…”

Diagnostik und Behandlungsmöglichkeiten extrakranieller Verschlußprozesse der Arteria carotis*

“…In umfangreichen Untersuchungsserien liegt die Letalität der Angiographie bei 0,1% ftir unausgelesene Patientengruppen (53,294,376,552), in Untersuchungsserien von Kranken mit zerebralen Gefäßprozessen ist mit einer Letalität bis etwa 1% zu rechnen (215,238,477,493). Die Häufigkeit bleibender neurologischer Ausfälle nach Angiographien ist ftir unausgelesene Patientengruppen um 0,2% anzusetzen (53), Patienten mit zerebralen Gefäßprozessen unterliegen demgegenüber einem Risiko zwischen 0,5% (130,215,477,491) und 5% (134,250,389).…”

“…Demgegenüber zeigen Patienten mit Veränderungen an der Karotis in etwa einem Drittel der Fälle gleichzeitig eine periphere arterielle Verschlußkrankheit(532). Die Häufigkeit peripherer Durchblutungsstörungen bei Patienten mit transitorischen ischämischen Attacken wird mit 10 bis 25% angegeben(22,109,124,233,238,472,491). Ebenso wird die Häufigkeit einer Beteiligung der Retinagefäße bei Patienten mit extrakraniellen Karotisveränderungen von Egli et al (1972) mit 20 % angegeben (127).…”