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Thrombolysis of stroke mimics via telestroke

Stroke & Vascular Neurology 2022年第3期7卷 267-270页

作者： Vivien H Lee Ravyn Howell randheer yadav Sharon Heaton Karen L Wiles Sushil Lakhani Neurology The Ohio State University Wexner Medical CenterColumbusOhioUSA

Background The rate of intravenous tissue plasminogen activator(IVtPA)administered to stroke mimics(SM)occurs in 24%-44%of telestroke *** We reviewed 270 suspected acute ischaemic stroke(AIS)patients who were evaluated by telestroke and received IVtPA from 1 July 2016 to 30 September 2017 at our academic comprehensive stroke *** Among 270 AIS patients who received IVtPA via telestroke,64(23.7%)were diagnosed with *** with patients who had a stroke,the SM group was younger(mean age 56.4 vs 68.2,p<0.0001),more likely to be female(60.9%vs 45.6%,p=0.0324)and had longer door-to needle times(85.3 vs 69.9,p=0.0008).The most common SM diagnoses were migraine 26(40.6%),conversion disorder 12(18.8%),encephalopathy 7(10.9%)and unmasking(9.4%).Among the SM,migraine and conversion disorder were younger compared with the other subgroups(p<0.001).Functional exam elements were noted more frequently in conversion disorder(66.7%)and migraine(34.6%),but rare in other diagnoses(p=0.006).Among the SM,23(35.9%)had a history of a prior similar episodes,and 15(23.4%)had a history of more than 5 *** In our telestroke programme,23.7%of those administered thrombolysis had a final diagnosis of SM.

关键词： needle diagnosis younger

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Role of MRI in the diagnosis and treatment of osteomyelitis in pediatric patients

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World Journal of Radiology 2014年第8期6卷 530-537页

作者： Brian S Pugmire randheer Shailam Michael S Gee Department of Radiology Massachusetts General Hospital Boston MA 01890 United States

Osteomyelitis is a significant cause of morbidity in children throughout the world. Multiple imaging modalities can be used to evaluate for suspected osteomyelitis, however magnetic resonance imaging(MRI) has distinct advantages over other modalities given its ability to detect early changes related to osteomyelitis, evaluate the true extent of disease, depict extraosseous spread of infection, and help guide surgical manage-ment. MRI has assumed a greater role in the evaluation of osteomyelitis with the increase in musculoskeletal infections caused by methicillin-resistant Staphylococ-cus aureus which have unique imaging features that are well-demonstrated with MRI. This review focuses primarily on the use of MRI in the evaluation of osteo-myelitis in children and will include a discussion of the clinically important and characteristic findings on MRI of acute bacterial osteomyelitis and related conditions.

关键词： Magnetic resonance imaging Osteomyelitis Pediatrics Infectious diseases

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