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Related Concept Videos

Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Stroke: Introduction and Types01:29

Stroke: Introduction and Types

A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...

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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

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Published on: January 18, 2018

Primary stroke centers should be located using maximal coverage models for optimal access.

Enrique C Leira1, Geoffrey Fairchild, Alberto M Segre

  • 1Division of Cerebrovascular Diseases, Carver College of Medicine, Iowa City, IA, USA. enrique-leira@uiowa.edu

Stroke
|July 20, 2012
PubMed
Summary
This summary is machine-generated.

A new algorithmic approach to locating Primary Stroke Centers (PSCs) significantly improves population coverage compared to the current self-initiated model. This directed strategy ensures more people have access to timely stroke care.

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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

Published on: January 15, 2017

Area of Science:

  • Public Health
  • Geographic Information Systems
  • Healthcare Management

Background:

  • Current self-initiated hospital acquisition of Primary Stroke Center (PSC) certification leads to inadequate geographic coverage in the US.
  • A directed, algorithmic approach could optimize PSC placement and improve population access to stroke care.

Purpose of the Study:

  • To develop and evaluate a web-based calculator using location-allocation modeling to determine near-optimal PSC locations.
  • To compare population coverage of the current PSC network in Iowa versus a maximal coverage model.
  • To estimate the efficiency gains in population coverage by using a maximal coverage model for future PSC placement.

Main Methods:

  • Employed geographic location-allocation modeling to create a universal web-based calculator.
  • Analyzed existing PSC network coverage in Iowa.
  • Compared current coverage with hypothetical coverage under a maximal coverage model for both existing and additional PSCs.

Main Results:

  • The 12 existing PSCs in Iowa cover 37% of the population (30-minute radius); maximal coverage model placement would cover 47.5%.
  • Achieving 75% population coverage requires 54 additional PSCs via the self-initiated model.
  • Only 31 additional PSCs are needed to reach 75% coverage using the maximal coverage model.

Conclusions:

  • A directed, maximal coverage model approach is justified for locating additional PSCs or recombinant tissue-type plasminogen activator-capable hospitals.
  • This algorithmic strategy substantially increases population access to acute stroke care.
  • Optimizing PSC locations enhances the efficiency of stroke care networks.