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Regulation of Stroke Volume01:27

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The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
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Cardiac output (CO), the amount of blood the heart pumps per minute, is a parameter in cardiovascular physiology determined by stroke volume and heart rate. Stroke volume, the amount of blood pushed from one of the ventricles per heartbeat, is influenced by preload, afterload, and contractility.
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Characterizing coma in large vessel occlusion stroke.

Michael J Young1, Amine Awad2, Alexander Andreev3

  • 1Department of Neurology, Massachusetts General Hospital and Harvard Medical School, 101 Merrimac Street, Suite 310, Boston, MA, 02114, USA. michael.young@mgh.harvard.edu.

Journal of Neurology
|February 17, 2024
PubMed
Summary
This summary is machine-generated.

Coma is a frequent presentation in large vessel occlusion (LVO) stroke, often linked to poor outcomes. Early recognition of LVO stroke presenting with coma is crucial for timely intervention and improved patient prognosis.

Keywords:
ComaConsciousnessLVONeuroethicsStrokeThrombectomy

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Area of Science:

  • Neurology
  • Stroke Medicine
  • Critical Care

Background:

  • Coma, a state of impaired consciousness, is not well-characterized in ischemic stroke.
  • Large vessel occlusion (LVO) stroke requires prompt diagnosis and treatment.
  • The presentation of coma in LVO stroke is underexplored.

Purpose of the Study:

  • To determine the incidence and clinical features of coma in patients with LVO stroke.
  • To investigate the outcomes associated with coma in LVO stroke.

Main Methods:

  • Retrospective identification of LVO stroke patients from July 2018 to December 2020.
  • Coma defined as a score of 3 on NIHSS item 1a.
  • Analysis of occlusion locations, treatments, and patient outcomes.

Main Results:

  • 4.4% of LVO stroke patients presented with coma (28/637).
  • Coma patients had significantly higher NIHSS scores (median 32 vs. 11).
  • Coma independently increased odds of comfort care (aOR 6.75) and decreased odds of good 90-day functional outcome (aOR 0.12).

Conclusions:

  • Coma is a significant presentation in LVO stroke, occurring in both anterior and posterior circulation occlusions.
  • Delayed recognition of LVO in comatose patients contributes to poor outcomes.
  • High suspicion and early diagnosis are vital for improving care in LVO stroke patients presenting with coma.