Neurology Research International最新文献

{"title":"Direct Oral Anticoagulants in Patients Undergoing Urgent Reperfusion for Nonvalvular Atrial Fibrillation-Related Ischemic Stroke: A Brief Report on Literature Evidence.","authors":"Luca Masotti,&nbsp;Elisa Grifoni,&nbsp;Alessandro Dei,&nbsp;Vieri Vannucchi,&nbsp;Federico Moroni,&nbsp;Grazia Panigada,&nbsp;Costanza Nicotra,&nbsp;Stefano Spolveri,&nbsp;Giancarlo Landini","doi":"10.1155/2019/9657073","DOIUrl":"https://doi.org/10.1155/2019/9657073","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal timing for starting anticoagulation in the early phase of nonvalvular atrial fibrillation (NVAF)-related acute ischemic stroke (AIS) remains a challenge, especially in patients undergoing urgent reperfusion by systemic thrombolysis or mechanical thrombectomy. The aim of our study was to review the literature evidence reporting on safety of direct oral anticoagulants (DOACs) starting in the early phase of NVAF-related AIS undergoing systemic thrombolysis and/or mechanical thrombectomy.</p><p><strong>Materials and methods: </strong>We reviewed the PubMed databases searching articles reporting on efficacy and safety of DOACs starting time within two weeks from AIS onset in patients undergoing systemic thrombolysis and/or mechanical thrombectomy.</p><p><strong>Results: </strong>Three studies were selected, overall including one hundred and six patients (62 females, 58.4%). Median National Institute of Health Stroke Scale (NIHSS) score at hospital admission ranged from 9 to 13 points. Median DOACs starting time ranged from 2 to 6 days. Median CHA₂DS₂-VASC score ranged from 4 to 6 points. Follow-up was limited to 14 days in one study, 30 days in another, and 90 days in a third one. Overall, stroke recurrence and/or intracranial bleeding occurred in two patients (1.9%) and no patient died at follow-up.</p><p><strong>Conclusion: </strong>Small sample size real life studies seem to demonstrate that the introduction of DOACs in the early phase of NVAF-related AIS undergoing urgent reperfusion is efficacious and safe. Prospective RCTs are necessary to confirm these findings.</p>","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"2019 ","pages":"9657073"},"PeriodicalIF":1.5,"publicationDate":"2019-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/9657073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37100347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Encephalopathy Only Stroke Codes\" (EoSC) Rarely Result in Stroke as Final Diagnosis.","authors":"Patrick M Chen,&nbsp;Dawn M Meyer,&nbsp;Robert Claycomb,&nbsp;Kunal Agrawal,&nbsp;Brett C Meyer","doi":"10.1155/2019/2105670","DOIUrl":"https://doi.org/10.1155/2019/2105670","url":null,"abstract":"<p><p>Stroke codes prompted by isolated encephalopathy often result in nonstroke final diagnoses but require intensive stroke center resources. We assessed the likelihood of \"Encephalopathy only Stroke Codes (EoSC)\" resulting in a true stroke (EoSC CVA+) final diagnosis. 3860 patients were analyzed in a prospective stroke code registry from 2004 to 2016. EoSC was defined using a standard and an exploratory definition. Definition 1 included EoSC patients as stroke codes where NIHSS was nonzero for LOC questions (questions la, 1b, and lc) but remainder of the NIHSS was zero. Definition 2 included the same definition but allowed symmetric pairings on motor questions (5a/5b, 6a/6b, or Question 4 scoring a 3). Groups were assessed for final diagnosis of stoke (EoSC CVA+) or not stroke (EoSC CVA-). EoSC accounted for 60/3860 (1.55%) of total stroke codes. EoSC CVA+ was found in 5/3860 (0.13%) of all stroke codes, 5/60 (8.33%) of EoSC stroke codes, and 5/1514 (0.33%) of all strokes. For Definition 2, EoSC accounted for 96/3860 (2.5%) of total stroke codes. EoSC CVA+ was found in 9/3860 (0.23%) of all stroke codes, 9/96 (9.38%) of EoSC stroke codes, and 9/1514 (0.59%) of all strokes. On multivariable logistic regression analysis, diabetes was the highest predictor of stroke (p=0.05). Encephalopathy only Stroke Codes only rarely result in cases with a true final diagnosis of stroke (EoSC CVA+), accounting for 0.1-0.2% of all stroke codes and 8-9% of EoSC stroke codes. This may have important significance for mobilization of limited acute stroke code resources in the future.</p>","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"2019 ","pages":"2105670"},"PeriodicalIF":1.5,"publicationDate":"2019-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/2105670","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37069720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Evaluation of Patients with Vestibular Dysfunction.","authors":"Vijay Renga","doi":"10.1155/2019/3931548","DOIUrl":"https://doi.org/10.1155/2019/3931548","url":null,"abstract":"<p><p>Dizziness is a common reason for outpatient neurology consultation. Oftentimes, a complete workup by general practitioner, including MRI brain fails to reveal a cause. Some patients would have also undergone an ENT evaluation before approaching neurology for an answer. Such scenarios provide a challenge as well as opportunity for the neurologist to exercise their knowledge and clinical skills in arriving at a diagnosis. Conditions like 'Unspecified Vestibular Dysfunction' and 'Presbyvertigo' are often the underlying causes, which are either not recognized or misdiagnosed as BPPV, psychogenic or perceptive dizziness. This article's goal is to help understand vestibular system and diagnose vestibular dysfunction in clinical practice.</p>","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"2019 ","pages":"3931548"},"PeriodicalIF":1.5,"publicationDate":"2019-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/3931548","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37050847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Diagnosis: Lived Experiences of Persons with Spinal Cord Injury in a Selected Town in Ghana.","authors":"Abdul-Ganiyu Fuseini,&nbsp;Patience Aniteye,&nbsp;Afizu Alhassan","doi":"10.1155/2019/9695740","DOIUrl":"https://doi.org/10.1155/2019/9695740","url":null,"abstract":"<p><strong>Background: </strong>Although several studies have been conducted on the lived experiences of persons with spinal cord injury (SCI) in high income countries, there is no published data on such experiences in Ghana. The purpose of this study was to explore the lived experiences of persons with SCI in the Tamale Metropolis of the Northern Region of Ghana.</p><p><strong>Material and methods: </strong>A qualitative descriptive design involving thirteen participants was conducted at the Tamale Metropolis-Ghana. A purposive sampling technique was used to recruit participants, using the Neurosurgical Unit of the Tamale Teaching Hospital as an outlet for recruitment of the sample. Data was gathered mainly through face-to-face in-depth interviews. The data was analyzed concurrently with data collection, using thematic content analysis. Ethical approval was obtained for the study from the Noguchi Memorial Institute for Medical Research and the research unit of the Tamale Teaching Hospital.</p><p><strong>Results: </strong>The three main themes that emerged from the data during analysis were \"physical effects,\" \"psychological effects,\" and \"social issues.\" <i>Conclusion</i>. The findings from the study suggest that SCI is a life threatening condition and that persons with SCI grapple with a myriad of physical symptoms that range from chronic pain and paralysis of lower and/or upper limbs, to bladder and bowel incontinence. These physical symptoms have significant psychological and social effects on the functioning of the affected persons.</p>","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"2019 ","pages":"9695740"},"PeriodicalIF":1.5,"publicationDate":"2019-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/9695740","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36989118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Cerebral Amyloid Angiopathy in Various Neurodegenerative Dementia Syndromes: A Neuropathological Study.","authors":"Jacques De Reuck","doi":"10.1155/2019/7247325","DOIUrl":"https://doi.org/10.1155/2019/7247325","url":null,"abstract":"<p><strong>Purpose: </strong>The Boston criteria for cerebral amyloid angiopathy (CAA) have to be confirmed by postmortem examination. The present study investigates the incidence and the cerebrovascular impact of the severity of CAA in various neurodegenerative dementia diseases.</p><p><strong>Material and methods: </strong>208 patients underwent an autopsy. They consisted of 92 brains with Alzheimer's disease (AD), 46 with frontotemporal lobar degeneration (FTLD), 24 with progressive supranuclear palsy (PSP), 21 with Lewy body dementia (LBD), 5 with corticobasal degeneration (CBD), and 20 controls. In addition to the macroscopic examination, a whole coronal section of a cerebral hemisphere, at the level of the mamillary body, was taken for semiquantitative microscopic evaluation of the small cerebrovascular lesions.</p><p><strong>Results: </strong>CAA is present in 2/3% of the AD brains of which half of them have a severe form, grade 3. Only the latter displays more cerebrovascular lesions. CAA is present in 45% of the LBD brains. Cortical microinfarcts are only more frequent in the CAA grade 3 group. In LBD additional AD pathology is present in 41% of the CAA grade 0, 83% in grade 1-2, and 100% in grade 3. In PSP only 21% had CAA grade 1-2. In FTLD, CBD, and normal controls no CAA pathology is observed.</p><p><strong>Conclusions: </strong>The present study shows that CAA is most frequently associated to AD but that only the severe form displays more cerebrovascular lesions. LBD is the second most frequent disease associated to CAA with a clear correlation between the incidence of the associated AD features and the increasing severity of the CAA. In PSP only 21% display mild CAA features. PSP, tau-FTLD, and CBD are part of the Pick complex diseases, who are known to have a favourable vascular profile which can explain their low incidence of cerebrovascular lesions, in contrast to AD and LBD brains.</p>","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"2019 ","pages":"7247325"},"PeriodicalIF":1.5,"publicationDate":"2019-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/7247325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36989116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Events of Antiepileptic Drugs Using Indonesian Version of Liverpool Adverse Events Profile.","authors":"Astri Budikayanti,&nbsp;Lubna Muhammad Qadri,&nbsp;Zakiah Syeban,&nbsp;Luh Ari Indrawati,&nbsp;Fitri Octaviana","doi":"10.1155/2018/8490639","DOIUrl":"https://doi.org/10.1155/2018/8490639","url":null,"abstract":"<p><strong>Introduction: </strong>Adverse events (AEs) associated with antiepileptic drugs (AEDs) affect people with epilepsy's (PWE) quality of life. A study conducted in 15 European countries showed that the AEs prevalence of AEDs in PWE was up to 80%. To date, there are no validated screening instruments to detect AEs of AEDs in Indonesian PWE. Therefore its epidemiology is currently unknown. This study aimed to validate the Indonesian version of Liverpool Adverse Events Profile (LAEP), consequently increasing physicians' awareness toward the probability of AEs and its necessary evaluation. Furthermore, this study was intended to determine the AEs prevalence of AEDs in Indonesian PWE.</p><p><strong>Methods: </strong>The questionnaire was translated from English into Indonesian version. The validity and reliability were tested using Spearman correlation and Cronbach's alpha measurement. An observational cross-sectional study was carried out on consecutive PWE in outpatient clinic, Cipto Mangunkusumo Hospital. We analyzed duration of epilepsy, onset of epilepsy, seizure frequency, type of epilepsy, etiology and epilepsy syndrome, number of AEDs, duration of AED use, and comorbidity.</p><p><strong>Results: </strong>All of the 19 items in the questionnaire were valid, with correlation coefficient ranging from 0.465 to 0.690 (moderate-strong correlation). Cronbach's alpha value was 0.846 (good consistency). The total of 90 subjects were enrolled with 91% screened as having AEs using LAEP questionnaire. The most common AEs were tiredness (67.8%), sleepiness (66.7%), memory problems (62.2%), and difficulty in concentrating (56.7%). The only clinical variable that influenced AEs was polytherapy.</p><p><strong>Conclusion: </strong>The Indonesian version of LAEP was a valid and reliable instrument to screen AE of AEDs in PWE. Almost all the subjects in this study were suspected having AEs. Polytherapy was the independent factor of AE.</p>","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"2018 ","pages":"8490639"},"PeriodicalIF":1.5,"publicationDate":"2018-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/8490639","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36866849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency of Different Types of Diagnostic Errors in Patients with Central Nervous System Infections: A Cross-Sectional Observational Study.","authors":"HamidReza Naderi,&nbsp;Fereshte Sheybani,&nbsp;Omid Khosravi,&nbsp;Mehdi Jabbari Nooghabi","doi":"10.1155/2018/4210737","DOIUrl":"https://doi.org/10.1155/2018/4210737","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the frequency of different types of diagnostic errors in patients with central nervous system (CNS) infection from the onset of symptoms to admission to the hospital, where the correct diagnosis was made.</p><p><strong>Methods: </strong>A cross-sectional observational design was used, and the information was collected by interviewing patients and/or their knowledgeable relatives as well as reviewing the accompanying medical record documents and hospital records.</p><p><strong>Results: </strong>Of 169 adult patients with CNS infection, 129 (76.33%) were subject to diagnostic errors. Failure in ordering tests and hypothesis generation were the most common types of diagnostic errors that accounted for more than 70% of errors. Several contributing factors that were associated with incorrect diagnostic hypotheses included failure in taking a patient's comprehensive history such as detecting relevant epidemiological clues, conducting a full clinical examination, and interpreting diagnostic evidence. The relationship between poor clinical outcome and longer delay from the onset of illness to diagnosis, inappropriate empirical antibiotic therapy, and lower level of consciousness on admission were found to be statistically significant.</p><p><strong>Conclusions: </strong>Although diagnosis and management of CNS infection in some patients are straightforward, clinical decision making in facing patients with complex scenarios often requires clinical reasoning instead of relying only on intuitive diagnosis. Justification in requesting diagnostic measures and interpretation of their results based on clinical findings and patient information could be a critical factor in preventing a substantial number of diagnostic errors in patients with CNS infection.</p>","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"2018 ","pages":"4210737"},"PeriodicalIF":1.5,"publicationDate":"2018-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/4210737","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36809792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potentiation of Antidepressant Effects of Agomelatine and Bupropion by Hesperidin in Mice.","authors":"Jegan Sakthivel Nadar, Pravin Popatrao Kale, Pramod Kerunath Kadu, Kedar Prabhavalkar, Ruchita Dhangar","doi":"10.1155/2018/9828639","DOIUrl":"10.1155/2018/9828639","url":null,"abstract":"<p><p>Hesperidin, a well-known flavanone glycoside mostly found in citrus fruits, showed neuroprotective and antidepressant activity. Agomelatine, a melatonergic MT₁/MT₂ agonist and 5-HT_2C receptor antagonist, exhibits good antidepressant efficacy. Bupropion has been widely used for the treatment of depression because of its dopamine and norepinephrine reuptake inhibition. The objective of present study was to assess the antidepressant effects of hesperidin combination with agomelatine or bupropion. Male Swiss Albino mice received treatment of saline, vehicle, 'hesperidin alone', 'agomelatine alone', hesperidin+agomelatine, 'bupropion alone', hesperidin+bupropion, and agomelatine+bupropion for 14 days. The immobility period was analysed 30 min after the treatment in forced swim and tail suspension tests. Dopamine and serotonin levels were analysed in hippocampus, cerebral cortex, and whole brain using HPLC with fluorescence detector. Hesperidin plus agomelatine treated group was better in terms of decrease in immobility period and increase in dopamine and serotonin levels when compared to their respective monotherapy treated groups.</p>","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"2018 ","pages":"9828639"},"PeriodicalIF":1.5,"publicationDate":"2018-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36748594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Hyperbaric Oxygen Therapy on Functional Impairments Caused by Ischemic Stroke.","authors":"Emily R Rosario,&nbsp;Stephanie E Kaplan,&nbsp;Sepehr Khonsari,&nbsp;Garrett Vazquez,&nbsp;Niyant Solanki,&nbsp;Melanie Lane,&nbsp;Hiriam Brownell,&nbsp;Sheila S Rosenberg","doi":"10.1155/2018/3172679","DOIUrl":"https://doi.org/10.1155/2018/3172679","url":null,"abstract":"<p><strong>Background: </strong>While research suggests a benefit of hyperbaric oxygen therapy (HBOT) for neurologic injury, controlled clinical trials have not been able to clearly define the benefits.</p><p><strong>Objective: </strong>To investigate the effects of HBOT on physical and cognitive impairments resulting from an ischemic stroke.</p><p><strong>Methods: </strong>Using a within-subject design a baseline for current functional abilities was established over a 3-month period for all subjects (n=7). Each subject then received two 4-week periods of HBOT for a total of 40 90-minute treatments over a 12-week period. Subjects completed a battery of assessments and had blood drawn six times over the 9-month total duration of the study.</p><p><strong>Results: </strong>We found improvements in cognition and executive function as well as physical abilities, specifically, improved gait. Participants reported improved sleep and quality of life following HBOT treatment. We also saw changes in serum levels of biomarkers for inflammation and neural recovery. In the functional domains where improvement was observed following HBOT treatment, the improvements were maintained up to 3 months following the last treatment. However, the physiological biomarkers showed a pattern of more transient changes following HBOT treatment.</p><p><strong>Conclusions: </strong>Findings from this study support the idea of HBOT as a potential intervention following stroke.</p>","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"2018 ","pages":"3172679"},"PeriodicalIF":1.5,"publicationDate":"2018-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/3172679","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36642930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and Attitudes of Saudi Emergency Physicians toward t-PA Use in Stroke.","authors":"Ali M Al Khathaami,&nbsp;Haya Aloraini,&nbsp;S Almudlej,&nbsp;Haifa Al Issa,&nbsp;Nourhan Elshammaa,&nbsp;Sami Alsolamy","doi":"10.1155/2018/3050278","DOIUrl":"https://doi.org/10.1155/2018/3050278","url":null,"abstract":"<p><strong>Background and objectives: </strong>Tissue plasminogen activator (t-PA) within 4.5 hours from onset improves outcome in patients with ischemic stroke and has been recommended by several international guidelines. Since its approval in 1996, the debate among emergency physicians continues particularly around the result interpretation of the first positive randomized controlled trial, the National Institute of Neurological Disorders and Stroke (NINDS) clinical trial. This lack of consensus might negatively affect the delivery of effective stroke care. Here we aimed to assess the knowledge and attitude of Saudi emergency physicians toward t-PA use within 4.5 hours of onset in acute ischemic stroke.</p><p><strong>Methods: </strong>A web-based, self-administered, locally designed questionnaire was sent to all emergency physicians practicing in the city of Riyadh from January to September 2017.</p><p><strong>Results: </strong>Out of 450 emergency physicians, 122 from ten hospitals in Riyadh participated in the survey, with a 27% response rate. The majority of participants were men (78%), and their mean age was 40 ± 8 years. Half of the participants were board certified, and 36% were consultants. Half of the participants consider the evidence for t-PA use in stroke within 4.5 hours of stroke onset to be controversial, and 41% recommend against its use due to lack of proven efficacy (37%), the risk of hemorrhagic complications (35%), lack of stroke expertise (21%), and medicolegal liability (9%). Nearly half were willing to administer IV t-PA for ischemic stroke in collaboration with remote stroke neurology consultation if telestroke is implemented.</p><p><strong>Conclusion: </strong>Our study detected inadequate knowledge and a negative attitude among Saudi emergency physicians toward t-PA use in acute stroke. This might negatively impact patient outcome. Therefore, we recommend developing urgent strategies to improve emergency physicians' knowledge, attitudes, and beliefs in the management of acute stroke.</p>","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"2018 ","pages":"3050278"},"PeriodicalIF":1.5,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/3050278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36621663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}