Education is needed to increase the speed with which healthcare personnel identify and treat PCS, a neurologist says.
“The symptoms of a PCS are not the typical symptoms that we tell patients to recognize as a stroke,” study investigator Julián Alejandro Rivillas, MD, a fellow in vascular neurology at the Université de Montréal and Centre Hospitalier de l’Université de Montréal, toldPrehospital scales like the Cincinnati Prehospital Stroke Scale, which is often used by emergency medical services, assess for facial droop, arm drift, and abnormal speech.
But these scales would not detect a PCS, noted Rivillas. The signs of a PCS generally are not familiar to the public and to first-line responders. This unfamiliarity leads to failure to recognize a PCS promptly, transport a patient quickly to the hospital, and initiate treatment promptly. Thus, the opportunity for intravenous thrombolysis is sometimes lost, explained Rivillas. The symptoms of a PCS can include dizziness, hearing loss, difficulty swallowing, double vision, and loss of balance.The investigators analyzed data from 2018 to 2022 from 20 Canadian stroke centers that participated in the OPTIMISE registry. They included 6391 patients in their analysis. Patients with PCS were younger , had longer onset-to-door times , and longer onset-to-puncture times of 0 at 90 days between patients with ACS and those with PCS was not significant. Similarly, the difference in the rate of mRS of 1 at 90 days between patients with ACS and those with PCS was not significant. Despite the similarities in the 3-month functional outcomes between the two groups of patients, Rivillas stressed that the data only captured part of the picture, since this follow-up 90-day analysis failed to capture the entire patient population. “We don’t know what happened with the other 50% of the patients,” said Rivillas. The investigators could not conclude that functional outcomes were the same at 90 days across arms because a lot of data were missing.“Clinically, ischemic stroke due to a posterior circulation occlusion is more difficult to recognize and evaluate,” Michael D. Hill, MD, professor of medicine at the University of Calgary’s Cumming School of Medicine, Calgary, told. “Thus, delays in presentation and delays in care are known to occur, and these data confirm and quantify those differences,” said Hill, who also is president of CNSF and did not participate in the study. A training initiative is therefore necessary, he said. “The solution, then, is education for all manner of healthcare personnel so that stroke can be recognized.” The study was conducted without external funding. Rivillas and Hill reported having no relevant financial relationships.
Cerebrovascular Accident CVA Cerebrovascular Accident (CVA) Thromboembolism Canada Canadian Otolaryngology ENT Specialty ENT Speciality General Anesthesia Acute Pain Pain Management Anesthesia Anesthetic Anesthaesia Anaesthetic Health Personnel Health Care Manpower Healthcare Personnel Healthcare Personnel (HCP) Hospitals Intracranial Hemorrhage
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