Time is brain: Stroke thrombolysis in Brunei Darussalam
2013
WCN 2013 No: 2225 Topic: 3 — Stroke Is thrombolysis realizable at the Department of Neurology, Fann Teaching Hospital, Dakar-Senegal? D. Coulibaly, Y. Bassong, P. Mbonda, K. Toure, A.G. Diop, M.M. Ndiaye. Neurology, Cheikh Anta Diop, Dakar, Senegal Background and purpose: Stroke is a real health problem with a high morbidity and mortality in developing countries. This figure is increasing and worsening because of a problem of management. Nevertheless, the organization of care in the acute phase significantly reduces the cost, morbidity and mortality of stroke. Among these treatments, thrombolysis is the most effective therapeutic means to prevent lasting disability. However neurological clinics exist in Africa, thrombolysis in stroke patients is not updated. The study focused on the feasibility of thrombolysis in our neurological department. Methods: This is a prospective study from September 2010 to April 2012 in a population of patients attending the Department of Neurology, Fann Teaching Hospital of Dakar-Senegal for stroke. Data on sociodemographic, lifestyle, delay to attend the clinic and to realize the CT scan of the brain were collected. We performed univariate and multivariate comparing the time of consultation and achievements of brain scan with socioeconomic data. Results: Data of 285 patients was collected. They had a mean age of 56.5 years, male (50%), and ischemic stroke (73%). The main risk factors for stroke were: hypertension and diabetes. The consultation period was within 3 h for 19.8% and within 6 h for 15.1%. 23.3% came by ambulance and 66.7% by public transport. 9% had the CT scan performed within 3 h and 18% within 6 h. No statistically significant difference between time compared to variables of interest before 6 h was observed. Conclusions: Thrombolysis appears feasible in our clinic. doi:10.1016/j.jns.2013.07.917 Abstract — WCN 2013 No: 2278 Topic: 3 — Stroke Time is brain: Stroke thrombolysis in Brunei Darussalam WCN 2013 No: 2278 Topic: 3 — Stroke Time is brain: Stroke thrombolysis in Brunei Darussalam G.C. Chan, U. Meyding-Lamade. Department of Neurology, Neuroscience Stroke and Rehabilitation Centre, Bandar Seri Begawan, Brunei; Department of Neurology, Krankenhaus Nordwest, Frankfurt/Main, Germany Background: Stroke is emerging as a major public health problem for Brunei Darussalam. The Neuroscience, Stroke and Rehabilitation Centre (NSRC) has established a dedicated stroke unit since 2010. Objective: To assess the demographic of patients admitted with ischaemic stroke into NSRC who were within the 4.5 hours thrombolytic window. Methods: Medical case-notes of all patients admitted with stroke (ischemic or haemorrhagic) from July 2010 to October 2012 were reviewed. Data collected included age, gender, referral centres, time of symptoms, time of arrival in NSRC, time of thrombolysis and length of stay. Results: Out of 456 charts reviewed, 21 patients (5%) received intravenous thrombolysis with Alteplase. There were 13 (62%) males and 8 (38%) females. 86% of patients were referred from Brunei Darussalam main hospital (RIPAS) while 14% were referred from Jerudong Park Medical Centre. The mean age of patients was 56 ± 12 years (range 23–88). The mean time from onset of symptoms to iv needle thrombolysis was 179 ± 62 min. The mean door to iv needle thrombolysis was 48± 22 min. Thus the mean time from onset of symptoms to reaching our unit (door) was 131 min. Conclusion: In our preliminary study (with small number of patients), there is a quick and efficient door to needle thrombolysis time of 48 min. However there is a need to improve the time delay (131 min) from the onset of symptoms to reaching our stroke unit. doi:10.1016/j.jns.2013.07.918 Abstract — WCN 2013 No: 2153 Topic: 3 — Stroke Demographic of stroke: A comparative study between Brunei Darussalam Neuroscience, Stroke and Rehabilitation Centre and Krankenhaus Nordwest, Frankfurt, Germany WCN 2013 No: 2153 Topic: 3 — Stroke Demographic of stroke: A comparative study between Brunei Darussalam Neuroscience, Stroke and Rehabilitation Centre and Krankenhaus Nordwest, Frankfurt, Germany G.C. Chan, B. Bassa, U. Meyding-Lamade. Department of Neurology, Neuroscience Stroke and Rehabilitation Centre, Bandar Seri Begawan, Brunei; Department of Neurology, Frankfurt/Main, Germany; Krankenhaus Nordwest, Frankfurt/Main, Germany Background: The Neuroscience, Stroke and Rehabilitation Centre (NSRC) of Brunei Darussalam has been working in collaboration with Krankenhaus Nordwest Hospital, Frankfurt since 2010. Objective: To compare the demographic of patients between the two centres. Methods:All patients admittedwith stroke (ischemic or haemorrhagic) from July 2010 to November 2011 to both centres were reviewed. Data collected included age and gender. Results: In the Brunei data, 254 patients (59% male, 41% female) were studied (mean age of 60 ± 14 years, range 22–95). The male to female ratio in age group 21–30 is 1:0, age group 31–40 is 3:1, age group 41–50 is 2:1, age group 51–60 is 3:2, age group 61–70 is 1:1, age group 71–80 is 1:1, and age group N 80 is 1:1. In the Frankfurt Krankenhaus Nordwest data, 3498 patients (50% male, 50% female) were studied (mean age 72.45 ± 20 years, range 19–103). The male to female ratio in age group 21–30 is 1:3, age group 31–40 is 1:2, age group 41–50 is 1:1, age group 51–60 is 2:1, age group 61–70 is 2:1, age group 71–80 is 1:1, and age group N 80 is 1:2. Conclusion: Comparing Brunei NSRC to Frankfurt Krankenhaus Nordwest the mean age of stroke disease is 12 years younger in the Brunei patients and higher male to female ratio in the age group of 31–40 and 41–50. This warrants further study to identify the possible reasons for the demographic difference between an Asian and Western population. doi:10.1016/j.jns.2013.07.919 Abstract — WCN 2013 No: 2200 Topic: 3 — Stroke Cortical deafness as a sole manifestation of ischemic cerebrovascular disease WCN 2013 No: 2200 Topic: 3 — Stroke Cortical deafness as a sole manifestation of ischemic cerebrovascular disease E. Papageorgiou, G. Matikas, X. Papastergios, V. Koukouni, G. Gekas. Neurology Department General Hospital of Nikaia, Athens, Greece Abstracts / Journal of the Neurological Sciences 333 (2013) e215–e278 e235
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