Stroke causes a vast amount of death and disability throughout the world, yet for many healthcare professionals it remains an area of therapeutic nihilism, and thus uninteresting. This negative perception is shared by the general public, who often have a poor understanding of the early symptoms and significance of a stroke. Yet within the past few years there have been many important developmen...

Cardiac diseases are common post-stroke and are associated with increased morbidity and mortality. One possible mechanism of acute cardiac injury is the neurogenic myocardial damage, where the cerebral injury is disturbing the normal sympathetic and parasympathetic neuronal outflow to the heart leading to cardiac damage including myocardial infarctions. The exact mechanism is not completely und...

OBJECTIVE To help family physicians who care for patients with acute stroke or who are involved in planning service delivery or resource allocation to understand recent developments in acute stroke care. QUALITY OF EVIDENCE A MEDLINE search indicated that most data were derived from well designed, randomized, double-blind, placebo-controlled trials, including all the largest international stu...

BACKGROUND AND PURPOSE Sex differences in the management of acute coronary symptoms are well documented. We sought to determine whether sex disparities exist in acute stroke management, particularly with regard to early hospital admission and thrombolytic therapy. METHODS We analyzed a prospective, countywide, hospital-based stroke registry. Between 1999 and 2005, all cases with a final diagn...

脳梗塞急性期は時間との戦いであり，血管再開通までの時間が治療の成否を分けてきた．しかし，新型コロナウイルス感染症（coronavirus disease 2019：COVID-19）パンデミック下の最優先事項は感染防御である．ときに時間を犠牲にしてでも医療従事者の安全を確保する．これは結果として多くの脳卒中患者を守ることにつながる．このコンセプトを明示した脳卒中急性期診療指針がProtected Code Stroke（PCS）である．2020年4月に発表された日本脳卒中学会版PCSでは，まずCOVID-19未判定例（英語のpatient under investigationに相当する造語）を定義し，PCSの要点として（1）確実な個人防護具の装着，（2）患者へサージカルマスクの装着，（3）必要最小限の人員での対応を示した．その後，施設毎の実情に即したPCSプロトコルが作成され，コロ...