Background: Most aneurysmal subarachnoid hemorrhages (SAHs) are accompanied by focal neurological deficits caused by a thunderclap headache. The neurological symptoms of aneurysmal SAH rarely present as vasospasm-induced cerebral ischemia.Case Report: A 51-year-old male presented to the emergency department with weakness in the left upper and lower limbs combined with dysarthria, which developed on the day of admission. An initial brain computed tomography scan revealed no clear signs of hemorrhage. However, the patient’s age (51 years) and history of thunderclap headache prompted further evaluation. Finally, the patient was diagnosed with vasospasm-induced ischemic stroke, caused by a ruptured cerebral aneurysm. Conclusion For patients with abrupt focal neurological deficits and severe thunderclap headaches, further consideration of aneurysmal rupture and the resulting vasospasm-induced cerebral ischemia may prevent the worst complications of stroke due to misdiagnosis.

Background: Most aneurysmal subarachnoid hemorrhages (SAHs) are accompanied by focal neurological deficits caused by a thunderclap headache. The neurological symptoms of aneurysmal SAH rarely present as vasospasm-induced cerebral ischemia.Case Report: A 51-year-old male presented to the emergency department with weakness in the left upper and lower limbs combined with dysarthria, which developed on the day of admission. An initial brain computed tomography scan revealed no clear signs of hemorrhage. However, the patient’s age (51 years) and history of thunderclap headache prompted further evaluation. Finally, the patient was diagnosed with vasospasm-induced ischemic stroke, caused by a ruptured cerebral aneurysm. Conclusion For patients with abrupt focal neurological deficits and severe thunderclap headaches, further consideration of aneurysmal rupture and the resulting vasospasm-induced cerebral ischemia may prevent the worst complications of stroke due to misdiagnosis.

Background: Most aneurysmal subarachnoid hemorrhages (SAHs) are accompanied by focal neurological deficits caused by a thunderclap headache. The neurological symptoms of aneurysmal SAH rarely present as vasospasm-induced cerebral ischemia.Case Report: A 51-year-old male presented to the emergency department with weakness in the left upper and lower limbs combined with dysarthria, which developed on the day of admission. An initial brain computed tomography scan revealed no clear signs of hemorrhage. However, the patient’s age (51 years) and history of thunderclap headache prompted further evaluation. Finally, the patient was diagnosed with vasospasm-induced ischemic stroke, caused by a ruptured cerebral aneurysm. Conclusion For patients with abrupt focal neurological deficits and severe thunderclap headaches, further consideration of aneurysmal rupture and the resulting vasospasm-induced cerebral ischemia may prevent the worst complications of stroke due to misdiagnosis.

This report presents the latest statistics on the stroke population in South Korea, sourced from the Clinical Research Collaborations for Stroke in Korea-National Institute for Health (CRCS-K-NIH), a comprehensive, nationwide, multicenter stroke registry. The Korean cohort, unlike western populations, shows a male-to-female ratio of 1.5, attributed to lower risk factors in Korean women. The average ages for men and women are 67 and 73 years, respectively.Hypertension is the most common risk factor (67%), consistent with global trends, but there is a higher prevalence of diabetes (35%) and smoking (21%). The prevalence of atrial fibrillation (19%) is lower than in western populations, suggesting effective prevention strategies in the general population. A high incidence of large artery atherosclerosis (38%) is observed, likely due to prevalent intracranial arterial disease in East Asians and advanced imaging techniques.There has been a decrease in intravenous thrombolysis rates, from 12% in 2017–2019 to 10% in 2021, with no improvements in door-to-needle and door-to-puncture times, worsened by the coronavirus disease 2019 pandemic. While the use of aspirin plus clopidogrel for noncardioembolic stroke and direct oral anticoagulants for atrial fibrillation is well-established, the application of direct oral anticoagulants for non-atrial fibrillation cardioembolic strokes in the acute phase requires further research. The incidence of early neurological deterioration (13%) and the cumulative incidence of recurrent stroke at 3 months (3%) align with global figures. Favorable outcomes at 3 months (63%) are comparable internationally, yet the lack of improvement in dependency at 3 months highlights the need for advancements in acute stroke care.

Aged people are challenged by serious complications from chronic diseases, such as mood disorder, diabetes, heart disease, and infectious diseases, which are also the most common causes of death in older people. Therefore, elderly care facilities are more important than ever. The most common causes of death in elderly care facilities were reported to be diabetes, cardiovascular disease, and pneumonia. Recently, the coronavirus disease 2019 (COVID-19) pandemic have a great impact on blind spots of safety where aged people were isolated from society. Elderly care facilities were one of the blind spots in the midst of the pandemic, where major casualties were reported from COVID-19 complications because most people had one or two mortality risk factors, such as diabetes or cardiovascular disease. Therefore, medical governance of public health center and hospital, and elderly care facility is becoming important issue of priority. Thus, remote health monitoring service by the Internet of Medical Things (IoMT) sensors is more important than ever. Recently, technological breakthroughs have enabled healthcare professionals to have easy access to patients in medical blind spots through the use of IoT sensors. These sensors can detect medically urgent situations in a timely fashion and make medical decisions for aged people in elderly care facilities. Real-time electrocardiograms and blood sugar monitoring sensors are approved by the medical insurance service. Real-time monitoring services in medical blind spots, such as elderly care facilities, has been suggested. Heart rhythm monitoring could play a role in detecting early cardiovascular disease events and monitoring blood glucose levels in the management of chronic diseases, such as diabetes, in aged people in elderly care facilities. This review presents the potential usefulness of remote monitoring with IoMT sensors in medical blind spots and clinical suggestions for applications.

Background: and Purpose Patients with dementia are particularly vulnerable to coronavirus disease 2019 (COVID-19) because they tend to be older and often have concomitant diseases. Previous studies have investigated the impact of dementia on COVID-19 outcomes, but the evidence is not robust for Asian populations. We aimed to determine the relationship between dementia and COVID-19 outcomes using data from a large-scale nationwide public database. Methods: Data on patients with COVID-19 who were released from quarantine between January 1, 2020 and April 30, 2020, published by the Korea Disease Control and Prevention Agency, were divided into two groups based on the dementia status. Propensity-score matching was used to adjust for multiple confounders between the dementia and no-dementia groups. Binary, ordinal logistic regression and multivariate Cox proportional-hazards models were used to compare mortality, quarantine duration, and clinical deterioration according to the dementia status in the two groups. Results: Males and older individuals (age ≥60 years) constituted 41.5% and 32.9%, respectively, of the 5,299 patients. The prevalence of dementia was 4.2%, and 4.5% of the participants died during hospitalization. In multivariate analysis, dementia was significantly associated with increased mortality (odds ratio [OR]=2.80, 95% confidence interval [CI]=1.60–4.60), longer duration of quarantine (hazard ratio=1.69, 95% CI=1.16–2.45), and larger shift to a worse clinical severity (common OR=1.74, 95% CI=1.18–2.61). Conclusions After adjusting for important clinical predictors, dementia was associated with increased in-hospital mortality, duration of quarantine, and clinical deterioration during hospitalization in COVID-19 patients.

Antithrombotic therapy is a cornerstone of acute ischemic stroke (AIS) management and secondary stroke prevention. Since the first version of the Korean Clinical Practice Guideline (CPG) for stroke was issued in 2009, significant progress has been made in antithrombotic therapy for patients with AIS, including dual antiplatelet therapy in acute minor ischemic stroke or high-risk transient ischemic stroke and early oral anticoagulation in AIS with atrial fibrillation. The evidence is widely accepted by stroke experts and has changed clinical practice. Accordingly, the CPG Committee of the Korean Stroke Society (KSS) decided to update the Korean Stroke CPG for antithrombotic therapy for AIS. The writing members of the CPG committee of the KSS reviewed recent evidence, including clinical trials and relevant literature, and revised recommendations. A total of 35 experts were invited from the KSS to reach a consensus on the revised recommendations. The current guideline update aims to assist healthcare providers in making well-informed decisions and improving the quality of acute stroke care. However, the ultimate treatment decision should be made using a holistic approach, considering the specific medical conditions of individual patients.