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#1. 急性缺血性腦中風<24小時動脈內取栓治療 - snc
NIHSS 大於等於6分, f.腦部電腦斷層評分ASPECT score 大於 ... C) 美國國衛院腦中風評估表(NIH Stroke Scale)評分4到25分之間。 D) 無出血性疾病.
#2. 2019台灣腦中風學會急性缺血中風靜脈血栓溶解治療指引
臨床評估為嚴重之中風(例如NIHSS. >25). V. V. X. W. (NIHSS >23). X. W. (NIHSS ≥26). X. 患者正接受口服抗凝血劑,如 warfarin sodium.
#3. NIHSS 中風量表之介紹與應用
NIHSS. • National Institute of Health Stroke Scale. ... NIHSS. • 總分由0-42分(但臨床上不可能評到最高的42分, 原因後述), ... (4-25分).
#4. 台灣腦中風學會rt-PA使用規範共識小組一、 前言: 缺血性腦 ...
美國國家衛生院中風量表,以下簡稱NIHSS,請見附件一)、判讀電腦斷層、病人的篩選及用藥後的病. 人照顧亦為今後的努力目標。 三、 急性腦中風病人的輸送及急診室的 ...
#5. 台灣醫檢雜誌- ALL ISSUES - 台灣醫事檢驗學會
而在這診斷的流程中,所有的檢驗檢查必須於到院一小時內完成,再配合電腦斷層沒有顱內出血,NIHSS評估落於4-25分等條件,才能合乎血栓溶解治療之條件,充份發揮急救之 ...
Use of the NIH Stroke Scale (NIHSS) in Acute Stroke Patients. 美國國家衛生研究院. 腦中風量表. 林口長庚神經內科系. 腦血管科. 鄭之光醫師.
#7. Intravenous thrombolysis of acute ischemic stroke 陳龍臺北 ...
例如NIHSS<6分); 臨床(例如NIHSS>25 )及/或適當之影像術評估為嚴重之中風(電腦斷層大於1/3中大腦動脈灌流區之低密度變化)。
#8. 中風照護教學研習會
且年齡≦80歲、未使用口服抗凝血劑、NIHSS分數≦25分、 ... “NIHSS 4-25”. Too mild to treat ? ... IV tPA for NIHSS 0-5, non-disabling stroke.
#9. 缺血性腦中風的治療之案例報告 - 藥學雜誌電子報123期
三、年齡在18歲到80歲之間。現行對於腦中風的評估指標有美國國家衛生研究院腦中風量表(National Institute of Health Stroke Scale, NIHSS),由十 ...
#10. IV thrombolysis in very severe and severe ischemic stroke - PMC
由 MV Mazya 著作 · 2015 · 被引用 53 次 — Objective: To study the safety of off-label IV thrombolysis in patients with very severe stroke (NIH Stroke Scale [NIHSS] scores >25) compared with severe ...
#11. 邱德發醫師學習目標熟悉理想的急性中風處置流程到院前
美國國衛院腦中風評估表(NIH Stroke Scale) ... NIHSS. 6-25 才考慮纖維蛋白溶解療法 (fibrinolytic therapy) (依健保局規定). 病例狀況. PM 7:50 (發作後1小時).
#12. 全民健康保險藥物給付項目及支付標準共同擬訂會議藥品部分第 ...
(1) 有關急性缺血性腦中風用藥r-TPA 之給付規定由美國中風量表NIHSS 介於. 「6-25 分」之標準調整為「4-25 分」案。 (2) 有關「台灣大腸直腸醫學會」建議修訂大腸癌 ...
#13. NIH Stroke Scale - Physiopedia
The NIHSS is a 15-item neurological examination stroke scale used to evaluate the effect of acute cerebral infarction on the levels of consciousness, language, ...
#14. Is stroke thrombolysis safe and efficacious in Hong Kong?
In addition, patients with borderline premorbid status on a modified Rankin Scale (mRS) score of. ≥3 or a minor deficit of ≤4 on the NIHSS score were excluded ...
#15. (PDF) IV thrombolysis in very severe and severe ischemic stroke
PDF | Objective: To study the safety of off-label IV thrombolysis in patients with very severe stroke (NIH Stroke Scale [NIHSS] scores >25) ...
#16. 2018 Guidelines for the Early Management of Patients With ...
The use of a stroke severity rating scale, preferably the NIHSS, is recommended. I. B-NR. Recommendation reworded for clarity from. 2013 AIS Guidelines.
#17. 突癱軟說不清黃金3h疏通血管 - 中華日報
當NIHSS分數介於4~25分,且在排除禁忌症的狀況下,實施靜脈融栓治療造成出血的風險較小且治療效果較好。 他指出,據最新的缺血性腦中風治療,臨床上 ...
#18. Current Treatment Approaches for Acute Ischemic Stroke
Severe stroke (NIHSS > 25). History of diabetes and prior stroke. Taking an oral anticoagulant regardless of INR. Alteplase (IV r-tPA) within 4.5 hours of ...
#19. PDF
NIHSS 4–25 (mean 15.5) were treated. Twenty-nine (97%) achieved mTICI 2b-3 within 3 passes, and 24 (80%) were with the first pass (FP).
#20. Escala NIHSS National Institute of Health Stroke Score
La escala NIHSS puntúa de forma numérica la gravedad del ictus. Se debe aplicar al inicio y durante la evolución del ictus. Puntuación mínima 0, puntuación ...
#21. 前循环串联病变的血管再通顺序对急性缺血性卒中短期预后的影响
两组患者年龄、性别构成、入院时美国独立卫生研究院卒中量表(NIHSS)评分等 ... scale,NIHSS)评分4~25分;(4)患者经MR DWI证实存在早期脑梗死,且与 ...
#22. Acute stroke fast track managment_stroke curriculum
NIHSS The National Institutes of Health Stroke Scale. Stroke. 2013;44:870-947. Total 42. Score. Severity. 0-4. Minor stroke. 5-15. Moderate stroke.
#23. 阿替普酶联合尤瑞克林治疗急性脑梗死中的疗效评估
功能缺损评分(NIHSS)4 ~ 25 分;(3)CT 扫描未见颅内. 出血及多发性脑梗死;(4)发病时间≤ 3 h ;(5)签署知情. 同意书。排除标准:(1)短暂性脑缺血 ...
#24. 1091016-急性缺血性腦中風治療的新進展 - SlideShare
15 腦中風評量表NIH Stroke Scale(NIHSS) 姓名: 病歷號: 日期時間: : : 項目評分指導分數Baseline 24hours 出院1a.意識程度警覺0 嗜睡1 木僵2 昏迷(痛刺激無反應) ...
#25. MRI‑guided thrombolysis for lenticulostriate artery stroke ...
admission systolic blood pressure and NIHSS score were significantly associated ... 4 (25). 1.00. Smoking. 36 (46.8). 16 (40). 0.49. 14 (51.9). 6 (37.5).
#26. Outcome after stroke attributable to baseline factors
Categorization of age and NIHSS was oriented towards [3, 4, 25], and categorization of BMI towards [27]. Patients included in our analyses.
#27. Manual Aspiration Thrombectomy Using Penumbra Catheter ...
NIHSS at discharge and favorable clinical outcomes at 3 months were ... Median initial NIHSS score was 10 (range : 4–25) and was 4 (range ...
#28. 血壓:急性缺血性腦中風時 - Guideline
臨床症狀太嚴重(例如NIHSS>25)及/或適當之影像術評估為嚴重之腦中風,如腦梗塞區超過1/3、出血性梗塞或早期出現腦梗塞。 ─, 腦中風發作時併發癲癇。
#29. ICTRP Search Portal
Key inclusion & exclusion criteria. Inclusion criteria: Age between 50-80 years. First ever stroke patients. Ischemic stroke. GCS<13. NIHSS=4-25
#30. Stroke care during the COVID-19 pandemic - Europe PMC
In cases with cerebral infarction, no increase in NIHSS scores on admission was ... an NIHSS score of 4–25, and an age of 18–80 years.
#31. Workforce Attachment after Ischemic Stroke – The Importance ...
The median NIHSS score at presentation was 4 (25th -75 th percentile 2-8), and the median time from symptom-onset to initiation of thrombolytic therapy was ...
#32. 急性缺血性卒中血管内机械取栓单中心临床研究 - 大专家
... 评价血管再通情况,术后24h采用美国国立卫生研究院卒中量表(NIHSS)评价神经功能, ... 例(26.83%)术后90d内死亡,前循环闭塞4例(16%,4/25)、后循环闭塞7例(7/16), ...
#33. Analysis of the new code stroke protocol in Asturias after one ...
tute of Health Stroke Scale (NIHSS) is the most widely used ... The median NIHSS score was 14 points (4-25).
#34. 阿加曲班联合硫酸氢氯吡格雷对急性后循环缺血性脑卒中患者 ...
状态、血小板(PLT)计数、美国国立卫生研究院卒中量表(NIHSS)评分和Barthel指数(BI)的 ... 11.17)h,NIHSS 评分4~25 分,平均(11.15±1.35).
#35. 腦中風黃金三小時談『靜脈血栓溶解治療』 - 亞東醫院
臨床(例如:NIHSS>25 )及/或適當之影像術評估為嚴重之中風(電腦斷層大於1/3中大腦動脈灌流區之低密度變化)。 4. 中風發作時併發癲癇。 5. 最近三個月內有中風病史 ...
#36. 丁苯酞用于急性缺血性卒中静脉溶栓或血管内治疗 ... - 指南医学
入组时NIHSS评分为4-25; 5.计划进行rt-PA静脉溶栓或包括动脉溶栓[国际指南不推荐]、机械取栓等在内的血管内治疗(不符合静脉溶栓标准或存在禁忌症)或桥接治疗; ...
#37. 急性缺血性卒中血管内机械取栓单中心临床研究
通情况,术后24 h 采用美国国立卫生研究院卒中量表(NIHSS)评价神经功能,术后90 d ... (14.63%)发生症状性颅内出血,前循环闭塞4 例(16%,4/25)、后循环闭塞2 ...
#38. 再創中風個案主要照顧者的契機照顧與指導 - 衛生福利部
(MASS)、急診中風識別(ROSIER) ,及美國國衛院腦中風評估表(NIHSS)等評估工具 ... 呂寶靜(2005)•支持家庭照顧者的長期照護政策之構思•國家政策季刊4(4),25-40。
#39. Tratamiento endovascular y trombólisis intraarterial en el ictus ...
Complete recanalization was observed in 11 (69%) and partial in 4 (25%). ... It could be indicated in patients with severe neurological injury (NIHSS >10), ...
#40. Blood glucose variability, NIHSS score, APACHE II score, and ...
Baseline data, baseline NIHSS score, APACHE II score, standard deviation of ... was significantly lower than that in the survival group [16.00% (4/25) vs.
#41. Monthly Stroke Webinar: NIHSS Review (November 2019)
This Minnesota Department of Health Stroke Program webinar is a review of the NIH Stroke Scale. It occurred on 11/20/2019.
#42. A single-center study on endovascular thrombectomy for acute ...
National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the ... including 4 patients (16%, 4/25) with anterior circulation occlusion and 7 ...
#43. Clinical effect of successful reperfusion in patients ... - BORIS
defined as drop in the NIHSS ≥ 4 [25] between admission. NIHSS and 24 h NIHSS without the occurrence of sICH. [8]. Data on 24 h NIHSS were ...
#44. 경증 급성 뇌경색 환자에서 정맥내혈전용해술 및 혈관내혈전 ...
of Health Stroke Scale, NIHSS) 4점 이하의 경증 뇌경색이었다. (Fig. 1).3 미국 뇌졸중 자료에서도 뇌경색 입원 환자의 초기 NIH뇌.
#45. 99 1 臨床概論 stroke treatments
when NIHSS 4-25, dosage 0.6- 0.9 mg/kg. • NINCDS trial in 1990s: 13% more favorable. • Symptomatic ICH rate: ~4% if no protocol violation,.
#46. 世界卫生组织国际临床试验注册平台一级注册机构
3、NIHSS评分4-25分; 4、脑CT或MRI基线无低密度影或可见病灶小于三分之一动脉供血区; 5、使用过阿替普酶治疗;. Inclusion criteria. 1. Acute ischemic stroke;
#47. Ischemic stroke management 2 (rt-PA) @ 醫學筆記匯集整理ED ...
NIHSS 4-25, < 3hr, > 80 y/o 有健保. 3 - 4.5 hr 可施打但需自費. Ischemic stroke with large vessel occlusion --> Combined therapy. rt-PA -> IA.
#48. Cerebral hemorrhage after intra-arterial thrombolysis for ...
territory, and an NIHSS score between four and 30 at the. From the Department of Neurology (Dr. ... studied after use of IV t-PA,4,25,26 IV streptokinase,27.
#49. Thrombolysis in acute stroke without angiographically ...
The median baseline NIH stroke scale mea- ... al Institute of Health Stroke Scale (NIHSS) score ... line NIHSS of 7 (range: 4-25)9, compared with.
#50. Efficacy and Safety of Butylphthalide for Acute Ischemic Stroke ...
A total of approximately 1200 patients (Age≥18years) within 6 hours of symptom onset of acute ischemic stroke, who shows NIHSS from 4-25 points and intend ...
#51. STROKE & COVID19 - American Heart Association
6:00 PM - Report of mild left-sided weakness; NIHSS = 4. ... 5:00 AM – Arrival at receiving hospital; NIHSS = 14. ... 4/25/20 2:53 PM.
#52. Effectiveness of Intravenous Recombinant Tissue ...
ผู้ป่วยโรคหลอดเลือดสมองขาดเลือดเฉียบพลันที่. ได้รับยา rtPA 618 คน มีคะแนน NIHSS แรกรับเฉลี่ยเท่า. กับ 11.8 (ระหว่าง 4-25 คะแนน) มีคะแนน NIHSS แรก. รับต ่าสุด 4 ...
#53. D‐dimer as a predictor of early neurologic deterioration in ...
END was defined as an increase of ≥1 point in the motor NIHSS ... The END group exhibited a higher discharge NIHSS score [8 (4–25) vs.
#54. ajnr.A3416.full.pdf - American Journal of Neuroradiology
an NIHSS score of 4–25 on hospital admission; contraindicated for IV thrombolysis or with persistent artery occlusion 60 minutes.
#55. Clinical effect of successful reperfusion in patients presenting ...
Non-hemorrhagic neurological worsening was defined as drop in the NIHSS ≥ 4 [25] between admission NIHSS and 24 h NIHSS without the ...
#56. Is tenecteplase ready to replace alteplase to treat acute ...
... open label, blinded-endpoint (PROBE) controlled design recruiting AIS patients with severity of National Institutes of Health Stroke Scale (NIHSS) 4–25.
#57. 脑卒中溶栓时间窗与预后关系的临床研究 - 期刊界
The selection criteria included: 1 )the definition of acute ischemic stroke according to Kidwell standard; 2)NIH stroke scale (NIHSS)scores 4-25; ...
#58. Journal of the Neurological Sciences
Health Stroke Scale (NIHSS) at baseline and after 24 h and modified ... Results: The median NIHSS score at baseline was 14 (range 4–25), after.
#59. Very Early Neurologic Improvement After Intravenous ...
Health Stroke Scale (NIHSS) at 24 hours ... NIHSS score of 0 or an improvement of 5 or more points com- ... 15 (4-25). 14 (6-23). 15 (4-25).
#60. 血栓溶解劑治療急性缺血性腦中風之一般準則~~超實用(3.5顆星)
為了用藥安全性,對於診治急性中風的醫師,訓練其做神經檢查(包括美國國家衛生院中風量表,以下簡稱NIHSS)、判讀電腦斷層、病人的篩選及用藥後的 ...
#61. Clinical Article - KoreaMed Synapse
NIHSS at discharge and favorable clinical outcomes at 3 months were ... Median initial NIHSS score was 10 (range : 4–25) and was 4 (range ...
#62. 急性缺血性中風之早期處置– Early Management of Acute ...
NE 的評估建議根據NIH Stroke Scale 進行系統性評估。總分42 分,越高分越嚴重。tPA 可以打的range 就是4-25 分。 ABC 一定要先做,病人意識可能很差 ...
#63. Treating Acute Stroke Patients With Intravenous tPA - CiteSeerX
Female sex, n (%). 23 (40). 47. 42/44. NIHSS admission. 14 (4–25)*. 14 (3–36)*. 14/14. Hypertension, n (%). 26 (46). 53. 66/67. Atrial fibrillation, n (%).
#64. Arti cial Intelligence for Clinical Decision Support in Acute ...
NIHSS 4-25. 196. Multilayer. Perceptrons. MRI/CT. 10. Absolute n x x. None. [88]. Worsening of. NIHSS within 3 days. NIHSS => 3.
#65. CLINICAL OUTCOME OF STROKE PATIENTS BASED ON THE ...
deficit using NIHSS at Dr. Hasan Sadikin General Hospital, Bandung. Methods: This study is a retrospective ... 4(25,0). 45-59. 33(39,3). 41(48,8). 10(11,9).
#66. Proximal Arterial Occlusion in Acute Ischemic Stroke with Low ...
occlusion and low NIHSS scores may not represent mild stroke in acute periods. Citation: Kim J-T, Park M-S, ... VBA occlusion (4/25, 4/25).
#67. navigating through stroke trials gaps - SciELO
low NIHSS with proximal occlusion, acute basilar occlusion, distal and medium vessel occlusion, ... 2021 Sep 4;25:100368. https://doi.org/10.1016/j.
#68. Risk and Fate of Cerebral Embolism After Transfemoral Aortic Valve ...
The NIHSS and NSE were not correlated with DW-MRI lesions. ... The patient demonstrated transient ataxia (NIHSS: 4). ... Diabetes, 1 (17), 4 (25), 1.0.
#69. 你對缺血性腦中風知多少?
NIHSS <6, >25. 有排除條件. 加護病房. (ICU). 是. 否. 這是一種較新的治療方式。目前沒有其他藥物可以像rt-PA 一樣,能有效地治療急性缺血性腦中風。罹患腦中風的病人 ...
#70. S100B, TRAIL, and adropin predicting stroke
The National Institutes of Health Stroke Scale (NIHSS) score was ... NIHSS score at admission. 17.08 ± 4.65. (4-25). 22.38 ± 1.95. (19-25).
#71. Effect of standardized nursing cooperation on intravenous ...
Institute of Health Stroke Scale (NIHSS) [10] was 4-25 points; and (4) The patients or their families gave informed consent to receive rt-PA.
#72. Acute Management and Selection for Endovascular Therapy
The National Institute of Health Stroke Score (NIHSS) is a ... The NIHSS can be reliably used ... NIHSS, particularly posterior circulation strokes.4,25,26.
#73. eve_25042016_132428_Acidente Vascular Cerebral (AVC)
1. Sintomas mínimos ou que melhoram completamente. 2. NIHSS <4 ou >25 para AVC em território anterior (relativa). 3. Convulsões ...
#74. Acute isolated anterior cerebral artery infarcts - Neurology Asia
(NIHSS) and Modified Rankin Scale (mRS) were used to assess stroke severity. Fischer's classification ... 12/25 (48%) and dyslipidemia 6/25 (24%); 4/25.
#75. protocolo de manejo inicial del ataque cerebrovascular (acv ...
% del territorio de la arteria cerebral media. • Score NIHSS de 4 a 25. • Consentimiento informado. Criterios de inclusión para trombolisis hasta 4,5 horas. • ...
#76. Predictors of weaning and extubation failure in mechanically ...
Abbreviations: NIHSS: National Institutes of Health Stroke Scale; ... patient cohort were similar to published literature [4,25]. However,.
#77. IS ACTIVITy LoSS PREDICTIVE FoR DEVELoPMENT oF ...
tional Institute of Health Stroke Scale (NIHSS), Fügl-Meyer. Assessment and modified Rankin Scale ... 4 (25). 31.5 (52). NIHSS (/42), median (IQR) 8 (8).
#78. ScienceDirect - Via Medica Journals
8.46 (4–25). Previous anticoagulant therapy, n (%). 32 (14.5). F – female, M – male, NIHSS – National Institutes of Health Stroke.
#79. Patient profiles contribute to differences in quality metrics of stroke ...
NIHSS, mean (SD), 7.69 ± 8.98, 4.01 ± 5.56, <0.001. NIHSS on admission*, <0.001. 4-25, 1,139 (48.5), 242 (33.9). 1-3 or >25, 856 (36.4), 295 (41.4).
#80. piste jnnp - UK Neurointerventional Group
These were age group (≤80 or >80), NIHSS score (6–12, 13–19, 20–42), ... MT, mechanical thrombectomy; NIHSS, National Institutes of Health Stroke Scale; ...
#81. Medical - Clinical Research & Reviews
Scale (NIHSS), and neuroradiological findings from non-contrast ... patients (3 out of 4; 75%); with B-method – 1 patient (1/4, 25%);.
#82. “SCORE NIHSS: PREDICTOR DE COMPLICACIONES ...
La National Institute of Health Stroke Scale (NIHSS) es una escala empleada ... un rango de 4-25 puntos, califica al cuadro neurológico como déficit leve ...
#83. Extending the Time Window (and the Efficacy) of Thrombolysis ...
Distribution of change in NIHSS ... 78 Male: IV tPA 4:25 Post Symptom Onset ... NIHSS ore was patients quartile lteplase to 1.9;. NIHSS ccurred teplase.
#84. A Clinical Observation of Intravenous Thrombolysis in Acute ...
NIHSS scores were recorded before thrombolysis and at one, three, ... Scale (NIHSS) scores of all patients before thrombolysis ranged within 4-25 points.
#85. NIHSS NATIONAL INSTITUTES OF HEALTH STROKE SCALE ...
INTRODUCTION Originally designed as a research tool to measure baseline data on patients in acute stroke clinical trials 15-item scoring system Integrating ...
#86. Clinical Trial Protocol Iranian Registry of Clinical Trials - IRCT
stroke patients Ischemic stroke GCS<13 NIHSS=4-25. MRS<2 before the stroke Stroke occurrence within prior. 12 hours.
#87. Argatroban, Rt-PA Trial in Shenyang (Argatroban combined with rt ...
Diagnosis of posterior circulation ischemic stroke;. Time from onset to treatment ≤6 hours;. NIHSS: 4-25;. Signed informed consent by patient self or legally ...
#88. Escalas Neurológicas en Patología Vascular Cerebral
La NIHSS es la escala más empleada para la valoración de funciones ... recomienda o no la administración del tratamiento (recomendado en rango NIHSS 4-25).
#89. National Institutes of Health Stroke Scale - DocCheck Flexikon
Die National Institutes of Health Stroke Scale, kurz NIHSS, ist ein Scoresystem zur Beurteilung eines akuten Schlaganfalls (Stroke) im Rahmen der ...
#90. Argatroban tPA Stroke Study - IS MUNI
Stroke Scale (NIHSS) level-of-consciousness score of 2 or more;. (2) baseline NIHSS total score less ... dian score was 14 (range, 4-25; 10 in 9 [60%] of 15.
#91. 急性缺血性中风: Butylphthalide, 丁苯酞安慰剂的临床试验
本试验是志向、随时、双盲、平等对照、 6小时内共有中心约6名当事人(1200岁≥18岁) 典型地典型中,显示NIHSS 4-25 分并提出将登记接受iv-rtPA 和/或机械血栓手术治疗的 ...
#92. 谷氨酰胺配合高压氧治疗对中青年缺血性脑卒中患者恢复期外周 ...
结果观察组治疗2周后,4周后NIHSS评分低于对照A组,对照B组和阴性对照组(P<0.05);BI ... 36±4. 25. 1. 557. 0. 104. 体质量指数/(kg/m. 2);(x. -±s). 24. 17±1. 56.
#93. Clinical and radiological outcomes of acute ischemic stroke ...
Patients better 3-month outcome than those with >10 NIHSS [OR then underwent DSA ... [5] 2003 28 7 (25) 58±15 7 (4–25) 226±68 22 (79) 21 (75) Slivka et al.
#94. Hazem Shoirah on Twitter: "And for the last case of fellowship ...
NIHSS 0 on day 3. Everyone happy and fellowship is done! Image. 4:25 PM · Jul 2, 2018 from Manhattan, NY·Twitter for iPhone.
#95. 84372374007.pdf - Redalyc
the study biomarkers and initial and third-month mRS, initial NIHSS, initial ... NIHSS score at admission. 17.08 ± 4.65. (4-25). 22.38 ± 1.95. (19-25).
#96. Seasonal Variations in Neurological Severity and Outcomes of ...
logical deficits assessed using an NIHSS score ≥10;27,28 neurological deterioration within the initial 7 days assessed.
nihss 4-25 在 Monthly Stroke Webinar: NIHSS Review (November 2019) 的推薦與評價
This Minnesota Department of Health Stroke Program webinar is a review of the NIH Stroke Scale. It occurred on 11/20/2019. ... <看更多>