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Review Article

Neurology

Initial diagnosis and management of acute ischemic stroke: updates and future directions
Sang Hee Ha, Sujin Koo, Seung Min Kim, Jae Young Park, Seung Eun Lee, Bum Joon Kim
Clin Exp Emerg Med 2026;13(1):5-12.   Published online January 14, 2026
DOI: https://doi.org/10.15441/ceem.25.241

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Initial diagnosis and management of acute ischemic stroke: updates and future directions
Clin Exp Emerg Med. 2026;13(1):5-12.   Published online January 14, 2026
DOI: https://doi.org/10.15441/ceem.25.241
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Initial diagnosis and management of acute ischemic stroke: updates and future directions
Clin Exp Emerg Med. 2026;13(1):5-12.   Published online January 14, 2026
DOI: https://doi.org/10.15441/ceem.25.241
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Outcomes in acute ischemic stroke (AIS) depend critically on rapid and accurate early diagnosis in the emergency department. Traditional prehospital tools and large vessel occlusion–focused scales facilitate triage but have limited capacity to distinguish ischemic from hemorrhagic stroke, a distinction essential for acute-phase treatment decisions. Recent advances include mobile stroke units equipped with computed tomography (CT), point-of-care laboratories, and telemedicine systems, as well as the emergence of biomarkers that enable field-based diagnosis and faster initiation of therapy. In-hospital imaging strategies incorporating CT, CT perfusion, and magnetic resonance imaging (MRI)-based tissue clocks have expanded eligibility for endovascular thrombectomy to include patients with large-core infarction or unclear-onset wake-up strokes. Prolonged cardiac monitoring and high-resolution vessel wall MRI have improved the detection of embolic sources and high-risk atherosclerotic plaques. Artificial intelligence now supports rapid imaging interpretation, workflow optimization, and treatment selection. Tenecteplase, a novel thrombolytic, provides a practical alternative to alteplase with comparable safety and efficacy, while post-thrombectomy management emphasizes individualized blood pressure control. In patients with minor stroke or high-risk transient ischemic attack, short-term dual antiplatelet therapy reduces early recurrence, and early initiation of lipid-lowering agents after AIS may stabilize vulnerable plaques and enhance vascular outcomes. Collectively, these innovations represent a shift toward integrated, time-sensitive, and precision-based AIS care spanning prehospital assessment, emergency department management, and post-reperfusion management.

Citations

Citations to this article as recorded by  Crossref logo
  • Current status and advances in comprehensive treatment of acute ischemic stroke in China: from evidence-based guidelines to clinical practice
    Ze-Ying Wang, Qin-Bao Zhang, Xiao-Ming Zheng
    Frontiers in Neurology.2026;[Epub]     CrossRef
  • 3,477 View
  • 177 Download
  • 1 Web of Science
  • 1 Crossref

Systematic Review

Use of biomarkers in the early diagnosis of Ischemic Stroke: A Systematic Review
José-Manuel León, Rosa Castillo-Olate, Jeffrey Penny
In Press, Received July 30, 2025  Accepted December 20, 2025  Available online January 14, 2026  
DOI: https://doi.org/10.15441/ceem.25.167    [Accepted]

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Use of biomarkers in the early diagnosis of Ischemic Stroke: A Systematic Review
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Use of biomarkers in the early diagnosis of Ischemic Stroke: A Systematic Review
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Objective
The diagnosis of acute ischemic stroke (AIS) is time-sensitive and reliant on neuroimaging, which is not always immediately accessible. This systematic review aims to identify and evaluate bloodbased biomarkers with potential to support early diagnostic decision-making and facilitate prompt referral for confirmatory imaging and treatment.
Methods
Following the PRISMA guidelines, a systematic search of PubMed, Web of Science, LILACS, Medline, Scopus, Scielo, Epistemonikos and TRIP Data Base was conducted for primary studies published in the last five years. Original studies evaluating blood-based biomarkers collected within 12 hours of symptom onset for early diagnosis of AIS were included. The methodological quality of included studies was assessed using the QUADAS-2 tool.
Results
Ten studies met the inclusion criteria, investigating a range of biomarkers including proteins, non-coding RNAs, and lipids. Most studies were case-control in design, with overall risk of bias rated as low to moderate. Multi-marker panels combining biomarkers with clinical scales (e.g., D-dimer and GFAP with FAST-ED; AUC = 0.95), and lipidomics-based models (AUC = 0.968), demonstrated the highest diagnostic performance. Several individual non-coding RNAs also showed promising accuracy (AUC > 0.85).
Conclusion
Blood-based biomarkers, especially when used in multi-marker panels, demonstrate considerable potential as triage tools for early AIS diagnosis. Their application in point-of-care settings could reduce diagnostic uncertainty and accelerate time to treatment. However, prospective validation in real-world emergency environments is essential prior to clinical implementation.
  • 712 View
  • 69 Download

Original Articles

Pediatrics | Environmental

Characteristics of pediatric patients with heat-related illness transferred to emergency departments: a descriptive analysis from Japan
Yohei Okada, Marcus Eng Hock Ong, Tadashi Ishihara, Shoji Yokobori, Jun Kanda
Clin Exp Emerg Med 2025;12(4):369-379.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.343

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Characteristics of pediatric patients with heat-related illness transferred to emergency departments: a descriptive analysis from Japan
Clin Exp Emerg Med. 2025;12(4):369-379.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.343
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Characteristics of pediatric patients with heat-related illness transferred to emergency departments: a descriptive analysis from Japan
Clin Exp Emerg Med. 2025;12(4):369-379.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.343
Close
Objective
Children are particularly vulnerable to heat-related illnesses due to their unique physiological and behavioral characteristics. Understanding the epidemiology and clinical features of heat-related illnesses in children is crucial for guiding targeted preventive measures and management strategies. This descriptive study aims to investigate the characteristics of pediatric patients with heat-related illness who were transferred to emergency departments in Japan.
Methods
This study was a secondary analysis of the Heatstroke Study, led by the Heatstroke and Hypothermia Surveillance Committee of the Japanese Association for Acute Medicine. This study included pediatric patients (<18 years) with heat-related illness transferred to emergency departments in the summer from 2017 to 2021. We summarized the circumstances of onset, clinical characteristics, and outcomes.
Results
Of the 3,154 registered patients, 146 children were included. Of them, 60% were male, with a median age of 15 years (interquartile range, 13–16 years). The most cases occurred in August (47%), and most (80%) were associated with sports activities and with outdoor settings (70%). Cases with a body temperature above 40 °C were rare (3%). Most cases were admitted to hospitals (75% to the general ward and 16% to the intensive care unit), and patients admitted to intensive care unit had altered consciousness with increased serum creatinine. There were two cases of mortality, both of which were out-of-hospital cardiac arrest.
Conclusion
Most pediatric cases with heat-related illness were middle or high school students, occurred in August, and were related to outdoor sports activity. Patients admitted to hospitals suffered altered consciousness, dehydration, and acute kidney injury.

Citations

Citations to this article as recorded by  Crossref logo
  • Association of Wet-Bulb Globe Temperature with heat-related illness hospitalizations in Japan: a time-stratified, case-crossover study
    Yuka Yamamura, Takashi Hongo, Tetsuya Yumoto, Fumiya Sasai, Kohei Tokioka, Takafumi Obara, Tsuyoshi Nojima, Jun Kanda, Shoji Yokobori, Hiromichi Naito, Takashi Yorifuji, Atsunori Nakao
    International Journal of Emergency Medicine.2026;[Epub]     CrossRef
  • Superior thermotolerance in young versus adult rats undergoing heat stroke is associated with age-related differences in intestinal barrier integrity and heat shock protein responses
    Yuanhao Cai, Lei Lei, Jikuai Chen, Xi Zhao, Juelin Chen, Jiawei Zhou, Yankun Pei, Yawei Wang, Yitong Gong, Jianyao You, Yangyang Cao, Muge Song, Jun Ma, Weiyi Ma, Meng Wang, Wenjun Chang, Qing Song, Lin Zhou, Lei Li, Shuogui Xu
    Frontiers in Cell and Developmental Biology.2026;[Epub]     CrossRef
  • Day type and heatstroke-related ambulance transports in Tokyo, Japan: a time-series study
    Yuji Nishiwaki, Sachie Mori, Takehiro Michikawa
    Environmental Health and Preventive Medicine.2026; 31: 51.     CrossRef
  • 6,501 View
  • 139 Download
  • 1 Web of Science
  • 3 Crossref

Neurology

Short-term functional outcomes and treatment trends for branch atheromatous disease and lacunar infarction: a retrospective cohort study of a nationwide multicenter registry
Gaku Fujiwara, Hideki Oka, Akihiro Fujii
Clin Exp Emerg Med 2024;11(4):365-371.   Published online July 19, 2024
DOI: https://doi.org/10.15441/ceem.24.220

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Short-term functional outcomes and treatment trends for branch atheromatous disease and lacunar infarction: a retrospective cohort study of a nationwide multicenter registry
Clin Exp Emerg Med. 2024;11(4):365-371.   Published online July 19, 2024
DOI: https://doi.org/10.15441/ceem.24.220
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Short-term functional outcomes and treatment trends for branch atheromatous disease and lacunar infarction: a retrospective cohort study of a nationwide multicenter registry
Clin Exp Emerg Med. 2024;11(4):365-371.   Published online July 19, 2024
DOI: https://doi.org/10.15441/ceem.24.220
Close
Objective
Branch atheromatous disease (BAD) is a form of ischemic stroke that presents with imaging findings similar to those of lacunar infarction, but has a different pathogenesis and is known to cause progressive paralysis. Due to regional variations, the epidemiology of BAD is not well understood, and its relationship with the functional prognosis remains unclear. Using a comprehensive Japanese stroke database, we investigated its epidemiological characteristics and associations with functional outcomes. Methods In this multicenter cohort study, we retrospectively analyzed data from 27 hospitals that contributed to the Saiseikai Stroke Database (2013–2021). We used multivariable logistic regression to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs) of BAD compared with lacunar infarction (LI) for functional outcomes at discharge. Ischemic stroke caused by BAD or LI was included, and demographic characteristics and clinical data were evaluated and contrasted between BAD and LI. Results Of the 5,966 analyzed patients, 1,549 (25.9%) had BAD and 4,434 (74.1%) had LI. BAD was associated with worse functional outcomes (aOR, 2.77; 95% CI, 2.42–3.17; relative to LI) and extended hospital stays (median 19 days for BAD vs. 13 days for LI). Moreover, aggressive treatment strategies, including the use of argatroban and dual antiplatelet therapy, were more common in BAD patients. Conclusion BAD presented worse functional outcomes and longer hospital stays than LI, necessitating treatment plans that take into account its progression and prognosis.

Citations

Citations to this article as recorded by  Crossref logo
  • Predicting early neurological deterioration in acute branch atheromatous disease without reperfusion therapy: a machine learning model
    Li Zeng, Wei He, Xiuxiu Lu, Liangbing Zhang
    Frontiers in Neuroscience.2026;[Epub]     CrossRef
  • Dual Antiplatelet Therapy in Acute Branch Atheromatous Disease (BAD)‐Related Stroke: A Multicenter Propensity‐Matched Cohort Analysis
    Haizhou Hu, Shengde Li, Yu Zhang, Yuhui Sha, Yaping Zhou, Feng Feng, Yicheng Zhu, Lixin Zhou, Bin Peng, Jun Ni
    CNS Neuroscience & Therapeutics.2026;[Epub]     CrossRef
  • Cerebral autoregulation in patients with acute lacunar infarction: a reliable predictor of outcome
    Xiang‐Kun Si, Song Xue, Xin Zhou, Ya‐Nan Guo, Wen‐Yu Du, Yang Qu, Xin Sun, Zhen‐Ni Guo
    Annals of Clinical and Translational Neurology.2025; 12(4): 724.     CrossRef
  • Association Between Argatroban and Outcomes of Branch Atheromatous Disease: A Propensity‐Matched Analysis From MRI‐Based Study
    Shengde Li, Haizhou Hu, Yaping Zhou, Ping Zhang, Guofang Chen, Hongying Bai, Bin Liu, Lixin Zhou, Yicheng Zhu, Bin Peng, Jun Ni
    CNS Neuroscience & Therapeutics.2025;[Epub]     CrossRef
  • Efficacy and Safety of Tenecteplase in the Treatment of Acute Branch Atheromatous Disease: A Retrospective Multicenter Case–Control Study
    Lili Zhu, Shengqi Fu, Ying Zhang, Baoyang Shi, Haoran Li, Fanchao Meng, Peng Ji, Dongya Zhang, Yanjun Zhang, Yuan Xu, Bo Jiang, Xiaofei Gao, Lijuan Liu, Weifeng Chen, Li Ruan, Shaolei Zhang, Yang Yang
    Neurology and Therapy.2025; 14(5): 2187.     CrossRef
  • Blood Pressure Variability and 90‐Day Functional Outcome in Branch Atheromatous Disease‐Related Stroke: A Multicenter Prospective Study
    Yaping Zhou, Shengde Li, Haizhou Hu, Yi‐Cheng Zhu, Bin Peng, Lixin Zhou, Jun Ni
    The Journal of Clinical Hypertension.2025;[Epub]     CrossRef
  • 7,921 View
  • 129 Download
  • 6 Web of Science
  • 6 Crossref

Imaging | Cardiovascular

A study on computed tomography cardiothoracic ratio in predicting left ventricular systolic dysfunction
Minki Chae, Ji Ung Na, Jang Hee Lee, Dong Hyuk Shin
Clin Exp Emerg Med 2023;10(1):52-59.   Published online February 14, 2023
DOI: https://doi.org/10.15441/ceem.22.382

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A study on computed tomography cardiothoracic ratio in predicting left ventricular systolic dysfunction
Clin Exp Emerg Med. 2023;10(1):52-59.   Published online February 14, 2023
DOI: https://doi.org/10.15441/ceem.22.382
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A study on computed tomography cardiothoracic ratio in predicting left ventricular systolic dysfunction
Clin Exp Emerg Med. 2023;10(1):52-59.   Published online February 14, 2023
DOI: https://doi.org/10.15441/ceem.22.382
Close
Objective
A cardiothoracic ratio ≥0.50 is widely used as an indicator of cardiomegaly, but associations between the cardiothoracic ratio and left ventricular systolic dysfunction (LVSD) have not been investigated previously. We conducted this study to investigate the relationship between cardiothoracic ratio measured using computed tomography (CT) and left ventricular ejection fraction (LVEF), and to determine the optimal cardiothoracic ratio for predicting left ventricular systolic dysfunction (LVSD).
Methods
A retrospective cross-sectional study was performed using data from patients who underwent both chest CT and echocardiography at the emergency department from January 1 to December 31, 2021. The patients were classified as normal, or having mild, moderate, and severe LVSD based on their LVEF, and the cardiothoracic ratios of each group were compared. The receiver operating characteristic (ROC) curve analyses were used to identify the optimal cardiothoracic ratio for prediction of mild, moderate, and severe LVSD.
Results
The final study population included 444 patients. The median CT-measured cardiothoracic ratio was 0.54 for patients with normal LVEF, and 0.60 for patients with LVSD (P<0.001). The optimal CT-measured cardiothoracic ratios for predicting mild, moderate, and severe LVSD were 0.56, 0.59, and 0.60, and their areas under the ROC curve were 0.653, 0.690, and 0.680, and negative predictive values were 90%, 94%, and 98%, respectively.
Conclusion
The best cutoff value for a CT-measured cardiothoracic ratio suggestive of LVSD was 0.56, which is very different from the 0.50 value typically considered an abnormal cardiothoracic ratio. The CT-measured cardiothoracic ratio ≥0.56 can be used as a rough indicator of mild LVSD, and a ratio <0.60 can exclude severe LVSD with a high degree of confidence.

Citations

Citations to this article as recorded by  Crossref logo
  • Comparison of Deep Learning Architectures for Cardiac Contour Segmentation in Catheterization Radiographs
    Kian A Huang, Bharath Subramanian, Haris K Choudhary, Aziz U Rehman, Neelesh S Prakash
    Cureus.2026;[Epub]     CrossRef
  • Association of artificial intelligence derived cardiothoracic ratio assessment on non-cardiac chest CT with heart failure and all-cause mortality: A retrospective single center study
    John LaForge, Ahmed Saleh, Vibhu Parcha, Akhilesh Gonuguntla, Shrikar Iragavarapu, Salomón Román Soto, Usman A. Hasnie, Gina Josey, Megan Nordberg, Andrew Smith, Steven Rothenberg, Stephen A. Clarkson
    The American Journal of the Medical Sciences.2026; 372(1): 27.     CrossRef
  • Analysis of non-coronary findings in coronary CT angiography: differences in gender, age, location, and clinical significance in the Turkish population
    Muhammet İkbal Isik, Mustafa Taşar
    RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren.2026;[Epub]     CrossRef
  • Novel Indexes in the Assessment of Cardiac Enlargement Using Chest Radiography: A New Look at an Old Problem
    Patrycja S. Matusik, Tadeusz J. Popiela, Paweł T. Matusik
    Journal of Clinical Medicine.2025; 14(3): 942.     CrossRef
  • Systematic review and comparison of measurement methods for determining the cardiothoracic ratio (CTR) on chest X-rays with subsequent validation using chest CT
    Dana Belde, Mattias Kettner, Michael J. Thali, Rahel A. Kubik-Huch, André Euler, Tilo Niemann
    Medicine.2025; 104(40): e45062.     CrossRef
  • Radiologic evaluation of subclinical cardiovascular structural changes in school cafeteria workers: a chest computed tomography study with age-matched controls
    Jung Hee Hong, Jin Young Kim, Kiook Baek
    Journal of Yeungnam Medical Science.2025; 42: 76.     CrossRef
  • 18,695 View
  • 219 Download
  • 6 Web of Science
  • 6 Crossref

Emergency Medical Services | Neurology

Uncooperative patients suspected of acute stroke ineligible for prehospital stroke screening test by emergency medical service providers: final hospital diagnoses and characteristics
Sol Han, Sung Wook Song, Hansol Hong, Woo Jeong Kim, Young Joon Kang, Chang Bae Park, Jeong Ho Kang, Ji Hwan Bu, Sung Kgun Lee, Seo Young Ko, Soo Hoon Lee, Chul-Hoo Kang
Clin Exp Emerg Med 2023;10(2):213-223.   Published online February 14, 2023
DOI: https://doi.org/10.15441/ceem.22.372

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Uncooperative patients suspected of acute stroke ineligible for prehospital stroke screening test by emergency medical service providers: final hospital diagnoses and characteristics
Clin Exp Emerg Med. 2023;10(2):213-223.   Published online February 14, 2023
DOI: https://doi.org/10.15441/ceem.22.372
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Uncooperative patients suspected of acute stroke ineligible for prehospital stroke screening test by emergency medical service providers: final hospital diagnoses and characteristics
Clin Exp Emerg Med. 2023;10(2):213-223.   Published online February 14, 2023
DOI: https://doi.org/10.15441/ceem.22.372
Close
Objective
This study investigated the hospital diagnoses and characteristics of uncooperative prehospital patients suspected of acute stroke who could not undergo a prehospital stroke screening test (PHSST).
Methods
This retrospective observational study was conducted at a single academic hospital with a regional stroke center. We analyzed three scenario-based prehospital stroke screening performances using the final hospital diagnoses: (1) a conservative approach only in patients who underwent the PHSST, (2) a real-world approach that considered all uncooperative patients as screening positive, and (3) a contrapositive approach that all uncooperative patients were considered as negative.
Results
Of the 2,836 emergency medical services (EMS)-transported adult patients who met the prehospital criteria for suspicion of acute stroke, 486 (17.1%) were uncooperative, and 570 (20.1%) had a confirmed final diagnosis of acute stroke. The diagnosis in the uncooperative group did not differ from that in the cooperative group (22.0% vs. 19.7%, P=0.246). The diagnostic performances of the PHSST in the conservative approach were as follows: 79.5% sensitivity (95% confidence interval [CI], 75.5%–83.1%), 90.2% specificity (95% CI, 88.8%–91.6%), and 0.849 area under the receiver operating characteristic curve (AUC; 95% CI, 0.829–0.868). The sensitivity and specificity were 83.3% (95% CI, 80.0%–86.3%) and 75.2% (95% CI, 73.3%–76.9%), respectively, in the real-world approach and 64.6% (95% CI, 60.5%–68.5%) and 91.9% (95% CI, 90.7%–93.0%), respectively, in the contrapositive approach. No significant difference was evident in the AUC between the real-world approach and the contrapositive approach (0.792 [95% CI, 0.775–0.810] vs. 0.782 [95% CI, 0.762–0.803], P>0.05).
Conclusion
We found overestimation (false positive) and underestimation (false negative) in the uncooperative group depending on the scenario-based EMS stroke screening policy for uncooperative prehospital patients suspected of acute stroke.

Citations

Citations to this article as recorded by  Crossref logo
  • LncRNA MCM3AP-AS1 protects against cerebral ischemia-reperfusion injury via targeting miR-27b-3p
    Rouli Dai, Wei Li, Bin Han
    Neurological Research.2026; 48(2): 229.     CrossRef
  • Impact of snoring on the risk of stroke in patients with diabetes mellitus
    Eujene Jung, U Chul Ju, Hyun Ho Ryu, Hyun Lee Kim
    Sleep and Breathing.2024; 28(6): 2675.     CrossRef
  • Epidemiology of stroke in emergency departments: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018–2022
    Sung Eun Lee, Hyo Jin Kim, Young Sun Ro
    Clinical and Experimental Emergency Medicine.2023; 10(S): S48.     CrossRef
  • 7,410 View
  • 122 Download
  • 3 Web of Science
  • 3 Crossref

Case Report

Environmental

Exertional heat stroke with reversible severe cerebral edema
Sangkil Lee, Sung-Hyun Lee
Clin Exp Emerg Med 2021;8(3):242-245.   Published online September 30, 2021
DOI: https://doi.org/10.15441/ceem.19.085

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Exertional heat stroke with reversible severe cerebral edema
Clin Exp Emerg Med. 2021;8(3):242-245.   Published online September 30, 2021
DOI: https://doi.org/10.15441/ceem.19.085
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Exertional heat stroke with reversible severe cerebral edema
Clin Exp Emerg Med. 2021;8(3):242-245.   Published online September 30, 2021
DOI: https://doi.org/10.15441/ceem.19.085
Close
Severe cerebral edema associated with exertional heat stroke is a major cause of death or disability. However, few studies on severe cerebral edema resulting from heat stroke have reported neuroradiological findings. Moreover, all the patients in these previous reports either died or remained severely disabled. Here, we report a case of exertional heat stroke with severe cerebral edema that probably developed or worsened due to delayed body temperature normalization. In contrast to previous reports, the patient showed complete clinical and neuroradiological recovery. This rare case suggests that severe cerebral edema could be reversed through meticulous supportive management. Moreover, it confirms the importance of rapid and effective cooling in heat stroke treatment.

Citations

Citations to this article as recorded by  Crossref logo
  • Dexamethasone restores blood–brain barrier integrity in an in vitro heatstroke model
    Kazuaki Okamura, Karoline Pichlerova, Takayuki Matsuo, Daisuke Watanabe, William D. Cutts, Brandon J. Kim, Yoichi Morofuji, Hideshi Okada
    PLOS One.2026; 21(6): e0352334.     CrossRef
  • Grey-to-white matter ratio on computed tomography for predicting neurological outcome in patients with heat stroke: a retrospective cohort study
    Hua Wei, Hongling Zhu, Menglong Liu, Xiaodan Zhu, Anyong Yu, Can Luo, Qingbo Zeng, Fating Zhou, Haizhen Duan
    Frontiers in Neurology.2025;[Epub]     CrossRef
  • Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) Triggered by Heat Stroke: A Case Report
    Kenko Aoki, Keisuke Suzuki, Takuya Shimada, Rei Ogawa, Kenji Dohi
    Cureus.2025;[Epub]     CrossRef
  • Ácido Tranexámico Prehospitalario versus Intrahospitalario en Trauma Mayor
    Rosa Itzel Hernández Pacheco , Hugo Alejandro Jiménez Nájera , Cristopher Alexis Lugo Farías , Lucero Joana Cortes Badillo , Anilu Calzadilla Rogel
    Estudios y Perspectivas Revista Científica y Académica .2025; 5(3): 3671.     CrossRef
  • The effect of general hyperthermia and local cooling on fentanyl tolerance in rats
    Ju. Ju. Ivnitsky, O. A. Vakunenkova, A. I. Golovko, N. V. Lapina, V. L. Rejniuk
    Extreme Medicine.2025; 27(4): 475.     CrossRef
  • Neurological disorders with general overheating of the body (scientific and literary review)
    O.V. Kravets, V.V. Yekhalov, V.A. Sedinkin, O.V. Pylypenko
    INTERNATIONAL NEUROLOGICAL JOURNAL.2024; 19(7): 202.     CrossRef
  • Surviving a classic heat stroke/hyperthermia > 42 °C – a case report
    Sonja Verena Schmidt, Jannik Hinzmann, Anna Stammler, Paula Wilhelms zu Bickern, Elisabete Macedo Santos, Marcus Lehnhardt, Christoph Wallner
    International Journal of Emergency Medicine.2024;[Epub]     CrossRef
  • Development and validation of a risk prediction model for multiple organ dysfunction syndrome secondary to severe heat stroke based on immediate assessment indicators on ICU admission
    Entong Ren, Hao Chen, Chenjiao Guo, Yuanyuan Peng, Li Tian, Lulu Yan, Huasheng Tong, Anwei Liu, Weihua Li
    Frontiers in Medicine.2024;[Epub]     CrossRef
  • Acquired heat acclimation in rats subjected to physical exercise under environmental heat stress alleviates brain injury caused by exertional heat stroke
    Xin Li, Fan Xv, Li-zhen Ma, Ling Xing, Jin-bao Zhao, Wei-jia Zhi, Li-feng Wang, Yang Wang, Han-ding Mao, Shu-yuan Liu, Ya-hua Liu, Qing Song
    Brain Research.2023; 1811: 148393.     CrossRef
  • 8,707 View
  • 122 Download
  • 6 Web of Science
  • 9 Crossref

Original Article

Predictors of poor prognosis in patients with heat stroke
Jae-Kwon Chun, Sangchun Choi, Hyuk-Hoon Kim, Hee Won Yang, Chang Seong Kim
Clin Exp Emerg Med 2019;6(4):345-350.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.18.081

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Predictors of poor prognosis in patients with heat stroke
Clin Exp Emerg Med. 2019;6(4):345-350.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.18.081
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Predictors of poor prognosis in patients with heat stroke
Clin Exp Emerg Med. 2019;6(4):345-350.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.18.081
Close
Objective
The predictors of poor prognosis in heat stroke (HS) remain unknown. This study investigated the predictive factors of poor prognosis in patients with HS.
Methods
Data were obtained and analyzed from the health records of patients diagnosed with heat illness at Ajou university hospital between January 2008 and December 2017. Univariate and multivariate analyses were performed to identify the independent predictors of poor prognosis.
Results
Thirty-six patients (median age, 54.5 years; 33 men) were included in the study. Poor prognosis was identified in 27.8% of the study population (10 patients). The levels of S100B protein, troponin I, creatinine, alanine aminotransferase, and serum lactate were statistically significant in the univariate analysis. Multiple regression analysis revealed that poor prognosis was significantly associated with an increased S100B protein level (odds ratio, 177.37; 95% confidence interval, 2.59 to 12,143.80; P=0.016). The S100B protein cut-off level for predicting poor prognosis was 0.610 μg/L (area under the curve, 0.906; 95% confidence interval, 0.00 to 1.00), with 86% sensitivity and 86% specificity.
Conclusion
An increased S100B protein level on emergency department admission is an independent prognostic factor of poor prognosis in patients with HS. Elevation of the S100B protein level represents a potential target for specific and prompt therapies in these patients.

Citations

Citations to this article as recorded by  Crossref logo
  • Energy metabolic dysregulation in heat stroke: from mitochondrial dysfunction to multi-organ failure mechanisms and targeted intervention
    Qiqi Li, Jinquan Wang, Xiaojie Qin, Biaochao Zhong, Qiantong Wei, Chunhui Zeng, Ke Yang
    Frontiers in Pharmacology.2026;[Epub]     CrossRef
  • Cracking the code of heatstroke: new insights into diagnosis and pathological mechanisms
    Hongli Xiong, Cunhao Bian, Yue Zhao, Yu sen Wang, Bi Wei, Hao Xiao, Li Zhang, Shisheng Zhu, Jianbo Li
    International Journal of Legal Medicine.2026;[Epub]     CrossRef
  • Grey-to-white matter ratio on computed tomography for predicting neurological outcome in patients with heat stroke: a retrospective cohort study
    Hua Wei, Hongling Zhu, Menglong Liu, Xiaodan Zhu, Anyong Yu, Can Luo, Qingbo Zeng, Fating Zhou, Haizhen Duan
    Frontiers in Neurology.2025;[Epub]     CrossRef
  • Age-leukocyte-international normalized ratio score (ALIS): A bedside triparametric tool for neurological prognostication in heat stroke emergencies
    Fating Zhou, Xiaodan Zhu, Haizhen Duan, Yunfei Xiang, Siyu Yang, Wanshu Que, Rui Huang, Shanmu Ai, Yu Ma
    The American Journal of Emergency Medicine.2025; 96: 217.     CrossRef
  • Prediction of in-hospital mortality in patients with exertional heatstroke: a 13-year retrospective study
    Xinghui Wu, Jing Qian, Songbin He, Xuezhi Shi, Ronglin Chen, Huaisheng Chen, LuLu Wang, Fanfan Wang, Jiale Yang, Na Peng, Huasheng Tong
    International Journal of Environmental Health Research.2024; 34(6): 2451.     CrossRef
  • How can heatstroke damage the brain? A mini review
    Kazuhiro Yoneda, Sanae Hosomi, Hiroshi Ito, Yuki Togami, Sayaka Oda, Hisatake Matsumoto, Junya Shimazaki, Hiroshi Ogura, Jun Oda
    Frontiers in Neuroscience.2024;[Epub]     CrossRef
  • Biomarkers of heatstroke‐induced organ injury and repair
    Zachary J. Schlader, Michael S. Davis, Abderrezak Bouchama
    Experimental Physiology.2022; 107(10): 1159.     CrossRef
  • Targeted temperature management in patients with severe heatstroke
    Yoon Seok Jung, Hyuk-Hoon Kim, Hee Won Yang, Sangchun Choi
    Medicine.2020; 99(45): e23159.     CrossRef
  • 9,000 View
  • 140 Download
  • 10 Web of Science
  • 8 Crossref

Review Article

Neurology

Emergency management of stroke in the era of mechanical thrombectomy
Ethan S. Brandler, Nayeem Baksh
Clin Exp Emerg Med 2019;6(4):273-287.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.18.065

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Emergency management of stroke in the era of mechanical thrombectomy
Clin Exp Emerg Med. 2019;6(4):273-287.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.18.065
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Emergency management of stroke in the era of mechanical thrombectomy
Clin Exp Emerg Med. 2019;6(4):273-287.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.18.065
Close
Emergency management of stroke has been directed at the delivery of recombinant tissue plasminogen activator (tPA) in a timely fashion. Because of the many limitations attached to the delivery of tPA and the perceived benefits accrued to tPA, its use has been limited. Mechanical thrombectomy, a far superior therapy for the largest and most disabling strokes, large vessel occlusions (LVOs), has changed the way acute strokes are managed. Aside from the rush to deliver tPA, there is now a need to identify LVO and refer those patients with LVO to physicians and facilities capable of delivering urgent thrombectomy. Other parts of emergency department management of stroke are directed at identifying and mitigating risk factors for future strokes and at preventing further damage from occurring. We review here the most recent literature supporting these advances in stroke care and present a framework for understanding the role that emergency physicians play in acute stroke care.

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  • Data integration using information and communication technology for emergency medical services and systems
    Ji Hoon Kim
    Clinical and Experimental Emergency Medicine.2023; 10(2): 129.     CrossRef
  • "Thrombectomy and Back:" A Novel Approach for Treating Patients with Large Vessel Occlusion in the Eastern Province of Saudi Arabia
    Hosam Al-Jehani, May Adel AlHamid, Kawthar Hudhiah, Aisha Al-Bakr, Reem Bunayan, Faisal AlAbbas
    Saudi Journal of Medicine & Medical Sciences.2021; 9(2): 175.     CrossRef
  • 13,476 View
  • 192 Download
  • 2 Web of Science
  • 2 Crossref

Case Report

Imaging

Dural sinus thrombosis identified by point-of-care ultrasound
Laura T. Director, David C. Mackenzie
Clin Exp Emerg Med 2018;5(3):199-203.   Published online September 30, 2018
DOI: https://doi.org/10.15441/ceem.17.237

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Dural sinus thrombosis identified by point-of-care ultrasound
Clin Exp Emerg Med. 2018;5(3):199-203.   Published online September 30, 2018
DOI: https://doi.org/10.15441/ceem.17.237
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Dural sinus thrombosis identified by point-of-care ultrasound
Clin Exp Emerg Med. 2018;5(3):199-203.   Published online September 30, 2018
DOI: https://doi.org/10.15441/ceem.17.237
Close
Dural sinus thrombosis (DST), or cerebral venous thrombosis, is an uncommon cause of stroke. It has a variable presentation, and the symptoms and signs can be non-specific. The diagnosis of DST can be difficult to make and is often delayed or missed. Computed tomography venography or magnetic resonance venography are the typical imaging modalities used to diagnose DST. However, computed tomography venography and magnetic resonance venography both have limitation for emergency department patients. In this article, we report the use of point-of-care ultrasound to facilitate the diagnosis of DST.

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  • Man With Seizure
    Mustafa Emin Canakci, Sevinc Erdem, Ulviyyat Jafarova, Nurdan Acar, Atilla Ozcan Ozdemir
    Annals of Emergency Medicine.2021; 77(4): e91.     CrossRef
  • 8,612 View
  • 83 Download
  • 1 Web of Science
  • 1 Crossref

Review Article

Neurology

Approach to dizziness in the emergency department
Ileok Jung, Ji-Soo Kim
Clin Exp Emerg Med 2015;2(2):75-88.   Published online June 30, 2015
DOI: https://doi.org/10.15441/ceem.15.026

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Approach to dizziness in the emergency department
Clin Exp Emerg Med. 2015;2(2):75-88.   Published online June 30, 2015
DOI: https://doi.org/10.15441/ceem.15.026
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Approach to dizziness in the emergency department
Clin Exp Emerg Med. 2015;2(2):75-88.   Published online June 30, 2015
DOI: https://doi.org/10.15441/ceem.15.026
Close
Acute dizziness/vertigo is among the most common causes for visiting the emergency department. The traditional approach to dizziness starts with categorizing dizziness into four types: vertigo, presyncope, disequilibrium, and nonspecific dizziness. However, a recently proposed approach begins with classifying dizziness/vertigo as acute prolonged spontaneous dizziness/vertigo, recurrent spontaneous dizziness/vertigo, recurrent positional vertigo, or chronic persistent dizziness and imbalance. Vestibular neuritis and stroke are key disorders causing acute prolonged spontaneous dizziness/vertigo, but the diagnosis of isolated vascular vertigo has increased by virtue of developments in clinical neurotology and neuroimaging. However, a well-organized bedside examination appears more sensitive than brain imaging in diagnosing strokes presenting with acute dizziness/vertigo. A detailed history is vital to diagnose recurrent spontaneous dizziness/vertigo since confirmatory diagnostic tests are usually unavailable. Isolated positional vertigo is usually caused by benign paroxysmal positional vertigo, which can be treated at the bedside. In recent years, marked progress has occurred in the evaluation/management of acute dizziness/vertigo. However, even with developments in imaging technology, the diagnosis of acute dizziness/vertigo largely relies on bedside examination.

Citations

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  • Post-stroke dizziness in anterior vs. posterior circulation ischemic stroke
    Sang Hee Ha, Gayoung Park, Bum Joon Kim, Jun Young Chang, Dayoung Seo, Dong-Wha Kang, Sun U. Kwon, Jong S. Kim, Eun-Jae Lee
    Frontiers in Neurology.2026;[Epub]     CrossRef
  • Annual epidemiologic trends of 6000 ENT cases in the Emergency Department in the post-pandemic era: a cross-sectional study from Crete, Greece
    Nikolaos Papadopoulos, Emmanuel Prokopakis, Manolis Linardakis, Alexander Karatzanis, Evangelia Mourellou, Emmanouil Symvoulakis
    Otolaryngologia Polska.2025; 79(5): 9.     CrossRef
  • Acute Bilateral Vestibular Neuropathy During Myocardial Infarction: A Case Report
    Francesco Comacchio, Elia Biancoli, Elisabetta Poletto, Barbara Bellemo, Paola Magnavita
    Journal of Otorhinolaryngology, Hearing and Balance Medicine.2025; 6(2): 15.     CrossRef
  • Suspected idiopathic vestibular syndrome in the horse: Eight cases (2014–2021)
    Amie Wilson, Rita Gonçalves, Harry Carslake, Fernando Malalana
    Equine Veterinary Education.2024;[Epub]     CrossRef
  • The Diagnostic Value of Brain CT Scans in Evaluating Dizziness in the Emergency Department: A Retrospective Study
    Abdulrahman Masood, Omar Alkhaja, Ali Alsetrawi, Fuad Alshaibani, Ahmed Awad, Zainab Habbash, Zahra Y Alyusuf, Naeema Ali, Sarah Al Mail, Tareq Al Taei
    Cureus.2024;[Epub]     CrossRef
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    Pouya Barahim Bastani, Shervin Badihian, Vidith Phillips, Hector Rieiro, Jorge Otero-Millan, Nathan Farrell, Max Parker, David Newman-Toker, Ali Saber Tehrani
    Research in Vestibular Science.2024; 23(3): 63.     CrossRef
  • Vertebral artery dissection presenting as vertigo–a rare case presentation in a young adult
    Mira Yuniarti, Deddy Andaka, Gilbert Sterling Octavius
    Egyptian Journal of Radiology and Nuclear Medicine.2024;[Epub]     CrossRef
  • Comparison of RPM (Re-positioning Maneuver) & Liberatory maneuvers vs Betahistine on BPPV (Benign Paroxysmal Positional Vertigo) for improving functional ability and quality of life
    Muhammad Talha , Somiya Asif, Hamza Shahid, Syeda Maria Nazir, Kiran Haq
    Pakistan Journal of Health Sciences.2023; : 54.     CrossRef
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    Deirdre Breslin, Pádraig Synnott, Colm Byrne
    Cureus.2023;[Epub]     CrossRef
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    Manish Gupta, Monica Gupta, Akanksha Gupta
    APIK Journal of Internal Medicine.2023; 11(4): 250.     CrossRef
  • Differential diagnosis of vertigo: Case reports
    Aleksandra Lučić-Prokin, Sanela Popović, Radmila Petrović, Aleksandra Lazić
    ABC - casopis urgentne medicine.2023; 23(1): 7.     CrossRef
  • Potential use of dimensionhydrinate/cinnarizine combination in the treatment of vertigo
    N. V. Pizova
    Meditsinskiy sovet = Medical Council.2022; (21-1): 35.     CrossRef
  • Differential diagnosis of vertigo
    Aleksandra Lučić-Prokin
    ABC - casopis urgentne medicine.2022; 22(1): 14.     CrossRef
  • A review of the diagnostic approaches in patients with acute vertigo, dizziness and imbalance
    Akihiro Nagata, Hiroki Takeda, Atsuhiko Uno
    Equilibrium Research.2021; 80(6): 516.     CrossRef
  • Diagnosis of benign paroxysmal positional vertigo in Emergency Department: Our experience
    Elisabetta Cristiano, Vincenzo Marcelli, Antonio Giannone, Stefania De Luca, Flavia Oliva, Roberto Varriale, Giovanni Motta, Fiorella Paladino, Margherita Benincasa, Marco Perrella, Filippo Ricciardiello
    Audiology Research.2020; 10(1): 232.     CrossRef
  • Abnormal Eye Movements in Parkinsonism and Movement Disorders
    Ileok Jung, Ji-Soo Kim
    Journal of Movement Disorders.2019; 12(1): 1.     CrossRef
  • Diagnosis of internal carotid artery stenosis in a patient referred to a physiotherapist for dizziness
    Ryan Boggs, Michael Ross, Michael Tall
    The Journal of Primary Health Care.2019; 11(4): 373.     CrossRef
  • Clinical approach to patients with dizziness
    Jae Han Park, Youngrok Do, Ji Soo Kim
    Journal of the Korean Medical Association.2018; 61(1): 44.     CrossRef
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    Štefan Sivák
    Neurologie pro praxi.2017; 18(3): 156.     CrossRef
  • Keep it simple: vascular risk factors and focal exam findings correctly identify posterior circulation ischemia in “dizzy” patients
    Karen Chen, Andrea L. C. Schneider, Rafael H. Llinas, Elisabeth B. Marsh
    BMC Emergency Medicine.2016;[Epub]     CrossRef
  • 65,535 View
  • 1,295 Download
  • 13 Web of Science
  • 20 Crossref

Original Article

Diffusion-weighted imaging–fluid-attenuated inversion recovery mismatch is associated with better neurologic response to intravenous thrombolytic therapy in acute ischemic stroke patients
Jong Yeong Jeong, Sang Kuk Han, Dong Hyuk Shin, Ji Ung Na, Hyun Jung Lee, Pil Cho Choi, Jeong Hun Lee
Clin Exp Emerg Med 2015;2(1):31-37.   Published online March 31, 2015
DOI: https://doi.org/10.15441/ceem.14.043

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Diffusion-weighted imaging–fluid-attenuated inversion recovery mismatch is associated with better neurologic response to intravenous thrombolytic therapy in acute ischemic stroke patients
Clin Exp Emerg Med. 2015;2(1):31-37.   Published online March 31, 2015
DOI: https://doi.org/10.15441/ceem.14.043
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Diffusion-weighted imaging–fluid-attenuated inversion recovery mismatch is associated with better neurologic response to intravenous thrombolytic therapy in acute ischemic stroke patients
Clin Exp Emerg Med. 2015;2(1):31-37.   Published online March 31, 2015
DOI: https://doi.org/10.15441/ceem.14.043
Close
Objective
To investigate differences in the effect of intravenous (IV) thrombolysis regarding the mismatch of diffusion-weighted imaging–fluid-attenuated inversion recovery (DWI-FLAIR) among acute ischemic stroke patients who visited the emergency department (ED) within 3 hours from the onset of symptoms.
Methods
Among ED patients presenting with an acute ischemic stroke between January 2011 and May 2013 at a tertiary hospital, those who underwent magnetic resonance imaging before IV thrombolytic therapy were included in this retrospective study. Patients were divided into DWI-FLAIR mismatch and match groups. National Institutes of Health Stroke Scale (NIHSS) scores obtained initially, 24 hours after thrombolytic therapy, and on discharge, and early neurologic improvement (ENI) and major neurologic improvement (MNI) were compared.
Results
During the study period, 50 of the 213 acute ischemic stroke patients who presented to the ED were included. The DWI-FLAIR mismatch group showed a statistically significantly greater reduction in NIHSS both at 24 hours after thrombolytic therapy and upon discharge than did the match group (5.5 vs. 1.2, P<0.001; 6.0 vs. 2.3, P<0.01, respectively). Moreover, ENI and MNI were significantly greater for the DWI-FLAIR mismatch group than for the match group (27/36 vs. 2/14, P<0.001; 12/36 vs. 0/14, P=0.012, respectively).
Conclusion
Among acute ischemic stroke patients who visited the ED within 3 hours from the onset of symptoms, patients who showed DWI-FLAIR mismatch showed a significantly better response to IV thrombolytic therapy than did the DWI-FLAIR match group in terms of neurologic outcome.

Citations

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  • Association of FLAIR Positivity and Worse Outcomes After Intravenous Thrombolysis in Known-Onset Strokes: A Systematic Review and Meta-Analysis
    Esra Zhubi, Azamat Bissenov, Anna Sára Lengyel, Réka Tóth, András Attila Horváth, Szabolcs Kéri, Marie Anne Engh, Péter Hegyi, Bence Gunda
    Journal of Clinical Medicine.2025; 14(22): 8031.     CrossRef
  • Fluid-Attenuated Inversion Recovery Hyperintense Ischemic Stroke Predicts Less Favorable 90-Day Outcome after Intravenous Thrombolysis
    Yongwoo Kim, Marie Luby, Nina-Serena Burkett, Gina Norato, Richard Leigh, Clinton B. Wright, Kyle C. Kern, Amie W. Hsia, John K. Lynch, Malik M. Adil, Lawrence L. Latour
    Cerebrovascular Diseases.2021; 50(6): 738.     CrossRef
  • 15,389 View
  • 135 Download
  • 2 Web of Science
  • 2 Crossref
Case Report

Environmental

Use of an external-cooling device for the treatment of heat stroke
Byung-Chan Lee, Jung Youn Kim, Sung Hyuk Choi, Young Hoon Yoon
Clin Exp Emerg Med 2014;1(1):62-64.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.004

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Use of an external-cooling device for the treatment of heat stroke
Clin Exp Emerg Med. 2014;1(1):62-64.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.004
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Use of an external-cooling device for the treatment of heat stroke
Clin Exp Emerg Med. 2014;1(1):62-64.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.004
Close

Heat stroke is caused by losing control of one’s body temperature. It can be life threatening without proper treatment. In this case report, we describe a heat stroke patient treated with an external-cooling device, which is commonly used for therapeutic hypothermia after cardiac arrest. A 67-year-old woman was found unconscious with spontaneous breathing in a sauna. Her body temperature was 40.5°C when she arrived at the emergency department, and she was diagnosed with heat stroke. At seven hours after applying the Arctic Sun Temperature Management System (Medivance), her body temperature declined to 36.5°C, with neurologic improvement (Glasgow Coma Scale score increased from 3 to 12). She was admitted to an intensive care unit and discharged 14 days after admission without any neurological sequelae. In conclusion, an external-cooling device can be used effectively for heat stroke, in addition to therapeutic hypothermia after cardiac arrest.

Citations

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  • Severe heat stroke with multiorgan failure following collapse in a sauna
    William Jack McIver, Muhammad Zia
    BMJ Case Reports.2025; 18(1): e262069.     CrossRef
  • Extravascular Temperature Control for Heatstroke With Multi‐Organ Failure: A Survivor's Case Report
    Van Ha Thi Bich, Lich Nguyen Duc, Anh Tran Ngoc
    Clinical Case Reports.2025;[Epub]     CrossRef
  • The climate crisis in clinical practice: Addressing air pollution, heat, and microplastics
    Elizabeth Cerceo
    European Journal of Internal Medicine.2025; 139: 106435.     CrossRef
  • Full neurological recovery from severe nonexertional heat stroke with multiple organ dysfunction: A case report
    Fang Du, Jun-Wei Zheng, Yan-Bo Zhao, Kai Yang, Hu-Nian Li
    World Journal of Clinical Cases.2023; 11(10): 2355.     CrossRef
  • Association between cooling temperature and outcomes of patients with heat stroke
    Lan Chen, Shuying Xu, Xiaoling Yang, Junlu Zhao, Yuping Zhang, Xiuqin Feng
    Internal and Emergency Medicine.2023; 18(6): 1831.     CrossRef
  • Using Esophageal Temperature Management to Treat Severe Heat Stroke: A Case Report
    Katherine Riley Martin, Melissa Naiman, Maurice Espinoza
    Journal of Neuroscience Nursing.2020; 52(1): 9.     CrossRef
  • Clinical characteristics, prognostic factors, and outcomes of heat‐related illness (Heatstroke Study 2017–2018)
    Junya Shimazaki, Toru Hifumi, Keiki Shimizu, Yasutaka Oda, Jun Kanda, Yutaka Kondo, Shinichiro Shiraishi, Shuhei Takauji, Kei Hayashida, Takashi Moriya, Masaharu Yagi, Junko Yamaguchi, Hiroyuki Yokota, Shoji Yokobori, Masahiro Wakasugi, Arino Yaguchi, Yas
    Acute Medicine & Surgery.2020;[Epub]     CrossRef
  • Feasibility and Safety of Intravascular Temperature Management for Severe Heat Stroke: A Prospective Multicenter Pilot Study
    Shoji Yokobori, Yuichi Koido, Hajime Shishido, Toru Hifumi, Kenya Kawakita, Tomoya Okazaki, Shinichirou Shiraishi, Eiji Yamamura, Takashi Kanemura, Takanobu Otaguro, Gaku Matsumoto, Yasuhiro Kuroda, Yasufumi Miyake, Yasutaka Naoe, Kyoko Unemoto, Hiroshi K
    Critical Care Medicine.2018; 46(7): e670.     CrossRef
  • Clinical Q & A: Translating Therapeutic Temperature Management from Theory to Practice
    Mary Kay Bader, Stephen A. Figueroa, Mary McKenna Guanci, Patricia A. Blissitt, William D. Cahoon
    Therapeutic Hypothermia and Temperature Management.2017; 7(1): 61.     CrossRef
  • Multiple organ dysfunction due to heatstroke after sauna: case report and review of the literature
    Yan Zhuang, Lin-feng Dai, Ren-zheng Diao
    JRSM Open.2017;[Epub]     CrossRef
  • 15,194 View
  • 126 Download
  • 10 Web of Science
  • 10 Crossref
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CEEM : Clinical and Experimental Emergency Medicine