Editors' Note

Editors' Note: In "Risks and benefits of clopidogrel–aspirin in minor stroke or TIA: Time course analysis of CHANCE," authors Pan et al. compared the use of dual antiplatelet therapy (DAPT) with aspirin alone for secondary stroke prevention in patients after a minor stroke or TIA. Drs. Gutierrez and Lekic point out that DAPT appeared to have a greater benefit than aspirin alone in patients with intracranial arterial stenosis (ICAS) in the first 2 weeks and ask the authors to provide a time-course analysis for the risk of ischemic stroke and hemorrhage by ICAS status.
Source: Neurology - Category: Neurology Authors: Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research

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Publication date: Available online 15 October 2018Source: Neurochemistry InternationalAuthor(s): Péter Hertelendy, Dániel P. Varga, Ákos Menyhárt, Ferenc Bari, Eszter FarkasAbstractSecondary injury following acute brain insults significantly contributes to poorer neurological outcome. The spontaneous, recurrent occurrence of spreading depolarization events (SD) has been recognized as a potent secondary injury mechanism in subarachnoid hemorrhage, malignant ischemic stroke and traumatic brain injury. In addition, SD is the underlying mechanism of the aura symptoms of migraineurs. The susceptibili...
Source: Neurochemistry International - Category: Neuroscience Source Type: research
CONCLUSIONS: Caregivers of people with stroke experience mental disorders and burden negatively affecting their quality of life. Therefore, there is a need to implement strategies which should aim to the management of these problems for the welfare of both patients and their caregivers. PMID: 30315561 [PubMed - in process]
Source: Acta Neurologica Taiwanica - Category: Neurology Tags: Acta Neurol Taiwan Source Type: research
This article addresses ethical concerns pertinent to each phase. First, we discuss ethical issues regarding consent for thrombolysis and endovascular treatment for acute ischemic stroke, including a review of considerations regarding the provision of acute stroke treatment advice over the telephone. Next, we discuss capacity for consent and prognostication after ischemic stroke and intracranial hemorrhage, with a focus on the problems of the self-fulfilling prophecy. Finally, we discuss residual disability and patients' return to driving. Consideration of these ethical dimensions of cerebrovascular disease will assist neur...
Source: Seminars in Neurology - Category: Neurology Authors: Tags: Review Article Source Type: research
Conclusions: These data from studies of neurocritically ill patients demonstrate that patients with primary neurologic diagnoses can meet diagnostic criteria for delirium and that delirious features may predict relevant untoward clinical outcomes. There is a need for ongoing investigations regarding delirium in these complicated neurocritically ill patients.
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Review Article Source Type: research
This article reviews telestroke models, NCCT interpretation pearls, and access challenges to the latest neuroradiology technology withi n rural and underserved regions.
Source: Neuroimaging Clinics - Category: Radiology Authors: Source Type: research
Stroke is a major health burden worldwide with attendant mortality, morbidity, and cost. In 2010, there were approximately 16.9 million strokes and an estimated 33 million stroke survivors worldwide. Also, in the United States, stroke is the third leading cause of death, with ischemic stroke resulting in 8% 30-day mortality (20% for hemorrhagic stroke). The staggering economic cost of the disease is driven largely by disability and long term care. Efforts in stroke healthcare delivery are focusing on performance, efficiency and value to better serve the consumer.
Source: Neuroimaging Clinics - Category: Radiology Authors: Source Type: research
Reperfusion is the first line of care in a growing number of eligible acute ischemic stroke patients. Early reperfusion with thrombolytic drugs and endovascular mechanical devices is associated with improved outcome and lower mortality rates compared with natural history. Reperfusion is not without risk, however, and may result in reperfusion injury, which manifests in hemorrhagic transformation, brain edema, infarct progression, and neurologic worsening. In this article, the functional and structural changes and underlying molecular mechanisms of ischemia and reperfusion are reviewed. The pathways that lead to reperfusion...
Source: Neuroimaging Clinics - Category: Radiology Authors: Source Type: research
Given the need for early restoration of blood flow and preservation of partially damaged brain cells after ischemic stroke, the noninterventional treatment of stroke relies heavily on the speedy recognition and classification of the clinical syndrome. Initiation of systemic thrombolysis with careful observation of contraindications within the 3.0 (4.5)-hour time window is the approved therapy of choice. Management of hemorrhagic complications and resumption of oral anticoagulation if indicated are also discussed in this article.
Source: Neuroimaging Clinics - Category: Radiology Authors: Source Type: research
CONCLUSIONS: Use of carbamazepine and valproic acid, but not lithium and lamotrigine, is associated with increased risk of stroke in patients with bipolar disorder.Declaration of interestNone. PMID: 30295208 [PubMed - as supplied by publisher]
Source: The British Journal of Psychiatry for Mental Science - Category: Psychiatry Tags: Br J Psychiatry Source Type: research
We describe the case of a 73 year old male with AIS and active dabigatran use. Idarucizumab was administered per an approved medical center protocol and the patient was subsequently treated with IV rt-PA. The patient had a severe stroke with no other contraindications to IV rt-PA other than dabigatran use. The patient was administered Idarucizumab and IV rt-PA was given. Within 24 h of treatment, the patient had minimal stroke deficits. Imaging revealed a right middle cerebral artery patchy infarct. The patient was restarted on dabigatran therapy for his atrial fibrillation and was discharged to a skilled nursing facil...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
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