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Source: Neurology
Condition: Ischemic Stroke

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Total 1519 results found since Jan 2013.

Vertebral artery stenosis: The hurdles of stenting are too high
Up to a quarter of patients with vertebrobasilar ischemic stroke or TIA have a symptomatic stenosis of the vertebrobasilar arteries.1,2 Patients with vertebral artery (VA) stenosis >50% have a high risk of recurrent stroke, comparable to patients with symptomatic carotid artery stenosis, with the highest risk during the first weeks after the initial TIA or ischemic stroke.3 Endovascular treatment of symptomatic VA stenosis has appeal as a treatment option that is widely performed, despite the scarcity of evidence for its safety or benefit.
Source: Neurology - September 18, 2017 Category: Neurology Authors: Compter, A., Chaturvedi, S. Tags: Stroke prevention, All Cerebrovascular disease/Stroke EDITORIALS Source Type: research

Incidence and management of seizures after ischemic stroke: Systematic review and meta-analysis
Conclusions: The burden of stroke-related seizures and epilepsy due to ischemic stroke is substantial. Further studies are required to determine risk factors for epilepsy following ischemic stroke and optimal secondary prevention.
Source: Neurology - September 18, 2017 Category: Neurology Authors: Wang, J. Z., Vyas, M. V., Saposnik, G., Burneo, J. G. Tags: All Cerebrovascular disease/Stroke, Incidence studies, All Epilepsy/Seizures ARTICLE Source Type: research

Does compensatory hyperparathyroidism predispose to ischemic stroke? Decreased bone mass and increased bone turnover with valproate therapy in adults with epilepsy; An alternative to vitamin D supplementation to prevent fractures in patients with MS; High prevalence of vitamin D deficiency and reduced bone mass in Parkinson's disease
Because of known issues leading to several retractions of papers by Y. Sato et al., the editors of Neurology® have, as a matter of due diligence, researched other papers that this group published in Neurology. To ensure that the scientific literature is correct, the Editor chooses to publish an Expression of Concern regarding 3 observational studies and a Letter to the Editor published in Neurology prior to the retracted clinical trials.1–4
Source: Neurology - September 18, 2017 Category: Neurology Tags: EXPRESSION OF CONCERN Source Type: research

Waxing and waning of white matter hyperintensities
Small vessel disease (SVD) manifests in myriad ways, most prominently as white matter hyperintensities (WMH).1,2 By the age of 60 years, virtually every healthy individual has evidence of WMH,3 and those with ischemic stroke have even more extensive changes.4 Cerebral ischemic injury from occlusion or stenosis of deep penetrating arteries due to (uncontrolled) hypertension ranks highest among the potential causes of WMH.5 These WMH are among the most important vascular contributors to cognitive decline, dementia, and parkinsonism.6
Source: Neurology - September 4, 2017 Category: Neurology Authors: de Leeuw, F.-E., Nichols, F. Tags: MRI, All Cerebrovascular disease/Stroke, Vascular dementia EDITORIALS Source Type: research

Sex-specific stroke incidence over time in the Greater Cincinnati/Northern Kentucky Stroke Study
Conclusions: Decreases in stroke incidence over time are driven by a decrease in ischemic stroke in men. Contrary to previous study periods, stroke incidence rates were similar by sex in 2010. Future research is needed to understand why the decrease in ischemic stroke incidence is more pronounced in men.
Source: Neurology - September 4, 2017 Category: Neurology Authors: Madsen, T. E., Khoury, J., Alwell, K., Moomaw, C. J., Rademacher, E., Flaherty, M. L., Woo, D., Mackey, J., De Los Rios La Rosa, F., Martini, S., Ferioli, S., Adeoye, O., Khatri, P., Broderick, J. P., Kissela, B. M., Kleindorfer, D. Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Incidence studies, Risk factors in epidemiology ARTICLE Source Type: research

White matter hyperintensity reduction and outcomes after minor stroke
Conclusions: Some WMH may regress after minor stroke, with potentially better clinical and brain tissue outcomes. The role of risk factor control requires verification. Interstitial fluid alterations may account for some WMH reversibility, offering potential intervention targets.
Source: Neurology - September 4, 2017 Category: Neurology Authors: Wardlaw, J. M., Chappell, F. M., Valdes Hernandez, M. d. C., Makin, S. D. J., Staals, J., Shuler, K., Thrippleton, M. J., Armitage, P. A., Munoz-Maniega, S., Heye, A. K., Sakka, E., Dennis, M. S. Tags: MRI, Vascular dementia, Infarction ARTICLE Source Type: research

Assessment of the interaction of age and sex on 90-day outcome after intracerebral hemorrhage
Conclusion: Unlike in ischemic stroke, there was no evidence that patient sex modified the effect of age on 90-day outcomes after ICH in a large multiracial/ethnic population. Future studies should evaluate biological reasons for these differences between stroke subtypes. Clinicaltrials.gov identifier: NCT01202864.
Source: Neurology - September 4, 2017 Category: Neurology Authors: James, M. L., Langefeld, C. D., Sekar, P., Moomaw, C. J., Elkind, M. S. V., Worrall, B. B., Sheth, K. N., Martini, S. R., Osborne, J., Woo, D., On behalf of the ERICH Investigators Tags: Outcome research, Clinical trials Observational study (Cohort, Case control), Intracerebral hemorrhage ARTICLE Source Type: research

Individualized risk prediction of major bleeding in secondary stroke prevention: Are we there yet?
In most patients diagnosed with a TIA or ischemic stroke, secondary stroke prevention relies on antiplatelet therapy unless anticoagulation is indicated. Aspirin has the largest evidence base and reduces the risk of early recurrent ischemic stroke without a major risk of early hemorrhagic complications.1 Because antiplatelet therapy typically continues for many years, clinicians and patients need an estimation of the annual bleeding risk to accurately assess future risk. In a meta-analysis of 25 randomized trials of antiplatelet therapy in primary or secondary prevention of cardiovascular disease, aspirin increased the abs...
Source: Neurology - August 28, 2017 Category: Neurology Authors: Lemmens, R., Al-Shahi Salman, R. Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Risk factors in epidemiology, Infarction EDITORIALS Source Type: research

Predicting major bleeding in patients with noncardioembolic stroke on antiplatelets: S2TOP-BLEED
Conclusions: The S2TOP-BLEED score can be used to estimate 3-year major bleeding risk in patients with a TIA or ischemic stroke who use antiplatelet agents, based on readily available characteristics. The discriminatory performance may be improved by identifying stronger predictors of major bleeding.
Source: Neurology - August 28, 2017 Category: Neurology Authors: Hilkens, N. A., Algra, A., Diener, H.-C., Reitsma, J. B., Bath, P. M., Csiba, L., Hacke, W., Kappelle, L. J., Koudstaal, P. J., Leys, D., Mas, J.-L., Sacco, R. L., Amarenco, P., Sissani, L., Greving, J. P., For the Cerebrovascular Antiplatelet Trialists' Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Risk factors in epidemiology, Infarction ARTICLE Source Type: research

DNA methylation predicts stroke outcome better: The epigenetic clock is ticking
As a leading cause of disability worldwide, stroke renders people disabled through several mechanisms. Over half of patients have sensorimotor and cognitive deficits, one-third experience depression and social disability, and half never return to work. Our ability to predict recurrent stroke and disability poststroke remains poor despite modern medical advances.1 The uncertainty surrounding the recovery process creates critical knowledge gaps for clinicians deciding on the most appropriate care plan, and leads to substantial anxiety for patients and their families. Identification of factors that affect prognosis after stro...
Source: Neurology - August 21, 2017 Category: Neurology Authors: Wang, L., Pare, G., Rundek, T. Tags: EDITORIALS Source Type: research

Serum matrix metalloproteinase-9 levels and prognosis of acute ischemic stroke
Conclusions: Higher serum MMP-9 levels in the acute phase of ischemic stroke were associated with increased risk of mortality and major disability, suggesting that serum MMP-9 could be an important prognostic factor for ischemic stroke.
Source: Neurology - August 21, 2017 Category: Neurology Authors: Zhong, C., Yang, J., Xu, T., Xu, T., Peng, Y., Wang, A., Wang, J., Peng, H., Li, Q., Ju, Z., Geng, D., Zhang, Y., He, J., For the CATIS Investigators Tags: Stroke prevention, Prognosis, All Cerebrovascular disease/Stroke, Clinical trials Observational study (Cohort, Case control), Cohort studies ARTICLE Source Type: research

Biological age is better than chronological as predictor of 3-month outcome in ischemic stroke
Conclusions: B-age, estimated by DNA methylation, is an independent predictor of ischemic stroke outcome regardless of chronological years.
Source: Neurology - August 21, 2017 Category: Neurology Authors: Soriano-Tarraga, C., Mola-Caminal, M., Giralt-Steinhauer, E., Ois, A., Rodriguez-Campello, A., Cuadrado-Godia, E., Gomez-Gonzalez, A., Vivanco-Hidalgo, R. M., Fernandez-Cadenas, I., Cullell, N., Roquer, J., Jimenez-Conde, J. Tags: All Cerebrovascular disease/Stroke, Cohort studies, Risk factors in epidemiology, All Genetics ARTICLE Source Type: research

Child Neurology: Childhood basilar artery occlusion and stroke
Stroke is one of the major causes of childhood mortality. Pediatric arterial ischemic stroke (PAIS) has an annual estimated rate as high as 3.3 cases per 100,000 children (with the vertebrobasilar territory involved in up to 36% of cases); however, the incidence of isolated childhood basilar artery occlusion (BAO) and stroke (BAS) is unknown.1 Adult BAO carries up to a 90% mortality rate, while death or severe neurologic deficits may be seen in 50% of children with BAO/BAS.1,2 The following case report describes a 12-year-old boy with BAO leading to BAS. Clinical symptoms, differential diagnoses, associated comorbidities, ...
Source: Neurology - August 14, 2017 Category: Neurology Authors: Lobbous, M., Williams, S., Rashid, S. Tags: Childhood stroke, Stroke in young adults, All Cerebrovascular disease/Stroke, Pediatric stroke; see Cerebrovascular Disease/ Childhood stroke RESIDENT AND FELLOW SECTION Source Type: research

Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation
Conclusions: In observational studies, anticoagulation with VKA is associated with a lower rate of IS than APA or no-ATM without increasing ICH recurrence significantly. A randomized controlled trial is needed to determine the net clinical benefit of anticoagulation in ICH survivors with AF.
Source: Neurology - August 14, 2017 Category: Neurology Authors: Korompoki, E., Filippidis, F. T., Nielsen, P. B., Del Giudice, A., Lip, G. Y. H., Kuramatsu, J. B., Huttner, H. B., Fang, J., Schulman, S., Marti-Fabregas, J., Gathier, C. S., Viswanathan, A., Biffi, A., Poli, D., Weimar, C., Malzahn, U., Heuschmann, P., Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Cardiac, Embolism, Intracerebral hemorrhage ARTICLE Source Type: research

Clinical Reasoning: Two see or not two see--Is it really double vision?
A 57-year-old right-handed woman presented to the emergency department with complaints of double vision and intractable nausea that began abruptly 2 days earlier. Her visual symptoms were characterized as seeing overlapping or separate horizontally or diagonally displaced objects. She had no history of headaches or stroke. Her cerebrovascular risk factors included hypertension, type II diabetes, coronary artery disease, and cigarette smoking. Her medications included clopidogrel, lisinopril, paroxetine, and oxycodone. Her family history was notable for late-onset ischemic heart disease in her parents with no first-degree r...
Source: Neurology - August 7, 2017 Category: Neurology Authors: Murphy, R. R., Al Sawaf, A., Rose, D. R., Goldstein, L. B., Smith, C. D. Tags: Clinical neurology examination, Diplopia (double vision), Visual fields, Visual processing, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research