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Specialty: Neurology
Source: Current Treatment Options in Neurology
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Total 69 results found since Jan 2013.
Treatment of Post-Stroke Depression
We present the reader with the most recent evidence to support pharmacological, psychosocial, and neuromodulation interventions in PSD. We also discuss the relevance of using antidepressants and psychotherapy to prevent PSD and discuss evidence that antidepressant treatment may reduce mortality after stroke.Recent findingsNeuroinflammation and decrease neurogenesis and plasticity may play an important role in the mechanism of PSD. The strongest predictors of PSD are stroke severity, early physical disability, and severity of loss of functioning. Nevertheless, populations at risk for PSD are yet to be identified. Recent met...
Source: Current Treatment Options in Neurology - June 24, 2019 Category: Neurology Source Type: research
Understanding Atrial Cardiopathy: an Under-Recognized Contributor to Cardioembolic Stroke
AbstractPurpose of reviewIschemic stroke is the fifth leading cause of death in the world with cardioembolic stroke (CES) causing a disproportional amount of the morbidity and mortality associated with stroke. Atrial fibrillation (AF) is the leading cause of CES, and as the population ages, the incidence of CES is anticipated to rise. The importance of proper diagnosis and treatment of patients with embolic-appearing stroke is significant due to the burden of disease and the severity of the illness.Recent findingsThe past decade has seen an explosion of treatment options for patients with CES related to AF as well as bette...
Source: Current Treatment Options in Neurology - June 24, 2019 Category: Neurology Source Type: research
Sleep Disorders and Stroke: Does Treatment of Obstructive Sleep Apnea Decrease Risk of Ischemic Stroke?
AbstractPurpose of reviewThis review aims to support obstructive sleep apnea (OSA) as a risk factor for ischemic stroke, review treatment strategies for OSA, provide a comprehensive review of clinical data on OSA treatment and ischemic stroke risk, and to critically assess if treatment of OSA decreases the risk of ischemic stroke and if treatment improves outcomes and subsequent ischemic stroke risk in post-stroke patients.Recent findingsSeveral observational studies, randomized controlled trials (RCTs), and meta-analyses have examined the risk of ischemic stroke and cardiovascular events in patients with OSA and have also...
Source: Current Treatment Options in Neurology - June 23, 2019 Category: Neurology Source Type: research
Prevention and Treatment of Acute Stroke in the Nonagenarians and Beyond: Medical and Ethical Issues
AbstractPurpose of reviewAs one of the fastest growing portions of the population, nonagenarians will constitute a significant percentage of the stroke patient population in the near future. Nonagenarians are nevertheless not specifically targeted by most clinical guidelines. In this review, we aimed to summarise the available evidence guiding stroke prevention and treatment in this age group.Recent findingsSeveral recent observational studies have shown that the benefits of anticoagulation for the oldest old patients with atrial fibrillation may outweigh the bleeding risk. A sub-analysis of the IST-3 trial has shown for t...
Source: Current Treatment Options in Neurology - May 7, 2019 Category: Neurology Source Type: research
Statins in Ischemic Stroke Prevention: What Have We Learned in the Post-SPARCL (The Stroke Prevention by Aggressive Reduction in Cholesterol Levels) Decade?
We describe the current status of lipid-lowering therapies for ischemic stroke prevention. The SPARCL trial published in 2006 has been a landmark study in vascular neurology. The trial demonstrated that high-dose atorvastatin prevents recurrent stroke, and led the AHA/ASA to recommend statin therapy for patients with stroke or TIA of atherosclerotic origin.Recent findingsRecently, the J-STARS study demonstrated that therapy with low-dose pravastatin reduced atherothrombotic infarction incidence among patients with prior ischemic stroke. Besides, several trials have shown improved stroke outcomes with non-statin lipid-lower...
Source: Current Treatment Options in Neurology - April 7, 2019 Category: Neurology Source Type: research
Stem Cell Therapy in Cerebrovascular Disease
AbstractPurpose of reviewThe purpose of this article is to provide a review of state-of-the-art cellular therapy in cerebrovascular diseases by discussing published and ongoing clinical trials.Recent findingsIn spite of the challenge in translating the success of cellular therapy in acute strokes from preclinical models to clinical trials, early phase clinical trial have recently shown promise in overcoming these challenges. Various stem cell types and doses are being studied, different routes of administration are under investigation, as well as defining the optimal time window to intervene. In addition, experimental meth...
Source: Current Treatment Options in Neurology - October 9, 2018 Category: Neurology Source Type: research
Acute Blood Pressure Management in Acute Ischemic Stroke and Spontaneous Cerebral Hemorrhage
AbstractPurpose of reviewWe discuss the evidence and guidelines for acute blood pressure (BP) management for patients presenting with acute ischemic stroke or spontaneous cerebral hemorrhage.Recent findingsObservational data suggest that the extremes of BP should be avoided in patients presenting with acute ischemic stroke. There is no convincing evidence that active BP reduction results in improved outcomes for ischemic stroke patients. Current guidelines recommend that BP be maintained ≤ 185/110 mmHg in patients who are candidates for intravenous tissue plasminogen activator (IV tPA) or mechanical thrombectomy and t...
Source: Current Treatment Options in Neurology - August 18, 2018 Category: Neurology Source Type: research
Antiplatelet Agents in Secondary Stroke Prevention: Selection, Timing, and Dose
AbstractPurpose of reviewThis narrative review critically evaluated the published studies regarding the systematic use of antiplatelet agents for secondary stroke prevention.Recent findingsStroke is a leading cause of morbidity and mortality around the world. Multimodal prevention is the most viable strategy for reducing the societal burden of stroke recurrence. For secondary stroke prevention, antiplatelet therapy is at the core of effective long-term vascular risk reduction among survivors of an ischemic stroke or transient ischemic attack (TIA). In addition to aspirin, there are several antiplatelet agents proven to be ...
Source: Current Treatment Options in Neurology - June 23, 2018 Category: Neurology Source Type: research
Surgical Treatment of Adult Moyamoya Disease
AbstractPurpose of reviewMoyamoya disease (MMD) is being increasingly diagnosed with the development of radiological surveillance technology and increased accessibility to medical care. Accordingly, there have been several recent reports on treatment outcomes in MMD. In this review, we summarize recent advances in surgical treatment and outcomes of adult MMD, while addressing related controversies.Recent findingsRecent studies suggest that revascularization surgery leads to significantly more favorable outcomes for stroke prevention, angiographic and hemodynamic changes, and clinical outcomes than does conservative treatme...
Source: Current Treatment Options in Neurology - May 28, 2018 Category: Neurology Source Type: research
Causes and Treatment of Acute Ischemic Stroke During Pregnancy
AbstractPurpose of reviewTreatment recommendations for pregnancy associated ischemic stroke are scarce. This may be due to the fact that, in general, obstetricians tend not to make recommendations for stroke patients and neurologists are not commonly involved in the care of pregnant women. Herein, we review the multiple etiologies of ischemic stroke during pregnancy, considerations for diagnostic testing, and acute treatment and prevention options, including associated risks specific to the pregnant and puerperal state.Recent findingsIntravenous tissue plasminogen activator (tPA) and endovascular thrombectomy have been use...
Source: Current Treatment Options in Neurology - May 21, 2018 Category: Neurology Source Type: research
Current Treatment Options: Headache Related to Menopause —Diagnosis and Management
AbstractPurpose of reviewMenopause is a life-changing event in numerous ways. Many women with migraine hold hope that the transition to the climacteric state will coincide with a cessation or improvement of migraine. This assumption is based mainly on common lay perceptions as well as assertions from many in the healthcare community. Unfortunately, evidence suggests this is far from the rule. Many women turn to a general practitioner or a headache specialist for prognosis and management. A natural instinct is to manipulate the offending agent, but in some cases, this approach backfires, or the concern for adverse events ou...
Source: Current Treatment Options in Neurology - March 6, 2018 Category: Neurology Source Type: research
Treatment of Tuberculous Meningitis and Its Complications in Adults
AbstractPurpose of reviewTuberculous meningitis (TBM) is a global health problem. In this review, we systematically evaluate the evidence for current and emerging antimicrobials, host-directed therapies and supportive managements.Recent findingsCurrent antimicrobial regimes do not factor the differing ability of drugs to cross the blood-brain barrier. Rifampicin may be more effective at higher doses yet the most recent clinical trial failed to demonstrate survival benefit at 15 mg/kg/day. Dose finding studies suggest that higher doses still may be safe and more effective. Fluoroquinolones are currently listed as importan...
Source: Current Treatment Options in Neurology - February 28, 2018 Category: Neurology Source Type: research
Resumption of Anticoagulation After Intracranial Hemorrhage
Opinion statementAnticoagulation is a vital therapy in a number of different disease processes, and is strongly recommended for the prevention of stroke in patients with atrial fibrillation and/or with mechanical prosthetic heart valves. Studies involving patients on oral anticoagulants (OACs) have revealed that ICH can occur eight times more frequently in this population, with an annual estimated incidence of 0.25 to 1.1%. The decision of whether and when to resume anticoagulation following intracranial hemorrhage is challenging and requires an assessment of associated risks and benefits. Clinical data, imaging, and risk ...
Source: Current Treatment Options in Neurology - September 30, 2017 Category: Neurology Source Type: research
