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Total 3153 results found since Jan 2013.

Body mass index in early life and stroke in adult life: What is the risk?
The article "BMI increase through puberty and adolescence is associated with risk of adult stroke" by Ohlsson et al.1 explores the relationship between body mass index (BMI) when a person is young (adolescence) and risk of stroke when the person is older (adults). Previous studies2,3 have shown that rate of stroke is decreasing in older adults but increasing in younger adults. This finding coincides with an increasing BMI in children and young adults. The researchers wanted to ask: Does an increased BMI during puberty and adolescence increase the risk for stroke later in life? The authors also explored whether the cha...
Source: Neurology - July 24, 2017 Category: Neurology Authors: Jones, S. H., Karceski, S. C. Tags: Stroke prevention, Other cerebrovascular disease/ Stroke, All Cerebrovascular disease/Stroke, Infarction, Intracerebral hemorrhage PATIENT PAGES Source Type: research

Adolescent weight gain confers long-term increased stroke risk: Weighty matters
Adult obesity has been consistently associated with risk of total, ischemic, and hemorrhagic stroke1–3; however, the degree to which change in weight and body mass index (BMI) during late childhood and adolescence affects adult risk of stroke has remained uncertain. Understanding this relationship is of particular importance given the rising obesity epidemic during childhood and adolescence.
Source: Neurology - July 24, 2017 Category: Neurology Authors: Rexrode, K. M., Kimm, S. Y. S. Tags: All Pediatric, Adolescence, Cohort studies, Infarction, Intracerebral hemorrhage EDITORIALS Source Type: research

Improving practice through neurovascular board
Management of cervical internal carotid artery (ICA) stenosis remains contentious despite numerous randomized trials and observational studies over the decades since the first report of carotid endarterectomy. Rimmele et al.1 in this issue of Neurology® summarize the 53-month experience of deliberations by a Neurovascular Board at the University Medical Center, Hamburg-Eppendorf (UKE), on management of ICA disease. The multidisciplinary board of senior vascular specialists reviewed 614 cases. The board recommended revascularization in 76% of symptomatic cases and in 27% of asymptomatic cases and encouraged trial p...
Source: Neurology - July 24, 2017 Category: Neurology Authors: Meschia, J. F., Brott, T. G. Tags: Stroke prevention EDITORIALS Source Type: research

Effects of increasing IV tPA-treated stroke mimic rates at CT-based centers on clinical outcomes
Conclusions: Thrombolysis of stroke mimics is increasing at our CT-based spoke hospitals and not at our MRI-based hub hospitals. Caution should be used in interpreting clinical outcomes based on large stroke databases when stroke diagnosis at discharge is unclear. Inadvertent reporting of treated stroke mimics as strokes will artificially elevate overall favorable clinical outcomes with additional downstream costs to patients and the health care system.
Source: Neurology - July 24, 2017 Category: Neurology Authors: Burton, T. M., Luby, M., Nadareishvili, Z., Benson, R. T., Lynch, J. K., Latour, L. L., Hsia, A. W. Tags: Outcome research, CT, MRI, DWI, All Cerebrovascular disease/Stroke ARTICLE Source Type: research

Aggressiveness of care following intracerebral hemorrhage in women and men
Conclusions: After ICH, women do not receive less aggressive care than men after controlling for the substantial comorbidity differences. Future studies on sex bias should include the presence of comorbidities, prestroke disability, and other factors that may influence management.
Source: Neurology - July 24, 2017 Category: Neurology Authors: Guha, R., Boehme, A., Demel, S. L., Li, J. J., Cai, X., James, M. L., Koch, S., Langefeld, C. D., Moomaw, C. J., Osborne, J., Sekar, P., Sheth, K. N., Woodrich, E., Worrall, B. B., Woo, D., Chaturvedi, S. Tags: All Cerebrovascular disease/Stroke, Intracerebral hemorrhage ARTICLE Source Type: research

Comment: Does patient sex affect decision-making after hemorrhagic stroke?
Women do worse than men after both ischemic and hemorrhagic stroke, with evidence that sex bias in physician decision-making may contribute to this increased morbidity and mortality.1 Intracerebral hemorrhage (ICH) poses additional challenges, as the etiologies—amyloid angiopathy associated with prior cognitive decline, illicit drug use—carry their own assumptions. Guha et al.2 report findings from the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study, a prospective, multicenter, triethnic, case-control study of ICH risk factors and outcomes. In almost 3,000 people, they examined comorbidities,...
Source: Neurology - July 24, 2017 Category: Neurology Authors: Brodtmann, A. Tags: All Cerebrovascular disease/Stroke, Intracerebral hemorrhage ARTICLE Source Type: research

BMI increase through puberty and adolescence is associated with risk of adult stroke
Conclusions: BMI increase through puberty and adolescence is associated with risk of adult IS and ICH in men. We propose that greater BMI increases during puberty contribute to increased risk of adult stroke at least partly via increased blood pressure.
Source: Neurology - July 24, 2017 Category: Neurology Authors: Ohlsson, C., Bygdell, M., Sonden, A., Jern, C., Rosengren, A., Kindblom, J. M. Tags: All Pediatric, Adolescence, Cohort studies, Infarction, Intracerebral hemorrhage ARTICLE Source Type: research

Upgoing thumb sign: A sensitive indicator of brain involvement?
Conclusions: An upgoing thumb sign is a sensitive and reliable indicator of brain involvement. This examination is noninvasive, easy, reliable, and highly compatible with and confirmatory of the patient's symptoms.
Source: Neurology - July 24, 2017 Category: Neurology Authors: Hachinski, V., Alsubaie, R., Azarpazhooh, M. R. Tags: ARTICLE Source Type: research

Real-world experience of treatment decision-making in carotid stenosis in a neurovascular board
Conclusions: Interdisciplinary board decisions are a helpful and transparent tool to assure adherence to guideline recommendations, and to provide consensus-based individualized treatment strategies in clinical practice in the absence of unequivocal evidence.
Source: Neurology - July 24, 2017 Category: Neurology Authors: Rimmele, D. L., Larena-Avellaneda, A., Alegiani, A. C., Rosenkranz, M., Schmidt, N. O., Regelsberger, J., Hummel, F. C., Magnus, T., Debus, E. S., Fiehler, J., Gerloff, C., Thomalla, G. Tags: Stroke prevention CONTEMPORARY ISSUES Source Type: research

Insulin resistance among obese middle-aged is associated with decreased cerebrovascular reactivity
Conclusions: IR is associated with impaired CVR; the relationship appears to be driven by the degree of IR and not by obesity. These rarely reported results suggest that early forms of cerebrovascular dysfunction exist among obese middle-aged individuals with significant IR but without type 2 diabetes mellitus. These functional vascular abnormalities may help explain the associations among IR, diabetes, and dementia, and suggest that interventions aiming to improve IR or CVR may help prevent cognitive decline later in life.
Source: Neurology - July 17, 2017 Category: Neurology Authors: Frosch, O. H., Yau, P. L., Osorio, R. S., Rusinek, H., Storey, P., Convit, A. Tags: MRI, All Cerebrovascular disease/Stroke ARTICLE Source Type: research

Diagnosis of DWI-negative acute ischemic stroke: A meta-analysis
Conclusions: A small but significant percentage of patients with AIS have a negative DWI scan. Patients with neurologic deficits consistent with posterior circulation ischemia have 5 times the odds of having a negative DWI scan compared to patients with anterior circulation ischemia. AIS remains a clinical diagnosis and urgent reperfusion therapy should be considered even when an initial DWI scan is negative.
Source: Neurology - July 17, 2017 Category: Neurology Authors: Edlow, B. L., Hurwitz, S., Edlow, J. A. Tags: MRI, DWI, All Cerebrovascular disease/Stroke, Infarction ARTICLE Source Type: research

Hospital safety among neurologic patients: A population-based cohort study of adverse events
Conclusions: This study demonstrates that neurologic patients have a high proportion of AEs in hospital. The findings provide information on the quality and safety of care for people with neurologic conditions in hospital, which can help inform future quality improvement initiatives.
Source: Neurology - July 17, 2017 Category: Neurology Authors: Sauro, K. M., Quan, H., Sikdar, K. C., Faris, P., Jette, N. Tags: All Health Services Research, Medical care, All Clinical Neurology, Patient safety ARTICLE Source Type: research

Cerebrovascular disease affects brain structural integrity long before clinically overt strokes
In the current issue of Neurology®, Werden et al.1 examined a group of patients experiencing first-ever or recurrent stroke to understand the relationships between stroke and cortical structural integrity. They performed 3T magnetic resonance scanning within 6 weeks of the most recent stroke and found that stroke patients had smaller hippocampal volumes and greater white matter hyperintensity (WMH) volume compared to controls. Because of the short time lag from stroke to scan, the authors do not believe that the index stroke itself caused the shrinkage in the hippocampus; rather, they believe that the stroke and the st...
Source: Neurology - July 10, 2017 Category: Neurology Authors: Knopman, D. S., Hooshmand, B. Tags: MRI, All Cerebrovascular disease/Stroke, Clinical trials Observational study (Cohort, Case control), Alzheimer's disease, Vascular dementia EDITORIALS Source Type: research

SUDEP: An important cause of premature mortality in epilepsy across the life spectrum
Sudden unexpected death in epilepsy (SUDEP) was originally defined as a sudden, unexpected death in an individual with epilepsy, witnessed or not, and not associated with drowning or status epilepticus, for which a cause cannot be identified upon autopsy examination.1 Cases can be divided into definite, probable, and possible based upon the level of diagnostic certainty, especially after postmortem examination.2 As research criteria have evolved, a more comprehensive set of diagnostic criteria has been derived, including the term plus to indicate that another cause could have resulted in death, e.g., SUDEP probable/plus.3 ...
Source: Neurology - July 10, 2017 Category: Neurology Authors: Buchhalter, J., Cascino, G. D. Tags: EDITORIALS Source Type: research

Structural MRI markers of brain aging early after ischemic stroke
Conclusions: Brain structure is likely to be compromised before ischemic stroke by vascular risk factors. Smaller hippocampal and total brain volumes and increased WMH load represent proxies for underlying vascular brain injury.
Source: Neurology - July 10, 2017 Category: Neurology Authors: Werden, E., Cumming, T., Li, Q., Bird, L., Veldsman, M., Pardoe, H. R., Jackson, G., Donnan, G. A., Brodtmann, A. Tags: MRI, All Cerebrovascular disease/Stroke, Clinical trials Observational study (Cohort, Case control), Alzheimer's disease, Vascular dementia ARTICLE Source Type: research