Query: stroke

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Source: JAMA Neurology

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Total 250 results found since Jan 2013.

New Horizons in Pharmacologic Therapy for Secondary Stroke Prevention
This narrative review summarizes the results of recent and ongoing randomized clinical trials of drugs for secondary stroke prevention.
Source: JAMA Neurology - July 27, 2020 Category: Neurology Source Type: research

Antihypertensive Medication Use Among Individuals With a History of Stroke and Hypertension, 2005 to 2016
This cross-sectional study investigates the adequacy of blood pressure control among stroke survivors and antihypertensive treatment trends using National Health and Nutrition Examination Survey data.
Source: JAMA Neurology - July 27, 2020 Category: Neurology Source Type: research

Stroke Thrombolysis With Tenecteplase to Reduce Spread of Coronavirus Disease 2019 and Alteplase Shortage
This Viewpoint advocates for expanded usage of tenecteplase in patients with stroke as a means of avoiding coronavirus disease 2019 spread and easing potential shortages of alteplase.
Source: JAMA Neurology - July 20, 2020 Category: Neurology Source Type: research

Characteristics of Recurrent Ischemic Stroke After ESUS
This secondary analysis of a randomized clinical trial assesses the subtype of recurrent ischemic stroke after embolic stroke of underdetermined source, the interaction with treatment assignment, and the consistency of cerebral location of the qualifying and recurrent strokes in the study population of the NAVIGATE-ESUS trial.
Source: JAMA Neurology - July 6, 2020 Category: Neurology Source Type: research

Prognosis of Cryptogenic Stroke With Patent Foramen Ovale at Older Ages and Implications for Trials
This systematic review and meta-analysis examines the recurrence of ischemic stroke and possible use of patent foramen ovale closure in patients aged 60 years or older.
Source: JAMA Neurology - July 6, 2020 Category: Neurology Source Type: research

Risk of Ischemic Stroke in Patients With Coronavirus Disease 2019 (COVID-19) vs Patients With Influenza
This cohort study compares the rate of ischemic stroke among patients with COVID-19 vs patients with influenza in 2 hospitals in New York City, New York.
Source: JAMA Neurology - July 2, 2020 Category: Neurology Source Type: research

Migraines During Pregnancy and the Risk of Maternal Stroke
This cohort study examines the extent to which hypertensive disorders mediate the association between migraines and maternal stroke.
Source: JAMA Neurology - June 1, 2020 Category: Neurology Source Type: research

Prognosis of Asymptomatic Intracranial Stenosis in Patients With Transient Ischemic Attack and Minor Stroke
This cohort study examines the age-specific prevalence and prognosis of asymptomatic intracranial stenosis in British patients with transient ischemic attack and minor stroke.
Source: JAMA Neurology - May 26, 2020 Category: Neurology Source Type: research

Asymptomatic Intracranial Artery Stenosis —One Less Thing to Worry About
Intracranial artery stenosis (ICAS) is a leading cause of stroke worldwide. It is estimated to account for 10% of ischemic strokes in the US and perhaps up to 50% of strokes in Asia. Despite its frequency and role in stroke-related morbidity and mortality, ICAS has received less attention compared with extracranial atherosclerotic disease. In the past 15 years, clinical trials have refined the treatment approach for patients with recent stroke or transient ischemic attack (TIA) and ICAS. However, less information is available pertaining to asymptomatic ICAS.
Source: JAMA Neurology - May 26, 2020 Category: Neurology Source Type: research

Care Delivery and Outcomes for Acute Stroke and Transient Ischemic Attacks in Rural and Urban Medicare Patients
This cohort study describes trends among rural and urban patients with acute ischemic stroke or transient ischemic attack in the type of health care centers to which patients were admitted, what care was provided, and patient outcomes.
Source: JAMA Neurology - May 4, 2020 Category: Neurology Source Type: research

Enhanced Paramedic Acute Stroke Treatment Assessment and Thrombolysis Delivery in Emergency Stroke Care
This cluster randomized clinical trial sought to examine whether adding enhanced paramedic assessment to standard care would result in increased rates of thrombolysis in patients experiencing stroke.
Source: JAMA Neurology - April 13, 2020 Category: Neurology Source Type: research

Implementation of a Prehospital Stroke Triage System Using Symptom Severity and Teleconsultation
This cohort study examines a system for prehospital triage for Swedish patients with suspected acute stroke.
Source: JAMA Neurology - April 6, 2020 Category: Neurology Source Type: research

Effect of Remote Ischemic Perconditioning on Brain Infarct Growth in Patients With Ischemic Stroke
This randomized clinical trial examines whether in-hospital treatment with remote ischemic perconditioning that is administered within 6 hours of symptom onset, with or without reperfusion therapy, can reduce brain infarction volume growth in patients with acute ischemic stroke.
Source: JAMA Neurology - March 30, 2020 Category: Neurology Source Type: research

Association of Black Race With Early Recurrence After Minor Ischemic Stroke or Transient Ischemic Attack
This secondary analysis of the POINT randomized clinical trial examines the association between race and risk of early ischemic stroke recurrence after a minor ischemic stroke or transient ischemic attack among US participants.
Source: JAMA Neurology - February 24, 2020 Category: Neurology Source Type: research

The Hazard of Negative (Not Neutral) Trials on Treatment of Acute Stroke
This narrative review summarizes randomized clinical trials with negative (vs neutral) outcomes to study why previous acute stroke interventions appeared to cause harm.
Source: JAMA Neurology - December 2, 2019 Category: Neurology Source Type: research

Association of Endovascular Treatment With Ischemic Stroke and Clinical Outcome in Pediatric Patients
This cohort study examines the use of endovascular recanalization in pediatric patients with arterial ischemic stroke and clinical outcomes.
Source: JAMA Neurology - October 14, 2019 Category: Neurology Source Type: research

Endovascular Therapy for Childhood Stroke —Working Together to Reach Prime Time
The standard of care for stroke treatment in adults changed rapidly in 2015 after results from 5 major clinical trials each showed efficacy of endovascular treatment of anterior circulation large-vessel occlusion within 6 hours of stroke onset. The positive results of these studies have since raised questions about whether endovascular therapy should be used for children who present with stroke due to large-vessel occlusion and, other than age, fit adult criteria for thrombectomy. Compared with the occurrence in adults, ischemic stroke in children is uncommon, but remains important to address because the resulting disabili...
Source: JAMA Neurology - October 14, 2019 Category: Neurology Source Type: research

Trends in Stroke Incidence Rates in Older US Adults
This cohort study evaluates whether stroke incidence declined among older adults from 1987 to 2011 vs 2011 to 2017 in the Atherosclerosis Risk in Communities study.
Source: JAMA Neurology - September 30, 2019 Category: Neurology Source Type: research

Association Between Low-Dose Rivaroxaban With or Without Aspirin and Ischemic Stroke Subtypes
This secondary analysis of a multinational randomized clinical trial of 27  395 participants with systemic atherosclerotic disease examines the association low-dose rivaroxaban plus aspirin, rivaroxaban alone, or aspirin alone and the risk of different ischemic stroke subtypes.
Source: JAMA Neurology - September 16, 2019 Category: Neurology Source Type: research

Prehospital Stroke Management Optimized by the Use of Clinical Scoring vs Mobile Stroke Unit
This randomized clinical trial explores how prehospital management optimized by the use of the Los Angeles Motor Scale compares with prehospital management in a mobile stroke unit that includes vascular imaging in accurately triaging patients with stroke to the appropriate target hospital providing (comprehensive stroke center) or not providing (primary stroke center) neurointerventional treatment.
Source: JAMA Neurology - September 3, 2019 Category: Neurology Source Type: research

Outcomes Associated With Clopidogrel-Aspirin Use in Minor Stroke or Transient Ischemic Attack
This pooled analysis combines data from 2 randomized clinical trials to estimate the efficacy and risk of dual antiplatelet therapy after minor ischemic stroke or transient ischemic attack.
Source: JAMA Neurology - August 19, 2019 Category: Neurology Source Type: research

Effect of Standard vs Intensive Blood Pressure Control on the Risk of Recurrent Stroke
This randomized clinical trial tests the hypothesis that targeting intensive blood pressure lowering of systolic and diastolic blood pressure less than 120 mm Hg and less than 80 mm Hg, respectively, reduces the rate of stroke recurrence compared with a standard blood pressure –lowering regimen.
Source: JAMA Neurology - July 29, 2019 Category: Neurology Source Type: research

Realizing Benefits From More Intensive Blood Pressure Control for Preventing Recurrent Stroke
Blood pressure (BP) targets below 140/90 mm Hg in high-risk patients, such as those who have had a stroke, remain a controversial topic. A pivotal meta-analysis of 61 prospective observational studies involving 1 million adults without previous cardiovascular (CV) disease showed a linear association between usual BP levels and deaths from ischemic heart disease and stroke, down to BP levels as low as 115/75 mm Hg. These data prompted the “lower the better” hypothesis and challenged the long-standing argument of a J-curve or U-curve association of BP levels in such patients. Before the pivotal Systolic Blood Pressure In...
Source: JAMA Neurology - July 29, 2019 Category: Neurology Source Type: research

Clinical Effectiveness of Direct Oral Anticoagulants vs Warfarin in Older Patients With Atrial Fibrillation and Ischemic Stroke
This cohort assesses the clinical effectiveness of direct oral anticoagulants vs warfarin for stroke prevention in patients with atrial fibrillation.
Source: JAMA Neurology - July 22, 2019 Category: Neurology Source Type: research

Effect of Stroke Education Pamphlets vs a 12-Minute Culturally Tailored Stroke Film
This cluster randomized clinical trial of stroke preparedness among black and Hispanic churchgoers evaluates the effect of culturally tailored 12-minute stroke films on stroke preparedness vs the usual care practice of distributing stroke education pamphlets.
Source: JAMA Neurology - July 1, 2019 Category: Neurology Source Type: research

Efficacy of Home-Based Telerehabilitation In-Clinic Therapy After Stroke
This randomized clinical trial examines whether a treatment targeting arm movement delivered via a home-based telerehabilitation system has comparable efficacy with dose-matched, intensity-matched therapy delivered in a traditional in-clinic setting for adults following stroke.
Source: JAMA Neurology - June 24, 2019 Category: Neurology Source Type: research

External Validation of a Scoring System for Predicting Fracture Risk After Ischemic Stroke
This prognostic study evaluated medical records of survivors of ischemic stroke from a national Canadian database to develop and validate a scoring system to predict low-trauma fractures within 1 year of hospital discharge.
Source: JAMA Neurology - May 13, 2019 Category: Neurology Source Type: research

Quality Improvement Intervention for Hospital Adherence to Therapies for Patients With Stroke
This cluster randomized clinical trial assesses the effect of a multifaceted quality improvement intervention compared with routine care on adherence to evidence-based therapy among patients with acute ischemic stroke and transient ischemic attack.
Source: JAMA Neurology - May 6, 2019 Category: Neurology Source Type: research

Tailoring the Approach to Embolic Stroke of Undetermined Source
This narrative review examines the existing evidence of the differing response of embolic stroke of undetermined source to anticoagulation therapy and hypothesizes about pathophysiological factors that may underlie such variations.
Source: JAMA Neurology - April 8, 2019 Category: Neurology Source Type: research

Recurrent Stroke With Rivaroxaban Compared With Aspirin
This secondary analysis of a randomized clinical trial investigates whether rivaroxaban is associated with a reduction in recurrent stroke among patients with embolic stroke of undetermined source who have an increased risk of atrial fibrillation.
Source: JAMA Neurology - April 8, 2019 Category: Neurology Source Type: research

Endovascular Thrombectomy as a Means to Improve Survival in Acute Ischemic Stroke
This meta-analysis examines 90-day mortality and 90-day intracranial hemorrhage reported in trials of endovascular thrombectomy vs medical therapy cited in the 2018 American Stroke Association/American Heart Association guidelines for acute ischemic stroke.
Source: JAMA Neurology - April 8, 2019 Category: Neurology Source Type: research

Prognostic Model of Swallowing Recovery and Enteral Tube Feeding After Ischemic Stroke
This validation study describes the development of a prognostic model to predict swallowing recovery and guide the decision for enteral tube feeding in people with dysphagia after ischemic stroke.
Source: JAMA Neurology - February 11, 2019 Category: Neurology Source Type: research

ABCB1 Polymorphisms and Outcomes of Clopidogrel Treatment for Minor Stroke or Transient Ischemic Attack
This secondary analysis of the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events (CHANCE) randomized clinical trial investigates the association ofABCB1 polymorphisms with efficacy of clopidogrel plus aspirin vs aspirin alone in patients with minor stroke or transient ischemic attack.
Source: JAMA Neurology - February 11, 2019 Category: Neurology Source Type: research

Pioglitazone Therapy in Patients With Stroke and Prediabetes
This post hoc analysis of Insulin Resistance Intervention After Stroke (IRIS) randomized clinical trial assesses the association of pioglitazone vs placebo with recurrent stroke, myocardial infarction, and other cardiovascular events.
Source: JAMA Neurology - February 7, 2019 Category: Neurology Source Type: research

Association of Time From Stroke Onset to Groin Puncture With Quality of Reperfusion After Mechanical Thrombectomy
This meta-analysis of individual patient data from 7 randomized clinical trials analyzes the rate of reperfusion after endovascular thrombectomy started at different intervals after symptom onset in patients with acute ischemic stroke.
Source: JAMA Neurology - January 22, 2019 Category: Neurology Source Type: research

Clinical Care and In-Hospital Outcomes of Asian American Patients With Acute Ischemic Stroke
This analysis compares the characteristics, care, and outcomes of Asian American and white patients with acute ischemic stroke at hospitals participating in the Get With The Guidelines –Stroke program.
Source: JAMA Neurology - January 22, 2019 Category: Neurology Source Type: research

Hypothermia in Addition to Decompressive Hemicraniectomy in Malignant Middle Cerebral Artery Stroke
This randomized clinical trial assesses whether moderate hypothermia after early hemicraniectomy reduces mortality in patients with malignant MCA stroke, compared with standard treatment.
Source: JAMA Neurology - January 18, 2019 Category: Neurology Source Type: research

Follow-up Infarct Volume and Functional Outcome After Endovascular Therapy in Acute Ischemic Stroke
This pooled data analysis of 7 randomized clinical trials of thrombectomy for acute ischemic stroke examines whether follow-up infarct volume mediates the relationship between endovascular therapy and functional outcome in patients with acute ischemic stroke.
Source: JAMA Neurology - January 7, 2019 Category: Neurology Source Type: research

Sex and Race Differences in the Association of Incident Ischemic Stroke With Risk Factors
This cohort study of 25  789 black and white individuals in the United States examines the incidence and risk factors for ischemic stroke by sex and race.
Source: JAMA Neurology - December 10, 2018 Category: Neurology Source Type: research

Effect of Cerebellar Stimulation on Gait and Balance Recovery in Patients With Hemiparetic Stroke
This randomized clinical trial determines whether cerebellar intermittent θ-burst stimulation can improve balance and gait functions in patients with hemiparesis due to stroke.
Source: JAMA Neurology - November 26, 2018 Category: Neurology Source Type: research

A Promising Skills-Based Intervention to Reduce Blood Pressure in Individuals With Stroke and Transient Ischemic Attack
Globally, stroke is the second leading cause of death and third leading cause of disability. More than 74% of the burden of stroke has been attributed to smoking, poor diet, and low physical activity, while more than 72% has been attributed to metabolic risk factors (high plasma glucose, high cholesterol, high blood pressure, overweight and obesity, and kidney disease). These are all risk factors that are modifiable with appropriate treatment or change in lifestyle behaviors.
Source: JAMA Neurology - October 8, 2018 Category: Neurology Source Type: research

Discharge Educational Strategies for Reduction of Vascular Risk in Stroke and Transient Ischemic Attack
This randomized clinical trial determines the efficacy of a culturally tailored skills-based educational intervention with telephone follow-up compared with standard discharge care on systolic blood pressure reduction in a multiethnic cohort of patients with mild/moderate stroke/transient ischemic attack.
Source: JAMA Neurology - October 8, 2018 Category: Neurology Source Type: research

A Promising Skills-Based Intervention to Reduce Blood Pressure in Individuals With Stroke and Transient Ischemic Attack
Globally, stroke is the second leading cause of death and third leading cause of disability. More than 74% of the burden of stroke has been attributed to smoking, poor diet, and low physical activity, while more than 72% has been attributed to metabolic risk factors (high plasma glucose, high cholesterol, high blood pressure, overweight and obesity, and kidney disease). These are all risk factors that are modifiable with appropriate treatment or change in lifestyle behaviors.
Source: JAMA Neurology - October 8, 2018 Category: Neurology Source Type: research

Discharge Educational Strategies for Reduction of Vascular Risk in Stroke and Transient Ischemic Attack
This randomized clinical trial determines the efficacy of a culturally tailored skills-based educational intervention with telephone follow-up compared with standard discharge care on systolic blood pressure reduction in a multiethnic cohort of patients with mild/moderate stroke/transient ischemic attack.
Source: JAMA Neurology - October 8, 2018 Category: Neurology Source Type: research

Optimizing Prehospital Triage for Patients With Stroke Involving Large Vessel Occlusion
The past 20 years have witnessed a revolution in the paradigm of acute ischemic stroke treatment. In 1996, intravenous alteplase was shown to improve outcomes among patients treated within 3 hours of stroke onset. This finding upended the historical therapeutic nihilism about stroke, and with it the leisurely armchair approach to stroke treatment. The concept of so-called acute ischemic stroke emerged. This changed the nature and practice of vascular neurology, created a vigorous and sometimes controversial debate between vascular neurologists and emergency physicians about the merits of alteplase, and paved the way for mo...
Source: JAMA Neurology - September 4, 2018 Category: Neurology Source Type: research

Modeling Stroke Patient Transport for All Suspected Large-Vessel Occlusion Patients
This modeling study examines strategies for optimal triage and transport of patients with suspected large-vessel occlusion stroke to the appropriate center to achieve optimal care.
Source: JAMA Neurology - September 4, 2018 Category: Neurology Source Type: research

Association of Medication Nonadherence Among Survivors of Stroke After Affordable Care Act Implementation
This study investigates whether the US Affordable Care Act is associated with medication affordability and adherence among middle-aged to older adults who have had a stroke.
Source: JAMA Neurology - August 27, 2018 Category: Neurology Source Type: research

Advances in Understanding the Pathophysiology of Lacunar Stroke
This narrative review of studies of cerebral small vessel disease published since 2012 investigates progress in understanding the pathogenesis, imaging characteristics, and genetic basis of lacunar stroke.
Source: JAMA Neurology - August 27, 2018 Category: Neurology Source Type: research

Stroke Quality of Care in GWTG-Stroke Hospitals
This longitudinal cohort study compares quality of stroke care measures for patients admitted to hospitals participating and not participating in Get With The Guidelines –Stroke.
Source: JAMA Neurology - August 6, 2018 Category: Neurology Source Type: research

Prehospital and Early Postarrival Neurological Deterioration in Acute Stroke
This exploratory analysis of 1690 patients enrolled in the Field Administration of Stroke Therapy-Magnesium Trial assesses the frequency, predictors, and outcomes of the neurological deterioration that occurs among patients during the ultra-early period after ischemic stroke or intracranial hemorrhage.
Source: JAMA Neurology - July 23, 2018 Category: Neurology Source Type: research