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Source: JAMA Neurology

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Total 364 results found since Jan 2013.

Considerations in Assessing Disability Trajectories
To the Editor We thank Dhamoon et al for their prospective longitudinal cohort study assessing the long-term disability trajectory before and after an ischemic stroke compared with myocardial infarction (MI). The authors found that the gradient of increasing disability was significantly steeper after a stroke but remained consistent after MI.
Source: JAMA Neurology - March 12, 2018 Category: Neurology Source Type: research

Thrombectomy in Transferred Patients in the Late Window
This secondary analysis of the Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3 trial evaluates whether the imaging-based selection criteria used in the trial would lead to comparable outcome rates and treatment benefits in transfer vs direct-admission patients with ischemic stroke.
Source: JAMA Neurology - February 7, 2019 Category: Neurology Source Type: research

Antiplatelet Therapy vs Anticoagulation in Cervical Artery Dissection
This randomized clinical trial examines whether antiplatelent or anticoagulant therapy is more effective in preventing stroke in cervical dissection and the risk of recurrent stroke in a randomized clinical trial setting.
Source: JAMA Neurology - February 25, 2019 Category: Neurology Source Type: research

SELECTing Patients With Large Ischemic Core Who May Benefit From Endovascular Reperfusion
In this issue of JAMA Neurology, Sarraj et al report on the clinical and radiologic outcomes in an observational cohort of 105 patients who had extensive ischemic changes on noncontrast computed tomographic (CT) scans (Alberta Stroke Program Early CT Scores [ASPECTS] of 0-5) or CT perfusion scans with ischemic core volume greater than 50 mL and who were treated within 24 hours of stroke onset with endovascular thrombectomy or medical management. All but 1 of the patients who received endovascular treatment and were included based on low ASPECTS had a score of 4 or 5. The ASPECTS regions are not volumetrically or functional...
Source: JAMA Neurology - July 29, 2019 Category: Neurology Source Type: research

Is Hyperselection of Patients the Right Strategy?
In 2019, intracerebral hemorrhage (ICH) remains the most devastating type of stroke, with a 30-day mortality rate of 40% and 60% of survivors who are dependent 1 year after ICH. Intracerebral hemorrhage volume is one of the main determinants of poor outcome, and the associated estimated risk of death or dependency increases of 5% for each millimeter of growth in the short-term phase. Up to one-third of ICHs enlarge during the first 24 hours, and the predicted probability of growth increases nonlinearly according to the ICH volume at admission, antithrombotic use, and the time window from symptom onset to imaging. Because o...
Source: JAMA Neurology - August 19, 2019 Category: Neurology Source Type: research

Error in Figure
This article was corrected online.
Source: JAMA Neurology - September 30, 2019 Category: Neurology Source Type: research

Correction to Author ’s Name in Byline
This article was corre cted online.
Source: JAMA Neurology - September 8, 2020 Category: Neurology Source Type: research

Cerebral Microbleeds and Antithrombotic Treatments —Stop Worrying About Bleeding
Cerebral microbleeds (CMBs) are found in up to one-third of patients with ischemic stroke. Because of their hemorrhagic histopathological substrate, they have been historically associated with a risk of intracerebral hemorrhage (ICH). This has led to concerns about the safety of anticoagulation use in patients with CMBs even in the context of high risk of recurrent ischemic stroke, such as in atrial fibrillation. However, growing evidence suggests that CMBs are not only markers of bleeding propensity but also markers of future ischemic events. To further evaluate both types of risks, an assessment of the number and anatomi...
Source: JAMA Neurology - October 19, 2020 Category: Neurology Source Type: research

Insights on Intensive Vs Nonintensive Prerandomization Systolic Blood Pressure Reduction —Reply
In Reply We thank Mahabala et al for their letter. We performed the analysis using postrandomization treatment groups based on systolic blood pressure (SBP) target values (intensive-arm goal, 110-139 mm Hg; standard-arm goal, 140-179 mm Hg). The first SBP level recorded in the emergency department was termed the initial SBP. The protocol permitted initiation of antihypertensive treatment (often by intravenous nicardipine infusion) before randomization to lower the SBP level to less than 180 mm Hg, which was consistent with the contemporary American Stroke Association Stroke Council guidelines, but the SBP level was to be m...
Source: JAMA Neurology - March 15, 2021 Category: Neurology Source Type: research

Diagnostic Challenges and Uncertainties of Embolic Strokes of Undetermined Source in Young Adults
Nearly 10% to 15% of acute ischemic strokes occur in young adults, with the incidence steadily increasing over the past few decades. Approximately 20% to 40% of these young patients with stroke are classified as having embolic strokes of undetermined source (ESUS), as the underlying stroke etiology cannot be reliably identified despite recommended diagnostic workup. The young ESUS population is an understudied group, as only a few studies, limited by their small size and the lack of prospective follow-up, have assessed their characteristics and outcomes.
Source: JAMA Neurology - March 14, 2022 Category: Neurology Source Type: research

Error in Text
The Original Investigation “Severity and Etiology of Incident Stroke in Patients Screened for Atrial Fibrillation vs Usual Care and the Impact of Prior Stroke: A Post Hoc Analysis of the LOOP Randomized Clinical Trial,” published online August 29, 2022, had an error in the Statistical Analysis section of the text. The cut off for statistical significance should read P< .05 rather than P> .05. This error has been corrected online.
Source: JAMA Neurology - October 17, 2022 Category: Neurology Source Type: research

Error in Table
The Original Investigation titled “Association Between Alberta Stroke Program Early Computed Tomography Score and Efficacy and Safety Outcomes With Endovascular Therapy in Patients With Stroke From Large-Vessel Occlusion: A Secondary Analysis of the Recovery by Endovascular Salvage for Cerebral Ultra-acute Embolism—Japan Large I schemic Core Trial (RESCUE-Japan LIMIT),” published online October 10, 2022, was corrected to add 2 missing P values in Table 2.
Source: JAMA Neurology - December 12, 2022 Category: Neurology Source Type: research

Novel Methods and Technologies for 21st-Century Clinical Trials A Review
Conclusions and RelevanceIncreased use of new tools and approaches in future clinical trials can enhance the design, improve the assessment, and engage participants in the evaluation of novel therapies for neurologic disorders.
Source: JAMA Neurology - March 2, 2015 Category: Neurology Source Type: research

Progress in Intravenous Thrombolytic Therapy for Acute Stroke
This review traces the development of intravenous thrombolysis to date, considers the shortcomings of alteplase, and examines alternative thrombolytic approaches currently in the pipeline, including the role of neuroimaging and the possibility of combination therapies.
Source: JAMA Neurology - June 1, 2015 Category: Neurology Source Type: research