Query: stroke

Filtered By:
Source: JAMA Neurology

This page shows you your search results in order of date. This is page number 2.

Order by Relevance | Date

Total 226 results found since Jan 2013.

Medical Specialties and Thrombectomy for Patients With Acute Ischemic Stroke
This cross-sectional analysis of Medicare data determined the specialty of physicians providing mechanical thrombectomy to patients with ischemic stroke.
Source: JAMA Neurology - January 25, 2018 Category: Neurology Source Type: research

Reperfusion and Brain Edema in Patients With Acute Ischemic Stroke
This study examines the association between reperfusion and brain edema in patients with acute ischemic stroke.
Source: JAMA Neurology - January 24, 2018 Category: Neurology Source Type: research

Effect of General Anesthesia and Conscious Sedation on Infarct Growth and Outcomes in Stroke
This randomized clinical trial analyzes the effect of general anesthesia and conscious sedation on infarct growth and clinical outcome of patients who underwent endovascular therapy for acute ischemic stroke.
Source: JAMA Neurology - January 16, 2018 Category: Neurology Source Type: research

Enoxaparin vs Aspirin in Patients With Cancer and Ischemic Stroke
This randomized clinical trial compares anticoagulation vs antiplatelet therapy in patients with cancer and acute ischemic stroke.
Source: JAMA Neurology - January 8, 2018 Category: Neurology Source Type: research

Thrombectomy for Acute Ischemic Stroke
In this issue ofJAMA Neurology, Nogueira et al report the results of a trial comparing aspiration-assisted stent retrieval with aspiration alone in patients with acute ischemic stroke. In a few years ’ time, mechanical thrombectomy has become a standard for treatment of acute ischemic stroke caused by proximal intracranial thromboembolic occlusions. This progress is amazing when one considers where we stood in 2013, with 3 neutral trials of intra-arterial treatment for stroke. The next 5 trial s that were published in quick succession in early 2015 and 2 later ones all indicated that early thrombectomy has a strong benef...
Source: JAMA Neurology - January 2, 2018 Category: Neurology Source Type: research

Prevalence of Systematic Atherosclerosis Burdens and Overlapping Stroke Etiologies
This study explores the frequency of intracranial atherosclerotic disease in patients who have had a stroke and whether it coexists with systemic atherosclerotic lesions and other stroke etiologies.
Source: JAMA Neurology - December 26, 2017 Category: Neurology Source Type: research

Emergency Department Stroke Care
To the Editor In his Editorial, Caplan retells a story of a patient he encountered in 1962 as he provides an opinion on the article by Topcuoglu et al on stroke recrudescence. Caplan suggests that taking a careful history and administering a physical examination could reduce unnecessary testing and treatments. He also suggests that “inexperienced doctors” in emergency departments (EDs) who follow checklists contribute to indiscriminate care.
Source: JAMA Neurology - December 11, 2017 Category: Neurology Source Type: research

Emergency Department Stroke Care —Reply
In Reply I agree with Meurer et al that the optimal management of patients who present to emergency departments with suspected strokes is best managed by a dedicated team of emergency physicians, trained and experienced stroke neurologists, and nurses. These teams are capable of thinking about what is wrong with the patient and the best management rather than blindly following recipes and guidelines.
Source: JAMA Neurology - December 11, 2017 Category: Neurology Source Type: research

Disability Trajectories Before and After Stroke and Myocardial Infarction
This population-based cohort study evaluates the long-term effects of stroke on functional ability in patients before and after stroke compared with before and after myocardial infarction.
Source: JAMA Neurology - October 23, 2017 Category: Neurology Source Type: research

Low-Dose vs Standard-Dose Alteplase for Patients With Acute Ischemic Stroke
This secondary analysis reports on the association of low-dose and standard-dose intravenous alteplase treatment with age, ethnicity (Asian vs non-Asian), and severity of acute ischemic stroke among patients in the ENCHANTED randomized clinical trial.
Source: JAMA Neurology - October 2, 2017 Category: Neurology Source Type: research

Stroke Imaging
In this issue ofJAMA Neurology, Boulouis et al report on the crucial influence of pretreatment collateral blood vessel status in determining the benefit of transfer for endovascular thrombectomy for large vessel acute ischemic stroke. All patients had relatively little evidence of irreversible injury on noncontrast computed tomography (CT) at their referring hospitals. However, when imaging was repeated at the comprehensive stroke center, a substantial proportion of patients had evolved large infarcts that caused them not to proceed to endovascular therapy or foreshadowed a poor outcome. These data contribute to the weight...
Source: JAMA Neurology - September 25, 2017 Category: Neurology Source Type: research

Which Patients With Ischemic Stroke and Insulin Resistance May Benefit From Pioglitazone?
The Insulin Resistance Intervention After Stroke (IRIS) trial has reported that treating insulin resistance with the peroxisome proliferator –activated receptor γ agonist pioglitazone hydrochloride reduced recurrent stroke or myocardial infarction (MI) by about one-fourth compared with placebo (pioglitazone, 9.0% vs placebo, 11.8%; hazard ratio [HR], 0.76; 95% CI, 0.62-0.93) in 3876 patients with recent (<6 months) ischemic stroke or transient ischemic attack and insulin resistance but without diabetes, heart failure, or bladder cancer. Pioglitazone was also associated with less incident diabetes vs placebo (3.8% vs ...
Source: JAMA Neurology - September 18, 2017 Category: Neurology Source Type: research

Targeting Pioglitazone Therapy After Stroke or Transient Ischemic Attack
This secondary analysis of the Insulin Resistance Intervention After Stroke trial estimates the relative and absolute effectiveness of pioglitazone after ischemic stroke or transient ischemic attack in subgroups of patients defined by pretreatment risk for stroke or myocardial infarction.
Source: JAMA Neurology - September 18, 2017 Category: Neurology Source Type: research

Anticoagulation Timing for Atrial Fibrillation in Acute Ischemic Stroke
Most stroke physicians will have been asked the best time to start anticoagulation for a patient with atrial fibrillation (AF) and acute ischemic stroke. There is no question that long-term anticoagulation with a direct oral anticoagulant or warfarin sodium reduces the risk of strokes in patients with AF, but the right time to start anticoagulation is uncertain.
Source: JAMA Neurology - September 11, 2017 Category: Neurology Source Type: research

Rivaroxaban vs Warfarin Sodium Early After AF-Related Mild Ischemic Stroke
This randomized clinical trial examines whether rivaroxaban or warfarin sodium is safer and more effective for preventing early recurrent stroke in patients with atrial fibrillation –related acute ischemic stroke.
Source: JAMA Neurology - September 11, 2017 Category: Neurology Source Type: research

Presenting to Primary Stroke Centers for Thrombolysis
To the Editor The study by Gerschenfeld et al attempted to address the topical question of whether patients should be brought to a primary stroke center (PSC) for early thrombolysis or be directly transported, despite a longer traveling distance, to a comprehensive stroke center (CSC) that was capable of performing a mechanical thrombectomy (ME). The study found no difference in 24-hour, discharge, or 3-month outcomes between groups of those presenting to a PSC who received thrombolysis and transferred to a CSC for ME and those who presented first to CSC and received thrombolysis and ME. The study concludes “that patient...
Source: JAMA Neurology - August 21, 2017 Category: Neurology Source Type: research

Childhood Body Mass Index and First Adult Ischemic Stroke
This population-based cohort study of schoolchildren born from the 1930s through the 1980s in Denmark investigates whether childhood body mass index (BMI) and change in BMI are associated with adult ischemic stroke and assesses whether the associations are age dependent or influenced by birth weight.
Source: JAMA Neurology - August 21, 2017 Category: Neurology Source Type: research

Longitudinal Care for Young Adults With Stroke
This Viewpoint discusses a longitudinal care program designed to explore and address unmet needs of stroke survivors.
Source: JAMA Neurology - August 21, 2017 Category: Neurology Source Type: research

Recrudescence of Deficits After Stroke
This crossover cohort, case-control study uses medical records from the Research Patient Data Repository to determine the features, triggers, and risk factors of poststroke recrudescence among patients with a previous stroke.
Source: JAMA Neurology - August 7, 2017 Category: Neurology Source Type: research

Birth in a High Stroke Mortality State, Race, and Risk of Dementia
This cohort study examines the risk of dementia in individuals who are born in the Stroke Belt but later reside in California.
Source: JAMA Neurology - July 31, 2017 Category: Neurology Source Type: research

Mechanical Thrombectomy in Acute Stroke
To the Editor In their recent article, Coutinho et al address whether patients who have had an acute stroke with proximal occlusion should undergo intravenous thrombolysis (IVT) before a mechanical thrombectomy (MT). In this analysis of pooled data from the SWIFT and STAR trials, MT after IVT did not appear to provide clinical benefits over MT alone. The authors concluded that randomized clinical trials should confirm their observation.
Source: JAMA Neurology - July 10, 2017 Category: Neurology Source Type: research

Mechanical Thrombectomy in Acute Stroke —Reply
In Reply We read with interest the letter by Seners and colleagues regarding our recent publication. The possibility of early recanalization among patients with acute ischemic stroke and a proximal intracranial occlusion was underestimated in the recent trials on mechanical thrombectomy (MT) because vascular imaging was in part done after starting intravenous thrombolysis (IVT), particularly in the MR CLEAN trial. However, Seners et al observed higher recanalization rates for M1 and M2 occlusions at an early stage, but this was not the case for carotid occlusions. Additionally, they defined early recanalization as happenin...
Source: JAMA Neurology - July 10, 2017 Category: Neurology Source Type: research

Cirrhosis and Stroke in a Nationally Representative Cohort
This cohort study of Medicare claims data investigates the association between cirrhosis and various stroke types.
Source: JAMA Neurology - June 5, 2017 Category: Neurology Source Type: research

Primary Stroke Center Protocol for Suspected Stroke by Large-Vessel Occlusion
This cohort study reports on the association of a primary stroke center protocol with the efficiency of care and the outcomes of patients with suspected emergent large-vessel occlusion who first present to a primary stroke center.
Source: JAMA Neurology - May 8, 2017 Category: Neurology Source Type: research

Primary Stroke Centers vs Comprehensive Stroke Centers
During all but the last 5 years of the 20th century, life was rather simple for health care planners who were concerned with care for patients with stroke. There was no proven effective treatment; therefore, no special guidelines were required. Stroke care changed significantly in 1995, when intravenous (IV) tissue plasminogen activator (tPA) was found to be an effective treatment when given soon after stroke onset. With the intent of improving care, hospitals were encouraged to develop primary stroke centers (PSCs) that had sufficient medical personnel, technology, and protocols that would enable them to deliver IV tPA efficiently.
Source: JAMA Neurology - March 20, 2017 Category: Neurology Source Type: research

Endovascular Thrombectomy for Acute Ischemic Stroke
This study compares the functional independence at 3 months between patients treated for acute ischemic stroke under the drip-and-ship paradigm and those treated on site (mothership paradigm).
Source: JAMA Neurology - March 20, 2017 Category: Neurology Source Type: research

Stroke Etiologic Classification —Moving From Prediction to Precision
It is a truism of vascular neurology that secondary prevention depends on the cause of an ischemic stroke. We revascularize those with extracranial carotid stenosis, we anticoagulate those with cardioembolic infarcts due to atrial fibrillation, and we treat with antibiotics those with infective endocarditis. Determining the etiologic subtype, or cause, of stroke is therefore rightly considered the main objective of the evaluation of the patient with stroke. Despite the central role of this evaluation, it is surprising that our ability to determine the cause of stroke in many cases is quite limited, and that the process of ...
Source: JAMA Neurology - February 27, 2017 Category: Neurology Source Type: research

Response to Endovascular Therapy for Acute Ischemic Stroke
To the Editor Recent data from randomized clinical trials provide clear evidence that endovascular treatment for acute ischemic stroke because of large vessel anterior circulation occlusion improves clinical outcomes for patients. These studies reported that most patients had an occlusion of the first segment (M1) of the middle cerebral artery and less than 10% in the M2 segment. The retrospective multicenter study conducted by Sarraj et al reports that endovascular treatment is safe and effective for an occlusion of the M2 segment. However, the literature reports different definitions for the M1 and M2 segments, which may...
Source: JAMA Neurology - February 27, 2017 Category: Neurology Source Type: research

Predictive Validity of Etiologic Stroke Classification
This study examines whether etiologic stroke subtyping using 3 different classification systems identifies different disease processes that can be recognized through their different clinical courses.
Source: JAMA Neurology - February 27, 2017 Category: Neurology Source Type: research

Association of Collateral Blood Vessels With Neurological Outcome After Stroke
This cohort study assesses the association between the presence of collateral vessels identified using arterial spin labeling magnetic resonance imaging and neurologic outcome in patients after acute ischemic stroke.
Source: JAMA Neurology - February 13, 2017 Category: Neurology Source Type: research

Stroke Diagnosis and Treatment in the Emergency Department
To the Editor We are somewhat perplexed after having read the Viewpoint by Avasarala, as it questions the role of the neurologist in the emergency department for acute stroke diagnosis. Although it is clear that the author is being deliberately provocative, we can only strongly disagree with the idea that a sudden-onset focal neurological deficit may be diagnosed as a stroke on the basis of a pattern-recognition algorithm alone, without a neurological assessment.
Source: JAMA Neurology - January 23, 2017 Category: Neurology Source Type: research

Stroke Diagnosis and Treatment in the Emergency Department —Reply
In Reply I thank Rota and colleagues for their comments on my Viewpoint, which challenged the status quo concerning the requirement of a neurologist to initiate the tissue plasminogen activator (tPA) protocol for an obvious diagnosis of acute stroke in the emergency department (ED). In today ’s world of Instagram, Facebook, and Twitter feeds, we all need to embrace change. A few years ago, for instance, no one knew what Altmetric represented. Today, all of us crave the statistics reported by Altmetric, which recognizes our work via the number of tweets and “cross-talk” across mult iple platforms. Funding, data collec...
Source: JAMA Neurology - January 23, 2017 Category: Neurology Source Type: research

Recurrence of Posterior Circulation Childhood Arterial Ischemic Stroke
This cohort study investigates the incidence of the recurrence of childhood arterial ischemic stroke in the posterior and anterior circulations to determine if the risk differs between the 2 locations.
Source: JAMA Neurology - January 23, 2017 Category: Neurology Source Type: research

Mechanical Thrombectomy for Acute Ischemic Stroke
Coutinho et al have performed a timely post hoc analysis consisting of a patient population from 2 large, prospective, core laboratory –adjudicated trials: Solitaire With the Intention for Thrombectomy (SWIFT) and Solitaire Flow Restoration Thrombectomy for Acute Revascularization (STAR), and their report appears in this issue ofJAMA Neurology. Given that 85% of the patients in mechanical thrombectomy (MT) trials received intravenous thrombolysis (IVT), they highlight an important group of patients in whom MT was successful without IVT. The recent IVT and MT trials have clearly established the new standard in therapy for...
Source: JAMA Neurology - January 9, 2017 Category: Neurology Source Type: research

Cardiovascular Risk Factors and Stroke in Alzheimer Disease
To the Editor I read with interest the article by Tosto et al studying the influence of cardiovascular risk factors and stroke in familial late-onset Alzheimer disease (LOAD). The main findings were that history of stroke increased the risk for LOAD, while hypertension decreased the risk for LOAD. The study suggests that stroke mediates the influence of cardiovascular risk factors on increased risk for LOAD.
Source: JAMA Neurology - November 14, 2016 Category: Neurology Source Type: research

Associations Between Sex-Specific Risk Factors and Stroke
This systematic review and meta-analysis examines sex-specific risk factors for ischemic stroke, hemorrhagic stroke, any stroke, and stroke mortality.
Source: JAMA Neurology - November 14, 2016 Category: Neurology Source Type: research

Lesion Size and Perspective in Acute Ischemic Stroke
The computed tomographic (CT) or magnetic resonance imaging (MRI) findings of early cerebral ischemia are literally, and figuratively, shades of gray in decision making regarding the triage of patients with acute ischemic stroke for revascularization. The subtleties and areas of uncertainty on imaging of this dynamic process, where an arterial occlusion is mitigated by collateral perfusion in the brain, defy concrete rules or thresholds that are equally consequential across individual patients. Imaging criteria, whether more than one-third of the middle cerebral artery territory, Alberta Stroke Program Early CT (ASPECT) sc...
Source: JAMA Neurology - November 7, 2016 Category: Neurology Source Type: research

Endovascular Treatment for Patients With Stroke and Large Ischemic Cores and Mismatch Imaging Profiles
This case-control study compares the outcomes of patients following stroke with large baseline ischemic cores on computed tomographic perfusion undergoing endovascular therapy with the outcomes of matched controls who had medical care alone.
Source: JAMA Neurology - November 7, 2016 Category: Neurology Source Type: research

Risk of Pregnancy-Associated Stroke Across Age Groups
This population-based cohort study uses data from the New York State SPARCS database to examine the risk of stroke in women of childbearing age who are pregnant or post partum compared with the risk in those who are not pregnant.
Source: JAMA Neurology - October 24, 2016 Category: Neurology Source Type: research

Mechanical Thrombectomy for Stroke
The publication of 5 randomized trials in 2015 unequivocally established that mechanical thrombectomy is the new standard of care for patients with acute ischemic stroke and an occlusion of the proximal anterior circulation. Although those trials mark a huge advancement in the field of stroke, important questions regarding the implementation of mechanical thrombectomy in routine clinical care remain. One of the more important of these questions is what constitutes the definition of a proximal occlusion. In those trials, most of the patients had an occlusion of the distal internal carotid artery or of the first segment (M1)...
Source: JAMA Neurology - September 12, 2016 Category: Neurology Source Type: research

Endovascular Therapy for Acute Ischemic Stroke
This pooled cohort study evaluates the safety and effectiveness of endovascular therapy for occlusions of the M2 segment of the middle cerebral artery in patients with ischemic stroke.
Source: JAMA Neurology - September 12, 2016 Category: Neurology Source Type: research

Neurologists and the Diagnosis of Acute Stroke in the ED
This Viewpoint proposes that acute stroke can be managed in the emergency department without the expertise of a neurologist.
Source: JAMA Neurology - September 6, 2016 Category: Neurology Source Type: research

Factors Associated With Neurological Outcome After Childhood Stroke
To the Editor We thank Grelli et al for their study investigating the factors associated with neurological outcome following childhood stroke. The authors reported an association between hyperglycemia and poor neurological outcome in their cohort.
Source: JAMA Neurology - August 22, 2016 Category: Neurology Source Type: research

Racial Differences in Utilization of Inpatient Procedures After Stroke
This study compares racial differences in the use of 6 common nondiagnostic inpatient procedures after stroke.
Source: JAMA Neurology - July 25, 2016 Category: Neurology Source Type: research

Recruiting Patients With Stroke Into Cell Therapy Trials
This review examines ethical issues surrounding the recruitment of patients with stroke into cell therapy studies.
Source: JAMA Neurology - July 18, 2016 Category: Neurology Source Type: research

Stent Retrievers for Treating Anterior Circulation Acute Ischemic Stroke
To the Editor Touma et al reported a comprehensive systematic review and meta-analysis of 5 randomized clinical trials evaluating the benefits and risks of stent retrievers in addition to recombinant tissue plasminogen activator (rtPA) for the treatment of acute ischemic stroke (AIS). The main conclusion of the study was that “the use of stent retrievers in conjunction with rtPA vs rtPA alone is associated with significant improvement of functional independence 90 days after AIS.” However, as pointed out by the authors, all studies included in their meta-analysis selected only patients with anterior circulation acute i...
Source: JAMA Neurology - July 5, 2016 Category: Neurology Source Type: research