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Source: JAMA Neurology

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Total 364 results found since Jan 2013.

Multiple Facial Ulcers Following a Stroke
A 66-year-old man presents with multiple progressive ulcers and hypesthesia on the right side of his face, new-onset hemiplegia and hemianopsia on the left side of his face, and ischemic posterior circulation stroke. What is your diagnosis?
Source: JAMA Neurology - July 19, 2021 Category: Neurology Source Type: research

Efficacy and Safety of Ticagrelor and Aspirin in Patients With Moderate Ischemic Stroke
This exploratory analysis of the THALES trial evaluates the efficacy and safety of ticagrelor plus aspirin in patients with moderate ischemic stroke (National Institutes of Health Stroke Scale score of 4 to 5).
Source: JAMA Neurology - July 9, 2021 Category: Neurology Source Type: research

Questions on Predicting Early Neurological Deterioration in Patients With Minor Stroke and Large-Vessel Occlusion
To the Editor We read with great interest the article by Seners and colleagues in which they investigated predictors of early neurological deterioration of presumed ischemic origin (ENDi) in large-vessel occlusion stroke with minor clinical deficits and developed a 4-point risk prediction score of ENDi. This is a common and probably underrecognized problem in large-vessel occlusion stroke, and characterizing patients at risk of ENDi is highly relevant for patient management.
Source: JAMA Neurology - July 6, 2021 Category: Neurology Source Type: research

Questions on Predicting Early Neurological Deterioration in Patients With Minor Stroke and Large-Vessel Occlusion —Reply
In Reply We thank Ospel and colleagues for their thoughtful comments on our article showing that more proximal occlusion and greater thrombus length predict early neurological deterioration of ischemic origin (ENDi) in patients with acute minor ischemic stroke with large-vessel occlusion treated with intravenous thrombolysis, with implications regarding how to best manage these patients. Although the precise pathophysiological links between more proximal occlusion, a longer thrombus, and ENDi are uncertain, we fully agree that a leading hypothesis is in situ thrombus extension leading to secondary hemodynamic compromise vi...
Source: JAMA Neurology - July 6, 2021 Category: Neurology Source Type: research

Streamlining the Path to Endovascular Reperfusion
In this issue of JAMA Neurology, Sarraj et al report on the associations of repeated imaging on arrival at an endovascular thrombectomy (EVT) –capable hospital with clinical outcomes after EVT. They studied an observational cohort of 2533 patients who had ischemic stroke with large vessel occlusion within 24 hours of stroke onset. It is well understood that a favorable outcome depends on the time from stroke onset to reperfusion, and th ere is no doubt that proceeding directly to the angiography suite (DTA) saves time compared with repeating imaging (median time, 26 minutes shorter in Sarraj et al). Direct transfer to th...
Source: JAMA Neurology - June 14, 2021 Category: Neurology Source Type: research

Progressive Ataxia and Downbeat Nystagmus in the Adult
A 63-year-old man presented with a history of vomiting, hypertension, dyslipidemia, type 2 diabetes, dilated ischemic cardiomyopathy, alcohol use, and stroke; physical examination found appendicular dysmetria with truncal ataxia and downbeat nystagmus. Brain magnetic resonance imaging revealed a hyperintensity on T2-weighted and fluid-attenuated inversion recovery sequences without reduced diffusion in the cerebellar nodule. What is your diagnosis?
Source: JAMA Neurology - May 17, 2021 Category: Neurology Source Type: research

Assessment of Recurrent Stroke Risk in Patients With a Carotid Web
This cohort study assesses the recurrent stroke risk in a population of patients with a large vessel occlusion stroke of the anterior circulation and ipsilateral carotid web.
Source: JAMA Neurology - May 10, 2021 Category: Neurology Source Type: research

Association Between Intracerebral Hemorrhage and Subsequent Arterial Ischemic Events
This analysis of pooled cohort data from 4 popluation-based cohort studies evaluates whether intracerebral hemorrhage was associated with an increased risk of incident ischemic stroke and myocardial infarction.
Source: JAMA Neurology - May 3, 2021 Category: Neurology Source Type: research

Healthy Life-Year Costs From Arrival to Endovascular Thrombectomy in Patients With Ischemic Stroke
This meta-analysis evaluates outcomes along the full health-related quality-of-life range associated with time to endovascular thrombectomy in patients with ischemic stroke.
Source: JAMA Neurology - May 3, 2021 Category: Neurology Source Type: research

Women in Stroke Trials —A Tale of Perpetual Inequity in Cardiovascular Research
“We cannot all succeed when half of us are held back.”Malala Yousafzai, activist
Source: JAMA Neurology - April 26, 2021 Category: Neurology Source Type: research

Sex Disparities in Enrollment in Recent Randomized Clinical Trials of Acute Stroke
This meta-analysis assesses if women were underenrolled in contemporary randomized clinical trials of acute stroke therapies published in 9 major journals, after accounting for their representation in underlying stroke populations.
Source: JAMA Neurology - April 26, 2021 Category: Neurology Source Type: research

Electronic Cigarette Use and Cigarette-Smoking Cessation Attempts Among Stroke Survivors in the US
This cross-sectional study estimates the prevalence of electronic cigarette use among actively smoking stroke survivors in the US and evaluates its association with at least 1 cigarette-smoking cessation attempt in the past year.
Source: JAMA Neurology - April 12, 2021 Category: Neurology Source Type: research

Complexities of Reperfusion Therapy in Patients With Ischemic Stroke Pretreated With Direct Oral Anticoagulants
This Viewpoint describes current issues with the use of thrombolysis in patients who have acute ischemic stroke but have recently been or are concurrently being treated with direct oral anticoagulation.
Source: JAMA Neurology - March 15, 2021 Category: Neurology Source Type: research

Administering Thrombolysis for Acute Ischemic Stroke in Patients Taking Direct Oral Anticoagulants
This Viewpoint discusses the when and how to best administer thrombolysis for patients with acute ischemic stroke taking direct oral anticoagulants.
Source: JAMA Neurology - March 15, 2021 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