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Association of Vascular Risk Factors and Genetic Factors With Penetrance of Variants Causing Monogenic Stroke
This cohort study examines data from UK Biobank participants who had whole-exome sequencing to determine the frequency of pathogenic variants in the 3 most common monogenic cerebral small vessel diseases and their associations with prevalent and incident stroke and dementia.
Source: JAMA Neurology - October 27, 2022 Category: Neurology Source Type: research

Prevalence of Atherosclerotic Risk Factors Among Children and Young Adults With Arterial Ischemic Stroke
This case-control study assesses hypertension, hyperlipidemia, obesity, smoking, and diabetes as risk factors associated with incident arterial ischemic stroke in children and young adults, stratified by decade of age.
Source: JAMA Neurology - August 1, 2022 Category: Neurology Source Type: research

Time for a New Perspective on Intracerebral Hemorrhage
More than 3 million people worldwide experience intracerebral hemorrhage (ICH) each year. Although the incidence of ICH is much lower than that of ischemic stroke, ICH imposes a 50% greater worldwide burden of disability. ICH has a 30-day case fatality rate of more than 40%, and most survivors are left with permanent disabilities. Because of the high likelihood of poor outcomes, physicians caring for patients with ICH tend to use clinical severity scores early on to estimate the risk of mortality or future disability to determine the aggressiveness of medical care and to guide conversations with patients ’ surrogates aro...
Source: JAMA Neurology - July 25, 2022 Category: Neurology Source Type: research

Outcomes After Endovascular Thrombectomy With or Without Alteplase in Routine Clinical Practice
This cohort study investigates the outcomes of combination endovascular thrombectomy with alteplase compared with endovascular thrombectomy alone for the treatment of patients with acute ischemic stroke attributable to large vessel occlusion.
Source: JAMA Neurology - June 13, 2022 Category: Neurology Source Type: research

Incidence and Natural History of Pediatric Large Vessel Occlusion Stroke
This cohort study investigates the incidence and natural history of pediatric large vessel occlusion stroke.
Source: JAMA Neurology - March 28, 2022 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

Evaluating Rates of Recurrent Ischemic Stroke Among Young Adults With Embolic Stroke of Undetermined Source
This cohort study evaluates rates of and factors associated with recurrent ischemic stroke and death as well as new-onset atrial fibrillation among younger adults.
Source: JAMA Neurology - March 14, 2022 Category: Neurology Source Type: research

Data Do Not Support Selection of Patients for Stroke Treatment Within the 16- to 24-Hour Interval —Reply
In Reply We thank Powers for his comments regarding our article. He raises the question if the positive result for patients with target perfusion-imaging mismatch in the 12.8- to 24-hour tercile in the Analysis of Pooled Data From Randomized Studies of Thrombectomy More Than 6 Hours After Last Well Known (AURORA) study could solely be due to a benefit from 12.8 to 16 hours since last known well subgroup, with neutral or negative effects in the 16- to 24-hour time period. This was not the case. Data for patients in the 16- to 24-hour group with the target mismatch profile demonstrated an odds ratio of 3.82 (95% CI, 1.07-13....
Source: JAMA Neurology - February 14, 2022 Category: Neurology Source Type: research

Disentangling Workflow Paradigms and Treatment Decision-Making in Acute Ischemic Stroke —Reply
In Reply We thank Ospel and Goyal for their interest in the Evaluation of Direct Transfer to Angiography Suite vs Computed Tomography Suite in Endovascular Treatment (ANGIOCAT) study and read with interest their letter in which they express some concerns in relation to the direct-to-angiography suite (DTAS) paradigm. In the ANGIOCAT study, patients adjudicated to the conventional imaging group, despite receiving computed tomography perfusion (CTP) in some cases, achieved one of the shortest workflow times reported ever (door-to-puncture time of 44 minutes). According to guidelines, CTP was never used to exclude patients fr...
Source: JAMA Neurology - February 7, 2022 Category: Neurology Source Type: research

Association of Ischemic Stroke Incidence, Severity, and Recurrence With Dementia in the ARIC Cohort Study
This cohort study evaluates the association between risk of dementia and incident ischemic stroke by stroke severity and recurrence.
Source: JAMA Neurology - January 24, 2022 Category: Neurology Source Type: research

Twenty-Year Change in Severity and Outcome of Ischemic and Hemorrhagic Strokes
This cohort study assesses secular changes in initial neurological severity and short-term functional outcomes of patients with acute stroke by sex using a large population.
Source: JAMA Neurology - December 6, 2021 Category: Neurology Source Type: research

Noncontrast CT vs CT Perfusion or MRI Selection in Late Presentation of Large-Vessel –Occlusion Stroke
This cohort study compares the clinical outcomes of patients with stroke who presented 6 to 24 hours after symptom onset and were selected for mechanical thrombectomy by noncontrast computed tomography vs those selected by computed tomography perfusion or magnetic resonance imaging.
Source: JAMA Neurology - November 8, 2021 Category: Neurology Source Type: research

Statewide Emergency Medical Services Protocols for Suspected Stroke and Large Vessel Occlusion
This cross-sectional study characterizes prehospital large vessel occlusion transport algorithms across the US.
Source: JAMA Neurology - September 20, 2021 Category: Neurology Source Type: research

Effects of Antiplatelet Therapy After Stroke Caused by Intracerebral Hemorrhage
A follow-up of the Restart or Stop Antithrombotics Randomized Trial, this study further examines the long-term effects of antiplatelet therapy after stroke caused by intracerebral hemorrhage.
Source: JAMA Neurology - September 3, 2021 Category: Neurology Source Type: research

Prehospital Comprehensive Stroke Center vs Primary Stroke Center Triage in Patients With Suspected LVO Stroke
This preimplementation-postimplementation study evaluates the association of a regional prehospital transport policy for comprehensive stroke center triage for patients with suspected acute ischemic stroke and large vessel occlusion with rates of endovascular therapy.
Source: JAMA Neurology - August 9, 2021 Category: Neurology Source Type: research

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