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The Power of Clinical Registries and Quality Improvement Collaboratives
The American Heart Association established the American Stroke Association in 1998 to improve stroke care and speed the implementation of evidence-based stroke treatments. In 2001, the Centers for Disease Control and Prevention funded the Paul Coverdell National Acute Stroke Registry pilot programs. The Massachusetts pilot program, 1 of 4, was modeled after the Get With the Guidelines –Coronary Artery Disease program and was called Get With the Guidelines–Stroke (GWTG-Stroke). GWTG-Stroke is a collaborative disease-specific clinical data registry and quality improvement program and includes evidence-based quality measu...
Source: JAMA Neurology - August 6, 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

Additional Factors Regarding Clinical Outcomes of General Anesthesia and Conscious Sedation for Acute Ischemic Stroke
To the Editor Simonsen et al concluded that general anesthesia (GA) did not influence infarct growth compared with conscious sedation in endovascular-treated patients with acute stroke. This is an interesting study that addresses topical questions. However, we would like to point out some limitations.
Source: JAMA Neurology - July 16, 2018 Category: Neurology Source Type: research

Additional Factors Regarding Clinical Outcomes of General Anesthesia and Conscious Sedation for Acute Ischemic Stroke —Reply
In Reply We thank Chabanne and Futier for the relevant question concerning ventilator parameters in the General or Local Anesthesia in Intra Arterial Therapy (GOLIATH) trial. Unfortunately, it was not possible for us to obtain periprocedural arterial blood gas parameters because of resource constraints. However, we have recently reported the end tidal carbon dioxide (EtCO2) levels in the general anesthesia (GA) arm (4.4 kPa; interquartile range, 4.2-4.8 kPa). Taking the normal arterial to EtCO2 gradient into account, our data indicate a normoventilation, which was the intention in the study protocol. The EtCO2 levels were ...
Source: JAMA Neurology - July 16, 2018 Category: Neurology Source Type: research

Presentation After TIA and Minor Stroke in Relation to the UK FAST Public Education Campaign
This population-based study investigates the association of public education with improving delays and failure in seeking medical attention among consecutive patients with first transient ischemic attack or stroke.
Source: JAMA Neurology - July 2, 2018 Category: Neurology Source Type: research

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

Care Quality for Veterans With Transient Ischemic Attack and Stroke
This cohort study assesses the quality of guideline-recommended transient ischemic attack and minor stroke care across the Veterans Health Administration system nationwide.
Source: JAMA Neurology - February 5, 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

Errors in Abstract and Figures 2 and 3
This article was c orrected online.
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

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

Infarct Progression in Patients During Mechanical Thrombectomy Transfer
This cohort study examines the clinical imaging factors associated with unfavorable imaging profile evolution for thrombectomy in patients with ischemic stroke initially transferred to non –thrombectomy-capable stroke centers.
Source: JAMA Neurology - September 25, 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

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