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Specialty: Neurology
Source: JAMA Neurology
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Total 364 results found since Jan 2013.
Factors Affecting Preventability of Stroke
To the Editor Fisher and colleagues conducted an evaluation of factors affecting the preventability of stroke, with special reference to treatment and comorbidity. Preventability of the presenting stroke was scored and univariate analysis was selected for the limited number of patients. I have some queries on their study approach.
Source: JAMA Neurology - May 2, 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
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
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
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
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
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
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
Dual Antiplatelet Therapy in Transient Ischemic Attack and Minor Stroke
This imaging substudy of a randomized clinical trial investigates whether infarction patterns can be used to stratify the risk of recurrent stroke within 3 months of a transient ischemic attack or minor ischemic stroke.
Source: JAMA Neurology - March 26, 2018 Category: Neurology Source Type: research
Additional Factors Regarding Clinical Outcomes of General Anesthesia and Conscious Sedation for Acute Ischemic Stroke
To the Editor We applaud Simonsen et al for performing a randomized clinical trial about the effect of general anesthesia (GA) and conscious sedation (CS) during endovascular therapy on infarct growth and clinical outcomes in acute ischemic stroke. Despite its equipoise, this study is important in the field because it reinforces the results of recent randomized clinical trials concerning GA safety in thrombectomy for acute ischemic stroke.
Source: JAMA Neurology - July 16, 2018 Category: Neurology Source Type: research
Prehospital and Early Postarrival Neurological Deterioration in Acute Stroke
This exploratory analysis of 1690 patients enrolled in the Field Administration of Stroke Therapy-Magnesium Trial assesses the frequency, predictors, and outcomes of the neurological deterioration that occurs among patients during the ultra-early period after ischemic stroke or intracranial hemorrhage.
Source: JAMA Neurology - July 23, 2018 Category: Neurology Source Type: research
A Promising Skills-Based Intervention to Reduce Blood Pressure in Individuals With Stroke and Transient Ischemic Attack
Globally, stroke is the second leading cause of death and third leading cause of disability. More than 74% of the burden of stroke has been attributed to smoking, poor diet, and low physical activity, while more than 72% has been attributed to metabolic risk factors (high plasma glucose, high cholesterol, high blood pressure, overweight and obesity, and kidney disease). These are all risk factors that are modifiable with appropriate treatment or change in lifestyle behaviors.
Source: JAMA Neurology - October 8, 2018 Category: Neurology Source Type: research
