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Specialty: Neurology
Source: JAMA Neurology

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Total 364 results found since Jan 2013.

Optimizing Prehospital Triage for Patients With Stroke Involving Large Vessel Occlusion
The past 20 years have witnessed a revolution in the paradigm of acute ischemic stroke treatment. In 1996, intravenous alteplase was shown to improve outcomes among patients treated within 3 hours of stroke onset. This finding upended the historical therapeutic nihilism about stroke, and with it the leisurely armchair approach to stroke treatment. The concept of so-called acute ischemic stroke emerged. This changed the nature and practice of vascular neurology, created a vigorous and sometimes controversial debate between vascular neurologists and emergency physicians about the merits of alteplase, and paved the way for mo...
Source: JAMA Neurology - September 4, 2018 Category: Neurology Source Type: research

Modeling Stroke Patient Transport for All Suspected Large-Vessel Occlusion Patients
This modeling study examines strategies for optimal triage and transport of patients with suspected large-vessel occlusion stroke to the appropriate center to achieve optimal care.
Source: JAMA Neurology - September 4, 2018 Category: Neurology Source Type: research

Association of Medication Nonadherence Among Survivors of Stroke After Affordable Care Act Implementation
This study investigates whether the US Affordable Care Act is associated with medication affordability and adherence among middle-aged to older adults who have had a stroke.
Source: JAMA Neurology - August 27, 2018 Category: Neurology Source Type: research

Effect of Dextroamphetamine on Poststroke Motor Recovery
This randomized clinical trial evaluates the effect of dextroamphetamine combined with physiotherapy vs placebo and physiotherapy for improving poststroke motor recovery among patients with ischemic stroke.
Source: JAMA Neurology - August 27, 2018 Category: Neurology Source Type: research

Advances in Understanding the Pathophysiology of Lacunar Stroke
This narrative review of studies of cerebral small vessel disease published since 2012 investigates progress in understanding the pathogenesis, imaging characteristics, and genetic basis of lacunar stroke.
Source: JAMA Neurology - August 27, 2018 Category: Neurology Source Type: research

Treatment of Poststroke Aphasia With Transcranial Direct Current Stimulation
Stroke remains a leading cause of human disability. Important gains have been realized in the setting of acute ischemic stroke, where thrombolytic and catheter-based reperfusion therapies can substantially improve long-term behavioral outcomes. However, most patients with a new stroke are not eligible for such therapies because of delays in diagnosis or hemorrhagic etiology, for example, and many who are treated nonetheless have substantial long-term disability. Additional classes of poststroke therapy are needed.
Source: JAMA Neurology - August 20, 2018 Category: Neurology Source Type: research

Transcranial Direct Current Stimulation to Treat Aphasia After Stroke
This randomized clinical trial examines the futility of studying anodal transcranial direct current stimulation vs sham stimulation as an adjunctive intervention during speech therapy to improve speech production (naming) for older adults with long-term poststroke aphasia.
Source: JAMA Neurology - August 20, 2018 Category: Neurology Source Type: research

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

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

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

Error in Table
The Research Letter titled, “Medical Specialties of Clinicians Providing Mechanical Thrombectomy to Patients with Acute Ischemic Stroke in the United States,” published in the April 2018 print issue included an error in the Table that presented the data for neurosurgeons in the row labeled “Neurology,” and the data for neurologists in the row labeled “Neurosurgery.” This included indicating that 110 thrombectomies were performed by neurosurgeons and 91 by neurologists. The Table has been corrected and now matches the data present in the main text of the article: 91 thrombectomies performed by neurosurgeons an d...
Source: JAMA Neurology - May 21, 2018 Category: Neurology Source Type: research