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Specialty: Neurology
Source: JAMA Neurology

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Total 364 results found since Jan 2013.

Additional Factors in Considering Patent Foramen Ovale Closure to Prevent Recurrent Ischemic Stroke
To the Editor In his Viewpoint, Kamel addresses some issues with the randomized clinical trials (RCTs) of patent foramen ovale (PFO) closure for preventing recurrent stroke and urges a judicious and evidence-based approach for patient selection. I would like to point out additional factors that further demonstrate need for extreme caution in selecting patients to undergo this procedure.
Source: JAMA Neurology - May 14, 2018 Category: Neurology Source Type: research

Additional Factors in Considering Patent Foramen Ovale Closure to Prevent Recurrent Ischemic Stroke —Reply
In Reply Powers raises several important issues that I did not address in detail in my Viewpoint about managing patent foramen ovale in patients with ischemic stroke. These additional points further highlight that many patients who are fully informed about the available data will reasonably choose medical therapy rather than patent foramen ovale closure.
Source: JAMA Neurology - May 14, 2018 Category: Neurology Source Type: research

Association of Sickle Cell Trait With Ischemic Stroke Among African Americans
This meta-analysis examines whether sickle cell trait is associated with a higher risk of incident ischemic stroke among African Americans.
Source: JAMA Neurology - April 23, 2018 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

Arterial Partial Pressure of Carbon Dioxide and Secondary Brain Injury
Secondary brain injury (SBI) occurs when tissue made vulnerable by a primary brain injury (eg, traumatic brain injury [TBI], stroke, or global cerebral ischemia), is exposed to additional insults, such as low blood flow, hypoxia, fever, seizures, or glucose concentration extremes. The prevention and treatment of SBI forms the basis for these conditions ’ neurocritical care management; guidelines emphasize maintaining parameters associated with blood pressure and ventilation thought to limit SBI. Cerebral blood flow (CBF) is regulated by a complex interplay of neurovascular coupling, pressure autoregulation, arterial bloo...
Source: JAMA Neurology - March 19, 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

Considerations in Assessing Disability Trajectories —Reply
In Reply We agree with Pan et al that endovascular thrombectomy for large vessel occlusions may improve long-term disability trajectories for those who receive this treatment. However, few patients with ischemic stroke currently receive this treatment, and it is not certain how much of an association endovascular thrombectomy will have with long-term disability trajectories for patients with ischemic stroke as a whole. It is certainly hoped that more trained specialists are available to provide the treatment, more capable stroke centers will be developed, and more patients will present within an amenable time window. Howev...
Source: JAMA Neurology - March 12, 2018 Category: Neurology Source Type: research

Speak Therapy
In this essay, a medical student reflects on his grandfather ’s experience with stroke and the ways emotions and personal relationships affect a patient’s health.
Source: JAMA Neurology - March 12, 2018 Category: Neurology Source Type: research

Leaving Against Medical Advice
She was never even supposed to be in the hospital. We got a telephone call from an ophthalmologist who suspected a stroke in a woman in her early 70s after finding a visual field defect. She had gone to the clinic because she was bumping into objects for a few days, but she expected to do a few tests, get a diagnosis, and go home, because whatever was wrong did not even bother her much. Instead, she was treated to an admission to our stroke center and a nothing by mouth designation overnight after she failed the nurse ’s swallowing screening. The ambient music of the ward—the echoes, beeps, snoring, and nurses and phys...
Source: JAMA Neurology - February 26, 2018 Category: Neurology Source Type: research

Keeping Faith With Patients After Stroke or Transient Ischemic Attack
I recently recommended statin therapy to a 68-year-old patient, explaining that it would reduce his risk of a major coronary event or stroke in the next 10 years from 18% to 15%. He asked, “But how will we know if it works?” I confessed we never would because success would be an uneventful walk through good health. He was not sold.
Source: JAMA Neurology - February 5, 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

Medical Specialties and Thrombectomy for Patients With Acute Ischemic Stroke
This cross-sectional analysis of Medicare data determined the specialty of physicians providing mechanical thrombectomy to patients with ischemic stroke.
Source: JAMA Neurology - January 25, 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

Effect of General Anesthesia and Conscious Sedation on Infarct Growth and Outcomes in Stroke
This randomized clinical trial analyzes the effect of general anesthesia and conscious sedation on infarct growth and clinical outcome of patients who underwent endovascular therapy for acute ischemic stroke.
Source: JAMA Neurology - January 16, 2018 Category: Neurology Source Type: research