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Source: Neurology
Condition: Hypertension

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Total 378 results found since Jan 2013.

Blood Pressure Trajectories from Mid to Late Life and Risk of Dementia: The Framingham Study (S49.003)
Conclusions:Elevated blood pressure in mid-life, persistent hypertension into late-life and, among non-hypertensives, a steep decline in blood pressure from mid-to-late life were each associated with an elevated risk of dementia in a community-based sample. Our data highlight the potential sustained cognitive benefits of lower midlife blood pressures and raise the possibility that lowering of blood pressure in older adults with borderline hypertension may be harmful to cognition, despite a beneficial impact on cardiovascular events.Study Supported by:Framingham Heart Study, (NHLBI/NIH contract HHSN268201500001I) to the Bos...
Source: Neurology - April 17, 2017 Category: Neurology Authors: McGrath, E., Beiser, A., DeCarli, C., Plourde, K., Ramachandran, V., Greenberg, S., Seshadri, S. Tags: Best Of: Aging and Dementia Source Type: research

Characteristics and Outcomes among Patients Transferred to Regional Stroke Centers across the United States for Specialized Stroke Care (S25.007)
Conclusions:Many hospitals receive high volumes of ischemic stroke patients via transfer. Because transfer-in patients have worse outcomes, these transfer-in patients have the potential to negatively influence institutional outcomes rates. Transfer-in patients should be carefully accounted for in risk adjusted models of hospital outcomes.Disclosure: Dr. Ali has nothing to disclose. Dr. Fonarow has received personal compensation for activities with UCLA as an employee. Dr. Fonarow has received research support from NIH. Dr. Smith has nothing to disclose. Dr. Liang has nothing to disclose. Dr. Xian has nothing to disclose. D...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Ali, S., Fonarow, G., Smith, E., Liang, L., Xian, Y., Bhatt, D., Schwamm, L. Tags: Cerebrovascular Disease and Interventional Neurology: Prehospital and Emergency Department Ischemic Stroke Care Source Type: research

Early Surgery for Infective Endocarditis with Stroke Does Not Increase Post-operative Neurological Complications: What are We Waiting For? (S29.007)
Conclusions:In IE patients with acute stroke, early surgery does not appear to increase post-operative neurological complications.Disclosure: Dr. Zhang has nothing to disclose. Dr. Cho has nothing to disclose. Dr. Marquardt has nothing to disclose. Dr. Hussain has nothing to disclose. Dr. Uchino has nothing to disclose. Dr. Wisco has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Zhang, L., Cho, S., Marquardt, R., Hussain, M., Uchino, K., Wisco, D. Tags: Cerebrovascular Disease and Interventional Neurology: Critical Care and Hemorrhage Source Type: research

Stroke Mortality Outcomes in Uganda (S32.002)
Conclusions:Our study highlights the poor outcome of stroke patients in southwestern Uganda with an overall 30-day mortality of 38.1%, and identifies NIHSS at admission, female sex, anemia, and HIV infection as predictors of mortality. While there was no statistically significant difference in mortality between hemorrhagic and ischemic strokes in our study, patients with hemorrhagic stroke did have statistically higher levels of impairment on hospital admission and discharge.Disclosure: Dr. Olum has nothing to disclose. Dr. Muyingo has nothing to disclose. Dr. Wilson has nothing to disclose. Dr. Hoxworth has nothing to dis...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Olum, S., Muyingo, A., Wilson, T., Hoxworth, J., Zhang, N., Demaerschalk, B., Hentz, J., Aguilar, M., Abdallah, A., Kayanja, A., OCarroll, C. Tags: Global Health Source Type: research

Prevalence and risk factors of intracranial arterial stenosis in asymptomatic population in a Chinese cohort (S36.004)
Conclusions:The prevalence of ICAS among asymptomatic Chinese subjects was 9.6%, which was relatively high. Advanced age, hypertension, diabetes and higher total cholesterol level were independent risk factors for ICAS.Study Supported by:This study was supported by the National Natural Science Foundation of China (No. 81173663, 81671173), National Key Technology R&D Program in the 12th five-year Plan of China (No. 2012BAJ18B04-3, 2015AA020506) and National Key Research & Development Program of China (No. 2016YFB1001402).Disclosure: Dr. Han has nothing to disclose. Dr. Yan has nothing to disclose. Dr. Zhai has nothi...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Han, F., Yan, S., Zhai, F., Zhou, L., Ni, J., Yao, M., Cui, L., Zhang, S., Li, M., Jin, Z., Zhu, Y. Tags: Cerebrovascular Disease and Interventional Neurology: Epidemiology Source Type: research

Whole-genome Sequencing in Familial Cases of Intracranial Atherosclerotic Disease (S36.005)
Conclusions:Compared with conventional case-control association study, whole-genome sequencing simultaneously identifies both rare structural variants and SNVs associated with ICAD. This study improved our understanding on the genetic contribution of stroke in ICAD families. The various novel mutations and structural variant identified indicates the heterogeneity and complexity of ICAD.Disclosure: Dr. Leung has nothing to disclose. Dr. Dong has nothing to disclose. Dr. Ip has nothing to disclose. Dr. Wong has nothing to disclose. Dr. Choy has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Leung, T., Dong, E., Ip, B., Wong, K. S. L., Choy, R. K. Tags: Cerebrovascular Disease and Interventional Neurology: Epidemiology Source Type: research

Clinical Reasoning: Corpus callosum lesion with multiple strokes
A 71-year-old woman with hypertension, diabetes, and recent stroke presented with acute left hemiparesis, which started 3.5 hours earlier but improved by the time of emergency department evaluation. Examination showed mild left-sided pronator drift and sensory extinction. Her history was significant for resection of a right frontoparietal meningioma for which she had received adjuvant radiation therapy 3 years previously.
Source: Neurology - April 3, 2017 Category: Neurology Authors: Sheikh, Z., Anadani, N., Raval, B., Sharer, L., Hillen, M. Tags: MRI, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research

Cervical artery dissection in patients >=60 years: Often painless, few mechanical triggers
Conclusion: In our study population of patients diagnosed with CeAD, 1 in 14 was aged ≥60 years. In these patients, pain and mechanical triggers might be missing, rendering the diagnosis more challenging and increasing the risk of missed CeAD diagnosis in older patients.
Source: Neurology - April 3, 2017 Category: Neurology Authors: Traenka, C., Dougoud, D., Simonetti, B. G., Metso, T. M., Debette, S., Pezzini, A., Kloss, M., Grond-Ginsbach, C., Majersik, J. J., Worrall, B. B., Leys, D., Baumgartner, R., Caso, V., Bejot, Y., Compter, A., Reiner, P., Thijs, V., Southerland, A. M., Ber Tags: Stroke in young adults, All Cerebrovascular disease/Stroke, Carotid artery dissection ARTICLE Source Type: research

Persistent brain injury after preeclampsia
Preeclampsia, a common hypertensive disorder of pregnancy, contributes substantially to maternal and fetal morbidity and mortality worldwide. While the cause of preeclampsia remains debated, it is clear that there are both placental and maternal causes of preeclampsia, making it a heterogeneous disease.1 Abnormal trophoblast invasion of spiral arteries during placentation leads to placental ischemia and release of placental-derived soluble factors into the maternal circulation.2 These circulating proinflammatory and antiangiogenic factors appear to produce maternal vascular inflammation and cause endothelial dysfunction th...
Source: Neurology - March 27, 2017 Category: Neurology Authors: Cipolla, M. J., Biller, J. Tags: Stroke prevention, MRI, All Cerebrovascular disease/Stroke EDITORIALS Source Type: research

Clinical Reasoning: A 43-year-old woman with right limb weakness
A 43-year-old woman presented with a 4-day history of right limb weakness. While biking 4 days earlier, she felt a weakness in her right hand and leg. She had a history of hypertension for more than 2 years, and was taking extended-release nifedipine tablets (40 mg) and perindopril (4 mg) daily, but her blood pressure was difficult to control (fluctuations of 150–180/90–115 mm Hg). The patient did not smoke or drink alcohol, and had no family history of similar diseases.
Source: Neurology - March 19, 2017 Category: Neurology Authors: Li, S., Zhang, J., Liu, P., Wei, R., Yuan, H., Ke, Q. Tags: Stroke in young adults RESIDENT AND FELLOW SECTION Source Type: research

Letter re: Influence of sodium consumption and associated knowledge on poststroke hypertension in Uganda
Kaddumukasa et al.1 should be commended for documenting the gaps in public knowledge of the health risks of high salt consumption in Uganda. Only 43% of the study participants had basic dietary salt knowledge.1 Since the participants were stroke survivors recruited from the national hospital and may have received some dietary counseling by health providers prior to enrollment in the study, rates of basic dietary salt knowledge are likely even lower in the general population. A corollary public health knowledge gap is the extremely low rate of awareness of hypertension in Uganda. A national cross-sectional survey conducted ...
Source: Neurology - March 12, 2017 Category: Neurology Authors: Chin, J. H. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research

Author response: Influence of sodium consumption and associated knowledge on poststroke hypertension in Uganda
We thank Dr. Chin for the interest and comments on our article.1 We agree that stroke survivors in our study may have received some informal health education, supporting the case for even lower knowledge rates in the public population.1 In Uganda, suboptimal blood pressure control remains a challenge with varied prevalence and excessively low awareness, treatment, and control.2 We agree that the effect of invisible salt in Uganda's urban areas relates to an increasing prevalence of high blood pressure in this population. If not addressed, this portends a high burden of cardiovascular stroke events.3 Because hypertension is...
Source: Neurology - March 12, 2017 Category: Neurology Authors: Kaddumukasa, M. N., Goldstein, L. B. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research

Early case fatality in intracerebral hemorrhage: Sophistication of care, application globally
Acute spontaneous (nontraumatic) intracerebral haemorrhage (ICH), presumed due to cerebral small vessel disease, remains a serious and difficult-to-treat form of stroke.1 The 1-month case fatality of ICH is around 40%, with half of the deaths occurring in the first few days after onset.1,2 This outlook has remained largely unchanged during the last decades.3 The consistently high case fatality, in combination with the diverse etiologies of ICH, may have hampered development of acute evidence-based management strategies.2 Similarly, despite improved management of vascular risk factors including hypertension, the overall ICH...
Source: Neurology - March 5, 2017 Category: Neurology Authors: Charidimou, A., Tirschwell, D. L. Tags: Prognosis, All Cerebrovascular disease/Stroke, Intracerebral hemorrhage EDITORIALS Source Type: research

Clinical Reasoning: Sudden-onset pulsatile headache in a previously healthy young man
A previously healthy 41-year-old man presented to the local hospital with a sudden-onset right-sided pulsatile headache, accompanied by vertigo, unstable gait, nausea, and vomiting. On admission, he additionally presented with left central facial paralysis, left-sided hemiparesis, and NIH Stroke Scale score of 2. The patient denied history of hypertension, diabetes, or any other high-risk factors for cerebral vascular diseases (CVD). Diffusion-weighted imaging (DWI) revealed multiple acute focal infarctions in the right frontoparietal lobe consistent with decreased blood supply through the right carotid artery (figure e-1A1 at Neurology.org).
Source: Neurology - January 15, 2017 Category: Neurology Authors: Qin, C., Pan, C., Tian, D.-S. Tags: Stroke in young adults, Carotid artery dissection RESIDENT AND FELLOW SECTION Source Type: research

Author Response: Role Of Sleep-Disordered Breathing And Sleep-Wake Disturbances For Stroke And Stroke Recovery
Drs. Fuchs and Strasser raise the question of how the increased stroke incidence and disturbed stroke recovery that are observed both in patients with sleep-disordered breathing and sleep-wake disturbances are mediated. Increased stroke incidence may be due to excessive sympathetic activation that results in arterial hypertension, inflammation, and atherosclerosis.1 Conversely, disturbed stroke recovery and neuroplasticity might indeed result from disturbed tryptophan metabolism, as proposed by Drs. Fuchs and Strasser. Reduced formation of serotonin from tryptophan is well-known from inflammation-associated depression, whe...
Source: Neurology - January 8, 2017 Category: Neurology Authors: Hermann, D. M., Bassetti, C. L. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research