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Summary of evidence-based guideline update: Prevention of stroke in nonvalvular atrial fibrillation: Report of the Guideline Development Subcommittee of the American Academy of Neurology
Objective: To update the 1998 American Academy of Neurology practice parameter on stroke prevention in nonvalvular atrial fibrillation (NVAF). How often do various technologies identify previously undetected NVAF? Which therapies reduce ischemic stroke risk with the least risk of hemorrhage, including intracranial hemorrhage? The complete guideline on which this summary is based is available as an online data supplement to this article. Methods: Systematic literature review; modified Delphi process recommendation formulation. Major conclusions: In patients with recent cryptogenic stroke, cardiac rhythm monitoring probabl...
Source: Neurology - February 24, 2014 Category: Neurology Authors: Culebras, A., Messe, S. R., Chaturvedi, S., Kase, C. S., Gronseth, G. Tags: All Cerebrovascular disease/Stroke SPECIAL ARTICLE Source Type: research

Recognition and management of stroke in young adults and adolescents
Approximately 15% of all ischemic strokes (IS) occur in young adults and adolescents. To date, only limited prior public health and research efforts have specifically addressed stroke in the young. Early diagnosis remains challenging because of the lack of awareness and the relative infrequency of stroke compared with stroke mimics. Moreover, the causes of IS in the young are heterogeneous and can be relatively uncommon, resulting in uncertainties about diagnostic evaluation and cause-specific management. Emerging data have raised public health concerns about the increasing prevalence of traditional vascular risk factors i...
Source: Neurology - September 16, 2013 Category: Neurology Authors: Singhal, A. B., Biller, J., Elkind, M. S., Fullerton, H. J., Jauch, E. C., Kittner, S. J., Levine, D. A., Levine, S. R. Tags: Childhood stroke, Stroke in young adults, All Cerebrovascular disease/Stroke, Carotid artery dissection, Infarction VIEWS & amp;amp; REVIEWS Source Type: research

The Workforce Task Force Report: Clinical implications for neurology
The American Academy of Neurology Workforce Task Force (WFTF) report predicts a future shortfall of neurologists in the United States. The WFTF data also suggest that for most states, the current demand for neurologist services already exceeds the supply, and by 2025 the demand for neurologists will be even higher. This future demand is fueled by the aging of the US population, the higher health care utilization rates of neurologic services, and by a greater number of patients gaining access to the health care system due to the Patient Protection and Affordable Care Act. Uncertainties in health care delivery and patient ac...
Source: Neurology - July 29, 2013 Category: Neurology Authors: Freeman, W. D., Vatz, K. A., Griggs, R. C., Pedley, T. Tags: CONTEMPORARY ISSUES Source Type: research

Summary of evidence-based guideline: Periprocedural management of antithrombotic medications in patients with ischemic cerebrovascular disease: Report of the Guideline Development Subcommittee of the American Academy of Neurology
Objective: To assess evidence regarding periprocedural management of antithrombotic drugs in patients with ischemic cerebrovascular disease. The complete guideline on which this summary is based is available as an online data supplement to this article. Methods: Systematic literature review with practice recommendations. Results and recommendations: Clinicians managing antithrombotic medications periprocedurally must weigh bleeding risks from drug continuation against thromboembolic risks from discontinuation. Stroke patients undergoing dental procedures should routinely continue aspirin (Level A). Stroke patients underg...
Source: Neurology - May 27, 2013 Category: Neurology Authors: Armstrong, M. J., Gronseth, G., Anderson, D. C., Biller, J., Cucchiara, B., Dafer, R., Goldstein, L. B., Schneck, M., Messe, S. R. Tags: Ultrasound, All Medical/Systemic disease, All Neuro-ophthalmology, All Cerebrovascular disease/Stroke, All Trauma SPECIAL ARTICLE Source Type: research

Predictors of Return To Driving after Stroke (P03.157)
CONCLUSIONS: Patients with higher FIM cognition and lower extremity Motricity Index scores at admission to inpatient rehabilitation are more likely to return to driving at six months. This model could be used by rehabilitation professionals to help counsel patients and their families and focus treatment goals.Supported by: American Academy of Neurology, NIH National Center for Advancing Translational Sciences, HealthSouth Corporation, Washington University McDonnell Center for Systems Neuroscience, and the Foundation for Barnes-Jewish Hospital.Disclosure: Dr. Aufman has nothing to disclose. Dr. Bland has received personal ...
Source: Neurology - February 14, 2013 Category: Neurology Authors: Aufman, E., Bland, M., Barco, P., Carr, D., Lang, C. Tags: P03 Cerebrovascular Disease III Source Type: research

Epidemiology of the Reversible Cytotoxic Edema of the Splenium of the Corpus Callosum: A Midwest Tertiary Center Experience (P03.198)
CONCLUSIONS: The prevalence of CESCC in the adult patient population at KUMC is rare. It has no gender predilection. In adults, it occurs between 20 to 60 years of age, typically presenting with alteration in mental status and associated headache. The lesions may last 1 to 4 weeks before completely resolving.Disclosure: Dr. Toma has nothing to disclose. Dr. Gronseth has received personal compensation for activities with Boehringer Ingelheim Pharmaceuticals, Inc as a speaker. Dr. Gronseth has received personal compensation in an editorial capacity for Neurology. Dr. Gronseth has received research support from the American Academy of Neurology.
Source: Neurology - February 14, 2013 Category: Neurology Authors: Toma, H., Gronseth, G. Tags: P03 Cerebrovascular Disease III Source Type: research

Lasting Relief from Chronic Pain after Cerebral Infarction (P02.005)
CONCLUSIONS: This patient's stroke appeared to produce the beneficial and persistent effect of dramatic pain relief, enabling him to discontinue all analgesic medications, including methadone. The alleviation of pain after ischemic infarction is highly unusual, and possible explanations include 1) damage to both anterior cingulate gyri producing apathy of such severity that the experience of pain was markedly blunted, and 2) bilateral injury to the nucleus accumbens abolishing a cerebral region critical for the appreciation of pain and opiate-related reward.Disclosure: Dr. Burke has nothing to disclose. Dr. Anderson's spou...
Source: Neurology - February 14, 2013 Category: Neurology Authors: Burke, H., Anderson, C., Filley, C. Tags: P02 Ethics, Pain, and Palliative Care Source Type: research

Teleneurology applications: Report of the Telemedicine Work Group of the American Academy of Neurology
Conclusions: Teleneurology is an effective tool for the rapid evaluation of patients in remote locations requiring neurologic care. These underserved locations include geographically isolated rural areas as well as urban cores with insufficient available neurology specialists. With this technology, neurologists will be better able to meet the burgeoning demand for access to neurologic care in an era of declining availability. An increase in physician awareness and support at the federal and state level is necessary to facilitate expansion of telemedicine into further areas of neurology.
Source: Neurology - February 11, 2013 Category: Neurology Authors: Wechsler, L. R., Tsao, J. W., Levine, S. R., Swain-Eng, R. J., Adams, R. J., Demaerschalk, B. M., Hess, D. C., Moro, E., Schwamm, L. H., Steffensen, S., Stern, B. J., Zuckerman, S. J., Bhattacharya, P., Davis, L. E., Yurkiewicz, I. R., Alphonso, A. L., Fo Tags: All Movement Disorders, All Cerebrovascular disease/Stroke, Models of care, All Practice Management, All Education CONTEMPORARY ISSUES Source Type: research

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