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Total 3153 results found since Jan 2013.

Effect of informed consent on patient characteristics in a stroke thrombolysis trial
Conclusions: Patients recruited by proxy consent were older, had more severe strokes, and had higher prevalence of aphasia than those with capacity to give personal consent. Variations in the manner of consent across countries may influence trial results. Clinicaltrials.gov and Clinicaltrialsregister.eu identifiers: NCT01525290 (clinicaltrials.gov); 2011-005906-32 (clinicaltrialsregister.eu).
Source: Neurology - September 25, 2017 Category: Neurology Authors: Thomalla, G., Boutitie, F., Fiebach, J. B., Simonsen, C. Z., Nighoghossian, N., Pedraza, S., Lemmens, R., Roy, P., Muir, K. W., Heesen, C., Ebinger, M., Ford, I., Cheng, B., Cho, T.-H., Puig, J., Thijs, V., Endres, M., Fiehler, J., Gerloff, C. Tags: MRI, All Clinical trials, All Cerebrovascular disease/Stroke, Clinical trials Methodology/study design, All Ethics in Neurology/Legal issues ARTICLE Source Type: research

Comment: Capacity, consent, and country in acute stroke research
As a general principle, any research involving humans requires voluntary participation based on informed consent.1 This also applies to enrollment in clinical trials und usually requires participants to give written informed consent after having received detailed information about potential benefits and risks as well as alternative treatment options, and after having had adequate time for consideration. Trials in acute stroke, however, present several challenges to this approach. Reperfusion therapies in acute stroke show a clear time-dependent effect, being more effective the earlier treatment is started, or reperfusion a...
Source: Neurology - September 25, 2017 Category: Neurology Authors: Chen, D. T., Worrall, B. B. Tags: ARTICLE Source Type: research

Association of intracranial aneurysm rupture with smoking duration, intensity, and cessation
Conclusions: Current cigarette smoking, smoking intensity, and smoking duration are significantly associated with ruptured IAs at presentation. However, the significantly increased risk persists after smoking cessation, and smoking cessation does not confer a reduced risk of aneurysmal subarachnoid hemorrhage beyond that of reducing the cumulative dose.
Source: Neurology - September 25, 2017 Category: Neurology Authors: Can, A., Castro, V. M., Ozdemir, Y. H., Dagen, S., Yu, S., Dligach, D., Finan, S., Gainer, V., Shadick, N. A., Murphy, S., Cai, T., Savova, G., Dammers, R., Weiss, S. T., Du, R. Tags: All Cerebrovascular disease/Stroke, Subarachnoid hemorrhage ARTICLE Source Type: research

Mystery Case: Diagnostic challenges in a young patient with hypereosinophilia
A 48-year-old woman with recent diagnosis of nonischemic cardiomyopathy and longstanding history of asthma and allergic rhinitis without additional vascular risk factors had intermittent chest pain and dyspnea for 6 weeks, treated with antibiotics and oral steroids without benefit. Subsequently, she developed bilateral leg edema, orthopnea, and chest pain, and was hospitalized twice at another institution. Transthoracic echocardiogram (TTE) demonstrated an ejection fraction (EF) of 30%. Cardiac catheterization was normal. CT of the chest showed a large pericardial effusion (~300 mL) and bilateral pleural effusions. She had...
Source: Neurology - September 25, 2017 Category: Neurology Authors: Ortiz, J. G., Douglas, P. W., Gill, C. E., Mehrotra, S., Biller, J. Tags: Stroke in young adults, Infarction RESIDENT AND FELLOW SECTION Source Type: research

Teaching NeuroImages: Wallerian degeneration in evolving pediatric stroke
An 8-year-old girl presented with acute hemiparesis and facial palsy. MRI demonstrated right middle cerebral artery territory infarction (figure, A and B), secondary to traumatic dissection. Following discharge, multiple visits for nonspecific neurologic symptoms prompted repeat short-term imaging, initially concerning for right midbrain infarction (figure, C–H).
Source: Neurology - September 25, 2017 Category: Neurology Authors: Jimenez-Gomez, A., Stowe, R. C. Tags: Childhood stroke, MRI, DWI, Other Education RESIDENT AND FELLOW SECTION Source Type: research

Teaching NeuroImages: RCVS causing simultaneous convexity subarachnoid hemorrhage and hemimedullary infarction
A 34-year-old previously healthy man presented with thunderclap headache, dysphagia, dysarthria, and oscillopsia. Neurologic examination revealed right-beating nystagmus, dysphagia, hypophonia, right hemianesthesia, and left hemiparesis. Brain imaging showed convexity subarachnoid hemorrhage (figure 1A) and left hemimedullary infarct (figure 1B). Catheter angiography showed tapering of left vertebral artery and diffuse segmental vasoconstriction (figure 2). Routine serum and CSF results were unremarkable. Thorough infectious, immunologic, and coagulopathy workup was negative. Reversible cerebral vasoconstriction syndrome (...
Source: Neurology - September 18, 2017 Category: Neurology Authors: Selvan, P., Levine, S. R. Tags: Stroke in young adults, Other cerebrovascular disease/ Stroke, All Cerebrovascular disease/Stroke, Infarction, Subarachnoid hemorrhage RESIDENT AND FELLOW SECTION Source Type: research

Vertebral artery stenosis: The hurdles of stenting are too high
Up to a quarter of patients with vertebrobasilar ischemic stroke or TIA have a symptomatic stenosis of the vertebrobasilar arteries.1,2 Patients with vertebral artery (VA) stenosis >50% have a high risk of recurrent stroke, comparable to patients with symptomatic carotid artery stenosis, with the highest risk during the first weeks after the initial TIA or ischemic stroke.3 Endovascular treatment of symptomatic VA stenosis has appeal as a treatment option that is widely performed, despite the scarcity of evidence for its safety or benefit.
Source: Neurology - September 18, 2017 Category: Neurology Authors: Compter, A., Chaturvedi, S. Tags: Stroke prevention, All Cerebrovascular disease/Stroke EDITORIALS Source Type: research

Incidence and management of seizures after ischemic stroke: Systematic review and meta-analysis
Conclusions: The burden of stroke-related seizures and epilepsy due to ischemic stroke is substantial. Further studies are required to determine risk factors for epilepsy following ischemic stroke and optimal secondary prevention.
Source: Neurology - September 18, 2017 Category: Neurology Authors: Wang, J. Z., Vyas, M. V., Saposnik, G., Burneo, J. G. Tags: All Cerebrovascular disease/Stroke, Incidence studies, All Epilepsy/Seizures ARTICLE Source Type: research

Stenting for symptomatic vertebral artery stenosis: The Vertebral Artery Ischaemia Stenting Trial
Conclusions: Stenting in extracranial stenosis appears safe with low complication rates. Large phase 3 trials are required to determine whether stenting reduces stroke risk. ISRCTN.com identifier: ISRCTN95212240. Classification of evidence: This study provides Class I evidence that for patients with symptomatic vertebral stenosis, angioplasty with stenting does not reduce the risk of stroke. However, the study lacked the precision to exclude a benefit from stenting.
Source: Neurology - September 18, 2017 Category: Neurology Authors: Markus, H. S., Larsson, S. C., Kuker, W., Schulz, U. G., Ford, I., Rothwell, P. M., Clifton, A., For the VIST Investigators Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Clinical trials Randomized controlled (CONSORT agreement) ARTICLE Source Type: research

Author response: Long-term cerebral white and gray matter changes after preeclampsia
We thank Dr. Culebras for the comment on our article.1 Sleep apnea might be among the pathophysiologic pathways linking preeclampsia with increased risk of cerebrovascular disease in previously preeclamptic women. In fact, research recently focused on the role of sleep apnea in the etiopathogenesis of cerebrovascular and cardiovascular disease and demonstrated an increased stroke risk in patients with obstructive sleep apnea (OSA).2,3 Intermittent hypoxia with consecutive vascular dysregulation has been identified as a possible mechanism whereby OSA increases risk of stroke. This might be relevant to previously preeclampti...
Source: Neurology - September 18, 2017 Category: Neurology Authors: Siepmann, T., Boardman, H., Bilderbeck, A., Griffanti, L., Kenworthy, Y., Zwager, C., McKean, D., Francis, J., Neubauer, S., Yu, G. Z., Lewandowski, A. J., Sverrisdottir, Y. B., Leeson, P. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research

Does compensatory hyperparathyroidism predispose to ischemic stroke? Decreased bone mass and increased bone turnover with valproate therapy in adults with epilepsy; An alternative to vitamin D supplementation to prevent fractures in patients with MS; High prevalence of vitamin D deficiency and reduced bone mass in Parkinson's disease
Because of known issues leading to several retractions of papers by Y. Sato et al., the editors of Neurology® have, as a matter of due diligence, researched other papers that this group published in Neurology. To ensure that the scientific literature is correct, the Editor chooses to publish an Expression of Concern regarding 3 observational studies and a Letter to the Editor published in Neurology prior to the retracted clinical trials.1–4
Source: Neurology - September 18, 2017 Category: Neurology Tags: EXPRESSION OF CONCERN Source Type: research

Direct oral anticoagulant- vs vitamin K antagonist-related nontraumatic intracerebral hemorrhage
Conclusions: DOAC-related ICH is associated with smaller baseline hematoma volume and lesser neurologic deficit at hospital admission compared to VKA-related ICH.
Source: Neurology - September 11, 2017 Category: Neurology Authors: Tsivgoulis, G., Lioutas, V.-A., Varelas, P., Katsanos, A. H., Goyal, N., Mikulik, R., Barlinn, K., Krogias, C., Sharma, V. K., Vadikolias, K., Dardiotis, E., Karapanayiotides, T., Pappa, A., Zompola, C., Triantafyllou, S., Kargiotis, O., Ioakeimidis, M., Tags: Intracerebral hemorrhage ARTICLE Source Type: research

Trends in stroke incidence in the United States: Will women overtake men?
Stroke poses a heavy burden on health systems, with serious implications for societies and economies. At the global level, stroke is the second leading cause of death and the third most common cause of disability.1 In the United States, about 795,000 strokes occur every year: on average, someone has a stroke every 40 seconds and someone dies as a result of a stroke every 4 minutes.2 Stroke incidence and mortality rates have decreased in the last decades3; however, the aging of populations and improvements in stroke management have resulted in higher numbers of people experiencing a stroke, and more stroke survivors requiri...
Source: Neurology - September 4, 2017 Category: Neurology Authors: Koton, S., Rexrode, K. M. Tags: EDITORIALS Source Type: research

Waxing and waning of white matter hyperintensities
Small vessel disease (SVD) manifests in myriad ways, most prominently as white matter hyperintensities (WMH).1,2 By the age of 60 years, virtually every healthy individual has evidence of WMH,3 and those with ischemic stroke have even more extensive changes.4 Cerebral ischemic injury from occlusion or stenosis of deep penetrating arteries due to (uncontrolled) hypertension ranks highest among the potential causes of WMH.5 These WMH are among the most important vascular contributors to cognitive decline, dementia, and parkinsonism.6
Source: Neurology - September 4, 2017 Category: Neurology Authors: de Leeuw, F.-E., Nichols, F. Tags: MRI, All Cerebrovascular disease/Stroke, Vascular dementia EDITORIALS Source Type: research

Sex-specific stroke incidence over time in the Greater Cincinnati/Northern Kentucky Stroke Study
Conclusions: Decreases in stroke incidence over time are driven by a decrease in ischemic stroke in men. Contrary to previous study periods, stroke incidence rates were similar by sex in 2010. Future research is needed to understand why the decrease in ischemic stroke incidence is more pronounced in men.
Source: Neurology - September 4, 2017 Category: Neurology Authors: Madsen, T. E., Khoury, J., Alwell, K., Moomaw, C. J., Rademacher, E., Flaherty, M. L., Woo, D., Mackey, J., De Los Rios La Rosa, F., Martini, S., Ferioli, S., Adeoye, O., Khatri, P., Broderick, J. P., Kissela, B. M., Kleindorfer, D. Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Incidence studies, Risk factors in epidemiology ARTICLE Source Type: research