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Total 3153 results found since Jan 2013.

Space and location of cerebral microbleeds, cognitive decline, and dementia in the community
Conclusions: Mixed or a higher load of CMBs, with some specificity for location, is associated with accelerated cognitive decline in older people. These findings suggest a role for hypertensive vasculopathy and the combined effect of hypertensive and cerebral amyloid angiopathy in the pathogenesis of cognitive deterioration.
Source: Neurology - May 29, 2017 Category: Neurology Authors: Ding, J., Sigurthsson, S., Jonsson, P. V., Eiriksdottir, G., Meirelles, O., Kjartansson, O., Lopez, O. L., van Buchem, M. A., Gudnason, V., Launer, L. J. Tags: MRI, Other cerebrovascular disease/ Stroke, Vascular dementia, Cognitive aging, Cohort studies ARTICLE Source Type: research

Endovascular therapy for ischemic stroke: Save a minute--save a week
Conclusions: Small reductions in endovascular delays lead to marked health benefits over patients' lifetimes. Services need to be optimized to reduce delays to endovascular therapy.
Source: Neurology - May 29, 2017 Category: Neurology Authors: Meretoja, A., Keshtkaran, M., Tatlisumak, T., Donnan, G. A., Churilov, L. Tags: Outcome research, Quality of life, All Cerebrovascular disease/Stroke, Models of care, Infarction ARTICLE Source Type: research

Optimal management of patients with asymptomatic carotid stenosis
Prior trials have shown that carotid endarterectomy (CEA) is superior to nonoperative management of asymptomatic carotid stenosis.1,2 More recent trials have shown surprisingly better outcomes for stroke patients managed with maximal medical therapy.3,4 As such, a number of experts have called for revisiting clinical trials of both CEA and carotid stenting for patients with symptomatic and asymptomatic carotid stenosis using modern medical therapy. Given the current substantial equipoise within the field, modern studies seem reasonable. A number of ongoing trials aim to address current areas of equipoise, but enrollment in...
Source: Neurology - May 22, 2017 Category: Neurology Authors: Starke, R. M. Tags: Stroke prevention, Other cerebrovascular disease/ Stroke, All Cerebrovascular disease/Stroke EDITORIALS Source Type: research

Asymptomatic carotid stenosis: Why a moratorium is needed on intervention outside clinical trials
In this issue of Neurology®, Heck et al.1 discuss the need for evidence regarding intervention for asymptomatic carotid stenosis (ACS). They say it is not proven that the risk of stroke in asymptomatic carotid stenosis is well below that of intervention. They inveigh against the suggestion that a moratorium on intervention in low-risk ACS outside of randomized trials be accepted in order to foster the development of the evidence we need to settle how to manage ACS. They assert further that only randomized trials can provide valid evidence. However, results in carefully vetted randomized trials do not reflect real-world...
Source: Neurology - May 22, 2017 Category: Neurology Authors: Spence, J. D. Tags: Stroke prevention, Other cerebrovascular disease/ Stroke, All Cerebrovascular disease/Stroke EDITORIALS Source Type: research

Lewis P. Rowland, MD (1925-2017)
Lewis P. Rowland, one of the most influential neurologists of our time, died on March 16 following a stroke. It was somehow fitting that his last days were in the neurologic intensive care unit at New York Presbyterian Hospital, one of the first in the country. Critical care neurology was a development that Bud had foreseen and strongly supported as essential for modern neurology and neurosurgery.
Source: Neurology - May 22, 2017 Category: Neurology Authors: Pedley, T. A., Mayeux, R., Griggs, R. C. Tags: IN MEMORIAM Source Type: research

Relationship between carotid arterial properties and cerebral white matter hyperintensities
Conclusions: Large carotid artery diameters are associated with greater burden of white matter hyperintensity (WMH) in this multiethnic population. The association between increased diameters, decreased STRAIN, and greater WMH burden is more pronounced among Hispanics. These associations suggest a potential important pathophysiologic role of extracranial large artery remodeling in the burden of WMH.
Source: Neurology - May 22, 2017 Category: Neurology Authors: Rundek, T., Della-Morte, D., Gardener, H., Dong, C., Markert, M. S., Gutierrez, J., Roberts, E., Elkind, M. S. V., DeCarli, C., Sacco, R. L., Wright, C. B. Tags: fMRI, Other cerebrovascular disease/ Stroke, Assessment of cognitive disorders/dementia ARTICLE Source Type: research

Alcohol use and risk of intracerebral hemorrhage
Conclusions: This study demonstrated potential protective effects of rare and moderate alcohol consumption on ICH risk. Heavy alcohol consumption was associated with increased ICH risk. Race/ethnicity was a significant factor in alcohol-associated ICH risk; heavy alcohol consumption in black and Hispanic participants poses significant nonlobar ICH risk.
Source: Neurology - May 22, 2017 Category: Neurology Authors: Chen, C.-J., Brown, W. M., Moomaw, C. J., Langefeld, C. D., Osborne, J., Worrall, B. B., Woo, D., Koch, S., For the ERICH Investigators Tags: All Cerebrovascular disease/Stroke, Alcohol, Case control studies, Risk factors in epidemiology, Intracerebral hemorrhage ARTICLE Source Type: research

Body mass index and outcome after revascularization for symptomatic carotid artery stenosis
Conclusions: BMI is not associated with periprocedural risk of stroke or death; however, BMI 25–<30 is associated with lower postprocedural risk than BMI 20–<25. These observations were similar for CAS and CEA.
Source: Neurology - May 22, 2017 Category: Neurology Authors: Volkers, E. J., Greving, J. P., Hendrikse, J., Algra, A., Kappelle, L. J., Becquemin, J.-P., Bonati, L. H., Brott, T. G., Bulbulia, R., Calvet, D., Eckstein, H.-H., Fraedrich, G., Gregson, J., Halliday, A., Howard, G., Jansen, O., Roubin, G. S., Brown, M. Tags: Stroke prevention, Clinical trials Systematic review/meta analysis, Risk factors in epidemiology, Infarction ARTICLE Source Type: research

Asymptomatic carotid stenosis: Medicine alone or combined with carotid revascularization
Two positive randomized trials established carotid endarterectomy (CEA) as a superior treatment to medical management alone for the treatment of asymptomatic carotid artery stenosis. However, advances in medical therapy have led to an active and spirited debate about the best treatment for asymptomatic carotid stenosis. The Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis (CREST 2) trial aims to better define the best treatment for the average patient with severe asymptomatic carotid stenosis. Enrollment in the trial may be hampered by strong opinions on either side of the debate. It is im...
Source: Neurology - May 22, 2017 Category: Neurology Authors: Heck, D. V., Roubin, G. S., Rosenfield, K. G., Gray, W. A., White, C. J., Jovin, T. G., Matsumura, J. S., Lal, B. K., Katzen, B. T., Dabus, G., Jankowitz, B. T., Brott, T. G. Tags: Stroke prevention, Other cerebrovascular disease/ Stroke, All Cerebrovascular disease/Stroke VIEWS & amp;amp; REVIEWS Source Type: research

Letter re: Early start of DOAC after ischemic stroke: Risk of intracranial hemorrhage and recurrent events
Seiffge et al.1 evaluated the effect of direct, non–vitamin K antagonist oral anticoagulants (DOACs) or vitamin K antagonists on intracranial hemorrhage (ICH) and recurrent ischemic events in patients with acute ischemic stroke or TIA and nonvalvular atrial fibrillation (NVAF). I have a concern about the study.
Source: Neurology - May 22, 2017 Category: Neurology Authors: Kawada, T. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research

Author response: Early start of DOAC after ischemic stroke: Risk of intracranial hemorrhage and recurrent events
We thank Prof. Kawada for his interest in our article.1 We agree that larger patient cohorts more accurately estimate the risk of intracranial hemorrhage (ICH) from direct, non–vitamin K antagonist oral anticoagulants (DOACs). However, the definition of ICH is crucial. In our study we looked at symptomatic ICH (sICH) only, and observed only 1 patient with sICH.1 In contrast, the cited study of Cappellari et al.2 looked at both sICH and asymptomatic ICH: Of the 7 patients with any ICH after DOAC start, only 1 had sICH. Therefore, the rates of sICH were comparable between the 2 studies.
Source: Neurology - May 22, 2017 Category: Neurology Authors: Seiffge, D. J., De Marchis, G. M. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research

Teaching NeuroImages: Takayasu arteritis: Neuroimaging progression after immunosuppressant treatment
A 29-year-old woman presented with a 2-year history of heel pain, constitutional symptoms, and increased acute phase reactants. CT and magnetic resonance (MR) angiography revealed a thickening of aortic walls and a thread-like appearance of bilateral subclavian and common carotid arteries. The findings were consistent with Takayasu arteritis (TA)1 and the patient was prescribed methylprednisolone, followed by azathioprine. Follow-up MR angiography, 6 years later, showed an important improvement with only a mild luminal narrowing of both common carotid arteries (figures 1 and 2, A and B). TA is a large-artery inflammatory d...
Source: Neurology - May 15, 2017 Category: Neurology Authors: Martinez Rodriguez, L., Caminal Montero, L., Pena Suarez, J., Garcia-Cabo Fernandez, C., Calleja Puerta, S. Tags: MRI, Vasculitis, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research

Diagnostic value of prehospital ECG in acute stroke patients
Conclusions: In a selected cohort of patients with stroke, the in-field recordings of the ECG detected a relevant rate of cardiac arrhythmia. The results can add to the in-hospital evaluation and should be considered in prehospital care of acute stroke.
Source: Neurology - May 15, 2017 Category: Neurology Authors: Bobinger, T., Kallmünzer, B., Kopp, M., Kurka, N., Arnold, M., Heider, S., Schwab, S., Köhrmann, M. Tags: All Cerebrovascular disease/Stroke, Cardiac, Critical care ARTICLE Source Type: research

Copeptin and NT-proBNP for prediction of all-cause and cardiovascular death in ischemic stroke
Conclusions: Copeptin and NT-proBNP may be useful independent prognostic markers of all-cause or CVD mortality in Chinese patients with AIS.
Source: Neurology - May 15, 2017 Category: Neurology Authors: Tu, W.-J., Ma, G.-Z., Ni, Y., Hu, X.-S., Luo, D.-Z., Zeng, X.-W., Liu, Q., Xu, T., Yu, L., Wu, B. Tags: Prognosis, All Cerebrovascular disease/Stroke, Cardiac ARTICLE Source Type: research

Risks and benefits of clopidogrel-aspirin in minor stroke or TIA: Time course analysis of CHANCE
Conclusions: Clopidogrel–aspirin treatment may have a benefit of reducing stroke risk outweighing the potential risk of increased bleeding especially within the first 2 weeks compared with aspirin alone in patients with minor stroke or TIA. Clinicaltrials.gov identifier: NCT00979589. Classification of evidence: This study provides Class II evidence that for patients with minor stroke or TIA, the reduction of stroke risk from clopidogrel plus aspirin within the first 2 weeks outweighs the risk of bleeding compared with aspirin alone.
Source: Neurology - May 15, 2017 Category: Neurology Authors: Pan, Y., Jing, J., Chen, W., Meng, X., Li, H., Zhao, X., Liu, L., Wang, D., Johnston, S. C., Wang, Y., Wang, Y., On behalf of the CHANCE investigators Tags: All Cerebrovascular disease/Stroke, Clinical trials Randomized controlled (CONSORT agreement) ARTICLE Source Type: research