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Time to Reperfusion and Treatment Effect for Acute Ischemic Stroke
This randomized clinical trial evaluates the influence of time from stroke onset to the start of treatment and from onset to reperfusion on the effect of intra-arterial treatment in a population of patients with acute ischemic stroke.
Source: JAMA Neurology - December 21, 2015 Category: Neurology Source Type: research

The Challenges of Stroke Prediction Scores
Transient ischemic attack (TIA) and stroke prediction scores have been a topic of both clinical and research interest for decades. The goal of these scores is to identify high-risk patients for both prognostic and clinical management purposes. There are several TIA and stroke prediction scores that aim to prognosticate recurrence or worsening of cerebrovascular events (CVEs). Some are purely clinical scales (eg, California, ABCD, ABCD2, and ABCD3), while others incorporate cerebral parenchyma and/or vascular imaging (eg, Clinical and Imaging-based Predictive model, Recurrence Risk Estimator at 90 Days, ABCDE+, ABCD-I, ABCD...
Source: JAMA Neurology - March 21, 2016 Category: Neurology Source Type: research

Factors Affecting Preventability of Stroke
In Reply We appreciate the interest of Kawada in our work. Our study was designed to analyze the association between ischemic stroke prevention and treatment; we defined our variables and conducted our data analysis accordingly. We disagree with Kawada’s statement that the “empirical method is not suitable for scientific research.” We look forward to further investigations of how stroke prevention and treatment are associated.
Source: JAMA Neurology - May 2, 2016 Category: Neurology Source Type: research

Mechanical Thrombectomy for Stroke
The publication of 5 randomized trials in 2015 unequivocally established that mechanical thrombectomy is the new standard of care for patients with acute ischemic stroke and an occlusion of the proximal anterior circulation. Although those trials mark a huge advancement in the field of stroke, important questions regarding the implementation of mechanical thrombectomy in routine clinical care remain. One of the more important of these questions is what constitutes the definition of a proximal occlusion. In those trials, most of the patients had an occlusion of the distal internal carotid artery or of the first segment (M1)...
Source: JAMA Neurology - September 12, 2016 Category: Neurology Source Type: research

Anticoagulation Timing for Atrial Fibrillation in Acute Ischemic Stroke
Most stroke physicians will have been asked the best time to start anticoagulation for a patient with atrial fibrillation (AF) and acute ischemic stroke. There is no question that long-term anticoagulation with a direct oral anticoagulant or warfarin sodium reduces the risk of strokes in patients with AF, but the right time to start anticoagulation is uncertain.
Source: JAMA Neurology - September 11, 2017 Category: Neurology Source Type: research

Rivaroxaban vs Warfarin Sodium Early After AF-Related Mild Ischemic Stroke
This randomized clinical trial examines whether rivaroxaban or warfarin sodium is safer and more effective for preventing early recurrent stroke in patients with atrial fibrillation –related acute ischemic stroke.
Source: JAMA Neurology - September 11, 2017 Category: Neurology Source Type: research

Stroke Imaging
In this issue ofJAMA Neurology, Boulouis et al report on the crucial influence of pretreatment collateral blood vessel status in determining the benefit of transfer for endovascular thrombectomy for large vessel acute ischemic stroke. All patients had relatively little evidence of irreversible injury on noncontrast computed tomography (CT) at their referring hospitals. However, when imaging was repeated at the comprehensive stroke center, a substantial proportion of patients had evolved large infarcts that caused them not to proceed to endovascular therapy or foreshadowed a poor outcome. These data contribute to the weight...
Source: JAMA Neurology - September 25, 2017 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

Additional Factors Regarding Clinical Outcomes of General Anesthesia and Conscious Sedation for Acute Ischemic Stroke
To the Editor We applaud Simonsen et al for performing a randomized clinical trial about the effect of general anesthesia (GA) and conscious sedation (CS) during endovascular therapy on infarct growth and clinical outcomes in acute ischemic stroke. Despite its equipoise, this study is important in the field because it reinforces the results of recent randomized clinical trials concerning GA safety in thrombectomy for acute ischemic stroke.
Source: JAMA Neurology - July 16, 2018 Category: Neurology Source Type: research

Prehospital and Early Postarrival Neurological Deterioration in Acute Stroke
This exploratory analysis of 1690 patients enrolled in the Field Administration of Stroke Therapy-Magnesium Trial assesses the frequency, predictors, and outcomes of the neurological deterioration that occurs among patients during the ultra-early period after ischemic stroke or intracranial hemorrhage.
Source: JAMA Neurology - July 23, 2018 Category: Neurology Source Type: research

A Promising Skills-Based Intervention to Reduce Blood Pressure in Individuals With Stroke and Transient Ischemic Attack
Globally, stroke is the second leading cause of death and third leading cause of disability. More than 74% of the burden of stroke has been attributed to smoking, poor diet, and low physical activity, while more than 72% has been attributed to metabolic risk factors (high plasma glucose, high cholesterol, high blood pressure, overweight and obesity, and kidney disease). These are all risk factors that are modifiable with appropriate treatment or change in lifestyle behaviors.
Source: JAMA Neurology - October 8, 2018 Category: Neurology Source Type: research

Follow-up Infarct Volume and Functional Outcome After Endovascular Therapy in Acute Ischemic Stroke
This pooled data analysis of 7 randomized clinical trials of thrombectomy for acute ischemic stroke examines whether follow-up infarct volume mediates the relationship between endovascular therapy and functional outcome in patients with acute ischemic stroke.
Source: JAMA Neurology - January 7, 2019 Category: Neurology Source Type: research

Clinical Care and In-Hospital Outcomes of Asian American Patients With Acute Ischemic Stroke
This analysis compares the characteristics, care, and outcomes of Asian American and white patients with acute ischemic stroke at hospitals participating in the Get With The Guidelines –Stroke program.
Source: JAMA Neurology - January 22, 2019 Category: Neurology Source Type: research

Endovascular Thrombectomy as a Means to Improve Survival in Acute Ischemic Stroke
This meta-analysis examines 90-day mortality and 90-day intracranial hemorrhage reported in trials of endovascular thrombectomy vs medical therapy cited in the 2018 American Stroke Association/American Heart Association guidelines for acute ischemic stroke.
Source: JAMA Neurology - April 8, 2019 Category: Neurology Source Type: research

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