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Broadening Our SCOPE of Understanding Patent Foramen Ovale High-risk Features and Stroke
Paradoxical embolization of a blood clot of presumed venous origin through a patent foramen ovale (PFO) is increasingly recognized as a legitimate cause of otherwise cryptogenic ischemic stroke (CIS). The term PFO-associated stroke has been proposed, as has where and how to classify this entity in the nomenclature of various ischemic stroke subtyping systems. PFOs are common, with prevalence as high as 25% in the general population. The prevalence of PFO is further increased in patients with CIS (overall 2.9 times higher), and especially so in the subset of younger patients (<55 years, 5.1 times higher). One estimate of...
Source: JAMA Neurology - October 10, 2022 Category: Neurology Source Type: research

Benefits of MRI for Patients With Low-risk Transient or Persistent Minor Neurologic Deficits
More than 1 million patients receive a diagnosis of stroke or transient ischemic attack (TIA) in the United States each year. These patients are at increased risk of stroke during the first few weeks after the initial event, with the greatest risk during the first 2 days. Evidence-based secondary preventive measures are available to lower the risk of recurrent ischemic events, but for these measures to be effectively implemented, patients with stroke or TIA must be rapidly and correctly identified. Accurate diagnosis is important because some secondary preventive strategies carry risks of their own and are usually not appr...
Source: JAMA Neurology - September 23, 2019 Category: Neurology Source Type: research

Sex and Race Differences in the Association of Incident Ischemic Stroke With Risk Factors
This cohort study of 25  789 black and white individuals in the United States examines the incidence and risk factors for ischemic stroke by sex and race.
Source: JAMA Neurology - December 10, 2018 Category: Neurology Source Type: research

Error in Table
The Research Letter titled, “Medical Specialties of Clinicians Providing Mechanical Thrombectomy to Patients with Acute Ischemic Stroke in the United States,” published in the April 2018 print issue included an error in the Table that presented the data for neurosurgeons in the row labeled “Neurology,” and the data for neurologists in the row labeled “Neurosurgery.” This included indicating that 110 thrombectomies were performed by neurosurgeons and 91 by neurologists. The Table has been corrected and now matches the data present in the main text of the article: 91 thrombectomies performed by neurosurgeons an d...
Source: JAMA Neurology - May 21, 2018 Category: Neurology Source Type: research

Informing vs Changing the Practice of Carotid Revascularization
The Carotid Revascularization Endarterectomy vs Stenting Trial (CREST) was a multicenter randomized clinical trial directly comparing the risks and benefits of stenting with those of endarterectomy for symptomatic and asymptomatic high-grade stenosis. Involving 2502 patients across the United States and Canada followed-up for up to 10 years, the trial did not detect significant differences in the end point of perioperative stroke, myocardial infarction, or death or ipsilateral ischemic stroke after the perioperative period. Primary results were published in 2010. CREST clearly informed practice guidelines, but the extent t...
Source: JAMA Neurology - December 4, 2017 Category: Neurology Source Type: research

Impact of Birth Place and Geographic Location on Risk Disparities in Cerebrovascular Disease
The geographic disparities in stroke and cerebrovascular disease have long been recognized with high-risk areas, such as the states in the Southeast with the greatest risk and identified as the Stroke Belt. These epidemiologic observations have facilitated the identification of risk factors associated with the excess disease burden as well as the benefits of interventions focused on disease control. The geographic disparities in stroke risks prompted specific investigations and conferences to determine the factors associated with the excess risk burden for specific geographic areas, such as the southeastern United States, ...
Source: JAMA Neurology - July 31, 2017 Category: Neurology Source Type: research