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Implications of the National Institutes of Health Stroke Scale Cookie Theft Picture —A Closer Look
This Viewpoint discusses the implications of use of the National Institutes of Health Stroke Scale Cookie Theft picture.
Source: JAMA Neurology - June 13, 2022 Category: Neurology Source Type: research

Data Do Not Support Selection of Patients for Stroke Treatment Within the 16- to 24-Hour Interval —Reply
In Reply We thank Powers for his comments regarding our article. He raises the question if the positive result for patients with target perfusion-imaging mismatch in the 12.8- to 24-hour tercile in the Analysis of Pooled Data From Randomized Studies of Thrombectomy More Than 6 Hours After Last Well Known (AURORA) study could solely be due to a benefit from 12.8 to 16 hours since last known well subgroup, with neutral or negative effects in the 16- to 24-hour time period. This was not the case. Data for patients in the 16- to 24-hour group with the target mismatch profile demonstrated an odds ratio of 3.82 (95% CI, 1.07-13....
Source: JAMA Neurology - February 14, 2022 Category: Neurology Source Type: research

Selection of Patients for Thrombectomy in the Extended Time Window
Based on the protocols used in the DAWN (Diffusion Weighted Imaging or Computerized Tomography Perfusion Assessment With Clinical Mismatch in the Triage of Wake Up and Late Presenting Strokes Undergoing Neurointervention) and DEFUSE 3 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3) randomized clinical trials (RCTs) of thrombectomy in the extended window, current guidelines recommend thrombectomy either in the 6- to 16-hour window in patients with a target perfusion imaging mismatch profile or in the 6- to 24-hour window in patients with a clinical imaging mismatch profile. However, these criteria ...
Source: JAMA Neurology - July 26, 2021 Category: Neurology Source Type: research

Efficacy and Safety of Ticagrelor and Aspirin in Patients With Moderate Ischemic Stroke
This exploratory analysis of the THALES trial evaluates the efficacy and safety of ticagrelor plus aspirin in patients with moderate ischemic stroke (National Institutes of Health Stroke Scale score of 4 to 5).
Source: JAMA Neurology - July 9, 2021 Category: Neurology Source Type: research

Importance of the Intention-to-Treat Principle
To the Editor The recent study by Goyal et al represents the third largest cohort study on patients with large vessel occlusions (LVOs) who present with mild deficits (National Institutes of Health Stroke Scale score, 0-5) and, to our knowledge, the largest meta-analysis regarding this topic. This highlights the growing interest on how to optimally treat such patients.
Source: JAMA Neurology - May 4, 2020 Category: Neurology Source Type: research

Distributional Validity and Prognostic Power of the NIHSS in US Administrative Claims Data
This cross-sectional study analyzes the distributional, convergent, and predictive validity of National Institutes of Health Stroke Scale (NIHSS) values in the National Inpatient Sample.
Source: JAMA Neurology - February 17, 2020 Category: Neurology Source Type: research

Managing Patients With Large Ischemic Core
To the Editor We read with interest the article by Rebello and colleagues on endovascular treatment. There is still uncertainty on how best to manage patients who have a large ischemic core and a large artery clot. Using matched controls is an excellent approach when the study is not a randomized clinical trial. The authors modified the approach of Mandava and colleagues, who had proposed matching controls based on the National Institutes of Health Stroke Scales, age, and pretreatment glucose level. The authors had substituted an “ischemic core on computed tomography perfusion” for the National Institutes of Health Str...
Source: JAMA Neurology - April 10, 2017 Category: Neurology Source Type: research

What Is in a Match? —Reply
In Reply We appreciate the interest of Phan and Ma in our recent article. We agree that patients may behave differently according to their stroke laterality, and that nondominant hemisphere infarcts with larger volumes may present with relatively lower National Institutes of Health Stroke Scales (NIHSS) scores. However, Fink et al found that infarct volumes were greater on the right side as compared with the left only among patients presenting with mild strokes (NIHSS  ≤ 5) with no significant right-left differences detected at higher NIHSS values. By contrast, our patient cohort was exclusively composed of patients ...
Source: JAMA Neurology - April 10, 2017 Category: Neurology Source Type: research

Improved Outcomes in Asymptomatic Obstructive Sleep Apnea
This study enrolled 1522 randomly selected, employed research subjects and observed them for 2 decades. The goal of WSCS was to answer one aspect of a US Congressional mandate to determine the overall public burden of sleep d isorders. The WSCS had a surprising finding: mild OSA was seen in 17% of adults, and, most concerning, 6% of adults had moderate to severe OSA. The WSCS finding most relevant to the current USPSTF recommendation statement is that only 35% of WSCS participants with moderate OSA and 37% of participant s with severe OSA reported excessive daytime sleepiness, the cardinal daytime symptom of OSA. This sugg...
Source: JAMA Neurology - January 24, 2017 Category: Neurology Source Type: research

Imaging and Recurrent Cerebrovascular Events in Patients After Stroke
This cohort study seeks to determine predictors of early recurrent cerebrovascular events among patients with transient ischemic attacks and minor strokes and National Institutes of Health Stroke Scale scores of 0 to 3.
Source: JAMA Neurology - March 21, 2016 Category: Neurology Source Type: research