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Source: JAMA Neurology
Condition: Stroke
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Total 364 results found since Jan 2013.
Phenotypic Destiny in Mitochondrial Disease?
Mitochondrial diseases are a group of heterogeneous disorders caused by inherited mutations in the mitochondrial genome (mtDNA) and nuclear genome. Typically, mutations in the mtDNA are maternally inherited and cause respiratory chain defects and account for a substantial fraction of childhood and adult neurometabolic disease, with an estimated prevalence of 1:5000 (0.02%). The most common mtDNA mutation is the mitochondrial 3243A>G mutation (m.3243A>G) in the MTTL1 gene (OMIM 590050), which encodes the transfer RNA tRNALeu(UUR). This mutation is associated with multiple clinical and psychiatric manifestations, including d...
Source: JAMA Neurology - June 20, 2016 Category: Neurology Source Type: research
Proton Pump Inhibitors and Dementia Incidence
To the Editor I read with interest the article by Gomm and colleagues, which examined the association between the use of proton pump inhibitors (PPIs) and incident dementia in elderly individuals in a prospective study. The authors adopted time-dependent Cox regression analysis, and the time-dependent covariates were polypharmacy and the comorbidities of depression, diabetes, ischemic heart disease, and stroke. Age and sex were also used as confounding factors. The hazard ratio of PPIs for incident dementia was 1.44 (95% CI, 1.36-1.52), and the authors recommended randomized clinical trials to confirm the causal associatio...
Source: JAMA Neurology - June 20, 2016 Category: Neurology Source Type: research
Mitochondrial 3243A>G Mutation in 2 Pairs of Monozygotic Twins
This case series describes 2 pairs of monozygotic twins with mitochondrial 3243A>G mutation who developed mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes syndrome.
Source: JAMA Neurology - June 20, 2016 Category: Neurology Source Type: research
Computed Tomography Perfusion and Diffusion-Weighted Imaging in Acute Stroke
In Reply We thank Luo and colleagues for their interest and comments regarding our article on patients presenting lacunar syndrome with altered brain computed tomography perfusion (CTP) and normal magnetic resonance imaging (MRI) findings.
Source: JAMA Neurology - June 27, 2016 Category: Neurology Source Type: research
The Dark Matter of Cerebral Microbleeds
In Reply We thank Charidimou for reading our recently published article in JAMA Neurology on the risk for symptomatic intracerebral hemorrhage after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS) and high cerebral microbleed (CMB) burden on pre-IVT magnetic resonance imaging (MRI) screening, and for his timely discussion on the topic.
Source: JAMA Neurology - August 15, 2016 Category: Neurology Source Type: research
Association Between CV Risk Factors and Familial Alzheimer Disease
This cohort study investigates associations between coronary risk factors, stroke, and late-onset Alzheimer dementia in patients with familial disease.
Source: JAMA Neurology - August 15, 2016 Category: Neurology Source Type: research
Association Between Calcium Level and Hematoma Size and Expansion
Intracerebral hemorrhage (ICH) is a common and deadly type of stroke, with high rates of morbidity and mortality (40%-50% in most series). There are several well-described and validated risk factors and diseases that increase the risk of ICH, including race, hypertension, use of anticoagulants, amyloid angiopathy, renal insufficiency, thrombolytic therapy, and drug abuse. However, not all ICHs are associated with one of these risk factors. This suggests that there might be some other modifying factors involved.
Source: JAMA Neurology - September 6, 2016 Category: Neurology Source Type: research
Cardiovascular Risk Factors and Stroke in Alzheimer Disease
Discussion section.
Source: JAMA Neurology - November 14, 2016 Category: Neurology Source Type: research
Intra-arterial Treatment for Basilar Artery Occlusion —Reply
In Reply We thank Bhatti and Sivakumaran for their comments on our article. First, the authors mention the relatively low mean age of 58 years of our cohort (this includes 1 child of 4 years). The patients in the Basilar Artery International Cooperation Study (BASICS) had a mean age of 63 years. We think it is unlikely that this difference of 5 years has had an important influence on the results. Moreover, BASICS is a prospective patient registry, without stringent inclusion criteria. This suggests that patients with basilar artery occlusion have a lower age compared with patients with anterior circulation stroke.
Source: JAMA Neurology - November 28, 2016 Category: Neurology Source Type: research
Thrombolysis and Thrombectomy vs Thrombectomy Alone for Ischemic Stroke
This study examines whether treatment with intravenous thrombolysis before mechanical thrombectomy with a stent retriever is beneficial in patients undergoing mechanical thrombectomy.
Source: JAMA Neurology - January 9, 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
Not All Middle Cerebral Artery M2 Segments Are the Same
To the Editor In the research article “Endovascular Therapy for Acute Ischemic Stroke With Occlusion of the Middle Cerebral Artery M2 Segment,” Sarraj and colleagues describe the advantage of endovascular therapy in addition to best medical therapy for patients with acute M2 occlusions. The article does not describe the distribution of the left- and right-sided lesions. It would be of interest to know whether the overall benefits hold true regardless of lesion lateralization or whether the results are primarily driven by benefits on one side.
Source: JAMA Neurology - February 27, 2017 Category: Neurology Source Type: research
Response to Endovascular Therapy for Acute Ischemic Stroke —Reply
In Reply We thank Silver and Morelli for their interest in our article. We agree that is it always of interest to look into the side of the lesion, specifically into dominance more than right vs left. Although this was not addressed in the recent randomized clinical trials, we looked into this aspect in our initial analyses. When performing our univariate analysis, we looked at factors that independently correlated with good outcomes with endovascular therapy (EVT) as detailed in the Results section of our article and further discussed in eTable 2 in our Supplement. The side of the lesion was tested in the univariate analy...
Source: JAMA Neurology - February 27, 2017 Category: Neurology Source Type: research
Conscious Sedation vs General Anesthesia for Vertebrobasilar Stroke Thrombectomy
This case-control study compares clinical and angiographic outcomes between monitored anesthesia care and general anesthesia in patients presenting with vertebrobasilar occlusion strokes.
Source: JAMA Neurology - April 10, 2017 Category: Neurology Source Type: research
