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Affiliation Error in Group Information Listing
This article was corrected online and in print.
Source: JAMA Neurology - February 8, 2016 Category: Neurology Source Type: research

Recombinant Tissue Plasminogen Activator Stroke Therapy
The results of recently completed clinical trials of acute ischemic stroke that report a clear and unequivocal benefit of stent-retriever devices used with intravenous recombinant tissue plasminogen activator (rtPA) vs rtPA alone are the second revolutionary therapeutic breakthrough in acute stroke care in the last 50 years. This breakthrough makes the case for a new standard of care for the treatment of acute ischemic stroke. When we look back at the controversy surrounding interventional acute stroke therapies after multiple trials of interventional treatment, most notably International Management of Stroke III (IMS III)...
Source: JAMA Neurology - January 25, 2016 Category: Neurology Source Type: research

Stent Retrievers for Acute Ischemic Stroke
This meta-analysis of randomized clinical trials aims to quantify the benefits and risks of using stent retrievers in addition to recombinant tissue plasminogen activator for the treatment of acute ischemic stroke.
Source: JAMA Neurology - January 25, 2016 Category: Neurology Source Type: research

Recurrent Ischemic Stroke Factors in the SAMMPRIS Medical Group
This post hoc analysis of a randomized clinical trial aims to determine baseline features that were associated with a high rate of the primary end point in the medical arm of the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis Trial.
Source: JAMA Neurology - January 4, 2016 Category: Neurology Source Type: research

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

Coexistent Small Vessel Disease and Intracranial Arterial Stenosis
This post hoc analysis of a clinical trial evaluated the risk of ischemic stroke in patients with large artery atherosclerosis and coexistent small vessel disease.
Source: JAMA Neurology - November 30, 2015 Category: Neurology Source Type: research

Intravenous Tissue Plasminogen Activator for Acute Ischemic Stroke
This observational study using data from the Get With the Guidelines–Stroke registry investigates the risks and benefits associated with long-term antiplatelet therapy among adult patients with ischemic stroke who receive intravenous tissue plasminogen activator.
Source: JAMA Neurology - November 9, 2015 Category: Neurology Source Type: research

Selection Criteria for Stroke Patients Likely to Benefit From Thrombectomy
This cohort study of patients with anterior circulation ischemic stroke compared outcomes after thrombectomy of patients classified as likely vs unlikely to benefit from the procedure based on clinical criteria and MRI findings.
Source: JAMA Neurology - November 2, 2015 Category: Neurology Source Type: research

Thrombolysis-Related Hemorrhage
Intravenous tissue plasminogen activator (tPA) improves outcomes when administered within 4.5 hours of symptom onset of ischemic stroke. Symptomatic intracranial hemorrhage (sICH) is the most feared complication after administration of intravenous tPA. The percentage of patients with a good functional outcome after sICH (as defined by the Safe Implementation of Thrombolysis in Stroke-Monitoring Study) following administration of tPA has been shown to be less than 7%, and mortality rates can be greater than 50%. Almost 2 decades after approval of intravenous tPA by the US Food and Drug Administration, our ability to prevent...
Source: JAMA Neurology - October 26, 2015 Category: Neurology Source Type: research

Acute Ischemic Stroke Therapy
This Viewpoint discusses the future of thrombolysis and thrombectomy for patients with acute brain ischemia.
Source: JAMA Neurology - October 5, 2015 Category: Neurology Source Type: research

Endovascular Therapy for Acute Ischemic Stroke
Patients with an occlusion of the distal internal carotid or proximal middle cerebral artery have among the most severe types of ischemic stroke that typically produce life-altering disabilities. Prior to a few months ago, the standard of care for such patients included intravenous (IV) alteplase and comprehensive peristroke care to avoid complications, including measures to prevent another stroke and comprehensive rehabilitation.
Source: JAMA Neurology - August 3, 2015 Category: Neurology Source Type: research

Genetic Variants Associated With Risk of Ischemic Stroke
This genome-wide association study identifies 2 novel genes, PDE4DIP and ACOT4, that are associated with an increased risk for ischemic stroke.
Source: JAMA Neurology - May 11, 2015 Category: Neurology Source Type: research

In-Hospital Stroke
There have been tremendous strides in standardization of the care for acute ischemic stroke since widespread use of thrombolytic therapy began almost 20 years ago. Efficacy is still limited by delayed presentation to the emergency department following stroke symptom onset, although this has also improved in that period with education of emergency medical services and the community at large. The real improvement lies in development of streamlined and standardized protocols for “code stroke,” so that thrombolysis rates of 20% are becoming typical and door-to-needle times are just as typically under 1 hour. These encourag...
Source: JAMA Neurology - May 4, 2015 Category: Neurology Source Type: research

Microbleeds, Mortality, and Stroke in Alzheimer Disease The MISTRAL Study
Conclusions and RelevanceIn patients with AD, the presence of nonlobar microbleeds was associated with an increased risk for cardiovascular events and cardiovascular mortality. Patients with lobar microbleeds had an increased risk for stroke and stroke-related mortality, indicating that these patients should be treated with the utmost care.
Source: JAMA Neurology - March 23, 2015 Category: Neurology Source Type: research

Outcomes in Mild Acute Ischemic Stroke Treated With Intravenous Thrombolysis A Retrospective Analysis of the Get With the Guidelines–Stroke Registry
Conclusions and RelevanceMany patients with ischemic stroke treated with IV rtPA have a mild stroke. Symptomatic intracranial hemorrhage is infrequent, but approximately 30% of these patients are unable to return directly home or ambulate independently at discharge. Additional studies are needed to identify strategies to improve the outcomes in patients with mild stroke who receive thrombolysis.
Source: JAMA Neurology - February 2, 2015 Category: Neurology Source Type: research

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