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Limb to Cranial Overflow Dystonia in a Patient After Stroke
This case report describes noncontiguous overflow dystonia in a patient with diabetes, hypertension, and a history of left putaminal hemorrhage and right hemiparesis.
Source: JAMA Neurology - March 6, 2023 Category: Neurology Source Type: research

Prevalence of Atherosclerotic Risk Factors Among Children and Young Adults With Arterial Ischemic Stroke
This case-control study assesses hypertension, hyperlipidemia, obesity, smoking, and diabetes as risk factors associated with incident arterial ischemic stroke in children and young adults, stratified by decade of age.
Source: JAMA Neurology - August 1, 2022 Category: Neurology Source Type: research

Inducers and Cardiovascular Risk —Potential Role for Lowered Drug Exposure—Reply
In Reply We thank Van der Linden and colleagues for their interest in our article, which describes the long-term cardiovascular risk associated with continued use of enzyme-inducing antiseizure medications (eiASMs). With respect to our mediation analysis, we considered incident dyslipidemia as a binary mediator variable, as opposed to a continuous variable of low-density lipoprotein cholesterol or total cholesterol, given its direct clinical relevance as the threshold over which treatment is initiated. However, we agree that future efforts at exploring a dose-dependent mediation between absolute and relative increases in l...
Source: JAMA Neurology - March 7, 2022 Category: Neurology Source Type: research

Progressive Ataxia and Downbeat Nystagmus in the Adult
A 63-year-old man presented with a history of vomiting, hypertension, dyslipidemia, type 2 diabetes, dilated ischemic cardiomyopathy, alcohol use, and stroke; physical examination found appendicular dysmetria with truncal ataxia and downbeat nystagmus. Brain magnetic resonance imaging revealed a hyperintensity on T2-weighted and fluid-attenuated inversion recovery sequences without reduced diffusion in the cerebellar nodule. What is your diagnosis?
Source: JAMA Neurology - May 17, 2021 Category: Neurology Source Type: research

Antihypertensive Medication Use Among Individuals With a History of Stroke and Hypertension, 2005 to 2016
This cross-sectional study investigates the adequacy of blood pressure control among stroke survivors and antihypertensive treatment trends using National Health and Nutrition Examination Survey data.
Source: JAMA Neurology - July 27, 2020 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

Hypertension —A Global Neurological Problem
This Viewpoint discusses the gap in hypertension and stroke care between low-income countries and high-income countries and the role neurologists should play in stroke-prevention efforts.
Source: JAMA Neurology - February 6, 2017 Category: Neurology Source Type: research

Cardiovascular Risk Factors and Stroke in Alzheimer Disease
To the Editor I read with interest the article by Tosto et al studying the influence of cardiovascular risk factors and stroke in familial late-onset Alzheimer disease (LOAD). The main findings were that history of stroke increased the risk for LOAD, while hypertension decreased the risk for LOAD. The study suggests that stroke mediates the influence of cardiovascular risk factors on increased risk for LOAD.
Source: JAMA Neurology - November 14, 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

Factors Associated With Neurological Outcome After Childhood Stroke
In Reply We thank Goh and Sivakumaran for their interest in and comments on our article, which was a retrospective study of blood pressure, blood glucose, and fever and their associations with outcome after arterial ischemic stroke (AIS) in children. Although we did not find a significant association between hypertension and neurological outcome or death at 3 months after stroke, we found that when carefully tracked, vital sign abnormalities were very common in the poststroke period. In our future directions section, we proposed a larger prospective study precisely because of the limitations of our study design and conflic...
Source: JAMA Neurology - August 22, 2016 Category: Neurology Source Type: research

Cerebral Microbleeds, Cognition and Therapeutic Implications
A recent major clinical advance in magnetic resonance imaging (MRI) of the brain is the development of paramagnetic-sensitive sequences such as T2-weighted gradient-recalled echo and susceptibility-weighted images for the detection of cerebral microbleeds (CMBs). On brain MRI, CMBs are small (≤5 to 10 mm in diameter), round, dark-signaled lesions that consist of extravasation of blood components through fragile microvascular walls that neuropathologically represent hemosiderin-laden macrophages. Magnetic resonance imaging–detected CMBs are common in elderly individuals, coexist with ischemic stroke and intracerebral he...
Source: JAMA Neurology - June 6, 2016 Category: Neurology Source Type: research

Vital Sign and Glucose Abnormalities and Outcome in Childhood Stroke
Childhood stroke studies often cite differences in risk factors between adult and pediatric patients, namely that traditional adult stroke risk factors, such as hypertension and hyperglycemia, are not common causes of childhood stroke. In a study of 83 children from the United Kingdom, only 8 children (10%) with available blood pressure data at admission were classified as having hypertension. The authors stated that this could be an overestimate because follow-up blood pressure data were not available, but they acknowledged that elevated blood pressure could be important in some children. In a multinational cohort of 676 ...
Source: JAMA Neurology - May 23, 2016 Category: Neurology Source Type: research