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Development and Validation of a Postprocedural Model to Predict Outcome After Endovascular Treatment for Ischemic Stroke
This prognostic study investigates the effectiveness of a prognostic tool to predict the functional outcome of individual patients after endovascular treatment for ischemic stroke.
Source: JAMA Neurology - July 31, 2023 Category: Neurology Source Type: research

Association Between Thrombectomy and Functional Outcomes in Pediatric Patients With Acute Ischemic Stroke From LVO
This case-control study evaluates whether pediatric patients with acute large vessel occlusion (LVO) stroke who undergo thrombectomy have better clinical outcomes than matched patients managed conservatively.
Source: JAMA Neurology - July 24, 2023 Category: Neurology Source Type: research

Symptomatic Intracranial Hemorrhage With Tenecteplase vs Alteplase in Patients With Acute Ischemic Stroke
This cohort study evaluates rates of symptomatic intracranial hemorrhage following stroke with tenecteplase vs alteplase.
Source: JAMA Neurology - May 30, 2023 Category: Neurology Source Type: research

Association of Mortality and Risk of Epilepsy With Type of Acute Symptomatic Seizure After Ischemic Stroke
This cohort study examines data for patients with acute ischemic stroke to compare the risk of poststroke mortality and epilepsy between different types of acute symptomatic seizures.
Source: JAMA Neurology - April 10, 2023 Category: Neurology Source Type: research

Quantification of Penumbral Volume in Association With Time From Stroke Onset in Acute Ischemic Stroke
This cross-sectional study examines changes in the penumbral and core volumes over time to imaging in patients with acute ischemic stroke.
Source: JAMA Neurology - March 20, 2023 Category: Neurology Source Type: research

Building Evidence on Safety of Thrombolysis for Patients Receiving Direct Oral Anticoagulants
Nearly 20% of patients with acute ischemic stroke (AIS) are undergoing direct oral anticoagulant (DOAC) treatment at the time of their stroke. Common indications for DOACs among these patients include stroke prevention from atrial fibrillation, treatment of venous and pulmonary thrombosis, and coronary and peripheral atherosclerotic disease. Novel indications for DOAC use are expected to emerge and may increase the proportion of patients with AIS who are undergoing treatment with DOACs. Current US and European acute stroke treatment guidelines recommend withholding intravenous thrombolysis (thrombolysis), a morbidity- and ...
Source: JAMA Neurology - January 3, 2023 Category: Neurology Source Type: research

Intravenous Thrombolysis in Patients With Ischemic Stroke and Recent Ingestion of Direct Oral Anticoagulants
This cohort study evaluates the risk of symptomatic intracranial hemorrhage associated with use of intravenous thrombolysis in patients with recent direct oral anticoagulant ingestion.
Source: JAMA Neurology - January 3, 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

Time for a New Perspective on Intracerebral Hemorrhage
More than 3 million people worldwide experience intracerebral hemorrhage (ICH) each year. Although the incidence of ICH is much lower than that of ischemic stroke, ICH imposes a 50% greater worldwide burden of disability. ICH has a 30-day case fatality rate of more than 40%, and most survivors are left with permanent disabilities. Because of the high likelihood of poor outcomes, physicians caring for patients with ICH tend to use clinical severity scores early on to estimate the risk of mortality or future disability to determine the aggressiveness of medical care and to guide conversations with patients ’ surrogates aro...
Source: JAMA Neurology - July 25, 2022 Category: Neurology Source Type: research

Outcomes After Endovascular Thrombectomy With or Without Alteplase in Routine Clinical Practice
This cohort study investigates the outcomes of combination endovascular thrombectomy with alteplase compared with endovascular thrombectomy alone for the treatment of patients with acute ischemic stroke attributable to large vessel occlusion.
Source: JAMA Neurology - June 13, 2022 Category: Neurology Source Type: research

Diagnostic Challenges and Uncertainties of Embolic Strokes of Undetermined Source in Young Adults
Nearly 10% to 15% of acute ischemic strokes occur in young adults, with the incidence steadily increasing over the past few decades. Approximately 20% to 40% of these young patients with stroke are classified as having embolic strokes of undetermined source (ESUS), as the underlying stroke etiology cannot be reliably identified despite recommended diagnostic workup. The young ESUS population is an understudied group, as only a few studies, limited by their small size and the lack of prospective follow-up, have assessed their characteristics and outcomes.
Source: JAMA Neurology - March 14, 2022 Category: Neurology Source Type: research

Evaluating Rates of Recurrent Ischemic Stroke Among Young Adults With Embolic Stroke of Undetermined Source
This cohort study evaluates rates of and factors associated with recurrent ischemic stroke and death as well as new-onset atrial fibrillation among younger adults.
Source: JAMA Neurology - March 14, 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

Disentangling Workflow Paradigms and Treatment Decision-Making in Acute Ischemic Stroke —Reply
In Reply We thank Ospel and Goyal for their interest in the Evaluation of Direct Transfer to Angiography Suite vs Computed Tomography Suite in Endovascular Treatment (ANGIOCAT) study and read with interest their letter in which they express some concerns in relation to the direct-to-angiography suite (DTAS) paradigm. In the ANGIOCAT study, patients adjudicated to the conventional imaging group, despite receiving computed tomography perfusion (CTP) in some cases, achieved one of the shortest workflow times reported ever (door-to-puncture time of 44 minutes). According to guidelines, CTP was never used to exclude patients fr...
Source: JAMA Neurology - February 7, 2022 Category: Neurology Source Type: research

Association of Ischemic Stroke Incidence, Severity, and Recurrence With Dementia in the ARIC Cohort Study
This cohort study evaluates the association between risk of dementia and incident ischemic stroke by stroke severity and recurrence.
Source: JAMA Neurology - January 24, 2022 Category: Neurology Source Type: research

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