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The Evolving Concept of Cryptogenic Stroke
This article discusses cryptogenic stroke and the results of recent randomized trials that can inform its evaluation and management. RECENT FINDINGS Most cryptogenic strokes appear embolic, leading to the term embolic stroke of undetermined source. It was previously thought that embolic stroke of undetermined source was a single, therapeutically relevant entity, the underlying sources of which would respond to anticoagulant therapy; however, two large randomized trials found no benefit with anticoagulation compared to antiplatelet therapy for secondary stroke prevention after embolic stroke of undetermined source. A sin...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Ischemic Stroke in Young Adults
This article reviews current knowledge on epidemiology, risk factors and causes, diagnostic considerations, management, and prognosis of ischemic stroke in young adults (those 55 years old and younger). RECENT FINDINGS The incidence of ischemic stroke in young adults has been increasing since the 1980s, which has occurred in parallel with increasing prevalence of vascular risk factors and substance abuse among the younger population. Young adults have a considerably wider range of risk factors than older patients, including age-specific factors such as pregnancy/puerperium and oral contraceptive use. Behavioral risk fac...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

The Migraine Aura
This article discusses the basic mechanisms of migraine aura and its clinical significance based upon evidence from human studies and animal models. RECENT FINDINGS Prospective clinical studies have reinforced the understanding that migraine aura is highly variable from one individual to the next as well as from attack to attack in an individual. While migraine with aura clearly has a higher heritability than migraine without aura, population studies have not identified specific genes that underlie this heritability for typical migraine with aura. Imaging studies reveal hypoperfusion associated with migraine aura, altho...
Source: CONTINUUM: Lifelong Learning in Neurology - August 1, 2018 Category: Neurology Tags: Review Articles Source Type: research

Neurologic Complications of Cardiac and Aortic Disease
This article discusses neurologic complications that can arise from cardiac and aortic disease and dysfunction. Recent Findings: Advances in the care of patients with cardiac or aortic disease include the use of prolonged cardiac monitoring in cryptogenic stroke and the approval of the use of left atrial appendage closure devices for stroke prevention in patients with atrial fibrillation who are not candidates for anticoagulation. Continuing controversy surrounds patent foramen ovale closure, and new evidence indicates that cognitive impairment following coronary artery bypass grafting surgery may be less common than prev...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2017 Category: Neurology Tags: Review Articles Source Type: research

Cardioembolic Stroke
This article summarizes the different causes of cardioembolism and outlines current management guidelines. Recent Findings: Since cardioembolic stroke is not a single disease entity, its diagnosis requires initial clinical suspicion and a comprehensive evaluation, including ECG, echocardiography, brain imaging, and cardiac monitoring. Atrial fibrillation is the most common cause of cardioembolic stroke, and anticoagulation is usually recommended. This article reviews risk stratification models to assist in the decision-making process and highlights the increased use of novel oral anticoagulants for stroke prevention in at...
Source: CONTINUUM: Lifelong Learning in Neurology - February 1, 2017 Category: Neurology Tags: Review Articles Source Type: research