Wiley: JUL 23, 2013 Only about 50% of people who have a stroke survive to five-years. Clinicians should identify those most at risk of dying, and gradually integrate palliative care. Such holistic and anticipatory care will be of benefit to patients and their family carers; should reduce futile treatments, medications, or unsuccessful resuscitation attempts; and help […]
Neurology: 7/12/13 Objective: We explored the relationship between the site of vascular occlusion and the response to endovascular treatment in patients with acute ischemic stroke and also considered the impact of mismatch profile. Methods: DEFUSE-2 was a prospective cohort study of patients treated with endovascular therapy. Patients with internal carotid artery (ICA) and middle cerebral artery (MCA) involvement […]
JAMA Neurol: 7/1/13 In 1996, the US Food and Drug Administration approved the use of intravenous recombinant tissue plasminogen activator (rtPA) for the treatment of carefully selected patients with acute ischemic stroke who could receive the medication within 3 hours of onset of symptoms. Since that time, the maximum time window for treatment has been expanded […]
JAMA Neurol: 7/1/13 Importance Pooled analysis of randomized controlled trials of intravenous thrombolysis shows no statistically significant benefit beyond 4.5 hours, with the possible advantage perhaps offset by risk. Objective To compare the outcomes of patients who were treated within 4.5 to 6 hours or within 3 to 4.5 hours of the onset of an ischemic […]
STROKEAHA: July 9, 2013 Background and Purpose—Through 2-way live video and audio communication, telestroke enhances urgent treatment of patients with acute stroke in emergency departments (EDs) without immediate access to on-site specialists. To assess for opportunities to shorten the door to thrombolysis time, we measured multiple time intervals in a telestroke system. Methods—We retrospectively analyzed 115 […]
Neurology: June 5, 2013 Objective: We tested the hypothesis that surveillance neuroimaging and neurologic examinations identified changes requiring emergent surgical interventions in patients with intracerebral hemorrhage (ICH). Methods: Patients with primary ICH were enrolled into a prospective registry between December 2006 and July 2012. Patients were managed in a neuroscience intensive care unit with a protocol that included […]
J NeuroIntervent Surg: 7/4/13 Background Benchmarking of complications is necessary in the context of the developing path to accountable care. We attempted to create a predictive model of negative outcomes in patients undergoing cerebral aneurysm coiling (CACo). Methods We performed a retrospective cohort study involving patients who underwent CACo from 2005 to 2009 and who were registered in […]
Neurology: June 28, 2013 New prospects for treatment and clinical research Brain cells die rapidly after stroke and any effective treatment must start as early as possible. In clinical routine, the tight time–outcome relationship continues to be the major limitation of therapeutic approaches: thrombolysis rates remain low across many countries, with most patients being treated at […]
STROKEAHA: June 27, 2013 Background and Purpose—Subarachnoid hemorrhage (SAH) accounts for <7% of all strokes, but is an enormous individual and societal burden. We investigated the risk of SAH associated with prior use of antithrombotic drugs and their influence on 30-day case fatality. Methods—We conducted a nested case–control study in a cohort of 13.4 million members […]
AHA: 7/1/13 In a recent systematic review and meta-analysis, the overall prevalence of unruptured intracranial aneurysms (IAs) is estimated as 3.2%.1 The prevalence of IAs is higher in patients with autosomal dominant polycystic kidney disease or a positive family history of IAs of subarachnoid hemorrhage (SAH).1 From the same review, the size of unruptured IAs is <5 […]
