Articles Tagged With: stroke
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CREST-2 Boosts Modern Medical Therapy for the Initial Treatment of Asymptomatic Carotid Stenosis
CREST-2 consisted of two parallel randomized trials in patients with ≥ 70% asymptomatic carotid stenosis, showing that intensive medical therapy alone produced very low stroke rates, with no significant additional benefit from carotid endarterectomy and a modest absolute risk reduction with carefully performed transfemoral carotid stenting over four years. These findings support intensive risk factor control as the default strategy and suggest reserving revascularization for highly selected patients at experienced centers.
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Detection of Atrial Fibrillation in Cryptogenic Stroke
The ANTARCTICA study is a pooled meta-analysis from multiple prospective studies of patients with ischemic stroke of varying etiologies, where loop monitoring was performed for atrial fibrillation detection. The groups were divided into cryptogenic stroke/transient ischemic attack or non-cryptogenic stroke/non-stroke. Both groups demonstrated an unadjusted rate of atrial fibrillation of about 30%.
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Detection of Atrial Fibrillation in Cryptogenic Stroke
The ANTARCTICA study is a pooled meta-analysis from multiple prospective studies of patients with ischemic stroke of varying etiologies, where loop monitoring was performed for atrial fibrillation detection. The groups were divided into cryptogenic stroke/transient ischemic attack or non-cryptogenic stroke/non-stroke. Both groups demonstrated an unadjusted rate of atrial fibrillation of about 30%.
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The Walk ’n Watch Trial: Stroke Recovery Through High-Intensity Walking
An intensive real-life walking protocol, started as soon as possible after acute stroke, resulted in improved overall walking endurance, mobility, balance, and quality of life
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The Walk ’n Watch Trial: Stroke Recovery Through High-Intensity Walking
An intensive real-life walking protocol, started as soon as possible after acute stroke, resulted in improved overall walking endurance, mobility, balance, and quality of life.
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Treatment Window for Lowering Blood Pressure in Acute ICH
Effective treatment for acute intracerebral hemorrhage (ICH) has remained elusive, with inconclusive results from surgical evacuations, as well as blood pressure management. The investigators performed a pooled analysis of four INTERACT trials that studied the effect of aggressive blood pressure lowering in patients with acute ICH. Ultra-early treatment (< 3 hours from onset) may be beneficial, but most patients are not so quickly diagnosed or treated.
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Use of IV Tenecteplase Prior to Thrombectomy in Stroke
In patients with acute ischemic stroke arriving at a thrombectomy-ready hospital within 4.5 hours of stroke onset, the combination of treatment with intravenous tenecteplase followed by mechanical thrombectomy resulted in superior outcomes compared to thrombectomy alone.
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Is Sex Still an Important Variable in Stroke Risk with Atrial Fibrillation?
An analysis of a very large database of patients with recent-onset atrial fibrillation has shown that whether sex was included in the formulas to predict thromboembolic risk and guide the use of oral anticoagulants probably is not as important as it was decades ago.
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Stroke Risk in Patients with New AFib During Unrelated Hospitalization
In a Canadian administrative database study of patients who developed atrial fibrillation during a hospitalization for other reasons, researchers followed the patients for one year to ascertain the risk of subsequent stroke. The incidence of stroke in those not anticoagulated generally was below the 2% per year threshold recommended for treatment with anticoagulants. However, in those with a CHA2DS2-VA score ≥ 5 (sex not included based on new data) and in those admitted for cardiac medical problems, the 95% confidence intervals of stroke risk did cross 2%. Thus, selected patients may be candidates for anticoagulation.
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Quantitative Pupillometry in Patients with Large Middle Cerebral Artery Strokes
Secondary neurologic decline after large middle cerebral artery (MCA) stroke is common and is associated with worse outcomes. This study aimed to evaluate the utility of quantitative pupillometry to predict neurologic decline before it occurs. Although no model was found to predict decline, stable Neurological Pupil index (NPi) and dilation velocities may provide some reassurance that an imminent decline is unlikely.