Scholars@Duke
Brian C. Mac Grory

Brian C. Mac Grory

Associate Professor of Neurology
Neurology, Stroke and Vascular Neurology
brian.macgrory@duke.edu
40 Duke Medicine Circle, Durham, NC 27708
Office hours 9AM-6PM Monday-Friday  

Selected Publications

Door-In-Door-Out Times at Referring Hospitals and Outcomes of Hemorrhagic Stroke.

Journal Article Ann Emerg Med · February 2025 STUDY OBJECTIVE: Interhospital transfer is often required in the care of patients with hemorrhagic stroke. Guidelines recommend a door-in-door-out (DIDO) time of ≤120 minutes at the transferring emergency department (ED); however, it is unknown whether DID ... Full text Link to item Cite

Random Survival Forest Machine Learning for the Prediction of Cardiovascular Events Among Patients With a Measured Lipoprotein(a) Level: A Model Development Study.

Journal Article Circ Genom Precis Med · February 2025 BACKGROUND: Established risk models may not be applicable to patients at higher cardiovascular risk with a measured Lp(a) (lipoprotein[a]) level, a causal risk factor for atherosclerotic cardiovascular disease. METHODS: This was a model development study. ... Full text Link to item Cite

Research Best Practices for Eye Stroke Vision Rehabilitation: A Qualitative Study.

Journal Article Curr Eye Res · January 28, 2025 PURPOSE: Central retinal artery occlusion, also known as an eye stroke, results in visual impairment and functional challenges. Our study objectives were to identify meaningful measures and factors that indicate or enable successful recovery after eye stro ... Full text Link to item Cite

Atrial Fibrillation and Retinal Stroke.

Journal Article JAMA Netw Open · January 2, 2025 IMPORTANCE: Atrial fibrillation (AF) is the most common, chronic, cardiac arrythmia in older US adults. It is not known whether AF is independently associated with increased risk of retinal stroke (central retinal artery occlusion), a subtype of ischemic s ... Full text Link to item Cite

Emergent Carotid Stenting During Thrombectomy in Tandem Occlusions Secondary to Dissection: A STOP-CAD Secondary Study.

Journal Article Stroke · January 2025 Background: The optimal endovascular management of cervical carotid dissection causing tandem occlusion remains uncertain. We investigated the impact of emergent carotid stenting during endovascular treatment (EVT) for acute ischemic stroke (AIS) in ... Full text Cite

Mobile Stroke Unit Management in Patients With Acute Ischemic Stroke Eligible for Intravenous Thrombolysis.

Journal Article JAMA Neurol · December 1, 2024 IMPORTANCE: Clinical trials have suggested that prehospital management in a mobile stroke unit (MSU) improves functional outcomes in patients with acute ischemic stroke who are potentially eligible for intravenous thrombolysis, but there is a paucity of re ... Full text Link to item Cite

Migraine May Represent an Independent Risk Factor for Retinal Stroke: A Population-Based Cohort Study.

Journal Article Clin Neurol Neurosurg · November 2024 INTRODUCTION: Migraine is an established risk factor for cerebral ischemic stroke, with an especially robust association in patients with migraine with aura. However, it is not known if migraine is a risk factor for retinal stroke (central or branch retina ... Full text Link to item Cite

Intravenous Thrombolysis in Patients With Cervical Artery Dissection: A Secondary Analysis of the STOP-CAD Study.

Journal Article Neurology · October 8, 2024 OBJECTIVES: Cervical artery dissection (CeAD) accounts for 25% of ischemic strokes in young adults. This study evaluated the benefits and harms of intravenous thrombolysis (IVT) in patients presenting with spontaneous CeAD and acute ischemic stroke symptom ... Full text Link to item Cite

Early REperfusion therapy with intravenous alteplase for recovery of VISION in acute central retinal artery occlusion (REVISION): Study protocol of a phase III trial.

Journal Article Int J Stroke · August 2024 RATIONALE: Meta-analyses of case series of non-arteritic central retinal artery occlusion (CRAO) indicate beneficial effects of intravenous thrombolysis when initiated early after symptom onset. Randomized data are lacking to address this question. AIMS: T ... Full text Link to item Cite

Prediction of Large Vessel Occlusion Stroke Using Clinical Registries for Research.

Journal Article Neurology · June 11, 2024 OBJECTIVES: A reliable method of predicting large vessel occlusion (LVO) stroke in data sets without neuroimaging could be retrospectively applied to expand research efforts. METHODS: We conducted a retrospective, cross-sectional cohort analysis of the Get ... Full text Link to item Cite

Antithrombotic Treatment for Stroke Prevention in Cervical Artery Dissection: The STOP-CAD Study.

Journal Article Stroke · April 2024 BACKGROUND: Small, randomized trials of patients with cervical artery dissection showed conflicting results regarding optimal stroke prevention strategies. We aimed to compare outcomes in patients with cervical artery dissection treated with antiplatelets ... Full text Link to item Cite

Management of Incomplete Microcirculatory Reperfusion After Endovascular Thrombectomy: Focus on Inhibition of the Glycoprotein IIb/IIIa Receptor Pathway

Journal Article Stroke: Vascular and Interventional Neurology · March 2024 Endovascular thrombectomy (EVT) is one of the most effective therapies for acute ischemic stroke attributable to large‐vessel occlusion but, despite successful treatment, there remains a significant number of patients with disability. ... Full text Cite

Time to Anticoagulation Reversal and Outcomes After Intracerebral Hemorrhage.

Journal Article JAMA Neurol · February 9, 2024 IMPORTANCE: Intracerebral hemorrhage (ICH) is the deadliest stroke subtype, and mortality rates are especially high in anticoagulation-associated ICH. Recently, specific anticoagulation reversal strategies have been developed, but it is not clear whether t ... Full text Open Access Link to item Cite

COVID-19 Infection Is Associated With Poor Outcomes in Patients With Intracerebral Hemorrhage.

Journal Article J Am Heart Assoc · February 6, 2024 BACKGROUND: Patients with ischemic stroke and concomitant COVID-19 infection have worse outcomes than those without this infection, but the impact of COVID-19 on hemorrhagic stroke remains unclear. We aimed to assess if COVID-19 worsens outcomes in intrace ... Full text Link to item Cite

Trends in Stroke Thrombolysis Care Metrics and Outcomes by Race and Ethnicity, 2003-2021.

Journal Article JAMA Netw Open · February 5, 2024 IMPORTANCE: Understanding is needed of racial and ethnic-specific trends in care quality and outcomes associated with the US nationwide quality initiative Target: Stroke (TS) in targeting thrombolysis treatment for acute ischemic stroke. OBJECTIVE: To exam ... Full text Open Access Link to item Cite

Penumbral Rescue by normobaric O = O administration in patients with ischemic stroke and target mismatch proFile (PROOF): Study protocol of a phase IIb trial.

Journal Article Int J Stroke · January 2024 RATIONALE: Oxygen is essential for cellular energy metabolism. Neurons are particularly vulnerable to hypoxia. Increasing oxygen supply shortly after stroke onset could preserve the ischemic penumbra until revascularization occurs. AIMS: PROOF investigates ... Full text Link to item Cite

National- and State-Level Trends in Medicare Hospice Beneficiaries for Stroke During 2013 to 2019 in the United States.

Journal Article Stroke · January 2024 BACKGROUND: Stroke is the fifth leading cause of death in the United States, one of the leading contributors to Medicare cost, including through Medicare hospice benefits, and the rate of stroke mortality has been increasing since 2013. We hypothesized tha ... Full text Link to item Cite

Performance of Thrombectomy-Capable, Comprehensive, and Primary Stroke Centers in Reperfusion Therapies for Acute Ischemic Stroke: Report From the Get With The Guidelines-Stroke Registry.

Journal Article Circulation · December 19, 2023 BACKGROUND: The thrombectomy-capable stroke center (TSC) is a recently introduced intermediate tier of accreditation for hospitals at which patients with acute ischemic stroke receive care. The comparative quality and clinical outcomes of reperfusion thera ... Full text Link to item Cite

Higher Procedural Volumes Are Associated with Faster Treatment Times, Better Functional Outcomes, and Lower Mortality in Patients Undergoing Endovascular Treatment for Acute Ischemic Stroke.

Journal Article Ann Neurol · September 20, 2023 OBJECTIVE: We aimed to characterize the association of hospital procedural volumes with outcomes among acute ischemic stroke (AIS) patients undergoing endovascular therapy (EVT). METHODS: This was a retrospective, observational cohort study using data pros ... Full text Link to item Cite

Risk of recurrent stroke in patients with atrial fibrillation treated with oral anticoagulants alone or in combination with anti-platelet therapy.

Journal Article Eur Stroke J · September 2023 INTRODUCTION: Ischaemic stroke patients with atrial fibrillation (AF) are at high risk of stroke recurrence despite oral anticoagulation therapy. Patients with cardiovascular comorbidities may take both antiplatelet and oral anticoagulation therapy (OAC/AP ... Full text Link to item Cite

Shorter Door-to-Needle Times Are Associated With Better Outcomes After Intravenous Thrombolytic Therapy and Endovascular Thrombectomy for Acute Ischemic Stroke.

Journal Article Circulation · July 4, 2023 BACKGROUND: Existing data and clinical trials could not determine whether faster intravenous thrombolytic therapy (IVT) translates into better long-term functional outcomes after acute ischemic stroke among those treated with endovascular thrombectomy (EVT ... Full text Open Access Link to item Cite

Recent Vitamin K Antagonist Use and Intracranial Hemorrhage After Endovascular Thrombectomy for Acute Ischemic Stroke.

Journal Article JAMA · June 20, 2023 IMPORTANCE: Use of oral vitamin K antagonists (VKAs) may place patients undergoing endovascular thrombectomy (EVT) for acute ischemic stroke caused by large vessel occlusion at increased risk of complications. OBJECTIVE: To determine the association betwee ... Full text Link to item Cite

Intra-arterial Thrombolysis for Acute Retinal Ischemia: A Retrospective, Observational, Cohort Study.

Journal Article J Neuroophthalmol · June 1, 2023 BACKGROUND: To determine whether intra-arterial thrombolysis (IAT) within 16 hours after the onset of symptoms is feasible and associated with better visual outcomes in patients with acute retinal ischemia (ARI). METHODS: The retrospective cohort study was ... Full text Link to item Cite

Complications of Intravenous Tenecteplase Versus Alteplase for the Treatment of Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.

Journal Article Stroke · May 2023 BACKGROUND: Prior systematic reviews have compared the efficacy of intravenous tenecteplase and alteplase in acute ischemic stroke, assigning their relative complications as a secondary objective. The objective of the present study is to determine whether ... Full text Link to item Cite

Borderzone Infarcts and Recurrent Cerebrovascular Events in Symptomatic Intracranial Arterial Stenosis: A Systematic Review and Meta-Analysis.

Journal Article J Stroke · May 2023 BACKGROUND AND PURPOSE: Intracranial arterial stenosis (ICAS)-related stroke occurs due to three primary mechanisms with distinct infarct patterns: (1) borderzone infarcts (BZI) due to impaired distal perfusion, (2) territorial infarcts due to distal plaqu ... Full text Link to item Cite

Association Between Hospital-Documented Atrial Fibrillation and Central Retinal Artery Occlusion.

Journal Article Stroke · April 2023 BACKGROUND: Carotid stenosis is thought to be the primary risk factor for central retinal artery occlusion (CRAO); however, it is not known whether atrial fibrillation (AF)-a cardiac arrhythmia that underlies over 25% of cerebral ischemic strokes-predispos ... Full text Link to item Cite

Subsequent ischemic stroke and tobacco smoking: A secondary analysis of the POINT trial.

Journal Article Eur Stroke J · March 2023 BACKGROUND: The aim of this study was to determine the effect of smoking status on subsequent stroke risk in patients with minor ischemic stroke or TIA and to determine whether smoking modifies the effect of clopidogrel-based DAPT on subsequent stroke risk ... Full text Link to item Cite

Abstract 30: Association Between Hospital-ascertained Atrial Fibrillation And Central Retinal Artery Occlusion: A Study Of 12 Million Patients

Conference Stroke · February 2023 Introduction: Atrial fibrillation (AF) is a major risk factor for cerebral ischemic stroke. However, it is not known whether AF predicts the development of central retinal artery occlusion (CRAO), a f ... Full text Cite

Abstract WP158: Impact Of Atrial Fibrillation On Clinical Outcomes After Endovascular Thrombectomy: A Post-Hoc Analysis Of The Defuse-3 Trial

Conference Stroke · February 2023 Introduction: Previous studies have failed to show an interaction between known atrial fibrillation (AF) and treatment effect of endovascular thrombectomy (EVT) performed within 6 hours of time last k ... Full text Cite

Abstract TP116: Procoagulant Reversal Of Warfarin After Intracranial Hemorrhage Is Not Associated With Improved Functional Outcome When Coagulation Is Abnormal Without Full Anticoagulation

Conference Stroke · February 2023 Introduction: Although the current guidelines recommend procoagulant reversal of elevated INR >= 2.0 (International Normalized Ratio) in patients with intracranial hemorrhage using warfarin, the be ... Full text Cite

Abstract 67: Endovascular Thrombectomy In Patients With Acute Ischemic Stroke And Recent Use Of Oral Vitamin K-Antagonists: The Get With The Guidelines-Stroke Program

Conference Stroke · February 2023 Introduction: Emergent endovascular thrombectomy (EVT) is effective in improving outcomes in patients with stroke caused by large vessel occlusion. However, there are limited data on the use of EVT in ... Full text Cite

Abstract 78: Neighborhood Socioeconomic Deprivation Is Associated With Increased 30-day Mortality After Stroke: Results From A Nationwide Study Of 755,899 Medicare Patients

Conference Stroke · February 2023 Introduction: The relationship between neighborhood socioeconomic deprivation- a reflection of the general economic and environmental conditions of a neighborhood- and outcomes after stroke is not kno ... Full text Cite

Abstract 25: Safety And Outcomes Of Endovascular Thrombectomy In Acute Ischemic Stroke Patients With Recent Use Of Non-vitamin K Antagonist Oral Anticoagulants

Conference Stroke · February 2023 Introduction: An increasing number of patients with acute ischemic stroke (AIS) have recently used non-vitamin K antagonist oral anticoagulants (NOACs). However, there are limited data on safety of en ... Full text Cite

Atrial fibrillation as a novel risk factor for retinal stroke: A protocol for a population-based retrospective cohort study.

Journal Article PLoS One · 2023 Central retinal artery occlusion (CRAO; retinal stroke or eye stroke) is an under-recognized, disabling form of acute ischemic stroke which causes severe visual loss in one eye. The classical risk factor for CRAO is ipsilateral carotid stenosis; however, n ... Full text Link to item Cite

Predictors of Recurrent Venous Thrombosis After Cerebral Venous Thrombosis: Analysis of the ACTION-CVT Study.

Journal Article Neurology · November 22, 2022 BACKGROUND AND OBJECTIVE: Cerebral venous thrombosis (CVT) is a rare cause of stroke carrying a nearly 4% risk of recurrence after 1 year. There are limited data on predictors of recurrent venous thrombosis in patients with CVT. In this study, we aim to id ... Full text Link to item Cite

Sex Differences in Endovascular Therapy for Ischemic Stroke: Results From the Get With The Guidelines-Stroke Registry.

Journal Article Stroke · October 2022 BACKGROUND: In 2015, endovascular therapy (EVT) for large vessel occlusions became standard of care for acute ischemic stroke. Lower utilization of IV alteplase has been reported in women, but whether sex differences in EVT use in the United States exists ... Full text Link to item Cite

Direct Oral Anticoagulants Versus Vitamin K Antagonists in Cerebral Venous Thrombosis: A Systematic Review and Meta-Analysis.

Journal Article Stroke · October 2022 BACKGROUND: High level evidence for direct oral anticoagulants (DOACs) in patients with cerebral venous thrombosis is lacking. We performed a systematic review and meta-analysis to assess the efficacy and safety of DOACs versus vitamin K antagonists in pat ... Full text Link to item Cite

Recurrent Ischemic Stroke and Bleeding in Patients With Atrial Fibrillation Who Suffered an Acute Stroke While on Treatment With Nonvitamin K Antagonist Oral Anticoagulants: The RENO-EXTEND Study.

Journal Article Stroke · August 2022 BACKGROUND: In patients with atrial fibrillation who suffered an ischemic stroke while on treatment with nonvitamin K antagonist oral anticoagulants, rates and determinants of recurrent ischemic events and major bleedings remain uncertain. METHODS: This pr ... Full text Link to item Cite

Outcomes After Endovascular Thrombectomy With or Without Alteplase in Routine Clinical Practice.

Journal Article JAMA Neurol · August 1, 2022 IMPORTANCE: The effectiveness and safety of intravenous alteplase given before or concurrently with endovascular thrombectomy (EVT) is uncertain. Randomized clinical trials suggest there is little difference in outcomes but with only modest precision and i ... Full text Open Access Link to item Cite

Analysis of Prescriptions for Dual Antiplatelet Therapy After Acute Ischemic Stroke.

Journal Article JAMA Netw Open · July 1, 2022 IMPORTANCE: After the publication of the CHANCE (Clopidogrel in High Risk Patients With Acute Nondisabling Cerebrovascular Events) and POINT (Platelet-Oriented Inhibition in New Transient Ischemic Attack and Minor Ischemic Stroke) clinical trials, the Amer ... Full text Link to item Cite

Risk Factors for Opioid Utilization in Patients with Intracerebral Hemorrhage.

Journal Article Neurocrit Care · June 2022 BACKGROUND: Headache is a common presenting symptom of intracerebral hemorrhage (ICH) and often necessitates treatment with opioid medications. However, opioid prescribing patterns in patients with ICH are not well described. We aimed to characterize the p ... Full text Link to item Cite

Acute Ischemic Stroke, Depressed Left Ventricular Ejection Fraction, and Sinus Rhythm: Prevalence and Practice Patterns.

Journal Article Stroke · June 2022 BACKGROUND: There are limited data about the epidemiology and secondary stroke prevention strategies used for patients with depressed left ventricular ejection fraction (LVEF) and sinus rhythm following an acute ischemic stroke (AIS). We sought to describe ... Full text Link to item Cite

Prolonged Cardiac Monitoring and Stroke Recurrence: A Meta-analysis.

Journal Article Neurology · May 10, 2022 BACKGROUND AND OBJECTIVES: Prolonged poststroke cardiac rhythm monitoring (PCM) reveals a substantial proportion of patients with ischemic stroke (IS) with atrial fibrillation (AF) not detected by conventional rhythm monitoring strategies. We evaluated the ... Full text Link to item Cite

Functional status at 30 and 90 days after mild ischaemic stroke.

Journal Article Stroke Vasc Neurol · April 26, 2022 BACKGROUND/OBJECTIVE: This study compares the global disability status of patients who had a mild ischaemic stroke at 30 and 90 days poststroke, as measured by the modified Rankin Scale (mRS), and identifies predictors of change in disability status betwee ... Full text Open Access Link to item Cite

Advances in Recurrent Stroke Prevention: Focus on Antithrombotic Therapies.

Journal Article Circ Res · April 15, 2022 The past decade has seen significant advances in stroke prevention. These advances include new antithrombotic agents, new options for dyslipidemia treatment, and novel techniques for surgical stroke prevention. In addition, there is greater recognition of ... Full text Link to item Cite

Moyamoya syndrome in a young person with Down syndrome: diagnostic and therapeutic considerations.

Journal Article BMJ Case Rep · March 4, 2022 An 18-year-old woman with a history of Down syndrome (DS) presented with left upper extremity weakness. Neurological examination revealed moderate hypotonia throughout, with mild spasticity of the left ankle. She had 2/5 left upper and lower extremity stre ... Full text Link to item Cite

Infarct on Brain Imaging, Subsequent Ischemic Stroke, and Clopidogrel-Aspirin Efficacy: A Post Hoc Analysis of a Randomized Clinical Trial.

Journal Article JAMA Neurol · March 1, 2022 IMPORTANCE: In the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) trial, acute treatment with clopidogrel-aspirin was associated with significantly reduced risk of recurrent stroke. There may be specific patient groups who are mo ... Full text Link to item Cite

Direct Oral Anticoagulants Versus Warfarin in the Treatment of Cerebral Venous Thrombosis (ACTION-CVT): A Multicenter International Study.

Journal Article Stroke · March 2022 BACKGROUND: A small randomized controlled trial suggested that dabigatran may be as effective as warfarin in the treatment of cerebral venous thrombosis (CVT). We aimed to compare direct oral anticoagulants (DOACs) to warfarin in a real-world CVT cohort. M ... Full text Link to item Cite

Advances in the management of cardioembolic stroke associated with patent foramen ovale.

Journal Article BMJ · February 9, 2022 Patent foramen ovale (PFO) describes a valve in the interatrial septum that permits shunting of blood or thrombotic material between the atria. PFOs are present in approximately 25% of the healthy population and are not associated with any pathology in the ... Full text Link to item Cite

Frequency and Prognostic Significance of Clinical Fluctuations Before Hospital Arrival in Stroke.

Journal Article Stroke · February 2022 BACKGROUND AND PURPOSE: Clinical fluctuations in ischemic stroke symptoms are common, but fluctuations before hospital arrival have not been previously characterized. METHODS: A standardized qualitative assessment of fluctuations before hospital arrival wa ... Full text Link to item Cite

Central Retinal Artery Visualization with Cone-Beam CT Angiography.

Journal Article Radiology · February 2022 Background There are multiple tools available to visualize the retinal and choroidal vasculature of the posterior globe. However, there are currently no reliable in vivo imaging techniques that can visualize the entire retrobulbar course of the retinal and ... Full text Link to item Cite

Hyperglycemia, Risk of Subsequent Stroke, and Efficacy of Dual Antiplatelet Therapy: A Post Hoc Analysis of the POINT Trial.

Journal Article J Am Heart Assoc · February 2022 Background One-quarter of all strokes are subsequent events. It is not known whether higher levels of blood glucose are associated with an increased risk of subsequent stroke after high-risk transient ischemic attack or minor ischemic stroke. Methods and R ... Full text Link to item Cite

Abstract TP96: Mild Luminal Stenosis Of Parent Artery And Neurologic Deterioration After Acute Lacunar Stroke

Conference Stroke · February 2022 Introduction: Neurologic deterioration (ND) occurs in a quarter of acute lacunar infarcts and may lead to severe disability, but underlying pathophysiology of ND remains poorly understood. We sought t ... Full text Cite

Abstract 116: Unmet Need In Acute Ischemic Stroke Patients Not Treated With Alteplase

Conference Stroke · February 2022 Introduction: Early administration of intravenous tissue plasminogen activator (IV alteplase) improves functional outcomes in patients with acute ischemic stroke (AIS), yet many patients are not treat ... Full text Cite

Abstract 35: Unmet Need In Acute Ischemic Stroke Patients Arriving After 4.5 Hours

Conference Stroke · February 2022 Introduction: Many patients arrive beyond the guideline-recommended time window for treatment with IV alteplase. For most of these patients, few treatment options exist. There is a need to understand ... Full text Cite

Abstract TMP77: Borderzone Infarction Predicts Recurrence In Patients With Intracranial Atherosclerosis: A Meta-analysis

Conference Stroke · February 2022 Background: Patients with symptomatic intracranial stenosis (ICAS) face elevated risks of recurrent cerebrovascular events (RCE) despite optimal medical therapy. Borderzone infarcts (BZI) indirectly c ... Full text Cite

Abstract 159: Recurrent Ischemic Stroke And Cigarette Smoking: A Secondary Analysis Of The POINT Trial

Conference Stroke · February 2022 Background: Recent data suggest that in patients with acute myocardial infarction (MI), the effect of clopidogrel on risk reduction of cardiovascular outcomes is more pronounced in smokers. The aim of ... Full text Cite

Abstract TMP74: Direct Oral Anticoagulants Vs. Vitamin K Antagonists In Patients With Cerebral Venous Thrombosis: A Systematic Review And Meta-analysis

Conference Stroke · February 2022 Introduction: Direct oral anticoagulants (DOACs) have emerged as a potential anticoagulant therapy for patients with cerebral venous thrombosis (CVT). We conducted a systematic review and meta-analysi ... Full text Cite

Abstract TP227: High Disability Rates In Young Patients With PFO Attributable Cryptogenic Ischemic Strokes

Conference Stroke · February 2022 Introduction: Approximately 30% of ischemic strokes are cryptogenic and 40-50% of these patients have a patent foramen ovale (PFO) detected during work up. While the risk of ischemic stroke attributed ... Full text Cite

Abstract 155: Hyperglycemia And Hypertension Predict Subsequent Ischemic Stroke In Patients With Minor Stroke Or TIA Treated With Dual Antiplatelet Therapy: A Post-hoc Analysis Of The POINT Trial

Conference Stroke · February 2022 Background: Randomized trials have shown that dual antiplatelet therapy (DAPT) reduces the risk of subsequent ischemic stroke in patients with minor stroke or high-risk TIA (MS-TIA). However, the 90 d ... Full text Cite

Exploring the Unmet Need in Acute Ischemic Stroke Patients Not Treated With Intravenous Alteplase: The Get With The Guidelines‐Stroke Registry

Journal Article Stroke: Vascular and Interventional Neurology · January 2022 BackgroundEarly administration of intravenous tissue plasminogen activator (IV alteplase) improves functional outcomes in patients with acute ischemic stroke, ... Full text Open Access Cite

Antiplatelet Use and Ischemic Stroke Risk in Minor Stroke or Transient Ischemic Attack: A Post Hoc Analysis of the POINT Trial.

Journal Article Stroke · December 2021 BACKGROUND AND PURPOSE: Dual antiplatelet therapy has been shown to reduce the risk of recurrent stroke in patients with minor stroke or transient ischemic attack. However, whether the effect of dual antiplatelet therapy is modified by pretreatment antipla ... Full text Link to item Cite

Psychiatric sequelae of stroke affecting the non-dominant cerebral hemisphere.

Journal Article J Neurol Sci · November 15, 2021 There are a plethora of cognitive sequelae in addition to neglect and extinction that arise with unilateral right hemispheric stroke (RHS). Cognitive deficits following non-dominant (right) hemisphere stroke are common with unilateral neglect and extinctio ... Full text Link to item Cite

Stroke Prevention in Patients with Patent Foramen Ovale.

Journal Article Curr Cardiol Rep · October 30, 2021 PURPOSE OF REVIEW: Patent foramen ovale (PFO) is widely prevalent and studies have suggested an association with ischemic stroke. In this review, we aim to highlight current management of patients with ischemic stroke in the setting of PFO and discuss some ... Full text Link to item Cite

Ischaemic stroke on anticoagulation therapy and early recurrence in acute cardioembolic stroke: the IAC study.

Journal Article J Neurol Neurosurg Psychiatry · October 2021 BACKGROUND AND PURPOSE: A subset of ischaemic stroke patients with atrial fibrillation (AF) have ischaemic stroke despite anticoagulation. We sought to determine the association between prestroke anticoagulant therapy and recurrent ischaemic events and sym ... Full text Link to item Cite

Effect of Alteplase Use on Outcomes in Patients With Atrial Fibrillation: Analysis of the Initiation of Anticoagulation After Cardioembolic Stroke Study.

Journal Article J Am Heart Assoc · August 3, 2021 Background Intravenous alteplase improves outcome after acute ischemic stroke without a benefit in 90-day mortality. There are limited data on whether alteplase is associated with reduced mortality in patients with atrial fibrillation (AF)-related ischemic ... Full text Link to item Cite

Detection of Atrial Fibrillation After Central Retinal Artery Occlusion.

Journal Article Stroke · August 2021 BACKGROUND: Central retinal artery occlusion (CRAO) causes sudden, irreversible blindness and is a form of acute ischemic stroke. In this study, we sought to determine the proportion of patients in whom atrial fibrillation (AF) is detected by extended card ... Full text Open Access Link to item Cite

Penumbra Consumption Rates Based on Time-to-Maximum Delay and Reperfusion Status: A Post Hoc Analysis of the DEFUSE 3 Trial.

Journal Article Stroke · August 2021 BACKGROUND AND PURPOSE: In patients with acute large vessel occlusion, the natural history of penumbral tissue based on perfusion time-to-maximum (Tmax) delay is not well established in relation to late-window endovascular thrombectomy. In this study, we s ... Full text Link to item Cite

Short- and long-term opioid use in survivors of subarachnoid hemorrhage.

Journal Article Clin Neurol Neurosurg · August 2021 OBJECTIVES: Opioids are frequently used for analgesia in patients with acute subarachnoid hemorrhage (SAH) due to a high prevalence of headache and neck pain. However, it is unclear if this practice may pose a risk for opioid dependence, as long-term opioi ... Full text Link to item Cite

Carotid Stenosis and Recurrent Ischemic Stroke: A Post-Hoc Analysis of the POINT Trial.

Journal Article Stroke · July 2021 BACKGROUND AND PURPOSE: Randomized trials demonstrated the benefit of dual antiplatelet therapy in patients with minor ischemic stroke or high-risk transient ischemic attack. We sought to determine whether the presence of carotid stenosis was associated wi ... Full text Link to item Cite

Structural and Functional Imaging of the Retina in Central Retinal Artery Occlusion - Current Approaches and Future Directions.

Journal Article J Stroke Cerebrovasc Dis · July 2021 Central retinal artery occlusion (CRAO) is a form of acute ischemic stroke which affects the retina. Intravenous thrombolysis is emerging as a compelling therapeutic approach. However, it is not known which patients may benefit from this therapy because th ... Full text Link to item Cite

Endarterectomy for symptomatic internal carotid artery web.

Journal Article J Neurosurg · July 1, 2021 OBJECTIVE: The carotid web (CW) is an underrecognized source of cryptogenic, embolic stroke in patients younger than 55 years of age, with up to 37% of these patients found to have CW on angiography. Currently, there are little data detailing the best trea ... Full text Link to item Cite

Thrombolytic therapy for wake-up stroke: A systematic review and meta-analysis.

Journal Article Eur J Neurol · June 2021 BACKGROUND AND PURPOSE: According to evidence-based clinical practice guidelines, patients presenting with disabling stroke symptoms should be treated with intravenous tissue plasminogen activator (IV tPA) within 4.5 h of time last known well. However, 25% ... Full text Link to item Cite

Predictors of Outcomes in Patients With Mild Ischemic Stroke Symptoms: MaRISS.

Journal Article Stroke · June 2021 BACKGROUND AND PURPOSE: Although most strokes present with mild symptoms, these have been poorly represented in clinical trials. The objective of this study is to describe multidimensional outcomes, identify predictors of worse outcomes, and explore the ef ... Full text Link to item Cite

How I do it: endarterectomy for carotid web.

Journal Article Acta Neurochir (Wien) · June 2021 BACKGROUND: The carotid web is an important and under recognized etiology for recurrent cryptogenic strokes. A management option for a symptomatic carotid web is a carotid endarterectomy (CEA) with surgical microdissection and removal of the intimal lumina ... Full text Link to item Cite

Management of Central Retinal Artery Occlusion: A Scientific Statement From the American Heart Association.

Journal Article Stroke · June 2021 PURPOSE: Central retinal artery occlusion (CRAO) is a form of acute ischemic stroke that causes severe visual loss and is a harbinger of further cerebrovascular and cardiovascular events. There is a paucity of scientific information on the appropriate mana ... Full text Link to item Cite

Anticoagulation use and Hemorrhagic Stroke in SARS-CoV-2 Patients Treated at a New York Healthcare System.

Journal Article Neurocrit Care · June 2021 BACKGROUND AND PURPOSE: While the thrombotic complications of COVID-19 have been well described, there are limited data on clinically significant bleeding complications including hemorrhagic stroke. The clinical characteristics, underlying stroke mechanism ... Full text Link to item Cite

Lacunar stroke: mechanisms and therapeutic implications.

Journal Article J Neurol Neurosurg Psychiatry · May 26, 2021 Lacunar stroke is a marker of cerebral small vessel disease and accounts for up to 25% of ischaemic stroke. In this narrative review, we provide an overview of potential lacunar stroke mechanisms and discuss therapeutic implications based on the underlying ... Full text Link to item Cite

Left Atrial Appendage Closure for Patients with Cerebral Amyloid Angiopathy and Atrial Fibrillation: the LAA-CAA Cohort.

Journal Article Transl Stroke Res · April 2021 Anticoagulation increases the risk of intracerebral hemorrhage (ICH) in patients with cerebral amyloid angiopathy (CAA), so the management of stroke-risk in patients with both atrial fibrillation (AF) and CAA is controversial. Advances in left atrial appen ... Full text Link to item Cite

Abstract P180: Protocolized Selection for Telestroke Activation in The Extended Window for Thrombectomy

Conference Stroke · March 2021 Background: The advent of biomarker-driven identification of candidates for acute therapies in the 4.5-24-hour time window has resulted in an increase in the number of telestroke consults with low yie ... Full text Cite

Abstract P661: Atheromatous Disease of the Parent Artery is Common in Patients With Lacunar Infarcts

Conference Stroke · March 2021 Background: Perforator disease caused by parent artery atheromatous disease is one of the mechanisms implicated in the pathogenesis of lacunar infarcts, but there is limited data on its prevalence. We ... Full text Cite

Abstract P674: Markers of Atherosclerotic Disease but Not Small Vessel Disease Predict Neurologic Deterioration in Acute Lacunar Strokes

Conference Stroke · March 2021 Introduction: Neurologic deterioration (ND) occurs in a quarter of acute lacunar infarct patients and may lead to severe disability. The underlying pathophysiology of ND in these patients is not clear ... Full text Cite

Abstract P592: Admission Hyperglycemia is Associated With Subsequent Ischemic Stroke After Transient Ischemic Attack or Minor Stroke: A Secondary Analysis of the POINT Trial

Conference Stroke · March 2021 Introduction: Hyperglycemia is associated with increased lesion volume and worse functional outcome after acute ischemic stroke, however, it is not known whether it is associated with further cerebrov ... Full text Cite

Abstract P254: Decompressive Hemicraniectomy and Functional Outcomes After Malignant Cerebral Infarction: Real World Experience From a Comprehensive Stroke Center

Conference Stroke · March 2021 Background: Decompressive hemicraniectomy (DHC), performed in select patients with malignant infarction (MCI), reduces mortality. However, there is conflicting evidence surrounding the use of DHC in i ... Full text Cite

Abstract MP46: Internal Carotid Artery Web and Acute Ischemic Stroke - A Systematic Review and Meta-Analysis

Conference Stroke · March 2021 Introduction: The carotid web is a compelling potential mechanism of embolic ischemic stroke. In this study, we perform a systematic review and meta-analysis to determine the prevalence of ipsilesiona ... Full text Cite

Abstract P387: Stroke Despite Anticoagulation Therapy Predicts Early Recurrence After Cardioembolic Stroke: The IAC-Study

Conference Stroke · March 2021 Background and purpose: A proportion of patients with ischemic stroke and atrial fibrillation (AF) have an ischemic stroke despite being prescribed anticoagulation therapy. In this study of patients w ... Full text Cite

Abstract P12: Alteplase Reduces Mortality in Patients With Ischemic Stroke and Atrial Fibrillation: Analysis of the IAC Study

Conference Stroke · March 2021 Background and Purpose: Multiple studies have established that intravenous thrombolysis with alteplase improves outcome after acute ischemic stroke. However, assessment of thrombolysis’ efficacy in st ... Full text Cite

Abstract P10: Posterior Circulation Strokes Are Less Likely to Receive Alteplase or Mechanical Thrombectomy: Analysis From the IAC Study

Conference Stroke · March 2021 Background: Emergent treatment with intravenous thrombolysis and mechanical thrombectomy improved outcomes in patients with acute ischemic stroke. We aim to identify differences in acute stroke treatm ... Full text Cite

Abstract P100: Hemorrhagic Stroke in the Setting of COVID-19 is Associated With Anticoagulation Use

Conference Stroke · March 2021 Introduction: While the thrombotic complications of COVID-19 have been described, there are limited data on its implications in hemorrhagic stroke. The clinical characteristics, underlying stroke mech ... Full text Cite

Abstract P677: Ischemic Stroke, Depressed Ejection Fraction, and Sinus Rhythm: Prevalence, Practice Patterns, and Outcomes

Conference Stroke · March 2021 Introduction: After WARCEF, there is limited data about the epidemiology and treatment strategies for patients after an acute ischemic stroke (AIS) with existing or new left ventricular cardiomyopathy ... Full text Cite

Abstract P649: Extracranial Hemorrhage in the Setting of Gastrointestinal Or Genitourinary Cancer is Associated With Increased Risk of Ischemic Stroke in Patients With Atrial Fibrillation

Conference Stroke · March 2021 Background and Purpose: Anticoagulation therapy reduces the risk for ischemic stroke in atrial fibrillation (AF) but also predisposes patients to hemorrhagic complications. Patients with GI or GU canc ... Full text Cite

Abstract 59: Presence of Infarct Predicts Recurrence and Efficacy of Dual Antiplatelet Therapy: A Post-Hoc Analysis of the POINT Trial

Conference Stroke · March 2021 Background: The combination of aspirin and clopidogrel for 90 days after minor stroke or transient ischemic attack (TIA) reduced the risk of recurrent stroke in the POINT trial. The risk reduction was ... Full text Cite

Abstract P27: Safety and Efficacy of Alteplase in Ischemic Stroke Patients > 80 Years of Age in the Extended Time Window

Conference Stroke · March 2021 Background: While patients > 80 years of age were originally excluded from the ECASS 3 trial showing benefit in the 3 – 4.5-hour window, recent studies have shown that intravenous alteplase is safe ... Full text Cite

Abstract P438: A Reassessment of Hemoglobin and Hematoma Expansion in Intracerebral Hemorrhage

Conference Stroke · March 2021 Background: Prior studies identified an increased risk of hematoma expansion (HE) in patients with spontaneous intracerebral hemorrhage (ICH) and lower admission hemoglobin (Hgb) levels. We aimed to e ... Full text Cite

Abstract 31: Penumbra Consumption Rates Based on T Max Delay and Reperfusion Status: A Post-Hoc Analysis of the Defuse-3 Trial

Conference Stroke · March 2021 Introduction: In patients with acute large vessel occlusion, the definition of penumbral tissue based on T max delay perfusion imaging is not well established in relation to late-window endovascular t ... Full text Cite

The Effect of Hyperglycemia on Infarct Growth after Reperfusion: An Analysis of the DEFUSE 3 trial.

Journal Article J Stroke Cerebrovasc Dis · January 2021 BACKGROUND AND PURPOSE: Brain infarct growth, despite successful reperfusion, decreases the likelihood of good functional outcome after ischemic stroke. In patients undergoing reperfusion, admission glucose is associated with poor outcome but the effect of ... Full text Link to item Cite

Effect of Low Intensity Transcranial Ultrasound Stimulation on Neuromodulation in Animals and Humans: An Updated Systematic Review.

Journal Article Front Neurosci · 2021 Background: Although low-intensity transcranial ultrasound stimulation (LI-TUS) has received more recognition for its neuromodulation potential, there remains a crucial knowledge gap regarding the neuromodulatory effects of LI-TUS and its potential for tra ... Full text Link to item Cite

Ipsilateral internal carotid artery web and acute ischemic stroke: A cohort study, systematic review and meta-analysis.

Journal Article PLoS One · 2021 INTRODUCTION: The carotid web is a compelling potential mechanism of embolic ischemic stroke. In this study, we aim to determine the prevalence of ipsilateral carotid web in a cohort of ischemic stroke patients and to perform a systematic review and meta-a ... Full text Link to item Cite

Thrombotic Strokes

Chapter · January 1, 2021 In this chapter, we will describe the management strategy in the large artery extracranial atherosclerotic disease of the neck, dissection of the extracranial arteries of the head and neck, as well as small vessel disease. The main mechanism of stroke in p ... Full text Cite

Carotid web: an occult mechanism of embolic stroke.

Journal Article J Neurol Neurosurg Psychiatry · December 2020 The carotid web is a proposed stroke mechanism that may underlie cryptogenic stroke, particularly in younger patients without vascular risk factors. The web appears as a shelf-like projection into the lumen of the proximal cervical internal carotid artery ... Full text Link to item Cite

Risk of Ischemic Stroke in Patients With Atrial Fibrillation After Extracranial Hemorrhage.

Journal Article Stroke · December 2020 BACKGROUND AND PURPOSE: Anticoagulation therapy not only reduces the risk of ischemic stroke in atrial fibrillation (AF) but also predisposes patients to hemorrhagic complications. There is limited knowledge on the risk of first-ever ischemic stroke in pat ... Full text Link to item Cite

Timing of initiation of oral anticoagulants in patients with acute ischemic stroke and atrial fibrillation comparing posterior and anterior circulation strokes

Journal Article European Stroke Journal · December 1, 2020 Introduction: The aim of this study in patients with acute posterior ischaemic stroke (PS) and atrial fibrillation (AF) was to evaluate (1) the risks of recurrent ischaemic event and severe bleeding and (2) these risks in relation with oral anticoagulant t ... Full text Cite

The impact of delirium on withdrawal of life-sustaining treatment after intracerebral hemorrhage.

Journal Article Neurology · November 17, 2020 OBJECTIVE: To determine the impact of delirium on withdrawal of life-sustaining treatment (WLST) after intracerebral hemorrhage (ICH) in the context of established predictors of poor outcome, using data from an institutional ICH registry. METHODS: We perfo ... Full text Link to item Cite

Anticoagulation Timing in Cardioembolic Stroke and Recurrent Event Risk.

Journal Article Ann Neurol · October 2020 OBJECTIVE: Guidelines recommend initiating anticoagulation within 4 to 14 days after cardioembolic stroke. Data supporting this did not account for key factors potentially affecting the decision to initiate anticoagulation, such as infarct size, hemorrhagi ... Full text Link to item Cite

Arrival blood pressure in hypertensive and non-hypertensive spontaneous intracerebral hemorrhage.

Journal Article J Neurol Sci · September 15, 2020 BACKGROUND AND PURPOSE: Hypertension is a known risk factor for intracerebral hemorrhage (ICH), but it is unclear whether blood pressure (BP) at hospital arrival can be used to distinguish hypertensive ICH from non-hypertensive etiologies. PATIENTS AND MET ... Full text Link to item Cite

Anticoagulation Type and Early Recurrence in Cardioembolic Stroke: The IAC Study.

Journal Article Stroke · September 2020 BACKGROUND AND PURPOSE: In patients with acute ischemic stroke and atrial fibrillation, treatment with low molecular weight heparin increases early hemorrhagic risk without reducing early recurrence, and there is limited data comparing warfarin to direct o ... Full text Link to item Cite

Mechanical Thrombectomy in Ischemic Stroke Patients with Severe Pre-Stroke Disability.

Journal Article J Stroke Cerebrovasc Dis · August 2020 Frequency and outcomes of mechanical thrombectomy (MT) in clinical practice for patients with severe pre-stroke disability are largely unknown. In this case series, we aim to describe the disability make-up and outcomes of 33 patients with severe pre-strok ... Full text Link to item Cite

SARS-CoV-2 and Stroke in a New York Healthcare System.

Journal Article Stroke · July 2020 BACKGROUND AND PURPOSE: With the spread of coronavirus disease 2019 (COVID-19) during the current worldwide pandemic, there is mounting evidence that patients affected by the illness may develop clinically significant coagulopathy with thromboembolic compl ... Full text Link to item Cite

Intravenous Fibrinolysis for Central Retinal Artery Occlusion: A Cohort Study and Updated Patient-Level Meta-Analysis.

Journal Article Stroke · July 2020 BACKGROUND AND PURPOSE: Central retinal artery occlusion results in sudden, painless, usually permanent loss of vision in the affected eye. There is no proven, effective treatment to salvage visual acuity and a clear, unmet need for an effective therapy. I ... Full text Link to item Cite

Early ischaemic and haemorrhagic complications after atrial fibrillation-related ischaemic stroke: analysis of the IAC study.

Journal Article J Neurol Neurosurg Psychiatry · July 2020 INTRODUCTION: Predictors of long-term ischaemic and haemorrhagic complications in atrial fibrillation (AF) have been studied, but there are limited data on predictors of early ischaemic and haemorrhagic complications after AF-associated ischaemic stroke. W ... Full text Link to item Cite

Hypoperfusion Distal to Anterior Circulation Intracranial Atherosclerosis is Associated with Recurrent Stroke.

Journal Article J Neuroimaging · July 2020 BACKGROUND AND PURPOSE: In patients with symptomatic vertebrobasilar intracranial atherosclerotic disease (ICAD), impaired distal flow predicts recurrent stroke, but limited data exist on the association between perfusion status and recurrent stroke in ant ... Full text Link to item Cite

Factors associated with therapeutic anticoagulation status in patients with ischemic stroke and atrial fibrillation.

Journal Article J Stroke Cerebrovasc Dis · July 2020 BACKGROUND AND PURPOSE: Understanding factors associated with ischemic stroke despite therapeutic anticoagulation is an important goal to improve stroke prevention strategies in patients with atrial fibrillation (AF). We aim to determine factors associated ... Full text Link to item Cite

Serum alpha-1 antitrypsin in acute ischemic stroke: A prospective pilot study.

Journal Article J Clin Neurosci · June 2020 BACKGROUND: Alpha-1 antitrypsin (AAT) is a potent anti-protease enzyme which may play a role in arterial wall stability. A variant of its encoding gene has been recently linked to ischemic stroke due to large artery atherosclerosis (LAA). We sought to expl ... Full text Link to item Cite

Redefined Measure of Early Neurological Improvement Shows Treatment Benefit of Alteplase Over Placebo.

Journal Article Stroke · April 2020 Background and Purpose- The first of the 2 NINDS (National Institute of Neurological Disorders and Stroke) Study trials did not show a significant increase in early neurological improvement, defined as National Institutes of Health Stroke Scale (NIHSS) imp ... Full text Link to item Cite

Peri-procedural stroke or death in stenting of symptomatic severe intracranial stenosis.

Journal Article J Neurointerv Surg · April 2020 BACKGROUND AND PURPOSE: There are limited data on predictors of 30-day stroke or death in patients with symptomatic intracranial atherosclerosis (sICAS) undergoing stenting. We aim to determine the factors associated with stroke or death at 30 days in the ... Full text Link to item Cite

Increased Left Atrial Appendage Density on Computerized Tomography is Associated with Cardioembolic Stroke.

Journal Article J Stroke Cerebrovasc Dis · April 2020 BACKGROUND AND PURPOSE: While studies have stratified cardioembolic (CE) stroke risk by qualitative left atrial appendage (LAA) morphology and biomarkers of atrial dysfunction, the quantitative properties that underlie these observations are not well estab ... Full text Link to item Cite

Redefining Early Neurological Improvement After Reperfusion Therapy in Stroke.

Journal Article J Stroke Cerebrovasc Dis · February 2020 BACKGROUND AND PURPOSE: Early neurologic improvement (ENI) in patients treated with alteplase has been shown to correlate with functional outcome. However, the definition of ENI remains controversial and has varied across studies. We hypothesized that ENI ... Full text Link to item Cite

The left atrial appendage morphology is associated with embolic stroke subtypes using a simple classification system: A proof of concept study.

Journal Article J Cardiovasc Comput Tomogr · 2020 BACKGROUND AND PURPOSE: The current left atrial appendage (LAA) classification system (cLAA-CS) categorizes it into 4 morphologies: chicken wing (CW), windsock, cactus, and cauliflower, though there is limited data on either reliability or associations bet ... Full text Link to item Cite

Predicting symptomatic intracranial haemorrhage after mechanical thrombectomy: the TAG score.

Journal Article J Neurol Neurosurg Psychiatry · December 2019 BACKGROUND: There is limited data on predictors of symptomatic intracranial haemorrhage (sICH) in patients who underwent mechanical thrombectomy. In this study, we aim to determine those predictors with external validation. METHODS: We evaluated mechanical ... Full text Link to item Cite

Cryptogenic Stroke: Diagnostic Workup and Management

Journal Article Current Treatment Options in Cardiovascular Medicine · November 1, 2019 Purpose of review: Cryptogenic stroke describes a subset of ischemic stroke for which no cause can be found despite a structured investigation. There are a number of putative mechanisms of cryptogenic ischemic stroke including a covert structural cardiac l ... Full text Cite

CSF Pressure, Volume, and Post-Dural Puncture Headache: A Case-Control Study and Systematic Review.

Journal Article Headache · September 2019 OBJECTIVES: (1) To perform a systematic literature review to evaluate associations between post-dural puncture headache (PDPH) and opening pressure (OP), closing pressure (CP), and volume of cerebrospinal fluid (V) removed. (2) To perform a case-control st ... Full text Link to item Cite

Infarct Pattern, Perfusion Mismatch Thresholds, and Recurrent Cerebrovascular Events in Symptomatic Intracranial Stenosis.

Journal Article J Neuroimaging · September 2019 BACKGROUND AND PURPOSE: Studies have shown an association between infarct patterns and recurrent stroke in patients with symptomatic intracranial stenosis (sICAS) but there are limited data on associations with perfusion imaging mismatch profile. We aim to ... Full text Link to item Cite

Prolonged Cardiac Rhythm Monitoring and Secondary Stroke Prevention in Patients With Cryptogenic Cerebral Ischemia.

Journal Article Stroke · August 2019 Background and Purpose- Although prolonged cardiac rhythm monitoring (PCM) can reveal a substantial proportion of ischemic stroke (IS) patients with atrial fibrillation not detected by conventional short-term monitoring, current guidelines indicate an unce ... Full text Link to item Cite

Left Atrial Volume Index Is Associated With Cardioembolic Stroke and Atrial Fibrillation Detection After Embolic Stroke of Undetermined Source.

Journal Article Stroke · August 2019 Background and Purpose- Left atrial enlargement has been shown to be associated with ischemic stroke, but the association with embolic stroke mechanisms remains unknown. We aim to study the associations between left atrial volume index (LAVI) and embolic s ... Full text Link to item Cite

Causes and Risk Factors of Cerebral Ischemic Events in Patients With Atrial Fibrillation Treated With Non-Vitamin K Antagonist Oral Anticoagulants for Stroke Prevention.

Journal Article Stroke · August 2019 Background and Purpose- Despite treatment with oral anticoagulants, patients with nonvalvular atrial fibrillation (AF) may experience ischemic cerebrovascular events. The aims of this case-control study in patients with AF were to identify the pathogenesis ... Full text Link to item Cite

The Addition of Atrial Fibrillation to the Los Angeles Motor Scale May Improve Prediction of Large Vessel Occlusion.

Journal Article J Neuroimaging · July 2019 BACKGROUND AND PURPOSE: There is evidence suggesting that Los Angeles Motor Scale (LAMS) ≥ 4 predicts large vessel occlusion (LVO). We aim to determine whether atrial fibrillation (AF) can improve the ability of LAMS in predicting LVO. METHODS: We included ... Full text Link to item Cite

Cardiac Biomarkers Predict Large Vessel Occlusion in Patients with Ischemic Stroke.

Journal Article J Stroke Cerebrovasc Dis · June 2019 BACKGROUND AND PURPOSE: Cardiac biomarkers may help identify stroke mechanisms and may aid in improving stroke prevention strategies. There is limited data on the association between these biomarkers and acute ischemic stroke (AIS) caused by large vessel o ... Full text Link to item Cite

Anticoagulation Resumption After Stroke from Atrial Fibrillation.

Journal Article Curr Atheroscler Rep · May 20, 2019 The goal of this paper is to review literature on the topic of anticoagulation resumption after stroke from atrial fibrillation. Following ischemic stroke, the average annual risk of recurrent stroke in a patient with a CHADS2 score of 9 is 12.2%%, transla ... Full text Link to item Cite

Serum Troponin Level in Acute Ischemic Stroke Identifies Patients with Visceral Infarcts.

Journal Article J Stroke Cerebrovasc Dis · May 2019 BACKGROUND AND PURPOSE: Patients with ischemic stroke of cardioembolic origin are at risk of visceral (renal or splenic) infarction. We hypothesized that serum troponin level at time of ischemic stroke would be associated with presence of visceral infarcti ... Full text Link to item Cite

Association between age and outcomes following thrombectomy for anterior circulation emergent large vessel occlusion is determined by degree of recanalisation.

Journal Article J Neurointerv Surg · February 2019 BACKGROUND: Older patients undergoing thrombectomy for emergent large vessel occlusion have worse outcomes. However, complete or near-complete reperfusion (modified Thrombolysis in Cerebral Ischemia (mTICI) score of 2 c/3) is associated with improved outco ... Full text Link to item Cite

Troponin Improves the Yield of Transthoracic Echocardiography in Ischemic Stroke Patients of Determined Stroke Subtype.

Journal Article Stroke · November 2018 Background and Purpose- Transthoracic echocardiography (TTE) is widely used in the ischemic stroke setting. In this study, we aim to investigate the yield of TTE in patients with ischemic stroke and known subtype and whether the admission troponin level im ... Full text Link to item Cite

Baseline NIH Stroke Scale is an inferior predictor of functional outcome in the era of acute stroke intervention.

Journal Article Int J Stroke · October 2018 Background and aims Baseline National Institutes of Health Stroke Scale (NIHSS) scores have frequently been used for prognostication after ischemic stroke. With the increasing utilization of acute stroke interventions, we aimed to determine whether baselin ... Full text Link to item Cite

Prognostication

Chapter · October 1, 2018 A patient's prognosis refers to the expected course of his or her disease process, including not only timing of eventual death but also future functional status and quality of life while living, with or without treatment. Understanding prognosis is central ... Full text Cite

Predictors of symptomatic intracranial haemorrhage in patients with an ischaemic stroke with neurological deterioration after intravenous thrombolysis.

Journal Article J Neurol Neurosurg Psychiatry · August 2018 OBJECTIVES: Early neurological deterioration prompting urgent brain imaging occurs in nearly 15% of patients with ischaemic stroke receiving intravenous tissue plasminogen activator (tPA). We aim to determine risk factors associated with symptomatic intrac ... Full text Link to item Cite

Perfusion imaging and recurrent cerebrovascular events in intracranial atherosclerotic disease or carotid occlusion.

Journal Article Int J Stroke · August 2018 Background Large vessel disease stroke subtype carries the highest risk of early recurrent stroke. In this study we aim to look at the association between impaired perfusion and early stroke recurrence in patients with intracranial atherosclerotic disease ... Full text Link to item Cite

Level of consciousness at discharge and associations with outcome after ischemic stroke.

Journal Article J Neurol Sci · July 15, 2018 BACKGROUND: Many factors may potentially complicate the stroke recovery process, including persistently impaired level of consciousness (LOC)-whether from residual stroke effects or from superimposed delirium. We aimed to determine the degree to which impa ... Full text Link to item Cite

A Simple Score That Predicts Paroxysmal Atrial Fibrillation on Outpatient Cardiac Monitoring after Embolic Stroke of Unknown Source.

Journal Article J Stroke Cerebrovasc Dis · June 2018 BACKGROUND: Occult paroxysmal atrial fibrillation (AF) is detected in 16%-30% of patients with embolic stroke of unknown source (ESUS). The identification of AF predictors on outpatient cardiac monitoring can help guide clinicians decide on a duration or m ... Full text Link to item Cite

Left Atrial Appendage Morphology and Embolic Stroke of Undetermined Source: A Cross-Sectional Multicenter Pilot Study.

Journal Article J Stroke Cerebrovasc Dis · June 2018 BACKGROUND: The left atrial appendage (LAA) is the main source of thrombus in atrial fibrillation, and there is an association between non-chicken wing (NCW) LAA morphology and stroke. We hypothesized that the prevalence of NCW LAA morphology would be high ... Full text Link to item Cite

Distinguishing Characteristics of Headache in Nontraumatic Subarachnoid Hemorrhage.

Journal Article Headache · March 2018 INTRODUCTION: Subarachnoid hemorrhage (SAH) is a life-threatening emergency that is frequently missed due to its varied and often subtle presentation. The most common presentation of SAH is with a severe headache. The classical adjective used in SAH is "th ... Full text Link to item Cite

Early Elevated Troponin Levels After Ischemic Stroke Suggests a Cardioembolic Source.

Journal Article Stroke · January 2018 BACKGROUND AND PURPOSE: Elevated cardiac troponin is a marker of cardiac disease and has been recently shown to be associated with embolic stroke risk. We hypothesize that early elevated troponin levels in the acute stroke setting are more prevalent in pat ... Full text Link to item Cite

TGF-β1 modulates microglial phenotype and promotes recovery after intracerebral hemorrhage.

Journal Article J Clin Invest · January 3, 2017 Intracerebral hemorrhage (ICH) is a devastating form of stroke that results from the rupture of a blood vessel in the brain, leading to a mass of blood within the brain parenchyma. The injury causes a rapid inflammatory reaction that includes activation of ... Full text Link to item Cite

Cerebral Microhemorrhages and Meningeal Siderosis in Infective Endocarditis.

Journal Article Cerebrovasc Dis · 2017 OBJECTIVE: Patients with infective endocarditis (IE) frequently experience cerebral insults, and neurological involvement in IE has been reported to herald a worse prognosis. In this manuscript, we describe a distinctive pattern of findings on susceptibili ... Full text Link to item Cite

The effect of pro-inflammatory cytokines on the discharge rate of vagal nerve paraganglia in the rat.

Journal Article Respir Physiol Neurobiol · April 30, 2010 Vagal paraganglia resemble the carotid body and are chemosensitive to reduction in the partial pressure of oxygen (P O2) (O'Leary et al., 2004). We hypothesised that they may also mediate communication between the immune system and the central nervous syst ... Full text Link to item Cite