Journal articleJ Am Heart Assoc · August 4, 2026
BACKGROUND: Patients dually eligible for Medicare and Medicaid have higher mortality rates and disparate outcomes for acute cardiovascular conditions compared with those eligible for Medicare alone. However, the association between dual eligibility, cardio ...
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Journal articleStroke · July 2026
BACKGROUND: Rural residents have been experiencing higher stroke mortality than urban residents, and the gap has widened. Disparity in postacute care after stroke may increase the rural-urban gaps of mortality and disability. We aimed to examine whether ru ...
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Journal articleJAMA Netw Open · July 1, 2026
IMPORTANCE: Although P2Y purinergic receptor 12 (P2Y12) inhibitors are commonly used in patients with atherosclerotic cardiovascular disease, there are limited data on intracerebral hemorrhage (ICH) associated with use of P2Y12 inhibitors. OBJECTIVE: To co ...
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Journal articleJAMA Netw Open · July 1, 2026
IMPORTANCE: Tenecteplase is an alternative to alteplase for intravenous thrombolysis in acute ischemic stroke given its simplified administration and comparable safety and efficacy. However, its impact on workflow metrics that may affect clinical outcomes, ...
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Journal articleCirculation · June 23, 2026
Resources for observational comparative research have expanded enormously in recent years to include very large sources of granular, routinely collected health care data and modern statistical, epidemiologic, and econometric techniques. This scientific sta ...
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Journal articleStroke · June 2026
BACKGROUND: Stroke is a possible complication after bioprosthetic aortic valve replacement (AVR) for severe aortic stenosis (AS), impacting morbidity and mortality. Accurate estimates of the proportion of individuals who experience stroke within and beyond ...
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Journal articleJ Am Heart Assoc · May 19, 2026
BACKGROUND: Cervical artery dissection (CeAD) is a common cause of stroke in young adults but is frequently misdiagnosed due to its nonspecific symptoms. This study examines factors associated with possible diagnostic error in CeAD and evaluates its impact ...
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Journal articleJ Neurointerv Surg · May 14, 2026
Tandem occlusions (TOs)-concurrent extracranial large artery steno-occlusion and intracranial artery occlusion-represent a challenging clinical predicament. Stroke due to TOs is associated with high mortality and morbidity. Because of increased clot burden ...
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Journal articleAnn Neurol · May 2026
OBJECTIVE: Cervical artery dissection (CeAD) may be limited to the extracranial extradural space or extend to the intradural space. Intradural extension can potentially increase the risk of stroke and subarachnoid hemorrhage. However, the factors associate ...
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Journal articleStroke · May 2026
BACKGROUND: The best revascularization strategy for acute ischemic stroke from isolated vertebral artery occlusion remains unclear. METHODS: This retrospective, international, multicenter cohort study included patients from 30 comprehensive stroke centers ...
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Journal articleAJNR Am J Neuroradiol · April 2, 2026
BACKGROUND AND PURPOSE: Intracranial aneurysms treated with endovascular embolization often require surveillance imaging using DSA, an invasive, risky, and expensive procedure. Existing noninvasive imaging modalities (standard or MRA) are often unsatisfact ...
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Journal articleAnn Neurol · April 2026
OBJECTIVE: The objective of this study was to test the hypothesis that minimally invasive surgery (MIS), an emerging surgical treatment for spontaneous intracerebral hemorrhage (sICH), is associated with better clinical outcomes than open craniotomy with c ...
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Journal articleStroke · April 2026
BACKGROUND: Cervical artery dissection (CeAD) may result in dissecting aneurysm (DA) formation. We aimed to characterize risk factors and clinical outcomes associated with DA in a large, international CeAD cohort. METHODS: We performed a secondary analysis ...
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Journal articleJ Am Heart Assoc · February 17, 2026
BACKGROUND: Triptan medications are proposed as an association of cerebral ischemic stroke in patients with migraine, but population-based data on this are lacking. METHODS: A retrospective, observational, cohort study was performed using computerized clai ...
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Journal articleJ Am Heart Assoc · February 17, 2026
BACKGROUND: Patients with anticoagulation-associated intracerebral hemorrhage are often transferred from the presenting hospital to one with additional resources. Understanding differences in timeliness and care, including anticoagulant reversal, between t ...
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Journal articleNeurology · February 10, 2026
BACKGROUND AND OBJECTIVES: Calcitonin gene-related peptide (CGRP) inhibitors have entered widespread use in the United States for treatment of migraine, but data on their cardiovascular risk profile are lacking. The objective of this study was to determine ...
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Journal articleJ Am Heart Assoc · January 6, 2026
BACKGROUND: Delayed hospital arrival after 4.5 hours of stroke onset excludes patients from intravenous thrombolytic therapy. In the United States, prehospital triage is regulated by each state. Understanding race- and ethnicity-specific prehospital delays ...
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Journal articleJ Intern Med · January 2026
BACKGROUND: The impact of first prescription of oral anticoagulation on ischemic stroke and major bleeding events among Medicare beneficiaries with atrial fibrillation (AF) is not known. METHODS: A retrospective, observational, cohort study was performed b ...
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Journal articlePLoS One · 2026
IMPORTANCE: Central retinal artery occlusion (CRAO) is a disabling subtype of acute ischemic stroke. It is not known whether intravenous (IV) thrombolysis delivered within 4.5 hours of time last known well (LKW) improves visual outcomes. STUDY DESIGN: Syst ...
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Journal articleAlzheimers Dement · December 2025
BACKGROUND: About one in three COVID-19 patients experience neurological problems; and acute ischemic stroke (AIS) is one of the common comorbidities of COVID-19. As stroke doubles the risk of dementia, AIS patients with COVID-19 infection may experience e ...
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Journal articleAlzheimers Dement · December 2025
BACKGROUND: Anti-amyloid monoclonal antibodies (lecanemab and donanemab) received full approval by the FDA to treat early Alzheimer's disease and entered routine clinical practice in July 2023 and July 2024 respectively. Uptake patterns and post-approval s ...
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Journal articleJAMA Netw Open · November 3, 2025
IMPORTANCE: Fibromuscular dysplasia (FMD) is found in 6 to 14% of patients with spontaneous cervical artery dissection (SCEAD) and may be associated with recurrent SCEAD. OBJECTIVE: To evaluate the correlates of FMD in patients with SCEAD and to determine ...
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Journal articleStroke · November 2025
BACKGROUND: The introduction of novel therapeutics into clinical practice could impact equity in health outcomes. METHODS: This was a retrospective, observational cohort study based on the Get With The Guidelines-Stroke program of the American Heart Associ ...
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Journal articleStroke · November 2025
BACKGROUND: Current guidelines recommend reversal of warfarin anticoagulation in intracranial hemorrhages. The benefit of reversing subtherapeutic warfarin anticoagulation in acute spontaneous intracerebral hemorrhage is uncertain. METHODS: An observationa ...
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Journal articleJACC Adv · November 2025
BACKGROUND: It is essential to understand the prevalence of cardiovascular multimorbidity and to recognize disparities by race and sex to promote health equity. OBJECTIVES: The objectives of the study are to investigate disparities in the development and p ...
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Journal articleCirc Cardiovasc Qual Outcomes · November 2025
BACKGROUND: The Target Stroke Phase III program is a national quality improvement initiative led by the American Heart Association, which sought to improve the quality of care for patients with acute stroke undergoing acute reperfusion therapy including en ...
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Journal articleNeuroepidemiology · October 6, 2025
INTRODUCTION: Sustainable and low-cost data systems for national and global surveillance of stroke are urgently needed to address the growing burden of stroke. Routinely collected health data (including registries and administrative data) are proliferating ...
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Journal articlemedRxiv · October 3, 2025
IMPORTANCE: Central retinal artery occlusion (CRAO) is a disabling subtype of acute ischemic stroke. It is not known whether intravenous (IV) thrombolysis delivered within 4.5 hours of time last known well (LKW) improves visual outcomes. STUDY DESIGN: Syst ...
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Journal articleStroke · October 2025
BACKGROUND: Racial disparities have been reported in stroke care, but understanding if there is regional variability is critical to focusing policies and resources. Here, we sought to study racial and ethnic inequity in the administration of thrombolysis a ...
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Journal articleJAMA Neurol · October 1, 2025
IMPORTANCE: Sex differences may contribute to disparities in dementia outcomes. OBJECTIVE: To understand the association between sex and mortality and health care services use after dementia diagnosis. DESIGN, SETTING, AND PARTICIPANTS: This nationwide coh ...
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Journal articleStroke · June 2025
BACKGROUND: Patients presenting with cervical artery dissection (CAD) are at risk for subsequent ischemic events. We aimed to identify characteristics that are associated with increased risk of ischemic stroke after initial presentation of CAD and to evalu ...
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Journal articleStroke · June 2025
BACKGROUND: The efficacy of minimally invasive surgery (MIS) in improving outcomes after nontraumatic intracerebral hemorrhage (ICH) remains uncertain, with inconsistent findings from randomized clinical trials. Our objective was to evaluate the real-world ...
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Journal articleBMJ · May 20, 2025
OBJECTIVE: To determine the incidence and prevalence of dementia in a nationally representative cohort of US Medicare beneficiaries, stratified by important subgroups. DESIGN: Population based study. SETTING: Nationwide study between 2015 and 2021. PARTICI ...
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Journal articleCurr Eye Res · May 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 ...
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Journal articleStroke Vasc Interv Neurol · May 2025
BACKGROUND: Two randomized clinical trials have failed to demonstrate the superiority of anticoagulation over antiplatelet therapy in acute cervical artery dissection, with many patients still receiving anticoagulation despite bleeding risks. In this analy ...
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Journal articleStroke · April 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 for acute ischemic stroke in patients with tand ...
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Journal articleJAMA Netw Open · March 3, 2025
IMPORTANCE: Tenecteplase is an alternative to alteplase for emergency treatment of acute ischemic stroke. However, limited data are available comparing their clinical effectiveness in routine clinical practice. OBJECTIVE: To compare short-term effectivenes ...
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Journal articleAnn 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 ...
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Journal articleCirc 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. ...
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Journal articleJAMA 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 ...
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Journal articleProc (Bayl Univ Med Cent) · 2025
BACKGROUND: Emergency medical services (EMS) play a key role in identifying stroke patients and transporting them to specialty care centers. We aimed to quantify the time saved in stroke care by EMS prehospital notification. METHODS: We performed a retrosp ...
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Journal articleJAMA 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 ...
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Journal articleNeurosurg Rev · November 5, 2024
In patients with acute ischemic stroke, midregional proatrial natriuretic peptide (MR-proANP) has shown promise in preliminary studies for risk stratification. The objective of this study is to evaluate the prognostic utility of MR-proANP in AIS, focusing ...
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Journal articleClin 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 ...
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Journal articleNeurology · 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 ...
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Journal articleJ Neurol Sci · August 15, 2024
In the last decade, mobile stroke units (MSUs) have shown the potential to transform prehospital stroke care, marking a paradigm shift in delivering ultra-rapid thrombolysis and streamlining triage processes. These units bring acute stroke care directly to ...
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Journal articleThromb Haemost · August 2024
BACKGROUND: With the widespread use of direct oral anticoagulants (DOACs), there is an urgent need for a rapid assay to exclude clinically relevant plasma levels. Accurate and rapid determination of DOAC levels would guide medical decision-making to (1) d ...
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Journal articleInt 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 ...
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Journal articleNeurology · 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 ...
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Journal articleStroke · 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 ...
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Journal articleJ Stroke Cerebrovasc Dis · April 2024
OBJECTIVES: Central retinal artery occlusion (CRAO) is a stroke of the retina potentially amenable to intravenous thrombolysis (IVT). We aimed to determine feasibility of an emergency treatment protocol and risk profile of IVT for CRAO in a comprehensive s ...
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Journal articleStroke Vasc Interv Neurol · 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. The phenomenon of inc ...
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Journal articleJAMA 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 ...
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Journal articleJ 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 ...
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Journal articleJAMA 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 ...
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Journal articleInt 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 ...
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Journal articleStroke · 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 ...
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Journal articleNEJM Evid · January 2024
BACKGROUND: Rivaroxaban and dabigatran were not superior to aspirin in trials of patients with embolic stroke of undetermined source (ESUS). It is unknown whether apixaban is superior to aspirin in patients with ESUS and known risk factors for cardioemboli ...
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Journal articleCirculation · 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 ...
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Journal articleAnn 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 ...
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Journal articleEur 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 ...
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Journal articleCirculation · 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 ...
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Journal articleJAMA · 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 ...
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Journal articleJ 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 ...
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Journal articleStroke · 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 ...
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Journal articleJ 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 ...
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Journal articleStroke · 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 ...
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Journal articleEur 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 ...
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Journal articlePLoS 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 ...
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Journal articleNeurology · 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 ...
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Journal articleStroke · 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 ...
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Journal articleStroke · 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 ...
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Journal articleStroke · 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 ...
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Journal articleJAMA 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 ...
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Journal articleJAMA 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 ...
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Journal articleNeurocrit 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 ...
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Journal articleStroke · 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 ...
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Journal articleNeurology · 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 ...
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Journal articleStroke 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 ...
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Journal articleCirc 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 ...
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Journal articleBMJ 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 ...
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Journal articleJAMA 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 ...
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Journal articleStroke · 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 ...
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Journal articleBMJ · 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 ...
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Journal articleStroke · 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 ...
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Journal articleRadiology · 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 ...
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Journal articleJ 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 ...
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Journal articleStroke Vasc Interv Neurol · January 2022
BACKGROUND: Early administration of intravenous tissue plasminogen activator (IV alteplase) improves functional outcomes in patients with acute ischemic stroke, yet many patients are not treated with IV alteplase. There is a need to understand the reasons ...
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Journal articleStroke Vasc Interv Neurol · January 2022
BACKGROUND: Early neurologic deterioration (END) occurs in a quarter of acute lacunar infarcts, but the underlying pathophysiological features are poorly understood. We sought to determine the association between luminal stenosis (<50%) of the parent arter ...
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Journal articleStroke · 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 ...
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Journal articleJ 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 ...
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Journal articleCurr 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleStroke · 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 ...
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Journal articleStroke · 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 ...
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Journal articleClin 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 ...
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Journal articleStroke · 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleEur 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% ...
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Journal articleStroke · 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 ...
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Journal articleActa 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 ...
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Journal articleStroke · 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 ...
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Journal articleNeurocrit 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 ...
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Journal articleJ 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 ...
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Journal articleTransl 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 ...
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Journal articleJ 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 ...
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Journal articleFront 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 ...
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Journal articlePLoS 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 ...
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Journal articleJ 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 ...
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Journal articleStroke · December 2020
Background and purposeAnticoagulation 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 ...
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Journal articleEur Stroke J · December 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 ...
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Journal articleNeurology · 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 ...
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Journal articleAnn 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 ...
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Journal articleJ 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 ...
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Journal articleStroke · 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 ...
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Journal articleJ 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 ...
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Journal articleStroke · 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 ...
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Journal articleStroke · 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleStroke · May 2020
Background and Purpose- We aimed to compare functional and procedural outcomes of patients with acute ischemic stroke with none-to-minimal (modified Rankin Scale [mRS] score, 0-1) and moderate (mRS score, 2-3) prestroke disability treated with mechanical t ...
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Journal articleStroke · 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleAm J Geriatr Psychiatry · February 2020
Substance use disorders (SUDs) among older persons are among the fastest growing health problems in the United States. The number of older persons is projected to exceed 72.1 million persons by 2030, following a trend of general population growth in the mi ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ Neurointerv Surg · December 2019
INTRODUCTION: Atraumatic convexity subarachnoid hemorrhage is a subtype of spontaneous subarachnoid hemorrhage that often presents a diagnostic challenge. Common etiologies include cerebral amyloid angiopathy, vasculopathies, and coagulopathy; however, ane ...
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Journal articleCurrent 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 ...
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Journal articleHeadache · 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 ...
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Journal articleJ 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 ...
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Journal articleStroke · 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 ...
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Journal articleStroke · 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 ...
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Journal articleStroke · 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 ...
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Journal articleJ 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 ...
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Journal articleJ Neurol Neurosurg Psychiatry · July 2019
BACKGROUND: The aetiology of wall motion abnormalities (WMA) in patients with ischaemic stroke is unclear. We hypothesised that WMAs on transthoracic echocardiography (TTE) in the setting of ischaemic stroke mostly reflect pre-existing coronary heart disea ...
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Journal articleJ 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 ...
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Journal articleCurr 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleStroke · 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 ...
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Journal articleInt 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 ...
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Journal articleJ 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 ...
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Journal articleInt 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleJ 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 ...
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Journal articleHeadache · 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 ...
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Journal articleStroke · 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 ...
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Journal articleJ 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 ...
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Journal articleCerebrovasc 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 ...
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Journal articleRespir 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 ...
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Journal articleN Engl J Med · August 10, 2006
BACKGROUND: Statins reduce the incidence of strokes among patients at increased risk for cardiovascular disease; whether they reduce the risk of stroke after a recent stroke or transient ischemic attack (TIA) remains to be established. METHODS: We randomly ...
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