Review
Clinical Neurology
Yannick Bejot
Summary: There is still insufficient exploration on the optimal personalized management of blood pressure in stroke patients, with a need for further research on strategies for blood pressure control in different clinical contexts. Future studies should take into account factors such as circadian variations and variability in blood pressure to guide clinical practice effectively.
JOURNAL OF NEUROLOGY
(2021)
Review
Peripheral Vascular Disease
Dariusz Gasecki, Mariusz Kwarciany, Kamil Kowalczyk, Krzysztof Narkiewicz, Bartosz Karaszewski
Summary: This review examines the complexity of the relationship between changes in blood pressure and clinical outcomes in AIS patients, depending on treatment strategies and local vessel status. It also reviews possible additional clinical markers, such as arterial hypertension and comorbid organ dysfunction, as informative factors in therapeutic decision-making, and discusses recent data on neurovascular monitoring targeting person-specific local cerebral perfusion and metabolic demand.
CURRENT HYPERTENSION REPORTS
(2021)
Article
Multidisciplinary Sciences
Nicholas Omid Daneshvari, Michelle Christina Johansen
Summary: The study found a significant association between ischemic stroke infarct volume and stroke subtypes, with each 5mL increase in infarct volume leading to a change in the risk of different stroke types. Multiple infarcts may be associated with cardioembolic strokes, while a single large-volume infarct may be related to large-artery atherosclerosis.
Article
Medicine, General & Internal
Paola Forti, Fabiola Maioli
Summary: The prognostic significance of early glycemic profile after acute ischemic stroke varies between patients with lacunar and non-lacunar infarction. A retrospective analysis of data from 4011 ischemic stroke patients showed a correlation between glycemic profile and poor outcomes such as early neurological deterioration, severe stroke at discharge, or 1-month mortality. This correlation was stronger in non-lacunar infarction patients and weaker in lacunar infarction patients.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Clinical Neurology
Xia Wang, Jatinder S. Minhas, Tom J. Moullaali, Gian Luca Di Tanna, Richard Lindley, Xiaoying Chen, Hisatomi Arima, Guofang Chen, Candice Delcourt, Philip M. Bath, Joseph P. Broderick, Andrew M. Demchuk, Geoffrey A. Donnan, Alice C. Durham, Pablo M. Lavados, Tsong-Hai Lee, Christopher Levi, Sheila O. Martins, Veronica V. Olavarria, Jeyaraj D. Pandian, Mark W. Parsons, Octavio M. Pontes-Neto, Stefano Ricci, Shoichiro Sato, Vijay K. Sharma, Federico Silva, Nguyen H. Thang, Ji-Guang Wang, Mark Woodward, John Chalmers, Lili Song, Craig S. Anderson, Thompson G. Robinson
Summary: Post hoc analysis of thrombolyzed acute ischemic stroke patients showed that reducing systolic blood pressure and decreasing systolic blood pressure variability were associated with better recovery outcomes, while the magnitude of systolic blood pressure reduction did not affect the outcomes. Higher systolic blood pressure and greater systolic blood pressure variability were associated with an increased risk of intracranial hemorrhage.
Article
Clinical Neurology
Iain J. McGurgan, Peter J. Kelly, Tanya N. Turan, Peter M. Rothwell
Summary: Reducing blood pressure is an effective strategy for long-term stroke prevention, but there is still uncertainty surrounding the issue of BP lowering after a stroke and the risk of recurrent stroke, coronary events, and vascular death. Questions in secondary prevention include who should be treated, when should BP-lowering treatment be commenced, how intensively should BP be lowered, what drugs are best, and how should long-term BP control be optimized and monitored.
Article
Clinical Neurology
Orit Mazza, Onn Shehory, Nirit Lev
Summary: This study aims to develop a decision support tool using machine learning (ML) techniques to improve the management of extremely high blood pressure (BP) during the first 24 hours after acute ischemic stroke. The analysis of retrospective data identified diastolic BP (DBP) as the main variable for predicting BP reduction, and proposed treatment options based on different BP parameters.
FRONTIERS IN NEUROLOGY
(2022)
Review
Cardiac & Cardiovascular Systems
Damien Tharmaratnam, Christopher C. Karayiannis, Taya A. Collyer, Hisatomi Arima, Leslie A. McClure, John Chalmers, Craig S. Anderson, Oscar R. Benavente, Carole L. White, Ale Algra, Chris Moran, Thanh G. Phan, Wei C. Wang, Velandai Srikanth
Summary: The study found that blood pressure lowering can reduce the risk of recurrent stroke without increasing adverse events for both younger and very elderly trial participants. However, very elderly individuals have an increased risk of hypotensive symptoms when using blood pressure lowering medications.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Article
Peripheral Vascular Disease
Rainer Malik, Marios K. Georgakis, Marijana Vujkovic, Scott M. Damrauer, Paul Elliott, Ville Karhunen, Alice Giontella, Cristiano Fava, Jacklyn N. Hellwege, Megan M. Shuey, Todd L. Edwards, Tormod Rogne, Bjorn O. Asvold, Ben M. Brumpton, Stephen Burgess, Martin Dichgans, Dipender Gill
Summary: Utilizing genetic variants to proxy the effect of blood pressure on cardiovascular disease risk, this study found no evidence supporting nonlinear relationships between blood pressure and cardiovascular outcomes.
Article
Medicine, General & Internal
Greg Arling, Anthony Perkins, Laura J. Myers, Jason J. Sico, Dawn M. Bravata
Summary: This study examines the impact of blood pressure trajectories on post-stroke prognosis. The findings suggest that patients with higher blood pressure trajectories experience a significant decrease in systolic blood pressure after the stroke with intensified antihypertensive medication. Patients with very low or very high blood pressure trajectories have a higher risk of mortality.
AMERICAN JOURNAL OF MEDICINE
(2022)
Article
Clinical Neurology
Marialuisa Zedde, Ilaria Grisendi, Federica Assenza, Gabriele Vandelli, Manuela Napoli, Claudio Moratti, Franco Valzania, Rosario Pascarella
Summary: The study presents a rare case of a male patient who developed lacunar ischemic stroke and atypical variant of PRES with chronic small vessel disease markers, as seen in the MRI findings. The association between PRES and ischemic stroke provides insights into the pathomechanisms of PRES.
NEUROLOGICAL SCIENCES
(2023)
Review
Clinical Neurology
Josephine McCarthy, Jun Yang, Ben Clissold, Morag J. Young, Peter J. Fuller, Thanh Phan
Summary: Primary aldosteronism carries a higher risk of stroke, atrial fibrillation, and cardiovascular disease compared to essential hypertension. While there are targeted treatments and potentially curative surgical options for primary aldosteronism, there is a lack of guidelines for screening and diagnosing the condition in stroke patients with hypertension. However, accurate diagnosis of primary aldosteronism could lead to improved blood pressure control and reduced cardiovascular risk in this population.
Article
Geriatrics & Gerontology
Myung-Sun Song, Yeon joo Choi, Hyunjin Kim, Myung Ji Nam, Chung-woo Lee, Kyungdo Han, Jin-Hyung Jung, Yong-Gyu Park, Do-Hoon Kim, Joo-Hyun Park
Summary: The study of very elderly hypertensive patients showed that excessively low blood pressure levels were not always beneficial, and it is important to avoid too low diastolic and systolic blood pressure. Maintaining appropriate blood pressure levels within a certain range is crucial for preventing stroke, myocardial infarction, and all-cause mortality.
Article
Clinical Neurology
Alastair J. S. Webb, Amy Lawson, Sara Mazzucco, Linxin Li, Peter M. Rothwell
Summary: In patients with transient ischemic stroke or minor stroke, median beat-to-beat blood pressure variability decreases in midlife, indicating a loss of physiological, organized blood pressure variability. However, the rate of markedly elevated blood pressure variability significantly increases with age, suggesting that blood pressure variability may be particularly important in older patients.
INTERNATIONAL JOURNAL OF STROKE
(2021)
Review
Biochemistry & Molecular Biology
Maria Luz Alonso-Alonso, Ana Sampedro-Viana, Sabela Fernandez-Rodicio, Marcos Bazarra-Barreiros, Alberto Ouro, Tomas Sobrino, Francisco Campos, Jose Castillo, Pablo Hervella, Ramon Iglesias-Rey
Summary: Blood-brain barrier dysfunction is closely associated with cerebrovascular disease, but its detrimental or reparative effects depend on the stage of stroke. Understanding the structure, function, and chronic alterations of the BBB related to ischemic stroke is important for new drug development and clinical translation.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Psychiatry
Judit Joseph Fortuny, Guillem Navarra-Ventura, Sol Fernandez-Gonzaloa, Esther Pousa Tomas, Josep Maria Crosas Armengol, Diego Palao Vidal, Merce Jodar Vicente
Summary: This study found deficits in theory of mind (ToM) and emotional processing in patients with a first psychotic episode. Patients performed worse in tasks of social cognition compared to healthy controls, with impairment in second-order ToM and preserved first-order ToM. Happiness was the easiest emotion to identify for both patients and controls, while fear was most difficult for patients and disgust for controls.
SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH
(2023)
Article
Neuroimaging
Rosalie McDonough, Johanna M. Ospel, Charles B. L. M. Majoie, Jeffrey L. Saver, Philip White, Diederik W. J. Dippel, Scott B. Brown, Andrew M. Demchuk, Tudor G. Jovin, Peter J. Mitchell, Serge Bracard, Bruce C. Campbell, Keith W. Muir, Michael D. Hill, Francis Guillemin, Mayank Goyal
Summary: This study examined the effect of pre-stroke functional levels on the outcome of endovascular therapy. The results showed that patients with mild pre-existing disability/symptoms had worse outcomes compared to those without disability. However, within the subgroup of patients with mild disability/symptoms, endovascular therapy still had a significant benefit.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2023)
Article
Clinical Neurology
Leah E. Kuzmuk, Alexander D. Rebchuk, Halina M. Deptuck, Molly Cairncross, Noah D. Silverberg, Thalia S. Field
Summary: This study investigated the practice effects of the NIHTB-CB in young healthy adults. The results showed significant practice effects on the composite scores and some of the subtests of the NIHTB-CB. The study suggests the need for further research on the practice effects of the NIHTB-CB to accurately interpret its role in study results.
CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES
(2023)
Review
Anesthesiology
Denise J. Wooding, Thalia S. Field, Stephan K. W. Schwarz, Su-Yin Macdonell, Jaycee Farmer, Shobana Rajan, Alana M. Flexman
Summary: We conducted a scoping review to characterize and synthesize contemporary guidelines on perioperative brain health for noncardiac, non-neurologic surgery. Through a structured search, we identified eight publications providing 129 recommendations on perioperative complications including stroke and neurocognitive disorders. The recommendations were categorized by subtopics, types, and strategies, and we found both concordant and discordant recommendations among the publications. We synthesized the recommendations for clinical practice and highlighted areas that require further high-quality evidence.
JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY
(2023)
Review
Cardiac & Cardiovascular Systems
Thalia S. Field, Luciano A. Sposato, Michael D. Hill, Jeff S. Healey, Jason G. Andrade, Lily W. Zhou
Summary: In 2014, the concept of embolic stroke of un-determined source (ESUS) was introduced to the clinical stroke community. Two large clinical trials have shown that there is still no clear uniform antithrombotic strategy for secondary prevention after ESUS. However, this work has provided valuable information about patient phenotypes and generated hypothesis-generating substudies for personalized approaches in embolic stroke prevention.
CANADIAN JOURNAL OF CARDIOLOGY
(2023)
Review
Clinical Neurology
Lily W. Zhou, Amy Y. X. Yu, Long Ngo, Michael D. Hill, Thalia S. Field
Summary: This study examined the incidence of cerebral venous thrombosis (CVT) in British Columbia, Canada, and found that it has increased over time. The literature on CVT incidence showed significant heterogeneity and possible publication bias.
Article
Cardiac & Cardiovascular Systems
Raed A. Joundi, Amy Y. X. Yu, Eric E. Smith, Charlotte Zerna, Andrew M. Penn, Robert F. Balshaw, Kristine Votova, Maximilian B. Bibok, Melanie Penn, Viera Saly, Janka Hegedus, Shelagh B. Coutts
Summary: The relationship between the duration of transient neurological events and the presence of diffusion-weighted lesions varies depending on symptom type. For focal-only symptoms, there is a continuous increase in the probability of DWI lesion with longer duration, particularly in women. However, for nonfocal or mixed symptoms, the probability of DWI lesion remains constant regardless of duration.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2023)
Article
Clinical Neurology
Katarzyna Krzywicka, Diana Aguiar de Sousa, Charlotte J. Cordonnier, Felix S. Bode, Thalia Field, Dominik Michalski, Johann Pelz, Mona Skjelland, Markus Wiedmann, Julian Zimmermann, Matthias Wittstock, Bruno Zanotti, Alfonso Ciccone, Monica Bandettini di Poggio, Afshin Borhani-Haghighi, Sophie Chatterton, Avinash Aujayeb, Annemie Devroye, Vanessa Dizonno, Thomas Geeraerts, Fabrizio Giammello, Albrecht R. Guenther, Nasli Ichaporia, Timothy S. Kleinig, Espen Kristoffersen, Robin Lemmens, Emmanuel De Maistre, Zahra Mirzaasgari, Jean-Francois Payen, Jukka Putaala, Marco Petruzzellis, Nicolas Raposo, Elyar Sadeghi-Hokmabadi, Silvia Schoenenberger, Meenakshisundaram Umaiorubahan, Padmavathy N. Sylaja, Anita van de Munckhof, Mayte Sanchez van Kammen, Erik Lindgren, Katarina Jood, Adrian R. Scutelnic, Mirjam Heldner, Sven Poli, Marieke J. H. A. Kruip, Antonio B. Arauz, Adriana Conforto, Sanjith Aaron, Saskia Middeldorp, Turgut Tatlisumak, Marcel M. Arnold, Jonathan Coutinho, Jose M. Ferro
Summary: This study describes the clinical characteristics, therapeutic management, and outcomes of CVST-VITT patients who underwent decompressive surgery, as well as explores predictors of in-hospital mortality in these patients. Almost two-thirds of surgical CVST-VITT patients died during hospital admission. Preoperative coma and bilateral absence of pupillary responses were associated with higher mortality rates.
EUROPEAN JOURNAL OF NEUROLOGY
(2023)
Article
Clinical Neurology
Anita van de Munckhof, Afshin Borhani-Haghighi, Sanjith Aaron, Katarzyna Krzywicka, Mayte Sanchez van Kammen, Charlotte Cordonnier, Timothy J. Kleinig, Thalia S. Field, Sven Poli, Robin Lemmens, Adrian Scutelnic, Erik Lindgren, Jiangang Duan, Yildiz Arslan, Eric C. M. van Gorp, Johanna A. Kremer Hovinga, Albrecht Guenther, Katarina Jood, Turgut Tatlisumak, Jukka Putaala, Mirjam R. Heldner, Marcel Arnold, Diana Aguiar de Sousa, Mohammad Wasay, Antonio Arauz, Adriana Bastos Conforto, Jose M. Ferro, Jonathan M. Coutinho
Summary: This study examined the frequency, manifestations, treatment, and outcomes of cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) in low- and middle-income countries (LMICs). The number of CVST-VITT cases reported from LMICs was small, but the clinical manifestations, treatment, and mortality were largely similar to high-income countries (HICs).
INTERNATIONAL JOURNAL OF STROKE
(2023)
Article
Clinical Neurology
Anas Alrohimi, David Z. Rose, W. Scott Burgin, Swetha Renati, Nicholas Corbin Hilker, Wei Deng, Guilherme H. Oliveira, Theresa M. Beckie, Arthur J. Labovitz, Michael G. Fradley, Nhi Tran, Laura C. Gioia, Mahesh Kate, Kelvin Ng, Dar Dowlatshahi, Thalia S. Field, Shelagh B. Coutts, Muzzafar Siddiqui, Michael D. Hill, Jodi Miller, Glen Jickling, Ashfaq Shuaib, Brian Buck, Mike Sharma, Ken S. Butcher
Summary: This study aimed to assess the risk of hemorrhagic transformation (HT) in acute ischemic stroke (AIS) associated with the initiation of direct oral anticoagulant (DOAC). The results showed that initiating DOAC within 48 hours post-stroke was not associated with an increased risk of HT, and no patients developed symptomatic HT. However, early DOAC use was not significant in reducing the risk of recurrent ischemic events.
INTERNATIONAL JOURNAL OF STROKE
(2023)
Review
Hematology
Diana J. Kim, Asaf Honig, Arshia Alimohammadi, Amir A. Sepehry, Lily W. Zhou, Thalia S. Field
Summary: The absence of recanalization is associated with worse functional outcomes, CVT recurrence, and headache. The relationship between recanalization and functional outcomes is modified by sex. Partial recanalization is associated with a higher risk of headache.
RESEARCH AND PRACTICE IN THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Clinical Neurology
Fouzi Bala, Mohammed Almekhlafi, Nishita Singh, Ibrahim Alhabli, Ayoola Ademola, Shelagh B. Coutts, Yan Deschaintre, Houman Khosravani, Ramana Appireddy, Francois Moreau, Stephen Phillips, Gord Gubitz, Aleksander Tkach, Luciana Catanese, Dar Dowlatshahi, George Medvedev, Jennifer Mandzia, Aleksandra Pikula, Jay Shankar, Heather Williams, Thalia S. Field, Alejandro Manosalva, Muzaffar Siddiqui, Atif Zafar, Oje Imoukhoude, Gary Hunter, Faysal Benali, MacKenzie Horn, Michael D. Hill, Michel Shamy, Tolulope T. Sajobi, Brian H. Buck, Richard H. Swartz, Bijoy K. Menon, Alexandre Y. Poppe
Summary: This study investigated the safety and efficacy of intravenous tenecteplase versus intravenous alteplase in patients with carotid tandem lesions. The results suggest that intravenous tenecteplase may be associated with similar or better clinical outcomes and angiographic reperfusion rates compared to alteplase in patients treated with endovascular thrombectomy.
INTERNATIONAL JOURNAL OF STROKE
(2023)
Article
Clinical Neurology
Johannes Weller, Katarzyna Krzywicka, Anita van de Munckhof, Franziska Dorn, Katharina Althaus, Felix J. Bode, Monica Bandettini di Poggio, Brian Buck, Timothy Kleinig, Charlotte Cordonnier, Vanessa Dizonno, Jiangang Duan, Ahmed Elkady, Beng Lim Alvin Chew, Carlos Garcia-Esperon, Thalia S. Field, Catherine Legault, Mar Morin Martin, Dominik Michalski, Johann Pelz, Silvia Schoenenberger, Simon Nagel, Marco Petruzzellis, Nicolas Raposo, Mona Skjelland, Domenico Sergio Zimatore, Sanjith Aaron, Mayte Sanchez van Kammen, Diana Aguiar de Sousa, Erik Lindgren, Katarina Jood, Adrian Scutelnic, Mirjam R. Heldner, Sven Poli, Antonio Arauz, Adriana B. Conforto, Jukka Putaala, Turgut Tatlisumak, Marcel Arnold, Jonathan M. Coutinho, Albrecht Guenther, Julian Zimmermann, Jose M. Ferro
Summary: This study describes the clinical characteristics and outcomes of CVST-VITT patients treated with EVT. Half of the patients receiving EVT died during hospital admission, but most survivors achieved functional independence.
EUROPEAN STROKE JOURNAL
(2023)
Article
Obstetrics & Gynecology
Alexandra Yakeline Meneses Meneses, Sol Fernandez-Gonzalo, Merce Jodar Vicente
Summary: This research examines the clinical and neuropsychological profiles and quality of life of Ecuadorian women who have experienced physical, psychological, or sexual violence, and investigates their correlations with sociodemographic factors.
WOMENS HEALTH REPORTS
(2023)
Article
Clinical Neurology
Vicky Chalos, Esmee Venema, Maxim J. H. L. Mulder, Bob Roozenbeek, Ewout W. Steyerberg, Marieke J. H. Wermer, Geert J. Lycklama A. Nijeholt, H. Bart van der Worp, Mayank Goyal, Bruce C. V. Campbell, Keith W. Muir, Francis Guillemin, Serge Bracard, Philip White, Antoni Davalos, Tudor G. Jovin, Michael D. Hill, Peter J. Mitchell, Andrew M. Demchuk, Jeffrey L. Saver, Aad van der Lugt, Scott Brown, Diederik W. J. Dippel, Hester F. Lingsma
Summary: This study developed and validated a model to predict functional outcome for individual patients after endovascular treatment (EVT) for ischemic stroke. The model showed good discrimination and calibration in predicting functional independence and survival. It can be applied 1 day after EVT to provide accurate outcome expectations and personalize follow-up and rehabilitation plans.
