Midlife Stroke Disparity in U.S. Women vs. Men?
Neurology
Summary and Comment
A recent U.S. survey finds that middle-aged women were more than twice as likely as middle-aged men to have had a stroke. Is a surge in vascular risk factors among the women to blame?
By Philip B. Gorelick, MD, MPH
January 29, 2008
Covering:
Towfighi A et al., Neurology 2007 Nov 13; 69:1898
Barrett KM and Worrall BB., Neurology 2007 Nov 13; 69:1894
Hemodynamic Parameters and Stroke Risk
Neurology
Summary and Comment
This population-based study produced interesting findings but leaves us with many unanswered questions.
By Farzaneh A. Sorond, MD, PhD
January 29, 2008
Covering:
Bos MJ et al., Stroke 2007 Sep; 38:2453
Stroke After TIA
Emergency Medicine
Summary and Comment
Free
More than 15% of patients can be expected to have a stroke within 90 days of TIA presentation.
Coronary Artery Calcium and Cardiovascular Events in Women Classified as Low Risk
Cardiology
Summary and Comment
CT findings of extensive coronary artery calcium were associated with increased risk for cardiovascular events.
By Joel M. Gore, MD
January 16, 2008
Covering:
Lakoski SG et al., Arch Intern Med 2007 Dec 10; 167:2437
USPSTF Recommends Against Screening for Asymptomatic Carotid Artery Stenosis
General Medicine
Clinical Practice Guideline Watch
Free
At first glance, the recommendation seems surprising — but upon further examination, it makes sense.
By Richard Saitz, MD, MPH, FACP, FASAM
January 15, 2008
Covering:
Wolff T et al., Ann Intern Med 2007 Dec 18; 147:860
U.S. Preventive Services Task Force., Ann Intern Med 2007 Dec 18; 147:854
Rapid Evaluation and Treatment of TIA
Neurology
Summary and Comment
Two studies demonstrate impressive reductions in stroke at 90 days, but questions remain.
By Lawrence R. Wechsler, MD
January 15, 2008
Covering:
Rothwell PM et al., Lancet 2007 Oct 20; 370:1432
Dean N and Shuaib A., Lancet 2007 Oct 20; 370:1398
Lavallée PC et al., Lancet Neurol 2007 Nov; 6:953
Kernan WN and Schindler JL., Lancet Neurol 2007 Nov; 6:940
Inadequate Blood Pressure Control in U.S. Adults
Cardiology
Summary and Comment
Patients at risk for cardiovascular events are likely to have high blood pressure, even when treated for hypertension.
By Joel M. Gore, MD
January 9, 2008
Covering:
Wong ND et al., Arch Intern Med 2007 Dec 10; 167:2431
Do Hollenhorst Plaques or Retinal Artery Occlusions Predict Stroke?
General Medicine
Summary and Comment
Free
Researchers challenge the assumption that these ocular findings herald hemispheric neurologic events.
By Allan S. Brett, MD
January 8, 2008
Covering:
Dunlap AB et al., J Vasc Surg 2007 Dec; 46:1125
Preventing Thromboembolism in PNH Patients
Is eculizumab effective?
By David Green, MD, PhD
January 8, 2008
Covering:
Hillmen P et al., Blood 2007 Dec 1; 110:4123
Rosse WF., Blood 2007 Dec 1; 110:3821
Occupational Therapy After Stroke
Neurology
Summary and Comment
This study is the first to isolate the effects on patients functional ability of functionally oriented OT as distinct from the effects of nursing or physical therapy.
By Joanne Borg-Stein, MD
January 8, 2008
Covering:
Legg L et al., BMJ 2007 Nov 3; 335:922
Risk Factors for Stroke in Patients with Atrial Fibrillation
Neurology
Summary and Comment
This systematic review implicates prior stroke or TIA, increasing age, hypertension, and diabetes mellitus.
By Patrick T. Ellinor, MD, PhD
January 8, 2008
Covering:
The Stroke Risk in Atrial Fibrillation Working Group., Neurology 2007 Aug 7; 69:546
Cardiac Events After Acute Ischemic Stroke
Neurology
Summary and Comment
Monitoring stroke patients for nonfatal cardiac events might enable intervention to prevent cardiac deaths.
By Marc I. Chimowitz, MBChB
January 8, 2008
Covering:
Prosser J et al., Stroke 2007 Aug; 38:2295
Incidental Brain MRI Abnormalities Hardly Abnormal
Neurology
Summary and Comment
Asymptomatic brain infarcts and other abnormalities are surprisingly common in apparently healthy adults.
By Thomas H. Lee, MD
January 8, 2008
Covering:
Vernooij MW et al., N Engl J Med 2007 Nov 1; 357:1821
Prognosis of Nonfocal Transient Neurologic Attacks
General Medicine
Summary and Comment
Risk for stroke is nearly the same with nonfocal as with focal transient attacks.
Metabolic Syndrome: Risk Factor for Leukoaraiosis and Age-Related Dementia?
Neurology
Summary and Comment
Some facets of metabolic syndrome are related to leukoaraiosis; aggressive treatment of these might reduce risks for stroke and dementia.
By Rima M. Dafer, MD, MPH, FAHA, and José Biller, MD, FACP, FAAN, FAHA
December 21, 2007
Covering:
Park K et al., Neurology 2007 Sep 4; 69:974
Migraine and Ischemic Stroke: Clearly Connected, But How?
Neurology
Summary and Comment
Uncertainty persists about the migraine subgroups affected and the magnitude and clinical implications of stroke risk.
By Elizabeth Loder, MD, MPH
December 18, 2007
Covering:
MacClellan LR et al., Stroke 2007 Sep; 38:2438
Statins and Hemorrhagic Stroke: Shedding Light on SPARCL
Cardiology
Summary and Comment
Free
A new analysis of influential trial data clarifies the risks associated with statins for secondary prevention of stroke.
By JoAnne M. Foody, MD
December 12, 2007
Covering:
Goldstein LB et al. on behalf of the SPARCL investigators., Neurology 2007 Dec 12
Patent Foramen Ovale Is Associated with Cryptogenic Stroke, Even in Older Patients
Cardiology
Summary and Comment
As in younger patients, a conduit for paradoxical embolism is more likely to be present when the cause of stroke is unknown.
Patent Foramen Ovale and Cryptogenic Stroke
General Medicine
Summary and Comment
Embolism through a patent foramen ovale may be an important cause of stroke at any age.
By Allan S. Brett, MD
December 11, 2007
Covering:
Handke M et al., N Engl J Med 2007 Nov 29; 357:2262
Interrupting Statins Worsens Acute Stroke Outcomes
Neurology
Summary and Comment
Free
Withholding statins after acute stroke substantially increased the likelihood of death or disability.
By Nerses Sanossian, MD, and Bruce Ovbiagele, MD
December 11, 2007
Covering:
Blanco M et al., Neurology 2007 Aug 28; 69:904
Occupational Therapy Improves Post-Stroke Outcomes
General Medicine
Summary and Comment
The results of this study justify the common practice of prescribing occupational therapy for stroke patients.
By Paul S. Mueller, MD, MPH, FACP
December 4, 2007
Covering:
Legg L et al., BMJ 2007 Nov 3; 335:922
McPerson KM and Ellis-Hill C., BMJ 2007 Nov 3; 335:894
Cognitive Disorders in Acute Stroke
Neurology
Summary and Comment
Cognitive deficits soon after stroke are most often associated with hemorrhagic, cortical, and left-hemispheric strokes.
By Amytis Towfighi, MD
December 4, 2007
Covering:
Nys GM et al., Cerebrovasc Dis 2007 ; 23:408
Does rFVIIa Play a Role in Traumatic Intracranial Hemorrhage?
Emergency Medicine
Summary and Comment
Free
The data are promising, but the study was uncontrolled and too small to confirm the value of this treatment.
Comparative Effectiveness of ACE Inhibitors and Angiotensin-Receptor Blockers for Hypertension
Cardiology
Summary and Comment
A meta-analysis revealed no between-class difference in effectiveness but a dearth of clinical outcomes data.
By Joel M. Gore, MD
November 28, 2007
Covering:
Matchar DB et al., Ann Intern Med 2007 Nov 5
Parfrey PS., Ann Intern Med 2007 Nov 5
Cardiovascular Disease Following Stem-Cell Transplantation
Adverse arterial events were significantly more common among allogeneic HSCT recipients than among autologous recipients.