- Effectiveness of CHA2DS2-VASc based decision support on stroke prevention in atrial fibrillation: A cluster randomised trial in general practice. [Journal Article]
- IJInt J Cardiol 2018 Sep 08
- CONCLUSIONS: In this study in patients with AF in general practice, underuse of anticoagulants was relatively low. Providing practitioners with CHA2DS2-VASc based decision support did not result in a reduction in stroke incidence, affect bleeding risk or anticoagulant over- or underuse.
- Screening for Atrial Fibrillation With Electrocardiography: An Evidence Review for the U.S. Preventive Services Task Force [BOOK]
- BOOKAgency for Healthcare Research and Quality (US): Rockville (MD)
- CONCLUSIONS: There is uncertainty about the benefits and harms of screening for AF with ECG. Although screening with ECG can detect previously unknown cases of AF, it has not been shown to detect more cases than opportunistic screening that is focused on pulse palpation. Most older adults with previously unknown AF have a stroke risk above the threshold for anticoagulation. Multiple treatments for AF reduce the risk of stroke and all-cause mortality, and increase the risk of bleeding, but trials have not assessed whether treatment of screen-detected asymptomatic older adults results in better health outcomes than treatment after detection by usual care or after symptoms develop.
- Lower extremity function is independently associated with hospitalization burden in heart failure with preserved ejection fraction. [Journal Article]
- JCJ Card Fail 2018 Sep 13
- CONCLUSIONS: Lower extremity function, as measured by the SPPB, independently predicts hospitalization burden in outpatients with HFpEF. Additional studies are warranted to explore shared mechanisms and treatment implications of frailty in HFpEF.
- Reduced Stroke After Transcatheter Patent Foramen Ovale Closure: A Systematic Review and Meta-analysis. [Journal Article]
- AJAm J Med Sci 2018; 356(2):103-113
- CONCLUSIONS: TPFO closure plus antiplatelet therapy is superior to medical therapy in patients with a PFO and cryptogenic stroke. PFO closure is associated with new-onset atrial fibrillation and a trend toward reduced neuropsychiatric events.
- Carotid Artery Entrapment By Hyoid Bone - A Rare Cause of Recurrent Strokes in a Young Patient. [Journal Article]
- AVAnn Vasc Surg 2018 Sep 12
- The search for etiology of stroke in a young patient may present a diagnostic challenge. In rare cases, chronic trauma to the carotid artery may be the cause of cerebral thromboembolic events. The hy...
The search for etiology of stroke in a young patient may present a diagnostic challenge. In rare cases, chronic trauma to the carotid artery may be the cause of cerebral thromboembolic events. The hyoid bone lies in close proximity to the carotid artery bifurcation, and anatomic variants have been implicated in carotid compression, stenosis, dissection, and pseudoaneurysm. We report a case of recurrent strokes in a 32 year-old woman due to an elongated hyoid bone causing thrombus formation in her right internal carotid artery (ICA) resulting in recurrent embolic strokes confirmed on diffusion-weighted magnetic resonance imaging (MRI). Computed tomography angiography (CTA) of the neck and head demonstrated the right hyoid bone was located between the ICA and external carotid artery (ECA), just above the carotid bifurcation, with residual non-occlusive thrombus in the right ICA. Carotid duplex ultrasonography confirmed that with the neck in neutral position the hyoid was located between the ICA and ECA; however with neck rotation the hyoid slipped across the ICA and out of the bifurcation. There was no evidence of carotid stenosis. Following an initial course of anticoagulation and anti-platelet therapy, resection of the greater cornu of the hyoid bone with release of the right ICA was performed. One year post-operatively the patient had complete return of neurologic function and had no further neurologic events. Hyoid bone entrapment of the carotid artery is a rare etiology of thromboembolic stroke caused by repetitive local trauma. The diagnosis can be confirmed by carotid duplex with provocative maneuvers. Partial hyoid resection is a safe and effective treatment to relieve recurrent symptoms. Hyoid bone entrapment may be an important and under-recognized cause of stroke in young adults.
- The effects of cardiovascular risk factor combined anti-platelet therapy and the risk of cerebrovascular events in patients with T2DM in an urban community over 96-months follow-up: The Beijing Communities Diabetes Study 19. [Journal Article]
- DRDiabetes Res Clin Pract 2018 Sep 12
- We investigated the prognostic significance of metabolic risk scores and aspirin with respect to cerebrovascular events.
We investigated the prognostic significance of metabolic risk scores and aspirin with respect to cerebrovascular events.
- Usefulness of EEG for the differential diagnosis of possible transient ischemic attack. [Journal Article]
- CNClin Neurophysiol Pract 2018; 3:11-19
- CONCLUSIONS: FSWA was the commonest EEG abnormality found in the early EEG of patients with possible TIA, but did not distinguish between TIA and seizure patients. In patients with seizures, FSWA was more common than EA and its presence in the late EEG was more likely in patients with epileptic seizures than with TIA.
- Response by Lau and Rothwell to Letter Regarding Article, "Antiplatelet treatment after transient ischemic attack and ischemic stroke in patients with cerebral microbleeds in 2 large cohorts". [Comment]
- SStroke 2018; 49(9)
- [Role of pre-hospital and hospital emergency services in the management of stroke]. [Journal Article]
- SSoins 2018; 63(828):33-35
- Any out-of-hospital neurological deficit of less than 24 hours should prompt a call for emergency medical help Urgent Medical Aid Service. Early identification of signs of stroke or transient ischaem...
Any out-of-hospital neurological deficit of less than 24 hours should prompt a call for emergency medical help Urgent Medical Aid Service. Early identification of signs of stroke or transient ischaemic attack allows to guide the therapeutic approach towards intravenous thrombolysis or other alternatives. Telemedicine centres complement the network of neurovascular units.
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- Cardiovascular, Respiratory, and Related Disorders [BOOK]
- BOOKThe International Bank for Reconstruction and Development / The World Bank: Washington (DC)
- According to the World Health Organization’s Global Health Estimates, stroke was the second-leading cause of death and the third-leading cause of disability-adjusted life years (DALYs) lost globally ...
According to the World Health Organization’s Global Health Estimates, stroke was the second-leading cause of death and the third-leading cause of disability-adjusted life years (DALYs) lost globally in 2012. In certain low- and middle-income countries (LMICs), such as China, the disease burden of stroke increased significantly over the past two decades, accounting for the most years of life lost in 2010. This chapter—the first on stroke in the history of the Disease Control Priorities publications—presents evidence on the disease burden of stroke, describing the epidemiology, disability, and socioeconomic burdens, then discusses modifiable and other risk factors for stroke. The chapter describes primary prevention, treatment, and management of stroke during the acute phase as well as secondary prevention and rehabilitation, with a focus on cost-effective strategies in LMICs, where such evidence exists. The chapter concludes with recommendations for policy makers and future research directions. There are two main types of stroke—ischemic, including transient ischemic attack, and hemorrhagic, including intracerebral and subarachnoid. The term stroke refers to all subtypes. The two main subtypes are distinguished from one another when appropriate because the etiology and management of these subtypes can be very different. Within the hemorrhagic subtype, we focus mainly on intracerebral hemorrhage, given that subarachnoid hemorrhage occurs spontaneously, usually from a ruptured cerebral aneurysm, or results from a head injury.