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Stroke 2025 Is Here!

Stroke 2025: Optimizing Outcomes with Clinical Approaches provides evidence-based, cutting edge, clinical information on treating stroke and other neurological problems in a concise, accurate, and clinically relevant format. Written and edited by leading experts in the fields of neurology and emergency medicine, Stroke 2025 is an unbiased resource for any physician or nurse working in an emergency department or stroke center. Healthcare providers can earn all of the Joint Commission-required stroke credits at one time through this electronic publication.

ABCD² Score as a Predictor of Three-Year Stroke Risk

This retrospective cohort study using the National Patient Registry in Denmark analyzed a three-year follow-up period following a transient ischemic attack, looking at the rate of recurrent stroke and mortality. The patients were divided into low risk (ABCD² score 0-3) and high risk (ABCD² score ≥ 4). The stroke rate was 6% in the high-risk group and 4% in the low-risk group.

ABCD² Score as a Predictor of Three-Year Stroke Risk

This retrospective cohort study using the National Patient Registry in Denmark analyzed a three-year follow-up period following a transient ischemic attack, looking at the rate of recurrent stroke and mortality. The patients were divided into low risk (ABCD² score 0-3) and high risk (ABCD2 score ≥ 4). The stroke rate was 6% in the high-risk group and 4% in the low-risk group.

Intravenous Tenecteplase for Stroke After 4.5 Hours Does Not Improve Outcome

Standard therapy for acute ischemic stroke is intravenous thrombolysis within 4.5 hours from onset of symptoms. Alteplase has been the standard medication, but in recent years, tenecteplase has supplanted alteplase because of its ease of administration as a single intravenous bolus and lower cost.

DOACs Can Safely Be Started Early After Atrial Fibrillation-Associated Stroke

In ischemic stroke associated with atrial fibrillation, early restart of anticoagulation with apixaban one to three days after ischemic stroke, compared to late restart (seven to 14 days), resulted in no significant differences between the groups in the primary outcome — a composite endpoint including recurrent ischemic stroke, symptomatic intracranial hemorrhage, and systemic embolism.

DOACs Can Safely Be Started Early After Atrial Fibrillation-Associated Stroke

In ischemic stroke associated with atrial fibrillation, early restart of anticoagulation with apixaban one to three days after ischemic stroke, compared to late restart (seven to 14 days), there were no significant differences between the groups in the primary outcome — a composite endpoint including recurrent ischemic stroke, symptomatic intracranial hemorrhage, and systemic embolism.

Indications for Reduced-Dose Direct Oral Anticoagulants

A subgroup analysis of the ENGAGE-AF TIMI 48 study of edoxaban 60 mg/day vs. 30 mg/day compared to warfarin in patients with atrial fibrillation of the group 80 years of age or older has shown that 30 mg/day results in less major bleeding without a concomitant increase in stroke risk compared to 60 mg/day or warfarin.

Are Women with Atrial Fibrillation Still at Higher Risk of Ischemic Stroke?

A Finnish national database study of newly diagnosed atrial fibrillation from 2007-2018 has shown that the independent association of ischemic stroke risk with female sex initially was high but trended downward to nonsignificant at the end of the study. This has implications for the risk stratification of atrial fibrillation patients regarding oral anticoagulation therapy.

Searching for a Neuroprotective Agent in Celery Seed Oil

A Phase III double-blind, placebo-controlled, randomized, controlled trial suggests that early administration of DL-3-n-butylphthalide, when given adjunctively to thrombolysis or endovascular therapy, improves functional outcomes in patients with acute ischemic stroke. Statistically significant results of well-designed analyses are tantalizing, but confidence in the findings is tempered by a lack of generalizability, an unclear mechanism of action, and trial design irregularities.

Timing of Anticoagulation Administration Following Atrial Fibrillation-Associated Stroke

A prospective, blinded, randomized study of early vs. later administration of oral anticoagulation after ischemic stroke in patients with atrial fibrillation calibrated by cerebral imaging showed no significant difference in 30-day outcomes.

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