Stroke
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Recanalization Treatment in Pediatric Arterial Ischemic Stroke
In a population-based study from Switzerland, the authors found that recanalization treatment (intravenous thrombolysis or endovascular treatment) overall was safe without significant side effects or increased mortality compared to standard care.
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Dual Antiplatelet Therapy for Minor Ischemic Stroke or TIA
These investigators undertook this study to evaluate the effect of clopidogrel plus aspirin, vs. aspirin alone, in an international population of patients who had minor ischemic stroke or TIA — Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT).
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Tenecteplase vs. Alteplase for Ischemic Stroke
In a recent trial, treatment with tenecteplase before thrombectomy was associated with a higher incidence of reperfusion and better functional outcome than alteplase if administered to patients with ischemic stroke within 4.5 hours of symptom onset.
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Postoperative Atrial Fibrillation After Coronary Artery Bypass Graft
The data from this study do not indicate that new-onset postoperative atrial fibrillation should be regarded as having the same risks as primary nonvalvular atrial fibrillation in terms of long-term thromboembolic risk, and that anticoagulation in this group may not be necessary unless the atrial fibrillation is persistent.
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Proceedings From the International Stroke Conference, Los Angeles, February 2018
Message from the editor: The following reviews of studies presented at the 2018 International Stroke Conference were written after my personal attendance at the presentations, followed by review of the simultaneous publications in the journals Stroke, The New England Journal of Medicine, JAMA Neurology, and the Journal of the American Medical Association.
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Thrombectomy Is Effective Up to 24 Hours After Stroke – the DAWN Trial
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Migraine With Aura, Stroke Risk, and Biomarkers
A longitudinal cohort study of twins found no increased stroke risk related to migraine overall, but there was a modestly increased risk for stroke related to migraine with aura. Familial factors and vascular biomarkers associated with migraine with aura may explain its correlation with vascular disease.
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What Is the Ideal Target for Blood Pressure Control?
Patient-reported outcomes in a recent trial of subjects who received intensive treatment with a target systolic blood pressure of < 120 mmHg were similar to those who received standard care, supporting the recommendations of SPRINT.
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Cerebrolysin Is Unproven as a Neuroprotectant for Acute Ischemic Stroke
The routine use of Cerebrolysin in acute stroke is not justified.
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Idarucizumab for Reversal of the Anticoagulant Effects of Dabigatran
The administration of idarucizumab is effective and safe for the reversal of the direct thrombin inhibitor, dabigatran, and should be used in appropriate clinical situations.