Stroke
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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.
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Sudden Prehospital Death From Subarachnoid Hemorrhage
Based on recent nationwide data reported from Finland, one-fourth of those experiencing their first ever subarachnoid hemorrhage died suddenly before being admitted to a hospital.
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Treatment of Intracerebral Hemorrhage Guided by the ‘Spot Sign’
Although the “spot sign” is a predictor of early hematoma expansion, selective treatment of this group with aggressive antihypertensive therapy did not alter hematoma size or neurological outcome.
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Atypical Transient Symptoms Require Aggressive Investigation for Cause
Atypical transient symptoms, such as partial sensory deficit, dysarthria, vertigo and unsteadiness, unusual visual deficits, and diplopia, usually are not classified as transient ischemic attacks, and they frequently are not investigated in the same fashion. However, one-year risk of recurrent major vascular events was not significantly different between patients who had typical TIA symptoms or atypical isolated or non-isolated symptoms. Therefore, these patients should be investigated intensively in a manner similar to patients with classical TIA symptoms.
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What Is the Risk of Hemorrhage During Pregnancy for a Woman with Brain Arteriovenous Malformation?
The risk of hemorrhage in a pregnant woman with a brain arteriovenous malformation (AVM) is uncertain and management is controversial.
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Deep Brain Stimulation May Offer Hope in Treating Post-stroke Pain
This trial of deep brain stimulation of the ventral striatum/anterior limb of the internal capsule improved several measures of the affective sphere of pain in those suffering from post-stroke pain, despite no significant improvement seen in the pain disability index.
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Stroke: Rehabilitation and Recovery
Rehabilitation is a critical component of stroke treatment, as most stroke survivors are left with significant neurological impairments and other sequelae, such as spasticity and pain. Stroke rehabilitation aims to reverse these impairments to the extent possible, maximize functionality through the use of compensatory approaches, prevent complications, and manage comorbidities. This article reviews the basic principles of rehabilitation, current practices, and evidence supporting various aspects of stroke rehabilitation.