Open access

NEWS - Neurology

Endovascular treatment for acute ischaemic stroke in routine clinical practice: prospective, observational cohort study (MR CLEAN Registry) – The BMJ (free)

Related guideline: 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association / American Stroke Association (free PDF) AND Summary for ED-relevant care: 2018 AHA/ASA Ischemic Stroke Updates – emDocs (free)

“In routine clinical practice, endovascular treatment for patients with acute ischemic stroke is at least as effective and safe as in the setting of a randomized controlled trial”.


Socioeconomic disparities in first stroke incidence, quality of care, and survival: a nationwide registry-based cohort study of 44 million adults in England – The Lancet Public Health (free)

Invited commentary: Preventing stroke on the street where you live, work, and play (free)

Patients from the lowest socioeconomic groups had first stroke a median of 7 years earlier than those from the highest and a 26% higher adjusted risk of 1-year mortality.


Outcomes, experiences and palliative care in major stroke: a multicentre, mixed-method, longitudinal study – Canadian Medical Association Journal (free)

““Palliative care” had connotations of treatment withdrawal and imminent death… practicing the principles of palliative care is needed, but the term “palliative care” should be avoided or reframed”.

See related articles on this subject: Palliative care: renaming as supportive care and integration into comprehensive cancer care – CMAJ (free) AND Perceptions of palliative care among patients with advanced cancer and their caregivers (free)


Comparative Effectiveness and Safety of Cognitive Enhancers for Treating Alzheimer’s Disease: Systematic Review and Network Meta-analysis – Journal of the American Geriatrics Society (free)

Source: Medscape (free registration required)

“Cognitive enhancers in general have minimal effects on cognition according to minimal clinically important difference and global ratings. The drugs appear safe, but this must be interpreted cautiously because trial participants may have less comorbidity and fewer adverse effects than those treated with these drugs in clinical practice”.


Effect of Haloperidol on Survival Among Critically Ill Adults With a High Risk of Delirium: The REDUCE Randomized Clinical Trial – JAMA (free)

Prophylactic haloperidol in this population with elevated risk of delirium did not reduce mortality or any of the 15 prespecified secondary outcomes, including delirium incidence, 28-day delirium-free and coma-free days, duration of mechanical ventilation, and ICU and hospital length of stay.


Prognostic effects of delirium motor subtypes in hospitalized older adults: A prospective cohort study – PLOS One (free) (via @DrMeganHoseyPhD)

“One in three acutely ill hospitalized older adults who suffered hypoactive or mixed delirium died in the hospital”


Five and 10 minute Apgar scores and risks of cerebral palsy and epilepsy: population based cohort study in Sweden – The BMJ (free)

Infographic: The vital ­first 10 minutes (free PDF)

Even slight changes within the normal Apgar score range (7-10) from five to 10 minutes have a major influence in the risks of cerebral palsy and epilepsy.


Traumatic brain injury and the risk of dementia diagnosis: A nationwide cohort study – PLOS One (free)

Commentaries: TBI is associated with increased dementia risk for decades after injury – PLOS, via ScienceDaily (free) AND More evidence traumatic brain injuries raise later dementia risk – Reuters (free)

“Using longitudinal, case-control, and sibling-matched analyses of nationwide data from Sweden, Peter Nordström & Anna Nordström describe the association between TBI and dementia, its time course, and the influence of familial factors”. (via @PLOSMedicine see Tweet)


2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association (free PDF)

Commentaries: More stroke patients eligible for crucial treatments under new guidelines – American Heart Association News (free) AND More stroke patients may receive crucial treatments under new guideline – AHA/ASA Newsroom (free)

“A new guideline for treating acute ischemic stroke recommends an increased treatment window for mechanical clot removal from six hours to up to 24 hours in certain patients with clots in large vessels”. (from AHA/ASA Newsroom)


Association of Time to Treatment With Short-term Outcomes for Pediatric Patients With Refractory Convulsive Status Epilepticus – JAMA Neurology (free for a period)

Editorial: Time May Be of the Essence in the Treatment of Pediatric Patients With Refractory Convulsive Status Epilepticus (free)

Commentary: Delays Raise Death Risk in Kids with Status Epilepticus – MedPage Today (free registration required)

“These findings may change the perception of acute seizure and status epilepticus treatment, tentatively converting it into an extremely time-sensitive emergency that is similar to stroke or other cardiovascular events”.


Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial – The Lancet (free)

Commentaries: Learning from TARDIS: time for more focused trials in stroke prevention – The Lancet (free) AND Triple Antiplatelets for Reducing Dependency After Ischaemic Stroke – TARDIS – American College of Cardiology, Latest in Cardiology (free)

“Among patients with recent cerebral ischaemia, intensive antiplatelet therapy did not reduce the incidence and severity of recurrent stroke or TIA, but did significantly increase the risk of major bleeding. Triple antiplatelet therapy should not be used in routine clinical practice”.


Practice guideline update summary: Mild cognitive impairment – American Academy of Neurology (free PDF)

Commentary: Mild cognitive impairment: a practice guideline update – Clinical Advisor (free)

“For patients diagnosed with MCI, clinicians may choose NOT to offer cholinesterase inhibitors”.

“If clinicians choose to offer cholinesterase inhibitors, they must first discuss with patients the fact that this is an off-label prescription not currently backed by empirical evidence”.


Early Recurrence and Major Bleeding in Patients With Acute Ischemic Stroke and Atrial Fibrillation Treated With Non–Vitamin‐K Oral Anticoagulants (RAF‐NOACs) Study – Journal of the American Heart Association (free)

“Composite rates of recurrence and major bleeding were 12.4% in patients who initiated NOACs within 2 days after acute stroke, 2.1% in those who initiated NOACs between 3 and 14 days, and 9.1% in patients who initiated NOACs >14 days after acute stroke. Future randomized studies to assess timing of initiation and choice of agent in patients with acute stroke and AF are warranted”.


First Dementia Global Monitoring System Launched: Global Dementia Observatory (free resources)

News release: Dementia: number of people affected to triple in next 30 years – World Health Organization (free)


Clinical Management of Insomnia Disorder – JAMA (free)

“Cognitive Behavior Therapy for insomnia is recommended as 1st-line Tx; pharmacotherapy, if used, should be on a short-term basis” (RT @JAMAInternalMed see Tweet)


Increasing prevalence of vascular risk factors in patients with stroke – Neurology (link to abstract – $ for full-text)

Commentary: Health Conditions That Increase Stroke Risk Rise Across All Ages, Races – NPR (free)

“An estimated 80% of all 1st strokes are due to risk factors that can be changed,” says new study (RT @ACCmediacenter see Tweet)


Relationship of Sleep Duration With All‐Cause Mortality and Cardiovascular Events: A Systematic Review and Dose‐Response Meta‐Analysis of Prospective Cohort Studies – Journal of The American Heart Association (free)

“Our findings indicate that both short and long sleep duration is associated with an increased risk of all‐cause mortality and cardiovascular events”.


Antipsychotic Use With and Without Comorbid Psychiatric Diagnosis Among Adults with Intellectual and Developmental Disabilities – The Canadian Journal of Psychiatry (link to abstract – $ for full-text)

Commentaries: Antipsychotics common for adults with intellectual and developmental disabilities – Centre for Addiction and Mental Health (free) AND Antipsychotics Overused in Intellectually Disabled Adults – Medscape (free registration required)

“Antipsychotics are used inappropriately particularly in vulnerable groups: Poor children; Intellectually challenged; Autistic; Nursing homes. (RT @AllenFrancesMD see Tweet)


Individualised prediction model of seizure recurrence and long-term outcomes after withdrawal of antiepileptic drugs in seizure-free patients: a systematic review and individual participant data meta-analysis – The Lancet Neurology (link to abstract – $ for full-text)

Commentary: Model Predicts Outcomes After AED Withdrawal – Neurology Reviews (free registration required)

Source: Journal Watch ($ resource to find articles of interest)

“A meta-analysis allows researchers to identify predictors of seizure recurrence and long-term seizure outcomes” (from Neurology Reviews).


Headache and migraine: interventions for preventing or treating headache and migraine – Cochrane Library (free) (RT @CochraneUK see Tweet)

Migraine awareness week (3-9 September). Latest Cochrane Evidence on interventions for preventing or treating headache and migraine.


Physical Activity Frequency and the Risk of Stroke: A Nationwide Cohort Study in Korea – Journal of The American Heart Association (free)

“Even 1 to 2 times a week of moderate‐ to vigorous‐intensity physical activity might be beneficial to prevent a first‐ever stroke in the general population… from a public health perspective, we need to encourage inactive people to start exercising with more‐achievable goals”.


Head injuries in sport must be taken more seriously – Nature News (free)

“Sports organizations are only starting to understand the harm that can be inflicted by high-contact activities. Science must play its part in highlighting the problem and in aiding diagnosis”.


Association of Sleep-Disordered Breathing With Cognitive Function and Risk of Cognitive Impairment: A Systematic Review Meta-analysis – JAMA Neurology (link to abstract – $ for full-text)

Commentaries: Breathing Disorders During Sleep Tied to Cognitive Issues – MedPage Today (free registration required) AND Sleep-Disordered Breathing Raises Risk for Cognitive Decline – Medscape (free registration required)

This meta-analysis of observational studies suggests a possible association. Further studies are needed to examine whether the treatment of this condition can help in the prevention of dementia and in improvement of cognition.


Long-Term Effects of Repeated Injections of Local Anesthetic With or Without Corticosteroid for Lumbar Spinal Stenosis: A Randomized Trial – Archives of Physical Medicine and Rehabilitation (free)

Source: ACP Journal Wise ($)

“Epidural injections of corticosteroid plus lidocaine offered no benefits from 6 weeks to 12 months beyond that of injections of lidocaine alone”


Page 1 of 212

Stay updated in your specialty!

No spam, just news
Unsubscribe with one click