Strokes still cause death every 3.3 minutes in the United States and are a leading cause of disability. Although the thrombolytic tissue plasminogen activator has been available for the treatment of ischemic stroke since 1996, no neuroprotectant acute stroke treatment strategy to preserve dysfunctional neurons in the ischemic penumbra has shown efficacy in clinical trials. New approaches for th...

Cryptogenic stroke represents one third of ischemic strokes, initial work up includes Computed Tomography (CT), Magnetic resonance imaging (MRI), laboratory investigations, Electrocardiogram (ECG) and Echocardiography either transthoracic (TTE) or Transesophageal (TEE). Patent foramen ovale (PFO) which is seen in between 15% and 25% of adults has been identified as a source for cryptogenic isch...

BACKGROUND AND PURPOSE Prehospital activation of in-hospital stroke response hastens treatment but depends on accurate emergency medical services (EMS) stroke recognition. We sought to measure EMS stroke recognition accuracy and identify clinical factors associated with correct stroke identification. METHODS Using EMS and hospital records, we assembled a cohort of EMS-transported suspect, con...

BACKGROUND Associations between fish consumption and stroke risk have been inconsistent, possibly because of the differences in types of fish meals consumed. Additionally, such relationships have not been specifically evaluated in the elderly, in whom disease burden may be high and diet less influential. METHODS Among 4775 adults 65 years or older (range, 65-98 years) and free of known cerebr...

BACKGROUND AND PURPOSE We aimed to examine the impact of fibrinogen concentrations on the incidence of stroke. METHODS We examined the association between fibrinogen and risk of total stroke and stroke subtypes in an 11-year prospective study of 4608 men and 7589 women aged 40 to 79 years with no history of stroke and/or coronary heart disease. The analysis was repeated, stratified by smoking...

BACKGROUND Stroke symptoms noticed upon waking, wake-up stroke, account for up to a quarter of all acute ischemic strokes. Patients with wake-up stroke, however, are often excluded from thrombolytic therapy. METHODS Using our prospectively collected stroke registry, wake-up stroke and known-onset morning strokes were identified. Wakeup stroke was defined as a patient who was asleep >3 hours a...

A 70-year-old man with a history of high blood pressure and multiple ischemic strokes was diagnosed stage 2 chronic myelomonocytic leukemia in 2014. At diagnosis, estimated glomerular filtration rate normal (100 ml/min per 1.73 m2). Bone marrow aspiration showed 15% blasts, for which azacytidine prescribed. The patient refused the recommended treatment, hydroxyurea introduced instead.

BACKGROUND Although it is preferable that all patients with a recent Transient Ischemic Attack (TIA) undergo acute carotid imaging, there are centers with limited access to such acute examinations. It is controversial whether ABCD2 or ABCD3 scores can be used to triage patients to acute or delayed carotid imaging. It would be acceptable that some patients with a symptomatic carotid stenosis are...