]> Subscribe to the latest newsworthy research about Stroke as soon as it is published in <em>Neurology</em>^&reg;, the medical journal of the American Academy of Neurology. <em>Neurology</em> is the world's most widely read and highly cited peer-reviewed neurology journal. http://www.aan.com/rss/?event=feed&channel=14 en ababb@aan.com kwiersma@aan.com Thu, 13 Nov 2008 16:31:16 GMT Sat, 21 Nov 2009 11:27:51 GMT AXON RSS Extension http://blogs.law.harvard.edu/tech/rss ababb@aan.com Channel Feedback http://www.aan.com/rss/?event=feed&channel=14 http://www.aan.com/rss/images/channels/channel_14_s.jpg 144 144 Subscribe to the latest newsworthy research about Stroke as soon as it is published in <em>Neurology</em>^&reg;, the medical journal of the American Academy of Neurology. <em>Neurology</em> is the world's most widely read and highly cited peer-reviewed neurology journal. false 1 http://www.aan.com/rss/index.cfm/getfile/AAN_1835.pdf A new study shows that people who are smokers and have a family history of brain aneurysm appear to be significantly more likely to suffer a stroke from a brain aneurysm themselves. The research is published in the December 31, 2008, online issue of Neurology&reg;, the medical journal of the American Academy of Neurology and will appear in the January 6, 2009, print issue of Neurology&reg;. The type of stroke, called subarachnoid hemorrhage, is one of the bleeding types of stroke and is deadly in about 35 to 40 percent of people. In the study, scientists looked at 339 people who suffered a stroke from a brain aneurysm and 1,016 people who had not had a stroke due to an aneurysm. Current smokers made up half of the group that had a stroke. The other half had never smoked or had smoked in the past. The research found people who smoked and had a family history of stroke were more than six times more likely to suffer a stroke than those who did not smoke and did not have a family history of stroke or brain aneurysm. The study also found that people with a family history of stroke could cut their risk by more than half by quitting smoking. The results were the same regardless of high blood pressure, diabetes, alcohol use, body mass index and education level. "While all people should be advised to quit smoking, our findings suggest that there is an interaction so that if you smoke and you have a family history of aneurysms, you are at an extremely high risk of suffering a stroke from a ruptured brain aneurysm," says study author Daniel Woo, MD, with the University of Cincinnati in Ohio and member of the American Academy of Neurology. To learn the five signs of stroke, visit www.giveme5forstroke.org. Give Me Five for Stroke is a joint campaign of the American Academy of Neurology, the American College of Emergency Physicians and the American Heart Association/American Stroke Association to encourage people to recognize stroke symptoms, call 9-1-1, and get to the emergency department. The study was supported by the National Institute of Neurological Disorders and Stroke. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as multiple sclerosis, restless legs syndrome, Alzheimer's disease, narcolepsy, and stroke. For more information about the American Academy of Neurology, visit www.aan.com. http://www.aan.com/rss/index.cfm/getfile/AAN_1835.pdf ababb@aan.com Wed, 31 Dec 2008 22:00:00 GMT 1 http://www.aan.com/rss/index.cfm/getfile/AAN_1836.pdf Two new studies show that hormone therapy for women is linked to brain shrinkage, but not to the small brain lesions that are the first sign of cerebrovascular disease. The studies are published in the January 13, 2009, print issue of Neurology&reg;, the medical journal of the American Academy of Neurology. Earlier studies showed that estrogen with or without added progestin increased the risk for developing dementia and cognitive decline, or difficulty with thinking skills and memory in women age 65 and older. These new studies aimed to look at how the hormones might affect memory and thinking skills. The studies involved participants of the Women's Health Initiative hormone therapy clinical trials who also agreed to participate in a substudy called the Women's Health Initiative Memory Study. These studies were stopped earlier than planned when researchers found that the hormone therapy increased health risks and failed to prevent heart disease. Researchers took MRI brain scans of 1,400 women ages 71 to 89 one to four years after the Women's Health Initiative hormone studies ended. They found women who had taken estrogen with or without progestin had smaller brain volumes in two areas of the brain than the women who had taken a placebo. Brain volume was 2.37 cubic centimeters lower in the frontal lobe in the women taking estrogen and .10 cubic centimeters lower in the hippocampus. Both areas are involved in thinking and memory skills, and loss of volume in the hippocampus is a risk factor for dementia. "These effects were most apparent in women who may already have had some memory problems before they started taking hormones," said study author Susan Resnick, PhD, of the National Institute on Aging in Baltimore, MD. "This suggests that estrogen may adversely affect thinking skills among women whose brains may already be beginning a neurodegenerative disease process." In the second study, researchers found that hormone therapy was not linked to an increase in volumes of small vascular lesions in the brain or "silent strokes" that are often the first sign of cerebrovascular disease. "This was not what we expected to find," said study author Laura H. Coker, PhD, of Wake Forest University Health Sciences in Winston-Salem, NC. Coker said the negative effects of hormone therapy on cognitive skills may not be related primarily to vascular disease but to neurodegeneration, which is supported by the first study's findings of brain atrophy. The Women's Health Initiative, a major 15-year research program designed to address the most frequent causes of death, disability and poor quality of life in postmenopausal women, is funded by the National Heart, Lung, and Blood Institute. The memory study was also funded in part by Wyeth Pharmaceuticals, Inc. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as multiple sclerosis, restless legs syndrome, Alzheimer's disease, narcolepsy, and stroke. For more information about the American Academy of Neurology, visit www.aan.com. http://www.aan.com/rss/index.cfm/getfile/AAN_1836.pdf ababb@aan.com Mon, 12 Jan 2009 22:00:00 GMT 1 http://www.aan.com/rss/index.cfm/getfile/AAN_1881.pdf The number of children with a certain blood disorder undergoing an ultrasound to help prevent stroke is up significantly in the past 10 years since the publication of a major study showing its benefits. However, limited access to labs that perform this type of screening appears to be a barrier to helping these children who are at a high risk of stroke. The research is published in the April 14, 2009, print issue of Neurology&reg;, the medical journal of the American Academy of Neurology. Researchers followed 157 children with sickle cell disease in northern California for an average of 8.5 years. Sickle cell disease is a lifelong blood disorder that increases a child's risk of stroke. Roughly one out of 10 children with the disease suffers a stroke by age 20. For the study, researchers determined how many children underwent a transcranial Doppler ultrasound (TCD) screening since 1998, when a major study, known as the STOP trial, was published. The STOP trial showed a more than 90-percent reduction in the stroke rate of children with sickle cell disease who received a TCD screening and were identified as having a high risk of stroke and could therefore have blood transfusion therapy. Since the STOP trial, the current study found the rate of TCD screening among children with sickle cell disease has increased six-fold while the annual stroke rate has dropped by more than half. However, researchers found children living farther away from a vascular laboratory were less likely to be screened. "Stroke in children with sickle cell disease should be a largely preventable disease, however, not all children at risk are getting screened," said Heather J. Fullerton, MD, MAS, with the University of California, San Francisco. "Limited access to labs that perform TCD screening, even among kids with comprehensive health insurance, appears to be a barrier to helping these kids reduce their high risk of stroke. Increased availability of these screening labs may help prevent stroke in these high risk children." Guidelines from the American Academy of Neurology recommend TCD screening of children with sickle cell disease beginning at age two. The study was supported by a grant from the Thrasher Research Fund. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as multiple sclerosis, restless legs syndrome, Alzheimer's disease, narcolepsy, and stroke. For more information about the American Academy of Neurology, visit www.aan.com. http://www.aan.com/rss/index.cfm/getfile/AAN_1881.pdf ababb@aan.com Mon, 13 Apr 2009 21:00:00 GMT 1 http://www.aan.com/rss/index.cfm/getfile/AAN_1897.pdf Reaching optimal levels for cholesterol and high blood pressure in people who've had a stroke adds up to prevent a second stroke or heart attack, according to a study to be presented as part of the Late-breaking Science Program at the American Academy of Neurology's 61st Annual Meeting in Seattle, April 25 - May 2, 2009. Researchers looked at four risk factors for stroke: high LDL cholesterol, low HDL cholesterol, high triglycerides, and high blood pressure. They found that for each risk factor that is controlled at the optimal level, the risk of stroke and other major cardiovascular problems goes down. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) study involved 4,731 people who had a recent stroke or transient ischemic attack, or mini stroke. Half received the cholesterol-lowering drug atorvastatin, and half received a placebo. The participants were followed for an average of 4.9 years. People who reached optimal levels in all four risk factors were 65 percent less likely to have another stroke as people who did not reach optimal levels on any of the risk factors. Those who reached the optimal level on three risk factors were 38 percent less likely to have another stroke, and those who reached the optimal level on two risk factors were 22 percent less likely to have another stroke. Those who reached the optimal level on only one risk factor were only two percent less likely to have another stroke than people who did not meet any of the optimal levels. "These results show that there is a cumulative effect to lowering cholesterol and blood pressure," said study author Pierre Amarenco, MD, of Denis Diderot University and Medical School in Paris, France, and a Fellow of the American Academy of Neurology. "People need to work with their doctors to reach the optimal level on all of these risk factors." Amarenco said prior to this study researchers knew that lowering cholesterol and blood pressure was helpful overall in preventing stroke, but did not know whether one risk factor played a stronger role than another. The optimal levels were defined as LDL "bad" cholesterol of lower than 70, HDL "good" cholesterol of higher than 50, triglycerides less than 150, and blood pressure less than 120/80. The study was supported by Pfizer Inc. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as multiple sclerosis, restless legs syndrome, Alzheimer's disease, narcolepsy, and stroke. For more information about the American Academy of Neurology, visit www.aan.com. http://www.aan.com/rss/index.cfm/getfile/AAN_1897.pdf ababb@aan.com Thu, 30 Apr 2009 01:15:00 GMT 1 http://www.aan.com/rss/index.cfm/getfile/AAN_1915.pdf EMBARGOED FOR RELEASE UNTIL 4 P.M. ET, MONDAY, MAY 25, 2009 Media Contacts: Rachel Seroka, rseroka@aan.com, (651) 695-2738 Angela Babb, ababb@aan.com, (651) 695-2789 Cholesterol-Lowering Drugs May Help Prevent Stroke Recurrence ST. PAUL, Minn. - People who take cholesterol-lowering drugs called statins after a stroke may be less likely to have another stroke later, according to research published in the May 26, 2009, print issue of Neurology&reg;, the medical journal of the American Academy of Neurology. Those who take statins after a stroke may also be less likely to die within the next 10 years than those who do not take statins. "Considering the large burden that stroke carries around the world, these potential benefits of statins are significant," said study author Sotirios Giannopoulos, MD, DSc, of the University of Ioannina School of Medicine in Greece. "Also, second strokes tend to result in more disability and longer time spent in hospitals than first strokes, so anything that can prevent these recurrent strokes is beneficial." The study involved 794 people who had strokes and had health information available for 10 years after the stroke. Researchers looked back at the records to see what factors affected the risk for having a second stroke or dying within 10 years after the stroke. During that time, 112 people had a second stroke and 224 people died. Those who took statins were 35 percent less likely to have a second stroke and 57 percent less likely to die within 10 years than those who did not take statins. About 8 percent of those on statins had a second stroke, compared to 16 percent of those not taking statins. Researchers analyzed other risk factors for stroke, such as high blood pressure, diabetes, smoking, and heart problems, but found that statin use was the only factor tied to a reduced risk of recurrent stroke and death. "It's possible that effects from the drugs that are separate from their cholesterol-lowering effects are responsible for this result," Giannopoulos said. "Statins have anti-inflammatory and antioxidative effects and also prevent blood clotting and stabilize plaque in the arteries, so one of these mechanisms may help to prevent recurrent stroke." The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as epilepsy, dystonia, migraine, Huntington's disease, and dementia. For more information about the American Academy of Neurology, visit www.aan.com or www.TheBrainMatters.org. http://www.aan.com/rss/index.cfm/getfile/AAN_1915.pdf ababb@aan.com Mon, 25 May 2009 21:00:00 GMT 1 http://www.aan.com/rss/index.cfm/getfile/AAN_1918.pdf EMBARGOED FOR RELEASE UNTIL 4 P.M. ET, MONDAY, JUNE 1, 2009 Media Contacts: Rachel Seroka, rseroka@aan.com, (651) 695-2738 Angela Babb, ababb@aan.com, (651) 695-2789 Suffer Stroke Symptoms? Second Strokes Often Follow Within Hours ST. PAUL, Minn. - About half of all people who have a major stroke following a warning stroke (a transient ischemic attack or mild stroke) have it within 24 hours of the first event, according to research published in the June 2, 2009, print issue of Neurology&reg;, the medical journal of the American Academy of Neurology. "Our study highlights the need for someone who is experiencing the symptoms of a mini-stroke or transient ischemic attack to get to an emergency room fast," said Peter Rothwell, MD, PhD, FRCP, FMedSci, with the University of Oxford in the United Kingdom. "That's because even after a very minor initial stroke, the immediate risk of a major stroke is very high." For the study, researchers analyzed the medical records of 1,247 people who experienced a TIA, or minor stroke. Of those, 35 had recurrent strokes within 24 hours during the first month after experiencing the TIA. Scientists looked at whether patients had another stroke within six, 12 and 24 hours after the first stroke. The timeline started when the person either experienced symptoms of a stroke or first called for medical help. The study found that after six hours, the risk of a second stroke went up by 1.2 percent. After 12 hours, the risk climbed another percent and by 24 hours the risk increased to 5 percent. "This is the first rigorous population based study of the risk of a second stroke within 24 hours of a minor stroke," said Rothwell. "We found a second stroke rate of about 5 percent, with half of all second strokes within seven days occurring in the first 24 hours, and half of these early recurrent strokes being disabling or fatal." To learn the five signs of stroke, visit www.giveme5forstroke.org. Give Me Five for Stroke is a joint campaign of the American Academy of Neurology, the American College of Emergency Physicians and the American Heart Association/American Stroke Association to encourage people to recognize stroke symptoms, call 9-1-1, and get to the emergency department. The study was supported by the UK Medical Research Council, the National Institute of Health Research, the Stroke Association, the Dunhill Medical Trust and the Oxford Partnership Comprehensive Biomedical Research Center. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as multiple sclerosis, restless legs syndrome, Alzheimer's disease, narcolepsy, and stroke. For more information about the American Academy of Neurology, visit www.aan.com or www.TheBrainMatters.org. http://www.aan.com/rss/index.cfm/getfile/AAN_1918.pdf ababb@aan.com Mon, 01 Jun 2009 21:00:00 GMT 1 http://www.aan.com/rss/index.cfm/getfile/AAN_1935.pdf "Silent" strokes, which are strokes that don't result in any noticeable symptoms but cause brain damage, are common in people over 60, and especially in those with high blood pressure, according to a study published in the July 28, 2009, print issue of Neurology&reg;, the medical journal of the American Academy of Neurology. "These strokes are not truly silent, because they have been linked to memory and thinking problems and are a possible cause of a type of dementia," said study author Perminder Sachdev, MD, PhD, of the University of New South Wales in Sydney, Australia. "High blood pressure is very treatable, so this may be a strong target for preventing vascular disease." The study involved 477 people age 60 to 64 who were followed for four years. At the beginning of the study 7.8 percent of the participants had the silent lacunar infarctions, small areas of damage to the brain seen on MRI that never caused obvious symptoms. They occur when blood flow is blocked in one of the arteries leading to areas deep within the brain, such as the putamen or the thalamus. By the end of the study, an additional 1.6 percent of the participants had developed "silent" strokes. People with high blood pressure were 60 percent more likely to have silent strokes than those with normal blood pressure. Also, people with another type of small brain damage called white matter hyperintensities were nearly five times as likely to have silent strokes as those without the condition. The study was supported by the National Health and Medical Research Council of Australia. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease, and multiple sclerosis. For more information about the American Academy of Neurology, visit http://www.aan.com or www.thebrainmatters.org. http://www.aan.com/rss/index.cfm/getfile/AAN_1935.pdf ababb@aan.com Mon, 27 Jul 2009 21:00:00 GMT 1 http://www.aan.com/rss/index.cfm/getfile/AAN_1956.pdf One out of every eight strokes is preceded by a "warning stroke," which is a transient ischemic attack (TIA) or mild stroke, according to research published in the September 29, 2009, print issue of Neurology&reg;, the medical journal of the American Academy of Neurology. "These results illustrate the need for better risk assessment tools for preventing strokes before they occur," said study author Daniel G. Hackam, MD, PhD, of the University of Western Ontario in London, ON. "Other studies have shown that up to 80 percent of strokes after TIA can be prevented when risk factors are managed intensively." For the study, researchers identified all people at Ontario hospitals with a diagnosis of stroke over four years. Of the 16,400 patients, 2,032, or 12.4 percent, had a TIA prior to the stroke. During a TIA, stroke symptoms last for less than 24 hours and then resolve. Those who did not have a warning stroke were more likely to have a more serious stroke than those who did have the warning stroke. Those with no warning were more likely to die while at the hospital (15.2 percent compared to 12.7 percent), more likely to have a heart arrest while in the hospital (4.8 percent compared to 3.1 percent) and less likely to be able to go home after the hospital stay, rather than to a nursing home or rehabilitation center (40.1 percent compared to 43.1 percent). Those with the warning stroke were typically older than those without warning strokes. They were also more likely to have diabetes, high blood pressure and heart problems. "It's possible that the blood vessels of those with warning strokes were preconditioned to the lack of blood flow, which protected them from the full result of the larger stroke. Any person who experiences even a minor stroke should get to the emergency room immediately." The study was supported by the Canadian Institutes of Health Research and Ontario Ministry of Health and Long-Term Care. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as epilepsy, dystonia, migraine, Huntington's disease, and dementia. For more information about the American Academy of Neurology, visit www.aan.com or www.thebrainmatters.org. http://www.aan.com/rss/index.cfm/getfile/AAN_1956.pdf ababb@aan.com Mon, 28 Sep 2009 21:00:00 GMT 1 http://www.aan.com/rss/index.cfm/getfile/AAN_1963.pdf People with high levels of a protein called C-reactive protein (CRP), a marker for inflammation in the blood, may be at higher risk for heart attack and death but not stroke, according to a study published in the October 20, 2009, print issue of Neurology&reg;, the medical journal of the American Academy of Neurology. The study involved 2,240 people from the Northern Manhattan Study who were 40 years old or older and stroke-free. Of the group, 63 percent were Hispanic, 20 percent non-Hispanic black and 15 percent non-Hispanic white residents. All participants had their blood tested for CRP levels and were evaluated for stroke and heart attack risk factors. They were followed for an average of eight years. In that time, there were 198 strokes, 156 heart-related events and 586 deaths. The researchers found that people with CRP levels greater than three milligrams per liter were 70 percent more likely to suffer a heart attack and 55 percent more likely to die early compared to people who had levels of one milligram per liter or less of the protein in their blood. The protein was not associated with an increased risk of stroke once other risk factors were taken into account. "The role of this protein in predicting risk of stroke has been controversial although prior studies have found it to be a marker for predicting risk of heart disease," said study author Mitchell Elkind, MD, MS, of Columbia University Medical Center in New York and a Fellow with the American Academy of Neurology. "However, in our large, multiethnic population, CRP levels did not play a role in predicting stroke, though they may still help determine whether someone is at risk of heart attack or early death." CRP protein levels are associated with such medical and lifestyle risk factors as diabetes, smoking, alcohol consumption and physical activity. "It appears that by living a healthy lifestyle, one may be able to lower these protein levels, thus lowering the risk of cardiac events and possibly early death," said Elkind. "It may be that the failure of CRP to predict stroke in our study, unlike in some other populations, reflects the fact that our population is older and has more of these risk factors. While CRP may be predictive in generally young healthy people, it may be less useful among older, sicker people. More research needs to be done on why the protein wasn't able to predict stroke in the same manner as heart disease." The study was supported by the National Institutes of Health. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as multiple sclerosis, restless legs syndrome, Alzheimer's disease, narcolepsy, and stroke. For more information about the American Academy of Neurology, visit http://www.aan.com or http://www.thebrainmatters.org. http://www.aan.com/rss/index.cfm/getfile/AAN_1963.pdf ababb@aan.com Mon, 19 Oct 2009 21:00:00 GMT