American Stroke Association, Feb. 17-19

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The American Stroke Association's International Stroke Conference

The annual American Stroke Association's International Stroke Conference was held from Feb. 17 to 19 in Los Angeles and attracted nearly 4,000 participants from around the world, including cerebrovascular research and practice experts. The conference featured more than 1,500 presentations that emphasized basic, clinical, and translational medicine, as well as providing insight into the prevention, management, and treatment of strokes.

In one study, Jenny P. Tsai, M.D., of Stanford University in California, and colleagues evaluated the association between onset-to-reperfusion time in patients with acute strokes affecting large arteries in the anterior circulation.

"We found that onset-to-reperfusion time has no significant association with the probability of good functional outcome in the subset of patients identified by computed tomography (CT) perfusion who achieved successful endovascular reperfusion," Tsai said.

The investigators concluded that the patients who have a target mismatch profile on CT perfusion, and achieve successful reperfusion, have a high probability of good functional outcome even well beyond the six-hour time window that is currently the recommended time frame for endovascular therapy.

"Whereas previous trials showed that the likelihood of achieving a good outcome after endovascular therapy decreases over time, and is in the range of 20 to 30 percent by eight hours, our results suggest that patients with a target mismatch profile still have a chance of doing well with endovascular therapy in the extended time window," Tsai added.

Several authors disclosed financial ties to pharmaceutical and medical device companies, including Covidien/Medtronic, Stryker Neurovascular, and iSchemaView.

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In another study, Souvik Sen, M.D., M.P.H., of the University of South Carolina School of Medicine in Columbia, and colleagues found that migraine with aura is significantly associated with increased risk of stroke both in men and women, and twice as likely when compared with migraine without aura.

"These results are in agreement with the previous studies which reported increased risk of stroke in migraine with aura. Furthermore, we found significant increased risk of cardioembolic stroke in migraine with aura, when compared to other subtypes of ischemic stroke," Sen said. "As our results point to the significant association of stroke with migraine, it emphasizes the importance of specific diagnostic testing to assess for cardioembolism and stroke prevention in migraine with aura patients."

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Haseeb A. Rahman, M.D., of the Zeenat Qureshi Stroke Institute in Minneapolis and Houston Methodist Hospital, and colleagues found that women who were currently taking hormone replacement therapy had an increased risk of having a worsening migraine over time. In addition, the investigators also found that patients who had no change in their migraine severity over the course of the study, but were taking hormone replacement therapy, still had a 10 percent increase in their risk of ischemic strokes.

"Perhaps the most important finding, which in fact was the basis of the study, was that patients who were currently taking hormone replacement therapy and had an increase in migraine severity had a 30 percent increase in risk of ischemic strokes when compared to those who were not taking hormone replacement therapy," Rahman said. "From these results, we concluded that patients who were currently taking hormone replacement therapy, and had an increase in migraine severity over their three-year follow up period, had an increased risk of ischemic strokes."

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ASA: Certain Factors Up Odds of Post-Stroke Bowel Obstruction

FRIDAY, Feb. 19, 2016 (HealthDay News) -- Gastrointestinal bowel obstruction (GIBO) is associated with worse prognosis for patients with acute ischemic stroke (AIS), according to a study presented at the annual American Stroke Association's International Stroke Conference, held from Feb. 17 to 19 in Los Angeles.

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ASA: Stenting, Endarterectomy Similar in Carotid Artery Stenosis

THURSDAY, Feb. 18, 2016 (HealthDay News) -- For patients with carotid artery stenosis, short- and long-term follow-up indicate that stenting has similar outcomes to endarterectomy, according to two studies published online Feb. 18 in the New England Journal of Medicine. The research was published to coincide with the annual American Stroke Association's International Stroke Conference, held from Feb. 17 to 19 in Los Angeles.

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ASA: Long-Term Seizure Risk for Patients With Stroke

THURSDAY, Feb. 18, 2016 (HealthDay News) -- A considerable proportion of patients with stroke develop a seizure, according to a study presented at the annual American Stroke Association's International Stroke Conference, held from Feb. 17 to 19 in Los Angeles.

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ASA: <50 Percent Stenosis in Some Acute Ischemic Strokes

THURSDAY, Feb. 18, 2016 (HealthDay News) -- Some ischemic strokes are not being ascribed to large-artery atherosclerosis because of <50 percent stenosis, according to a letter to the editor published online Feb. 17 in JACC: Cardiovascular Imaging to coincide with the annual American Stroke Association's International Stroke Conference, held from Feb. 17 to 19 in Los Angeles.

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ASA: Stroke Caregiving Costs Higher Than Previously Thought

THURSDAY, Feb. 18, 2016 (HealthDay News) -- Stroke survivors receive an average of 22 hours of caregiving per week, with the cost of caregiving for an elderly stroke survivor estimated at $11,300 annually, according to a study presented at the annual American Stroke Association's International Stroke Conference, held from Feb. 17 to 19 in Los Angeles.

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ASA: Pregnancy at Advanced Age Ups Hemorrhagic Stroke Risk

WEDNESDAY, Feb. 17, 2016 (HealthDay News) -- Pregnancy at an advanced age is associated with increased risk of hemorrhagic stroke after menopause, according to a study presented at the annual American Stroke Association's International Stroke Conference, held from Feb. 17 to 19 in Los Angeles.

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ASA: Pioglitazone After Stroke, TIA Helpful in Insulin Resistance

WEDNESDAY, Feb. 17, 2016 (HealthDay News) -- For patients with insulin resistance with recent stroke or transient ischemic attack (TIA), pioglitazone is associated with reduced risk of stroke or myocardial infarction, according to a study published online Feb. 17 in the New England Journal of Medicine. The research was published to coincide with the annual American Stroke Association's International Stroke Conference, held from Feb. 17 to 19 in Los Angeles.

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