Annals of neurology
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In light of the results of the recent trials comparing endovascular treatment for acute ischemic stroke compared to the previous standard of care, endovascular treatment is now the new standard for patients with acute ischemic stroke resulting from proximal vessel occlusion. This is probably the greatest advancement in stroke treatment in two decades. However, these results, in addition to creating great opportunities for better outcomes for stroke patients and for future research, have also brought with it new challenges. In this article, we present the key results of the trials, as well as future challenges and opportunities.
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Annals of neurology · Jan 2016
Tau positron emission tomographic imaging in aging and early Alzheimer disease.
Detection of focal brain tau deposition during life could greatly facilitate accurate diagnosis of Alzheimer disease (AD), staging and monitoring of disease progression, and development of disease-modifying therapies. ⋯ These findings suggest that (18)F T807 PET could have value as a biomarker that reflects both the progression of AD tauopathy and the emergence of clinical impairment.
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Annals of neurology · Jan 2016
Randomized Controlled TrialIschemic core and hypoperfusion volumes predict infarct size in SWIFT PRIME.
Within the context of a prospective randomized trial (SWIFT PRIME), we assessed whether early imaging of stroke patients, primarily with computed tomography (CT) perfusion, can estimate the size of the irreversibly injured ischemic core and the volume of critically hypoperfused tissue. We also evaluated the accuracy of ischemic core and hypoperfusion volumes for predicting infarct volume in patients with the target mismatch profile. ⋯ Ischemic core and hypoperfusion volumes, obtained primarily from CT perfusion scans, predict 27-hour infarct volume in acute stroke patients who were treated with reperfusion therapies.
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Annals of neurology · Dec 2015
Randomized Controlled TrialSimvastatin and vitamin D for migraine prevention: A randomized, controlled trial.
The aim of this work was to assess efficacy and tolerability of simvastatin plus vitamin D for migraine prevention in adults with episodic migraine. ⋯ The results demonstrate that simvastatin plus vitamin D is effective for prevention of headache in adults with episodic migraine. Given statins' ability to repair endothelial dysfunction, this economical approach may also reduce the increased risk for vascular diseases among migraineurs.
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Annals of neurology · Dec 2015
Case ReportsQuinidine in the treatment of KCNT1 positive epilepsies.
We report 2 patients with drug-resistant epilepsy caused by KCNT1 mutations who were treated with quinidine. Both mutations manifested gain of function in vitro, showing increased current that was reduced by quinidine. ⋯ The other, who had a novel phenotype, with severe nocturnal focal and secondary generalized seizures starting in early childhood with developmental regression, did not improve. Although quinidine represents an encouraging opportunity for therapeutic benefits, our experience suggests caution in its application and supports the need to identify more targeted drugs for KCNT1 epilepsies.