Rates of Acute Brain Injury Among Severely Hypertensive Patients Seen in the Emergency Department.

Background: Identifying patients with acute brain injury among patients who present to the Emergency Department (ED) with severe hypertension can be challenging. We explored rates of brain injury in a cohort of ED patients with severe hypertension in whom acute target-organ damage was or was not initially suspected.

Methods: We conducted a retrospective chart-review study at two different hospitals within the same urban health system.

Cost-Effectiveness of Increased Use of Dual Antiplatelet Therapy After High-Risk Transient Ischemic Attack or Minor Stroke.

Background: Rates of dual antiplatelet therapy (DAPT) after high-risk transient ischemic attack or minor ischemic stroke (TIAMIS) are suboptimal. We performed a cost-effectiveness analysis to characterize the parameters of a quality improvement (QI) intervention designed to increase DAPT use after TIAMIS.

Methods And Results: We constructed a decision tree model that compared current national rates of DAPT use after TIAMIS with rates after implementing a theoretical QI intervention designed to increase appropriate DAPT use.

Association of Assisted Reproductive Technology and Stroke During Hospitalization for Delivery in the United States.

Introduction: Infertility treatment with assisted reproductive technologies (ARTs) has been associated with adverse vascular events in some but not all previous studies. Endothelial damage, prothrombotic factor release, and a higher prevalence of cardiovascular risk factors in those receiving ART have been invoked to explain this association. We sought to explore the relationship between ART and stroke risk using population-level data.

Evaluation of Transient Ischemic Attack and Minor Stroke: A Rapid Outpatient Model for the COVID-19 Pandemic and Beyond.

The grim circumstances of the COVID-19 pandemic have highlighted the need to refine and adapt stroke systems of care. Patients' care-seeking behaviors have changed due to perceived risks of in-hospital treatment during the pandemic. In response to these challenges, we optimized a recently implemented, novel outpatient approach for the evaluation and management of minor stroke and transient ischemic attack, entitled RESCUE-TIA.

Smoking Cessation in Stroke Survivors in the United States: A Nationwide Analysis.

Background: Continued smoking after stroke is associated with a high risk of stroke recurrence and other cardiovascular disease. We sought to comprehensively understand the epidemiology of smoking cessation in stroke survivors in the United States. Furthermore, we compared smoking cessation in stroke and cancer survivors because cancer is another smoking-related condition in which smoking cessation is prioritized.

Posterior reversible encephalopathy syndrome in patients with COVID-19.

Objective: To report four patients with coronavirus disease 2019 (COVID-19) who developed posterior reversible encephalopathy syndrome (PRES).

Methods: Patient data was abstracted from medical records at Weill Cornell Medical Center.

Results: Four patients with SARS-CoV-2 infection and PRES were identified.

Gastrointestinal Disorders and the Nervous System.

Purpose Of Review: This article describes the neurologic sequelae of various nutritional micronutrient deficiencies, celiac disease, inflammatory bowel disease, and liver disease. Where relevant, appropriate treatments for these conditions are also discussed. The developing field of the microbiome and nervous system interaction is also outlined.

Vision Loss and Symmetric Basal Ganglia Lesions in Leber Hereditary Optic Neuropathy.

A 30-year-old woman with progressive vision loss was found to have asymptomatic, bilateral, and symmetric basal ganglia lesions on MRI and was later diagnosed with Leber hereditary optic neuropathy (LHON). The rare occurrence of basal ganglia changes on MRI in patients with LHON is discussed.

Neurologic manifestations of acute and chronic liver disease.

Purpose Of Review: This article summarizes the most common neurologic sequelae of acute and chronic liver failure, liver transplantation, and other treatments for liver disease, and outlines the pathogenesis, neurologic manifestations, and treatment of Wilson disease.

Recent Findings: The neurologic manifestations of liver disease are caused by the liver's failure to detoxify active compounds that have deleterious effects on the central and peripheral nervous systems. In addition, treatments for liver disease such as liver transplantation, transjugular intrahepatic portosystemic shunt, and antiviral medications can also be neurotoxic.

Dietary total fat intake and ischemic stroke risk: the Northern Manhattan Study.

Background: Dietary fat intake is associated with coronary heart disease risk, but the relationship between fat intake and ischemic stroke risk remains unclear. We hypothesized that total dietary fat as part of a Western diet is associated with increased risk of ischemic stroke.

Methods: As part of the prospective Northern Manhattan Study, 3,183 stroke-free community residents over 40 years of age underwent evaluation of their medical history and had their diet assessed by a food-frequency survey.

Outcomes with stroke and lateropulsion: a case-matched controlled study.

Background And Objective: Lateropulsion after stroke has not been tracked using a case-matched controlled study and a standardized lateropulsion scale. Matched pairs of patients with stroke, with and without lateropulsion, were compared for functional outcomes and discharge destination following inpatient rehabilitation.

Methods: A retrospective chart review of patients with ischemic stroke at an inpatient rehabilitation hospital matched 36 pairs of patients with versus without lateropulsion.

The metabolic syndrome and subclinical carotid atherosclerosis: the Northern Manhattan Study.

The metabolic syndrome (MetS) is a distinctive phenotype associated with an increased risk of vascular disease. Carotid plaque is a surrogate marker of subclinical atherosclerosis and a powerful predictor of vascular outcomes. The relationship between the MetS and subclinical atherosclerosis in multiethnic populations has not been well characterized.

Ischemic stroke subtype incidence among whites, blacks, and Hispanics: the Northern Manhattan Study.

Background: Stroke incidence is greater in blacks than in whites; data on Hispanics are limited. Comparing subtype-specific ischemic stroke incidence rates may help to explain race-ethnic differences in stroke risk. The aim of this population-based study was to determine ischemic stroke subtype incidence rates for whites, blacks, and Hispanics living in one community.