Temperature and Precipitation Associate With Ischemic Stroke Outcomes in the United States.

Background There is disagreement in the literature about the relationship between strokes and seasonal conditions. We sought to (1) describe seasonal patterns of stroke in the United States, and (2) determine the relationship between weather variables and stroke outcomes. Methods and Results We performed a cross-sectional study using Get With The Guidelines-Stroke data from 896 hospitals across the continental United States.

Evolution of blood pressure management in acute intracerebral hemorrhage.

Intracerebral hemorrhage (ICH) remains a prevalent and severe cause of death and disability worldwide. Control of the hypertensive response in acute ICH has been a mainstay of ICH management, yet the optimal approaches and the yield of recommended strategies have been difficult to establish despite a large body of literature. Over the years, theoretical and observed risks and benefits of intensive blood pressure reduction in ICH have been studied in the form of animal models, radiographic studies, and two recent large, randomized patient trials.

Factors Considered by Clinicians when Prognosticating Intracerebral Hemorrhage Outcomes.

Background: The early subjective clinical judgment of clinicians outperforms formal prognostic scales for accurate determination of outcome after intracerebral hemorrhage (ICH), with the judgment of physicians and nurses having equivalent accuracy. This study assessed specific decisional factors that physicians and nurses incorporate into early predictions of functional outcome.

Methods: This prospective observational study enrolled 121 ICH patients at five US centers.

Cerebral Microhemorrhages and Meningeal Siderosis in Infective Endocarditis.

Objective: Patients with infective endocarditis (IE) frequently experience cerebral insults, and neurological involvement in IE has been reported to herald a worse prognosis. In this manuscript, we describe a distinctive pattern of findings on susceptibility-weighted imaging (SWI) sequences in subjects with IE.

Methods: Patients with IE who underwent SWI MRI at an academic hospital from 2009 to 2014 were retrospectively analyzed.

Predicting Outcome for Intracerebral Hemorrhage Patients: Current Tools and Their Limitations.

Accurate outcome prognostication is critical to the management of patients with primary or spontaneous intracerebral hemorrhage (ICH). Prognostication may guide the decision to pursue aggressive acute management or to plan proper goals of care for patients who will likely suffer long-term severe disability. In particular, early predictions of poor outcome for ICH patients routinely influence discussions with surrogate decision makers to pursue do-not-resuscitate orders or comfort care, practices that may often be appropriate, but that are at risk for self-fulfilling prophecies.

Polyoma (BK) virus associated urothelial carcinoma originating within a renal allograft five years following resolution of polyoma virus nephropathy.

A direct role for BK polyomavirus infection in malignant tumors of renal allografts and urinary tract is emerging. Case reports suggest a link between BK virus (BKV) reactivation and development of malignancy in renal allograft recipients. Herein we describe the first case of BKV positive invasive urothelial carcinoma within the renal allograft, presenting with chronic diarrhea and weight loss 5 years following resolution of BK viremia/nephropathy (BKVN).

Temporal relationship between infective endocarditis and stroke.

Objective: Stroke frequently complicates infective endocarditis (IE). However, the temporal relationship between these diseases is uncertain.

Methods: We performed a retrospective study of adult patients hospitalized for IE between July 1, 2007, and June 30, 2011, at nonfederal acute care hospitals in California.

Readmission for infective endocarditis after ischemic stroke or transient ischemic attack.

Background And Purpose: Providers vary in their thresholds for obtaining blood cultures in patients with ischemic stroke or transient ischemic attack (TIA). We assessed the rate of missed diagnoses of infective endocarditis (IE) in patients discharged with stroke or TIA before blood culture results could have been available.

Methods: Using administrative claims data, we performed a retrospective cohort study of all patients discharged from nonfederal California emergency departments or acute care hospitals from 2005 through 2011 with stroke (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 433.

Decompressive craniectomy in neurocritical care.

Decompressive craniectomy (DC) involves the removal of a portion of the skull in the setting of life threatening brain edema or potentially uncontrollable intracranial pressures. Often performed on an emergent basis, evaluation and arrangement for DC should be swift and decisive. However, the evidence base for DC in the wide range of conditions for which it is currently performed is still developing.

Measurement of blood perfusion in spinal metastases with dynamic contrast-enhanced magnetic resonance imaging: evaluation of tumor response to radiation therapy.

Study Design: This was a retrospective study focusing on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to assess treatment response in patients with spinal metastases.

Objective: To demonstrate DCE-MRI changes before and after radiation treatment and correlating with other imaging and clinical findings.

Summary Of Background Data: Currently, conventional imaging is limited in evaluating early treatment success or failure, which impacts patient care.