Stroke is a major cause of morbidity and mortality. Neurosurgical decompression is often considered for the treatment of malignant infarcts and intraparenchymal hemorrhages, but this treatment can be frought with ethical dilemmas. In this article, the authors outline the primary principles of bioethics and their application to stroke care, provide an overview of key ethical issues and special situations in the neurosurgical management of stroke, and highlight methods to improve ethical decision-making for patients with stroke. Understanding these ethical principles is essential for stroke care teams to deliver appropriate, timely, and ethical care to patients with stroke.
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http://dx.doi.org/10.1161/STROKEAHA.121.038493 | DOI Listing |
J Neurointerv Surg
January 2025
Department of Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
Background: Early literature on the Woven EndoBridge (WEB) device reported 80-90% adequate aneurysm occlusion but low complete occlusion (40-55%). It is uncertain whether residual or recurrent aneurysms require re-treatment to prevent future rupture.
Objective: To systematically review the literature to meta-analyze occlusion and complication rates after re-treatment of these aneurysms.
AJNR Am J Neuroradiol
January 2025
From the University of Miami Department of Neurology (H.B.F., I.R., R.Y., A.A., M.S., Y.H., A.A., C.M.G., V.J.D.B., R.M.S., T.R., H.G., J.G.R., N.A.), Miami, FL, USA; University of South Florida Department of Neurology (D.Z.R. A.J.), Tampa, FL, USA.
Background And Purpose: Endovascular thrombectomy outcomes are impacted by changes in stroke systems of care. During the pandemic, SARS-CoV2 positive status had major implications on hospital arrival and treatment models of non-COVID related hospital admissions. Using the Florida Stroke Registry, we compared the rates of in-hospital death and discharge outcomes of patients treated with endovascular thrombectomy who tested positive for SARS-CoV2 infection during their hospitalization.
View Article and Find Full Text PDFJ Neurointerv Surg
January 2025
Department of Neurology, UTHealth Houston McGovern Medical School, Houston, Texas, USA
Background: Automated machine learning (ML)-based large vessel occlusion (LVO) detection algorithms have been shown to improve in-hospital workflow metrics including door-to-groin time (DTG). The degree to which care team engagement and interaction are required for these benefits remains incompletely characterized.
Methods: This analysis was conducted as a pre-planned post-hoc analysis of a randomized prospective clinical trial.
Alzheimers Dement
January 2025
Department of Psychiatry and Neuroscience, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Introduction: The beneficial effects of amyloid beta 1-38, or Aβ(1-38), on Alzheimer's disease (AD) progression in humans in vivo remain controversial. We investigated AD patients' cerebrospinal fluid (CSF) Aβ(1-38) and AD progression.
Methods: Cognitive function and diagnostic change were assessed annually for 3 years in 177 Aβ-positive participants with subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia from the German Center for Neurodegenerative Diseases (DZNE) longitudinal cognitive impairment and dementia study (DELCODE) cohort using the Mini-Mental State Examination (MMSE), Preclinical Alzheimer's Cognitive Composite (PACC), Clinical Dementia Rating (CDR), and National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria.
J Interprof Care
January 2025
Department of Neurobiology, Care Sciences and Society (NVS), Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
The aim of this paper is to describe a research process of actively engaging stakeholders using co-design in the development of interprofessional education and a health intervention program targeting stroke prevention. Stakeholders included potential patients, healthcare professionals, and healthcare experts/researchers. Collaborating through co-design can be utilized in developing primary healthcare interventions including educational strategies for interprofessional learning.
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