Posts Tagged ‘stroke’

Body-Mass Index in Adolescents

Posted by • June 24th, 2016

Overweight and obesity in adolescents have increased substantially in recent decades and affect a third of the adolescent population in some developed countries. Twig et al. assessed the risk of fatal cardiovascular events in adulthood according to the body-mass index range during adolescence, using a national database of 2.3 million Israeli adolescents in whom height… Read More…

Cryptogenic Stroke

Posted by • May 27th, 2016

Cryptogenic ischemic strokes are symptomatic cerebral infarcts for which no probable cause is identified after adequate diagnostic evaluation. In general, the percentage of ischemic strokes that are classified as cryptogenic has declined over time as diagnostic testing has advanced. However, stroke that is cryptogenic after a standard diagnostic evaluation remains a common clinical challenge, accounting… Read More…

Aphasia during a Transatlantic Flight

Posted by • April 28th, 2016

In more than 60% of patients with ischemic stroke, the cause is readily established and is most often atherosclerosis or heart disease. However, in a young patient with no traditional vascular risk factors and a large clot burden, the search can be broadened to include, at minimum, thrombophilia, arterial dissection, paradoxical embolism, and unusual arteriopathies. A… Read More…

Pioglitazone after Ischemic Stroke

Posted by • April 8th, 2016

The thiazolidinedione class of peroxisome proliferator–activated receptor γ (PPAR-γ) agonists are among the most potent insulin-sensitizing drugs available. One medication in this class, pioglitazone, may reduce the risk of cardiovascular events, including stroke, in patients with type 2 diabetes, for whom the drug is currently approved as a glucose-lowering agent. Kernan et al. designed the… Read More…

A Man with Sickle Cell Disease and Headache

Posted by • April 1st, 2016

Approximately 17% of patients with sickle cell disease have cerebrovascular symptoms; 75% of those patients have cerebral infarction, 20% have either cerebral or subarachnoid hemorrhage, and a small percentage have cerebral sinovenous thrombosis. A 22-year-old man with sickle cell disease presented with headache and difficulty speaking after smoking marijuana. He had anomia, apraxia, and alexia and was… Read More…

Asymptomatic Carotid Stenosis

Posted by • March 18th, 2016

Carotid-artery stenting has emerged as a therapeutic alternative to endarterectomy for the treatment of severe cervical carotid-artery stenosis. Rosenfield et al. conducted the Asymptomatic Carotid Trial (ACT) I trial, whose primary aim was to compare the outcomes of carotid endarterectomy versus stenting with embolic protection in patients with asymptomatic severe carotid-artery stenosis who were at… Read More…

New Conversations on the NEJM Group Open Forum

Posted by • December 18th, 2014

Will the results of the MR CLEAN trial change the standard of care for patients with acute ischemic stroke? Ask the authors and other experts in the field in the latest discussion about NEJM original research. From the NEJM CareerCenter “Fascinating Physician” series, meet Dr. Wen Dombrowski, a geriatrics physician executive who develops technology, business, and… Read More…

Adverse Health Effects of Marijuana Use

Posted by • June 5th, 2014

As marijuana use becomes legal in some states, the dominant public opinion is that marijuana is a harmless source of mood alteration. Although the harms associated with marijuana use have not been well studied, enough information is available to cause concern.  A new review on this topic comes from Drs. Nora Volkow, Ruben Baler, Wilson… Read More…

Dizziness and Vomiting

Posted by • November 1st, 2013

In the latest Case Record of the Massachusetts General Hospital, a 69-year-old man was admitted to this hospital because of dizziness and vomiting, which had begun abruptly 9 hours earlier, on awakening. Examination revealed nystagmus and a wide-based gait. CT revealed no intracranial hemorrhage. A diagnostic procedure was performed. Stroke is the leading cause of serious… Read More…

Getting Low: Rapid Blood Pressure Lowering after Intracerebral Hemorrhage

Posted by • June 19th, 2013

When a patient presents with signs of a stroke, time is of the essence.  But if the cause of the stroke turns out to be bleeding within the brain, how rapidly should the patient be treated?  Specifically, when it comes to high blood pressure — a common problem among these patients, and a predictor of… Read More…