No Net Benefit from Adding Antiplatelet Therapy to Anticoagulation After Ischemic Stroke With Atrial Fibrillation and Atherosclerosis — Higher Bleeding Risk
Posted inCardiology Neurology news

No Net Benefit from Adding Antiplatelet Therapy to Anticoagulation After Ischemic Stroke With Atrial Fibrillation and Atherosclerosis — Higher Bleeding Risk

In a randomized trial of 316 patients with ischemic stroke/TIA, nonvalvular atrial fibrillation, and atherosclerotic disease, adding an antiplatelet to anticoagulation did not reduce ischemic events but doubled clinically relevant bleeding compared with anticoagulant monotherapy.
Lower Posttreatment Amyloid Predicts Slower Clinical Decline and Reduced Tau/Glial Biomarkers After Donanemab: Secondary Analysis of TRAILBLAZER‑ALZ 2
Posted inNeurology news

Lower Posttreatment Amyloid Predicts Slower Clinical Decline and Reduced Tau/Glial Biomarkers After Donanemab: Secondary Analysis of TRAILBLAZER‑ALZ 2

A secondary analysis of TRAILBLAZER‑ALZ 2 found that lower posttreatment amyloid plaque levels after donanemab correlate strongly with less clinical decline and reductions in plasma p‑tau217, p‑tau181, and GFAP over 76 weeks, supporting plaque removal as a likely mechanism of benefit.
General vs Nongeneral Anesthesia in Endovascular Thrombectomy for Large Core Strokes: Insights from the SELECT2 Trial and Related Evidence
Posted inAnesthesiology Clinical Updates Neurology news

General vs Nongeneral Anesthesia in Endovascular Thrombectomy for Large Core Strokes: Insights from the SELECT2 Trial and Related Evidence

This review synthesizes evidence on anesthesia approaches during endovascular thrombectomy (EVT) for large core ischemic strokes, focusing on a prespecified secondary analysis of the SELECT2 trial that shows comparable 90-day outcomes between general anesthesia and non-general anesthesia.
General Anesthesia May Improve 90‑Day Outcomes and Reperfusion After EVT for Large‑Vessel Ischemic Stroke: Key Takeaways from the SEGA Randomized Trial
Posted inAnesthesiology Neurology news

General Anesthesia May Improve 90‑Day Outcomes and Reperfusion After EVT for Large‑Vessel Ischemic Stroke: Key Takeaways from the SEGA Randomized Trial

The SEGA randomized trial suggests general anesthesia (GA) during endovascular therapy for large‑vessel occlusion stroke may lead to better 90‑day functional outcomes and higher reperfusion rates than moderate sedation, though credible intervals overlap and uncertainties remain.
Seizure Burden Falls Over Time in Treatment‑Resistant Focal Epilepsy: Implications for Interpreting Open‑Label Disease‑Modifying Claims
Posted inNeurology news

Seizure Burden Falls Over Time in Treatment‑Resistant Focal Epilepsy: Implications for Interpreting Open‑Label Disease‑Modifying Claims

The HEP2 prospective cohort shows that most patients with focal treatment‑resistant epilepsy experienced substantial seizure reductions over 18–36 months; ASM additions produced modest gains but rarely achieved freedom, and device-treated patients followed similar trajectories to those without devices.
IV Thrombolysis Outperformed Endovascular Thrombectomy for Basilar Artery Occlusion in a Multicenter Cohort: What Clinicians Should Know
Posted inNeurology news

IV Thrombolysis Outperformed Endovascular Thrombectomy for Basilar Artery Occlusion in a Multicenter Cohort: What Clinicians Should Know

A 523‑patient multicenter cohort found intravenous thrombolysis alone was associated with better 3‑month functional outcomes and lower mortality than endovascular thrombectomy (± IVT) for acute basilar artery occlusion after adjustment for confounders. Results prompt cautious reappraisal of EVT vs IVT in BAO and call for randomized trials.
Giving IV Thrombolysis in the Late Window Before Transfer for Thrombectomy: Improved Recanalization and 3‑Month Outcomes in a Multicenter French Cohort
Posted inNeurology news

Giving IV Thrombolysis in the Late Window Before Transfer for Thrombectomy: Improved Recanalization and 3‑Month Outcomes in a Multicenter French Cohort

A multicenter retrospective cohort (OPEN-WINDOW) found that IV thrombolysis given beyond 4.5 hours before interhospital transfer for EVT was associated with higher rates of recanalization during transfer and better 3‑month functional outcomes without increased hemorrhagic complications.