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Lily Zhou (BHSc, MD), neurology resident in Vancouver with the University of British Columbia.



Cerebrovascular Disease

  • NAVIGATE ESUS: Rivaroxaban was not superior to aspirin in recurrent stroke prevention after an initial ESUS with increased bleeding risk
  • POINT: Dual anti-platelets with ASA and plavix for 90 days leads to decreased stroke recurrence at the risk of increased bleeding
  • MR CLEAN: IA intervention in addition to standard practice improves morbidity for proximal large artery strokes
  • FLAME: Early fluoxetine improves motor outcomes post stroke
  • EMBRACE: 30d EKG allowed for detection of more patients with AF among patients with cryptogenic strokes
  • CRYSTAL-AF: Implantable cardiac monitors allowed for detection of more patients with AF among patients with cryptogenic strokes
  • SAMMPRIS: IA intervention offered no benefit above best medical therapy for intracranial atherosclerosis
  • WASID: ASA is as effect as Warfarin and safer for secondary stroke prevention in patients with intra-cranial atherosclerosis
  • WARSS: No difference in ASA vs. Warfarin in recurrent ischemic in patients with non-cardioembolic stroke.
  • PROGRESS: Perindopril and indapamide vs perindopril alone for secondary stroke prevention showing benefit of perindopril (with addition of indapamide at the discretion of the treating clinician) decreases risk of recurrent stroke
  • HINTS study: 3-step beside assessments is better than MRI for differentiate peripheral vs. central vertigo
  • SPS3-BP: Intensive SBP (<130 mm Hg) management does not reduce incident stroke when compared to higher-target BP control (target SBP 140-150 mmHg), however, there was a non-significant trend towards benefit P=0.08
  • SPS3-Clopidogrel+ASA: Clopidogrel+ASA vs. ASA alone after lacunar stroke increases bleeding without lower risk of recurrent stroke
  • ATACH II: In those with ICH, SBP of 110-139 mm Hg did not result in a lower rate of death or disability compared to target of 140 to 179 mm Hg.

Seizures and Epilepsy

Multiple Sclerosis

  • Optic Neuritis Treatment Trial: 3d IV methylprednisolone 250 mg Q6H with 2w of oral prednisone at 1 mg/kg/day more beneficial than oral prednisone at 1 mg/kg/day for 2 weeks alone for treatment of optic neuritis and decrease rate of recurrence


  • RE-VERSE AD: Idarucizumab is effective for reversal of dabigatran anticoagulation


  • PROTECT AF: Percutaneous closure of the LAA with WATCHMAN device vs. warfarin therapy in AF


Landmark Papers Pending Summary

  • CT before LP: Which characteristics suggest presence of space occupying lesions in adults with suspected meningitis