WikiJournalClub:List of landmark papers/Neurology

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Alcohol Withdrawal

Anoxic Brain Injury

Resident

  • HACA: Mild hypothermia improves neurologic outcome and reduces mortality in patients after cardiac arrest. [4]

Fellow/Attending

  • OHCA: Moderate hypothermia improves outcomes in patients with coma after resuscitation from out-of-hospital cardiac arrest. [5]

Seizures

Resident

  • MESS In patients with infrequent seizures, early AED increases time to seizure recurrence, but has no effect on long-term seizure-free status [8]
  • SANAD Lamotrigine versus carbamazepine for patients with partial onset seizures. Valproate versus topiramate and lamotrigine for patients with generalized seizures. [9]

Ischemic Stroke

Management

  • ABCD2 This scoring system most predictive for stroke risk after TIA. [10]
  • CHARISMA
  • NASCET: CEA for symptomatic carotid stenosis
  • PROGRESS Perindopril reduced risk of stroke among pts with h/o stroke or TIA a history of stroke or transient ischaemic attack. Combination therapy w/ perindopril and indapamide produced larger BP reductions and larger risk reductions than did single drug therapy with perindopril alone. Treatment with these two agents should now be considered routinely for patients with a history of stroke or transient ischaemic attack, irrespective of their blood pressure.[11]
  • PRoFESS (Telmisartan) Telmisartan post-ischemi stroke did NOT lower rate rate of recurrent stroke, major cardiovascular events, or diabetes [12]
  • EXPRESS Early treatment after TIA reduces risk of recurrent stroke by 80% [13]
  • NINDS IV t-PA within three hours of onset of ischemic stroke improved clinical outcomes at three months [14]
  • ECASS IV alteplase between 3 and 4.5 hours after symptoms improved outcomes in patients with acute ischemic stroke versus placebo. [15]
  • ATLANTIS No significant benefit of IV t-PA between 3 and 5 hours [16]
  • EPITHET Alteplase was non-significantly associated with lower infarct growth and significantly associated with increased reperfusion in patients who had mismatch perfusion-weighted MRI (PWI) and diffusion-weighted MRI (DWI).
  • PROACT II Treatment with IA r-proUK within 6 hours of the onset of acute ischemic stroke caused by MCA occlusion significantly improved clinical outcome at 90 days; despite an increased frequency of early symptomatic intracranial hemorrhage [17]
  • WARSS No difference between aspirin and warfarin in the prevention of nonembolic stroke. [18]
  • WASID Aspirin superior to warfarin in Symptomatic Intracranial Arterial Stenosis [19]
  • 2005 WHS: Aspirin for stroke prevention in women [20]
  • CAST Aspirin decreases death and recurrent stroke [21]
  • IST Aspirin decreases death and recurrent stroke [22]
  • ESPRIT Dipyridamole and aspirin superior to aspirin alone [23]
  • MATCH Aspirin and clopidogrel not more effective than aspirin alone [24]
  • PRoFESS dipyridamole and aspirin comparable to clopidogrel alone in risk of recurrent stroke; decreased bleeding with clopidogrel [25]
  • PREVAIL (VTE) Enoxaparin more efficacious than UFH for venous thromboembolism prophylaxis in patients wich ischemic stroke [26]
  • HPS Simvastatin decreases rates of recurrent stroke., myocardial infarction. [27]
  • SPARCL In patients with recent stroke or TIA and without known coronary heart disease, atorvastatin reduced the overall incidence of strokes and of cardiovascular events. [28]
  • NASCET Carotid endarterectomy decreases major stroke for symptomatic patients with >70% carotid artery stenosis. [29]
  • ACST Carotid endarterectomy decreases major stroke for asymptomatic patients younger than 75 years of age with 70% or more carotid stenosis [30]
  • SAPPHIRE Carotid stenting is not inferior to carotid endarterectomy Among patients with severe carotid-artery stenosis [31] [32]
  • SPACE Carotid artery stenting is noninferior to carotid endarterectomy for periprocedural complication rate. [33]
  • EVA-3S Carotid endarterectomy decreases rates of death and stroke compared with stenting in patients with symptomatic carotid stenosis of 60% or more.
  • ICSS Carotid endarterectomy vs stenting [34]
  • PICSS On aspirin, PFO in stroke patients did not increase the chance of adverse events regardless of PFO size or the presence of atrial septal aneurysm. [35]
  • SHEP BP control to prevent CVA [36]

Hemorrhagic Stroke

  • HEME MRI as accurate as CT for the detection of acute hemorrhage in patients presenting with acute focal stroke symptoms and is more accurate than CT for the detection of chronic intracerebral hemorrhage. [37]
  • FAST Treatment with rFVIIa within four hours after the onset of intracerebral hemorrhage limits the growth of the hematoma, reduces mortality, and improves functional outcomes at 90 days, despite a small increase in the frequency of thromboembolic adverse events.
  • ISAT endovascular coiling versus neurosurgical correction of aneurysm/AVM [38]
  • Nimodipine nimodipine decreases risk of vasospasm in SAH [39]

Guillain-Barre Syndrome

  • GBSS Plasmapheresis [40]
  • IVIg IVIg is at least as effective as plasma exchange and may be superior. [41]
  • No additional benefit with both [42]

Migraine