IMPORTANCE It is uncertain whether coronavirus disease 2019 (COVID-19) is associated with a higher risk of ischemic stroke than would be expected from a viral respiratory infection. OBJECTIVE To compare the rate of ischemic stroke between patients with COVID-19 and patients with influenza, a respiratory viral illness previously associated with stroke.

The apolipoprotein E genotype can identify patients with lobar intracerebral hemorrhage who are at highest risk for early recurrence. This finding makes possible both the provision of prognostic information to patients with lobar hemorrhage and a method of targeting and assessing potential strategies for prevention.

Embolic strokes are the commonest cause of stroke in patients with cancer, due partially to hypercoagulability, whereas atherosclerosis accounted for only 22% of stroke in this population. Outcome was primarily determined by the underlying malignancy and the patient's neurologic condition.

Background and Purpose-The goal of this study was to evaluate the utility of perfusion-weighted CT (PWCT) in predicting final infarct volume and clinical outcome in patients with acute middle cerebral artery (MCA) stroke. Methods-Twenty-two consecutive patients with MCA stem occlusion who underwent intra-arterial thrombolysis within 6 hours of stroke onset had noncontrast CT and CT angiography with whole-brain PWCT imaging before treatment. Infarct volumes were computed from the initial PWCT and follow-up scans; clinical outcome was measured with the modified Rankin scale. Results-Initial PWCT lesion volumes correlated significantly with final infarct volume (Pϭ0.0002) and clinical outcome (Pϭ0.01). For the 10 patients with complete recanalization, the relationship between initial and final lesion volume was especially strong (R 2 ϭ0.94, PϽ0.0001, slope of regression lineϭ0.92). For those without complete recanalization, there was progression of lesion volume on follow-up imaging (R 2 ϭ0.50, Pϭ0.01, slope of regression lineϭ1.61). All patients with either initial PWCT lesion volumes Ͼ100 mL or no recanalization had poor outcomes (Rankin scores, 4 to 6). Mean admission NIH Stroke Scale scores and mean lesion volumes in the poor outcome group were significantly different compared with the good or fair outcome (Rankin scores, 0 to 3) group (21Ϯ4 versus 17Ϯ5, Pϭ0.05, and 106Ϯ79 versus 29Ϯ37 mL, Pϭ0.01). Patients with initial volumes Ͻ100 mL and partial or complete recanalization all had good (Rankin scores, 0 to 2) or fair (Rankin score, 3) outcomes. Conclusions-Lesion volumes on admission PWCT images approximate final infarct volume for patients with early complete recanalization of MCA stem occlusion. For those without complete recanalization, there is subsequent enlargement of lesion volume on follow-up. Initial PWCT lesion volumes also have predictive value; volumes Ͼ100 mL are associated with a poor clinical outcome. In these highly selected patients, initial PWCT lesion volume was a stronger predictor of clinical outcome than was initial NIH Stroke Scale score.

These data suggest that APOE epsilon2 and epsilon4 might promote CAA-related hemorrhage through separate mechanisms: epsilon4 by enhancing amyloid deposition and epsilon2 by causing amyloid-laden vessels to undergo the vasculopathic changes that lead to rupture.

Background and Purpose Impairments in CVR have been variably associated with increased risk of ischemic events and may stratify stroke risk in patients with high grade internal carotid artery (ICA) stenosis or occlusion. The purpose of this study is to perform a systematic review and meta-analysis to summarize the association of CVR impairment and stroke risk. Methods We performed a literature search evaluating the association of impairments in CVR with future stroke or transient ischemic attack (TIA) in patients with high grade ICA stenosis or occlusion. We included studies with a minimum of one year patient follow up with baseline CVR measures performed via any modality and primary outcome measures of stroke and/or TIA. A meta-analysis with assessment of study heterogeneity and publication bias was performed. Results were presented in a forest plot and summarized using a random-effects model. Results Thirteen studies met the inclusion criteria, representing a total of 1061 independent CVR tests in 991 unique patients with a mean follow up of 32.7 months. We found a significant positive relationship between impairment of CVR and development of stroke, with a pooled random effects odds ratio of 3.86 (95% CI, 1.99–7.48). Subset analysis showed that this association between CVR impairment and future risk of stroke/TIA remained significant regardless of ischemic outcome measure, symptomatic or asymptomatic disease, stenosis or occlusion, or CVR testing method. Conclusions CVR impairment is strongly associated with increased risk of ischemic events in carotid stenosis or occlusion and may be useful for stroke risk stratification.

Fever in SAH is associated with vasospasm and poor outcome independently of hemorrhage severity or presence of infection.

Intracranial hemorrhage in patients with cancer is often due to unique mechanisms. Prognosis is poor, but comparable to intracranial hemorrhage in the general population. Aggressive care is recommended despite high mortality, because many patients have good functional outcomes.