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Primary Care

Vascular Neurology   

Questions discussed in this category

What would you recommend for long term management of extensive dural venous sinus thrombosis (CVST) in young females when the only provoking risk factor is combined OCP?
Thrombophilia testing, including JAK2 is negative. When would you stop anticoagulation?
4 Answers available
How do you counsel patients who develop DVT or atrial fibrillation requiring anticoagulation when being treated with lecanemab or donanemab?
4 Answers available
When is air travel safe for patients with recent diagnosis of ischemic stroke?
1 Answer available
What is the optimal BP target for patients with diabetes and hypertension to reduce their risk of MI/stroke?
1 Answer available
Is moderate-intensity statin plus ezetimibe just as effective as high-intensity statin monotherapy in preventing major cardiovascular events?
4 Answers available
How do you counsel patients on wearable heart monitor devices when they ask about specific products and diagnostic accuracy of these devices available on the market?
2 Answers available
Should systemic anticoagulation be considered for patients with a less than 1% atrial fibrillation burden on outpatient monitoring with an elevated CHADSVASc score and acceptable bleeding risk?
2 Answers available
Do you recommend any particular type of contraceptive use in young patients with strokes of unclear etiology?
How do you guide what contraceptive type when asked by the medical team?
1 Answer available
Would you recommend a neck soft collar after a cervical internal carotid artery dissection?
If so, what is the typical duration?
1 Answer available
Can bleeding risk when switching from VKA treatment to a NOAC in frail, elderly patients be accurately compared if individual times in therapeutic range while on VKA treatment are not captured?
Individual times in the therapeutic range while on VKA treatment was not registered in FRAIL-AF.
2 Answers available
Do you screen adults in your practice with sickle cell disease for silent cerebral infarcts?
The ASH 2020 guidelines have "recommended that adults with HbSS or HbSβ0 thalassemia be screened at least once for silent cerebral infarcts even ...
1 Answer available
How often do you screen for cerebral aneurysms in patients with autosomal dominant polycystic kidney disease who do not have a family history of intracranial aneurysms or for whom the family history is unknown?
1 Answer available
How do you manage asymptomatic patients with incidental findings of the carotid web?
2 Answers available
Would you change an elderly, frail patient with atrial fibrillation who is already on a NOAC to VKA treatment?
In FRAIL-AF, switching VKA therapy to a NOAC was associated with higher risk of bleeding in elderly, frail patients. 
4 Answers available
Do you think that home INR monitoring is a feasible option for elderly, frail patients with atrial fibrillation on VKA treatment, given variations in socioeconomic status and access to care?
2 Answers available
Would you start anticoagulation in a patient with a history of CVA 1 year ago and high risk APL profile who was never started on anticoagulation, but is now presenting for follow up and without recurrent thrombotic events?
The patient has no known history of autoimmune disease.
4 Answers available
Is there a preference between the different high-intensity statins for high-risk stroke patients?
How does pravastatin differ in advantage from other high-intensity statins?
3 Answers available
Do you recommend life long aspirin 81mg daily for non-specific T2 white matter hyper-intensities on MRI brain?
7 Answers available
Is there a role to continue aspirin in patients with myeloproliferative disorders who have never had a thrombotic event that are starting DOAC for stroke prophylaxis with newly diagnosed atrial fibrillation?
2 Answers available
Would you favor restarting anticoagulation or pursuing left atrial appendage closure in a patient with hemorrhagic stroke on anticoagulation for non-valvular atrial fibrillation?
3 Answers available
Would it be prudent to complete long term cardiac monitoring (ie. 30 day) in a patient with a new typical appearing lacunar type thalamic infarct and history of hypertension?
1 Answer available
When do you start anticoagulation for secondary prevention in patients with HFrEF and history of embolic strokes?
For a relatively young, medically compliant patient with HFrEF (EF<35%) and h/o embolic stroke, what is the consensus of starting AC for secondary ...
1 Answer available
When do you restart anticoagulation in patients with atrial fibrillation who just had an ischemic stroke?
Would you change your practice in light of the recently published studies:  OPTIMAS Trial & Elan Trial
1 Answer available
Should patients with cerebral amyloid angiopathy have any statin medications discontinued?
1 Answer available


Papers discussed in this category

American journal of hematology, 2023 May 12
An integrated therapeutic approach to sickle cell disease management beyond infancy.
The New England journal of medicine, 2014 Aug 21
More blood for sickle cell anemia?
Ann Neurol, 2020 Aug 05
Anticoagulation Timing in Cardioembolic Stroke and Recurrent Event Risk.
The New England journal of medicine, 2012-05-17
Warfarin and aspirin in patients with heart failure and sinus rhythm.
The New England journal of medicine, 2018-10-04
Rivaroxaban in Patients with Heart Failure, Sinus Rhythm, and Coronary Disease.
The New England journal of medicine, 2019-05-16
Dabigatran for Prevention of Stroke after Embolic Stroke of Undetermined Source.
Heart, 2019 Apr 08
Anticoagulation therapy in heart failure and sinus rhythm: a systematic review and meta-analysis.
Neurology, 2015-10-13
Clinical Reasoning: An 87-year-old woman with left-sided numbness.
JAMA,
Effect of Long-term Continuous Cardiac Monitoring vs Usual Care on Detection of Atrial Fibrillation in Patients With Stroke Attributed to Large- or Small-Vessel Disease: The STROKE-AF Randomized Clinical Trial.
The New England journal of medicine, 2011-12-01
Effect of two intensive statin regimens on progression of coronary disease.
The New England journal of medicine, 2018-11-29
Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome.
Circulation, 2019 Nov 11
Effect of Alirocumab on Stroke in ODYSSEY OUTCOMES.
N Engl J Med, 2017 Mar 17
Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease.
Stroke, 2020 Apr 21
Stroke Prevention With the PCSK9 (Proprotein Convertase Subtilisin-Kexin Type 9) Inhibitor Evolocumab Added to Statin in High-Risk Patients With Stable Atherosclerosis.
Circulation, 2023 Aug 27
Safety of Switching from a Vitamin K Antagonist to a Non-Vitamin K Antagonist Oral Anticoagulant in Frail Older Patients with Atrial Fibrillation: Results of the FRAIL-AF Randomized Controlled Trial.
American heart journal, 2017 Apr 24
Rationale and design of the Apixaban for the Reduction of Thrombo-Embolism in Patients With Device-Detected Sub-Clinical Atrial Fibrillation (ARTESiA) trial.
The New England journal of medicine, 2023 Aug 25
Anticoagulation with Edoxaban in Patients with Atrial High-Rate Episodes.
Kidney360, 2023 Nov 22
All Patients with ADPKD Should Undergo Screening for Intracranial Aneurysms: PRO.
Stroke, 2023 Sep 07
Study of Rivaroxaban for Cerebral Venous Thrombosis: A Randomized Controlled Feasibility Trial Comparing Anticoagulation With Rivaroxaban to Standard-of-Care in Symptomatic Cerebral Venous Thrombosis.
Stroke, 2024 Jan 29
Diagnosis and Management of Cerebral Venous Thrombosis: A Scientific Statement From the American Heart Association.
The journal of prevention of Alzheimer's disease, 2023
Lecanemab: Appropriate Use Recommendations.
Stroke, 2024 Dec 11
Vascular Neurology Considerations for Antiamyloid Immunotherapy: A Science Advisory From the American Heart Association.
N Engl J Med, 2015 Nov 09
A Randomized Trial of Intensive versus Standard Blood-Pressure Control.
Diabetes care, 2025 Jan 01
10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes-2025.

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