David E Thaler

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BACKGROUND Adults with asymptomatic carotid artery stenosis are at increased risk for ipsilateral carotid territory ischemic stroke. PURPOSE To examine comparative evidence on management strategies for asymptomatic carotid stenosis and the incidence of ipsilateral stroke with medical therapy alone. DATA SOURCES MEDLINE, Cochrane Central Register of(More)
BACKGROUND Whether closure of a patent foramen ovale is effective in the prevention of recurrent ischemic stroke in patients who have had a cryptogenic stroke is unknown. We conducted a trial to evaluate whether closure is superior to medical therapy alone in preventing recurrent ischemic stroke or early death in patients 18 to 60 years of age. METHODS In(More)
The effect of severe hypoglycemia on the brain is well known, ranging from alterations of mental status to profound coma and death. We describe a case of global diffusion abnormalities eventually resulting in death. This otherwise healthy patient presented with seizures and a serum glucose level less than 20 mg/dL. Testing suggested that the hypoglycemia(More)
BACKGROUND AND PURPOSE Patent foramen ovale (PFO) is significantly associated with cryptogenic stroke (CS). However, even in patients with CS, a PFO can be an incidental finding. We sought to estimate the probability that a PFO in a patient with CS is incidental. METHODS A systematic search identified 23 case-control studies examining the prevalence of(More)
BACKGROUND AND PURPOSE Inflammatory response is a critical component of the complex pathophysiological response to stroke. Vitamin C has been shown to have important roles in cell performance and vascular function. In this study, we compared the nutritional status and levels of inflammatory markers between stroke cases and controls and assessed which(More)
We report several studies on the effects of removing the medial premotor cortex (supplementary motor area) in monkeys. The removal of this area alone does not cause either paralysis or akinesia. However, the animals were poor at performing a simple learned task in which they had to carry out an arbitrary action: they were taught to raise their arm in order(More)
BACKGROUND Spinal manipulation has been associated with cervical arterial dissection and stroke but a causal relationship has been questioned by population-based studies. Earlier studies identified cases using International Classification of Diseases Ninth Revision (ICD-9) codes specific to anatomic stroke location rather than stroke etiology. We(More)
PURPOSE OF REVIEW Controversy surrounds the issue of patent foramen ovale (PFO), stroke, and secondary prevention strategies. Paradoxical embolism is usually a presumed diagnosis, incidental PFOs are common, and treatment options have not been well compared. RECENT FINDINGS Paradoxical embolism occurs at any age. The most likely potentiator of stroke risk(More)
We report a case of stroke due to device thrombosis occurring three years following percutaneous patent foramen ovale (patent foramen ovale) closure with an Amplatzer atrial septal occluder device. We discuss risk factors that may have contributed to device thrombosis and raise concerns regarding the lack of a dedicated PFO closure device for clinical use(More)