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AIS and PD were defined by validated International Classification of Diseases (ICD) codes, pharmacy data, and encounter type. Covariates included demographics, smoking status, cardiovascular comorbidities, post\u2010traumatic stress disorder, traumatic brain injury, and frailty. Individuals with PD and stroke were matched 4:1 to controls and survival was measured over 10\u2009years. Two percent of strokes were manually reviewed for size, location, and mechanism per TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 3173 cases of PD and AIS were identified and matched to groups of PD\u2010only, stroke\u2010only, and controls (N\u2009=\u200912,692 each). Survival analysis showed PD\u2010only and stroke\u2010only had a predictable increased mortality (added deaths ranged from 1.9 [0.9, 2.9] to 4.7 [2.9, 6.6] per 100 person\u2010years). PD\u2009+\u2009stroke showed further increased mortality with distinct timelines at 0\u20131\u2010, 1\u20135\u2010, and 5\u201310\u2010year periods and synergy accounted for 2.9 [0.5, 5.4] to 19.3 [14.0, 24.6] additional deaths across 10\u2009years. Effects persisted after matching for cardiovascular comorbidities, neurotrauma, and frailty. PD\u2009+\u2009stroke compared with stroke\u2010only had smaller strokes (80.0% vs. 63.2%) and no differences in location, mechanism, or recurrence rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Patients with PD and AIS had greater than expected mortality that was independent of comorbidities or stroke characteristics. This may reflect widespread structural and functional deficits that may warrant a targeted therapeutic strategy. \u00a9 2026 The Author(s).\n                      <jats:italic>Movement Disorders<\/jats:italic>\n                      published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mds.70218","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T07:28:52Z","timestamp":1770708532000},"page":"1141-1151","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Small Strokes, Big Impact: Excessive Mortality After Acute Ischemic Stroke in Parkinson's Disease"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1866-0344","authenticated-orcid":false,"given":"Lee E.","family":"Neilson","sequence":"first","affiliation":[{"name":"Department of Neurology Oregon Health &amp; Science University  Portland Oregon USA"},{"name":"Neurology and Research Service VA Portland Health Care System  Portland Oregon USA"},{"name":"Department of Neurology University of Iowa  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Neurology Birmingham VA Medical Center  Birmingham Alabama USA"},{"name":"Department of Neurology Louisiana State University Health\u2010Shreveport  Shreveport Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anusha","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Neurology Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory D.","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Services VA Portland Medical Center  Portland Oregon USA"},{"name":"Department of Pathology Oregon Health &amp; 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