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haemorrhagic stroke

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https://www.readbyqxmd.com/read/29149179/postmenopausal-hormone-therapy-and-risk-of-stroke-a-pooled-analysis-of-data-from-population-based-cohort-studies
#1
Germán D Carrasquilla, Paolo Frumento, Anita Berglund, Christer Borgfeldt, Matteo Bottai, Chiara Chiavenna, Mats Eliasson, Gunnar Engström, Göran Hallmans, Jan-Håkan Jansson, Patrik K Magnusson, Peter M Nilsson, Nancy L Pedersen, Alicja Wolk, Karin Leander
BACKGROUND: Recent research indicates a favourable influence of postmenopausal hormone therapy (HT) if initiated early, but not late, on subclinical atherosclerosis. However, the clinical relevance of timing of HT initiation for hard end points such as stroke remains to be determined. Further, no previous research has considered the timing of initiation of HT in relation to haemorrhagic stroke risk. The importance of the route of administration, type, active ingredient, and duration of HT for stroke risk is also unclear...
November 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29144166/imaging-assessment-of-acute-ischaemic-stroke-a-review-of-radiological-methods
#2
Aubrey Smith, Chris Rowland Hill
Acute ischaemic stroke is the second largest cause of death worldwide and a cause of major physical and psychological morbidity. Current evidence based treatment includes intravenous thrombolysis (IVT) and mechanical thrombectomy (MT), both requiring careful patient selection and to be administered as quickly as possible within a limited time window from symptom onset. Imaging plays a crucial role identifying patients who may benefit from MT or IVT whilst excluding those that maybe harmed. For IVT, imaging must as a minimum exclude haemorrhage, stroke mimics and provide an estimate of non-viable brain...
November 16, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29141890/british-thoracic-society-clinical-statement-on-pulmonary-arteriovenous-malformations
#3
Claire L Shovlin, Robin Condliffe, James W Donaldson, David G Kiely, Stephen J Wort
Pulmonary arteriovenous malformations (PAVMs) are structurally abnormal vascular communications that provide a continuous right-to-left shunt between pulmonary arteries and veins. Their importance stems from the risks they pose (>1 in 4 patients will have a paradoxical embolic stroke, abscess or myocardial infarction while life-threatening haemorrhage affects 1 in 100 women in pregnancy), opportunities for risk prevention, surprisingly high prevalence and under-appreciation, thus representing a challenging condition for practising healthcare professionals...
December 2017: Thorax
https://www.readbyqxmd.com/read/29128801/oleuropein-protects-intracerebral-hemorrhage-induced-disruption-of-blood-brain-barrier-through-alleviation-of-oxidative-stress
#4
Jing Shi, Guofeng Wu, Xiaohua Zou, Ke Jiang
BACKGROUND: Intracerebral haemorrhage (ICH) as a devastating form of stroke has remained a public health threat due to lack of FDA-approved therapy. Oxidative stress originated from blood cell degradation products plays a crucial role in the ICH pathogenesis. In this study we evaluated oleuropein, a potent natural antioxidant from olive, in a well-established rat ICH model from overall symptoms to detailed molecular mechanism. METHODS: ICH model was established by collagenase injection to the brain of rats, which were randomly divided into groups with vehicle mock treatment, followed by treatment with different doses of oleuropein via daily intraperitoneal injection post-ICH for 3days...
May 11, 2017: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/29128343/post-stroke-depression-mechanisms-and-pharmacological-treatment
#5
REVIEW
Roberto Federico Villa, Federica Ferrari, Antonio Moretti
Depression, the most frequent psychiatric disorder following ischaemic stroke, negatively affects survivals' functional outcome, response to rehabilitation and quality of life. Approximately, one-third of them are affected by post-stroke depression (PSD), making it a serious social and public health problem and anti-depressant preventive and curative therapies worth investigating. However, a two-way association between depression and stroke has been also established: stroke increases the risk of PSD, but depression is an independent risk factor for stroke...
November 8, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29122931/outcome-of-left-atrial-appendage-occlusion-in-high-risk-patients
#6
Ahmed Masoud, Stefano Bartoletti, Timothy Fairbairn, Ayush Khurana, Periaswamy Velavan, William Lindsay Morrison, Afshin Khalatbari, Suneil Aggarwal, Nikhill Sharma, Paulus Kirchhof, Dhiraj Gupta
OBJECTIVE: Percutaneous left atrial appendage (LAA) occlusion can be an interventional alternative to oral anticoagulation for stroke prevention in patients with atrial fibrillation. METHODS: We delivered LAA occlusion therapy using a standardised approach to patient referral, multidisciplinary team assessment, implant criteria, imaging and follow-up. We analysed patient characteristics, efficacy and safety of the implant procedure, and 12-month outcomes. RESULTS: Of 143 referrals from October 2014 to December 2016, 83 patients (age 76±8 years, 32...
November 9, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29118803/multimodal-therapy-for-non-superacute-vertebral-basilar-artery-occlusion
#7
Xiongjun He, Liang Zhang, Juan Yang, Hui Zheng, Kaifeng Li, Yajie Liu
Objective: The aim of this study was to evaluate the feasibility and safety of multimodal therapy for patients with non-superacute vertebral basilar artery occlusion. Method: We performed a retrospective analysis of multimodal therapy for patients with vertebral basilar artery occlusion. All patients who were beyond the time window to receive intravenous thrombolysis and who had deterioration of symptoms after drug treatment received small-balloon dilatation of the occlusive artery to estimate vascular occlusion aetiology...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29118796/a-comparison-of-mechanical-thrombectomy-in-the-m1-and-m2-segments-of-the-middle-cerebral-artery-a-review-of-585-consecutive-patients
#8
Pervinder Bhogal, Philipp Bücke, Muhammad AlMatter, Oliver Ganslandt, Hansjörg Bäzner, Hans Henkes, Marta Aguilar Pérez
Background: Mechanical thrombectomy for anterior-circulation large-vessel occlusion has shown benefit; however, the question of whether this technique is safe and effective in the distal vasculature remains unanswered. We sought to compare the outcome data from mechanical thrombectomy of the M2 branches of the middle cerebral artery (MCA) with those of the M1 segment. Methods: We performed a retrospective analysis of prospectively collected data of patients with acute ischaemic stroke undergoing mechanical thrombectomy of isolated M1 or M2 branches of the MCA between August 2008 and August 2016...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29118788/mechanical-thrombectomy-for-m2-occlusions-a-single-centre-experience
#9
Pervinder Bhogal, Philipp Bücke, Marta Aguilar Pérez, Oliver Ganslandt, Hansjörg Bäzner, Hans Henkes
Background: The recent success of several mechanical thrombectomy trials has resulted in a significant change in the management of patients presenting with stroke. However, questions still remain as to whether certain groups will benefit from mechanical thrombectomy. In particular, it is still uncertain whether mechanical thrombectomy should be performed in the M2 branches and, more generally, in the distal vasculature. Methods: We retrospectively analysed our prospectively maintained database of all patients undergoing mechanical thrombectomy between January 2008 and August 2016...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29113716/plethysmography-variability-index-for-prediction-of-fluid-responsiveness-during-graded-haemorrhage-and-transfusion-in-sevoflurane-anaesthetized-mechanically-ventilated-dogs
#10
Yusuke Endo, Koudai Kawase, Taku Miyasho, Tadashi Sano, Kazuto Yamashita, William W Muir
OBJECTIVE: To examine the accuracy of plethysmography variability index (PVI) as a noninvasive indicator of fluid responsiveness in hypovolaemic dogs. STUDY DESIGN: Prospective experimental study. ANIMALS: Six adult healthy sevoflurane-anaesthetized Beagle dogs. METHODS: Dogs were anaesthetized with 1.3-fold their individual minimum alveolar concentration of sevoflurane. The lungs were mechanically ventilated after neuromuscular blockade with vecuronium bromide...
August 25, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29105904/predictors-of-symptomatic-intracranial-hemorrhage-in-off-label-thrombolysis-an-analysis-of-the-sits-registry
#11
Sibu Mundiyanapurath, Katharina Hees, Niaz Ahmed, Nils Wahlgren, Lorenz Uhlmann, Meinhard Kieser, Peter Arthur Ringleb, Werner Hacke, Simon Nagel
BACKGROUND: Intravenous thrombolysis is the only approved pharmacological treatment for acute ischemic stroke. Off-label intravenous thrombolysis for ischemic stroke is common. We aimed to analyse its safety in a large database. METHODS: Retrospective analysis of the SITS thrombolysis registry regarding 11 off-label criteria according to the European license for alteplase. Symptomatic intracranial haemorrhage (SICH) according to SITS was defined as primary safety endpoint and SICH according to the ECASS II definition and the NINDS definition as secondary safety endpoints...
November 6, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29102362/drug-eluting-stents-in-elderly-patients-with-coronary-artery-disease-senior-a-randomised-single-blind-trial
#12
Olivier Varenne, Stéphane Cook, Georgios Sideris, Sasko Kedev, Thomas Cuisset, Didier Carrié, Thomas Hovasse, Philippe Garot, Rami El Mahmoud, Christian Spaulding, Gérard Helft, José F Diaz Fernandez, Salvatore Brugaletta, Eduardo Pinar-Bermudez, Josepa Mauri Ferre, Philippe Commeau, Emmanuel Teiger, Kris Bogaerts, Manel Sabate, Marie-Claude Morice, Peter R Sinnaeve
BACKGROUND: Elderly patients regularly receive bare-metal stents (BMS) instead of drug-eluting stents (DES) to shorten the duration of double antiplatelet therapy (DAPT). The aim of this study was to compare outcomes between these two types of stents with a short duration of DAPT in such patients. METHODS: In this randomised single-blind trial, we recruited patients from 44 centres in nine countries. Patients were eligible if they were aged 75 years or older; had stable angina, silent ischaemia, or an acute coronary syndrome; and had at least one coronary artery with a stenosis of at least 70% (≥50% for the left main stem) deemed eligible for percutaneous coronary intervention (PCI)...
October 31, 2017: Lancet
https://www.readbyqxmd.com/read/29079663/favorable-revascularization-therapy-in-patients-with-aspects-%C3%A2-5-on-dwi-in-anterior-circulation-stroke
#13
Isabelle Mourand, Eitan Abergel, Daniel Mantilla, Xavier Ayrignac, Tzvika Sacagiu, Omer Faruk Eker, Gregory Gascou, Cyril Dargazanli, Carlos Riquelme, Marinette Moynier, Alain Bonafé, Caroline Arquizan, Vincent Costalat
BACKGROUND: A low baseline Alberta Stroke Programme Early CT Score (ASPECTS) is strongly associated with low rates of favorable outcome in patients with acute stroke. OBJECTIVE: To evaluate the efficacy and safety of revascularization therapy in patient with ASPECTS ≤5 in anterior circulation infarct. METHODS: We retrospectively analyzed 108 consecutive patients presenting low ASPECTS on diffusion-weighted imaging. Sixty patients were treated by mechanical thrombectomy, including 34 patients who received simultaneously intravenous thrombolysis...
October 27, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29078033/warfarin-prescription-in-patients-with-non-valvular-atrial-fibrillation-and-one-non-gender-related-risk-factor-cha2ds2vasc-1-or-2-a-treatment-dilemma
#14
Gentian Denas, Giacomo Zoppellaro, Seena Padayattil Jose, Emilia Antonucci, Francesco Marongiu, Daniela Poli, Sophie Testa, Armando Tripodi, Gualtiero Palareti, Vittorio Pengo
INTRODUCTION: The issue of anticoagulation in individuals with atrial fibrillation and 1 non-gender related risk factor is subject to debate. The reported risk of stroke in untreated individuals is not uniform, and the rate of haemorrhage associated with anticoagulation in this group of individuals is not well defined. To this end, we assessed the rate of stroke and major haemorrhage in individuals treated with warfarin. MATERIALS AND METHODS: individuals were extracted from the START register, an observational, multicentre, dynamic inception cohort study that collects data on AF individuals starting anticoagulation therapy...
October 27, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/29071290/data-from-a-multidisciplinary-poll-of-178-expert-physicians-on-the-usage-of-non-vitamin-k-oral-anticoagulants-in-patients-with-atrial-fibrillation-and-venous-thromboembolism
#15
Paolo Colonna, Felicita Andreotti, Walter Ageno, Vittorio Pengo, Niccolò Marchionni
This data article contains data from a multidisciplinary questionnaires filled in by 178 expert physicians on the usage of non-vitamin K Oral Anticoagulants in patients with atrial fibrillation (AF) and for the treatment of patients with venous thromboembolism (VTE). The questionnaire consists of 9 statements of clinical complex AF and VTE cases and informative campaign on antithrombotic therapy for stroke prevention in AF. The data are potentially valuable for the scientific community, showing the doubts of different specialists (Internists, Pneumologists, Geriatricians, Cardiologists and Neurologists) with a large experience in prescribing oral anticoagulation in difficult AF and VTE cases (see full list of participants provided)...
December 2017: Data in Brief
https://www.readbyqxmd.com/read/29068037/berg-balance-scale-score-at-admission-can-predict-walking-suitable-for-community-ambulation-at-discharge-from-inpatient-stroke-rehabilitation
#16
Dennis R Louie, Janice J Eng
OBJECTIVE: This retrospective cohort study identified inpatient rehabilitation admission variables that predict walking ability at discharge and established Berg Balance Scale cut-off scores to predict the extent of improvement in walking. METHODS: Participants (n=123) were assessed for various cognitive and physical outcomes at admission to inpatient stroke rehabilitation. Multivariate logistic regression identified admission predictors of regaining community ambulation (gait speed ≥0...
October 25, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29065915/interventions-for-acute-stroke-management-in-africa-a-systematic-review-of-the-evidence
#17
Leonard Baatiema, Carina K Y Chan, Adem Sav, Shawn Somerset
BACKGROUND: The past decades have witnessed a rapid evolution of research on evidence-based acute stroke care interventions worldwide. Nonetheless, the evidence-to-practice gap in acute stroke care remains variable with slow and inconsistent uptake in low-middle income countries (LMICs). This review aims to identify and compare evidence-based acute stroke management interventions with alternative care on overall patient mortality and morbidity outcomes, functional independence, and length of hospital stay across Africa...
October 24, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29061107/non-endoscopic-minimally-invasive-evacuation-of-intracerebral-haematoma-ich-a-case-report
#18
Tomaz Velnar
Spontaneous intracerebral haemorrhage (ICH) is one of the most serious causes of stroke, leading to high rates of disability and mortality. In addition to intensive medical treatment, surgery may help to improve the prognosis in patients with ICH. A rapid reversal of coagulopathy is essential in these patients, although it may be difficult to achieve in various bleeding disorders. In such cases, when surgery is needed, a minimally invasive approach is recommended. In this case report, we described and shortly discussed the evacuation of ICH with a minimally invasive non-endoscopic surgical technique...
October 24, 2017: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/29056588/neonatal-brain-injuries-in-england-population-based-incidence-derived-from-routinely-recorded-clinical-data-held-in-the-national-neonatal-research-database
#19
Chris Gale, Yevgeniy Statnikov, Sena Jawad, Sabita N Uthaya, Neena Modi
OBJECTIVE: In 2015, the Department of Health in England announced an ambition to reduce 'brain injuries occurring during or soon after birth'. We describe the development of a pragmatic case definition and present annual incidence rates. DESIGN: Retrospective cohort study using data held in the National Neonatal Research Database (NNRD) extracted from neonatal electronic patient records from all National Health Service (NHS) neonatal units in England, Wales and Scotland...
October 22, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29054448/brain-ischemia-ct-and-mri-techniques-in-acute-ischemic-stroke
#20
REVIEW
Pedro Vilela, Howard A Rowley
Imaging plays a central role for intravenous and intra-arterial arterial ischemic stroke treatment patient selection. Computed tomography (CT) / CT angiography or magnetic resonance (MR) / MR angiography imaging are used to exclude stroke mimics and haemorrhage, to determine the cause and mechanism of stroke, to define the extension of brain infarct and to identify the arterial occlusion. Imaging may identify the patients that will be benefit more from revascularization therapies independently of the conventional therapeutic time window allowing individualized treatment decisions and improving individual patient outcome...
August 24, 2017: European Journal of Radiology
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