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Transient ischaemic attack

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https://www.readbyqxmd.com/read/28747411/stroke-of-the-inferiomedial-temporal-lobe-causing-word-agnosia
#1
Hardi Hassan, Huq Ehsanula, Mahendra Pattanshetti
A 69-year-old man presented with sudden loss of ability to recognise written words and remember the meaning of words and names. He could not name the town he lived in nor name his children. It was difficult for him to remember the meaning of concrete and abstract nouns. His speech fluency and understanding of casual talks were normal. He remembered that he had a conversation with his family that morning, but not the exact content. He was referred to the transient ischaemic attack clinic by his general practitioner as he scored low on the abbreviated mental test score...
July 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28733710/a-matched-case-control-study-on-early-and-late-results-of-carotid-endarterectomy-performed-in-young-patients
#2
Walter Dorigo, Aaron Fargion, Elena Giacomelli, Giulia Bassoli, Raffaele Pulli, Giovanni Pratesi, Gabriele Piffaretti, Carlo Pratesi
OBJECTIVE: The aim of the study was to describe the perioperative and long-term results of carotid endarterectomy (CEA) in patients aged 60 or less and compare them to patients of more advanced age in a retrospective single-centre case-control study. METHODS: From January 1996 to December 2014, 5893 consecutive CEAs were performed in our institution. Data concerning these interventions were prospectively inserted in a dedicated database. A retrospective analysis of that database was performed and 457 interventions performed in patients aged 60 or less were found (group 1)...
July 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28709561/factors-associated-with-need-for-revascularisation-in-non-coronary-arterial-occlusive-lesions-secondary-to-takayasu-s-arteritis
#3
C A Hinojosa, J E Anaya-Ayala, Z Gomez-Arcive, H Laparra-Escareno, A Torres-Machorro, R Lizola
OBJECTIVE/BACKGROUND: Takayasu's arteritis (TA) is rare inflammatory large vessel form of vasculitis. The objective of this study was to evaluate experience in the management of TA patients and to identify the influence of inflammatory markers and clinical variables associated with disease progression, worsening ischaemic symptoms, and the need for interventions. METHODS: Demographics, and laboratory and clinical variables in patients that required revascularisation procedures were compared with those who had adequate symptomatic control with medical management...
July 11, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28705843/headache-tia-and-subarachnoid-haemorrhage-dissecting-an-unusual-cause-for-stroke-like-symptoms
#4
Elliot T Dawson, Desmond A Brown, Alejandro A Rabinstein
We present a case of supraclinoid internal carotid artery dissection. Eleven months prior, the patient developed isolated periorbital pain and was diagnosed with giant-cell arteritis with iritis. The patient experienced recurrent spells concerning for transient ischaemic attacks and was transferred to our institution for endovascular intervention after head CT revealed an embolic infarct with a 'dense middle cerebral artery sign.' Digital subtraction angiography was negative for occlusion, instead demonstrating luminal stenosis and poststenotic dilatation...
July 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28682128/the-effects-of-centralisation-of-vascular-surgical-services-in-the-bath-bristol-and-weston-area-on-the-carotid-endarterectomy-pathway
#5
E Partridge, M Brooks, C Curd, V Davis, C Oates, D McGeeney
Introduction Patients who experience a transient ischaemic attack are at the highest risk of having a subsequent stroke immediately after their symptoms. A carotid endarterectomy should be performed on symptomatic, surgically suitable patients who present with a greater than 50% North American Symptomatic Carotid Endarterectomy Trial stenosis of the internal carotid artery within 2 weeks of their symptoms. This study aimed to determine whether the effectiveness of the carotid endarterectomy pathway has been impacted by the centralisation of vascular surgical services in the Bath, Bristol and Weston area...
July 6, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28674629/morbidity-outcomes-after-surgical-aortic-valve-replacement
#6
Andreas Auensen, Amjad Iqbal Hussain, Bjørn Bendz, Lars Aaberge, Ragnhild Sørum Falk, Marte Meyer Walle-Hansen, Jorun Bye, Johanna Andreassen, Jan Otto Beitnes, Kjell Arne Rein, Kjell Ingar Pettersen, Lars Gullestad
OBJECTIVE: In patients with mild to moderate operative risk, surgical aortic valve replacement (SAVR) is still the preferred treatment for patients with severe symptomatic aortic stenosis (AS). Aiming to broaden the knowledge of postsurgical outcomes, this study reports a broad set of morbidity outcomes following surgical intervention. METHODS: Our cohort comprised 442 patients referred for severe AS; 351 had undergone SAVR, with the remainder (91) not operated on...
2017: Open Heart
https://www.readbyqxmd.com/read/28674141/a-cohort-study-on-physician-documentation-and-the-accuracy-of-administrative-data-coding-to-improve-passive-surveillance-of-transient-ischaemic-attacks
#7
Amy Y X Yu, Hude Quan, Andrew D McRae, Gabrielle O Wagner, Michael D Hill, Shelagh B Coutts
BACKGROUND: Administrative health data are valuable in health research and disease surveillance, but have low to moderate sensitivity in identifying transient ischaemic attacks (TIA) in the emergency department (ED). We aimed to identify the predictors of coding accuracy for TIA. METHODS: The study population was obtained from two ongoing studies on the diagnosis of TIA, minor stroke and stroke mimic. ED charts were manually reviewed by a stroke neurologist to obtain the clinical diagnosis, patient characteristics and content of physician documentation...
July 2, 2017: BMJ Open
https://www.readbyqxmd.com/read/28674132/exploration-into-lipid-management-and-persistent-risk-in-patients-hospitalised-for-acute-coronary-syndrome-in-japan-explore-j-protocol-for-a-prospective-observational-study
#8
Masato Nakamura, Kiyoko Uno, Atsushi Hirayama, Junya Ako, Atsushi Nohara, Hidenori Arai, Mariko Harada-Shiba
INTRODUCTION: The present study is the largest registry study ever conducted in Japan exploring the prevalence of familial hypercholesterolaemia (FH) among patients with acute coronary syndrome (ACS). Our study aims to (1) evaluate the status of lipid management and the subsequent risk of major cardiovascular events following hospitalisation of Japanese patients with ACS in real-world clinical practice; (2) determine the proportion of Japanese patients with ACS who achieve the lipid management goal and have a reduction of event risks with strict lipid management (low-density lipoprotein-cholesterol <1...
July 2, 2017: BMJ Open
https://www.readbyqxmd.com/read/28662483/intensity-of-anticoagulation-and-risk-of-thromboembolism-after-elective-cardioversion-of-atrial-fibrillation
#9
Tapio Hellman, Tuomas Kiviniemi, Ilpo Nuotio, Tuija Vasankari, Juha Hartikainen, Gregory Y H Lip, K E Juhani Airaksinen
BACKGROUND: Elective cardioversion (ECV) for atrial fibrillation (AF) is associated with a relatively low risk of thromboembolic complications. However, the optimal intensity of anticoagulation for ECV is unknown. We sought to assess the risk of thromboembolism in low (INR 2.0-2.4) vs. high (INR≥2.5) therapeutic range in a large retrospective cohort study. METHODS: This multi-centre "real world" study included 1424 ECVs in 1021 patients. The primary outcome was a stroke or a transient ischaemic attack (TIA) or a systemic embolus during the 30-day follow-up after ECV...
June 22, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28647723/a-retrospective-cohort-study-of-high-impact-users-among-patients-with-cerebrovascular-conditions
#10
Ahsan Rao, Alice Jones, Alex Bottle, Ara Darzi, Paul Aylin
OBJECTIVE: To apply group-based trajectory modelling (GBTM) to the hospital administrative data to evaluate, model and visualise trends and changes in the frequency of long-term hospital care use of the subgroups of patients with cerebrovascular conditions. DESIGN: A retrospective cohort study of patients with cerebrovascular conditions. SETTINGS: Secondary care of all patients with cerebrovascular conditions admitted to English National Hospital Service hospitals...
June 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28643004/effectiveness-and-safety-of-apixaban-therapy-in-daily-care-patients-with-atrial-fibrillation-results-from-the-dresden-noac-registry
#11
Sindy Helmert, Sandra Marten, Heike Mizera, Antje Reitter, Kurtulus Sahin, Luise Tittl, Jan Beyer-Westendorf
The effectiveness and safety of apixaban for stroke prevention in atrial fibrillation (SPAF) demonstrated in ARISTOTLE needs to be confirmed in daily care. To evaluate effectiveness and safety of apixaban therapy in SPAF patients in daily care, we used data from an ongoing, prospective, non-interventional registry of more than 3000 patients on novel oral anticoagulants in daily care. Between 1 December 2012 and 31 August 2015, 514 patients receiving apixaban were enrolled. During a mean follow-up of 803.5 ± 228...
August 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28630782/remote-assessment-of-platelet-function-in-patients-with-acute-stroke-or-transient-ischaemic-attack
#12
Philip M Bath, Jane May, Katie Flaherty, Lisa J Woodhouse, Natalia Dovlatova, Sue C Fox, Timothy J England, Kailash Krishnan, Thompson G Robinson, Nikola Sprigg, Stan Heptinstall, Tardis Investigators
BACKGROUND: The TARDIS trial assessed the safety and efficacy of intensive versus guideline antiplatelet agents given for one month in patients with acute stroke or TIA. The aim of this substudy was to assess the effect of antiplatelet agents taken at baseline on platelet function reactivity and activation. METHODS: Platelet function, assessed by remotely measured surface expression of P-selectin, was assessed in patients at their time of randomisation. Data are median fluorescence values...
2017: Stroke Research and Treatment
https://www.readbyqxmd.com/read/28627932/short-term-prognostic-effect-of-prior-cerebrovascular-and-peripheral-artery-disease-in-patients-with-acute-coronary-syndrome-can-we-do-better
#13
Filipa Cordeiro, Pedro S Mateus, Alberto Ferreira, Silvia Leao, Miguel Moz, J Ilidio Moreira
BACKGROUND: We sought to evaluate the impact of prior cerebrovascular and/or peripheral arterial disease (PAD) on in-hospital outcomes in patients with acute coronary syndromes. METHODS: From 1 October 2010 to 26 February 2016, 13,904 acute coronary syndrome patients were enrolled in a national multicentre registry. They were divided into four groups: prior stroke/transient ischaemic attack (stroke/TIA); prior PAD; prior stroke/TIA and PAD; none. The endpoints included in-hospital mortality and a composite endpoint of death, re-infarction and stroke during hospitalization...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28622955/age-specific-risks-severity-time-course-and-outcome-of-bleeding-on-long-term-antiplatelet-treatment-after-vascular-events-a-population-based-cohort-study
#14
Linxin Li, Olivia C Geraghty, Ziyah Mehta, Peter M Rothwell
BACKGROUND: Lifelong antiplatelet treatment is recommended after ischaemic vascular events, on the basis of trials done mainly in patients younger than 75 years. Upper gastrointestinal bleeding is a serious complication, but had low case fatality in trials of aspirin and is not generally thought to cause long-term disability. Consequently, although co-prescription of proton-pump inhibitors (PPIs) reduces upper gastrointestinal bleeds by 70-90%, uptake is low and guidelines are conflicting...
June 13, 2017: Lancet
https://www.readbyqxmd.com/read/28612910/percutaneous-left-atrial-appendage-occlusion-procedures-in-patients-with-heart-failure
#15
Magdalena Szymała, Witold Streb, Katarzyna Mitręga, Tomasz Podolecki, Grzegorz Mencel, Tomasz Kukulski, Zbigniew Kalarus
BACKGROUND: Atrial fibrillation (AF) is the most common supraventricular tachyarrhythmia. The percutaneous left atrial appendage occlusion (LAAO) may be considered for the stroke prophylaxis in patients with nonvalvular AF (NVAF), especially in contraindications for oral anticoagulants (OAC) or high risk of bleeding. The data about implantation, safety, efficacy and follow-up are limited. Moreover, there are no studies on patients with NVAF and heart failure with severe left ventricular systolic dysfunction (left ventricular ejection fraction - LVEF ≤ 35%)...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28590505/carotid-endarterectomy-for-symptomatic-carotid-stenosis
#16
REVIEW
Saritphat Orrapin, Kittipan Rerkasem
BACKGROUND: Stroke is the third leading cause of death and the most common cause of long-term disability. Severe narrowing (stenosis) of the carotid artery is an important cause of stroke. Surgical treatment (carotid endarterectomy) may reduce the risk of stroke, but carries a risk of operative complications. This is an update of the Cochrane Review, originally published in 1999, and most recently updated in 2011. OBJECTIVES: To determine the balance of benefit versus risk of endarterectomy plus best medical management compared with best medical management alone, in people with a recent symptomatic carotid stenosis (i...
June 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28578318/recurrent-brain-ischaemia-and-deep-vein-thrombosis-the-clot-thickens
#17
David Turner, Marie Scully, Sheldon Stone, David J Werring
A 65-year-old man presented with two transient ischaemic attacks, and was then found to have a deep vein thrombosis. He later had recurrent ischaemic strokes. After thorough investigation, the only cause we identified was a previously undiagnosed metastatic pancreatic cancer. We describe the assessment of this presentation and discuss the causes and management of cancer-related stroke.
June 3, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28572220/msoar-an-effective-bedside-stroke-prognosis-tool
#18
Mark Thaller, Nicholas Mitchell
The modified-SOAR (mSOAR) score is composed of the stroke subtype, Oxfordshire Community Stroke Project classification, age, pre-stroke modified Rankin score (mRS) and the National Institutes of Health Stroke Scale score. It has previously been shown to be a reliable predictor of mortality and length of -hospital stay. This study sought to identify whether the mSOAR can also be used to predict patient disability on discharge. A post-hoc calculation of mSOAR using Sentinel Stroke National Audit Programme (SSNAP) data and electronic discharge -summaries was performed on all stroke admissions to Bridgend Hospital over an 11-month period...
June 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28550068/age-specific-trends-of-atrial-fibrillation-related-ischaemic-stroke-and-transient-ischaemic-attack-anticoagulant-use-and-risk-factor-profile-in-chinese-population-a-15-year-study
#19
Yannie Soo, Nathan Chan, Kam Tat Leung, Xiang-Yan Chen, Vincent Mok, Lawrence Wong, Thomas Leung
BACKGROUND: Prevalence of atrial fibrillation (AF) is increasing globally, and the fivefold increase in stroke risk constitutes significant healthcare burden. AIMS: We aim to evaluate the trends of AF-related stroke and transient ischaemic attack (AF-stroke/TIA), prior anticoagulant use and their risk factors in different age groups in Chinese population. METHODS: Data were retrieved from the stroke registry at Prince of Wales Hospital. We compared the data at 5-year intervals over a 15-year period (years 1999, 2004, 2009 and 2014)...
May 26, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28538247/the-positive-predictive-value-of-an-ambulance-prealert-for-stroke-and-transient-ischaemic-attack
#20
Craig W Brown, Mary J Macleod
OBJECTIVE: Therapeutic options for ischaemic stroke, such as thrombolysis or thrombectomy, are time sensitive. Multiple innovations have been established to reduce the symptom-to-needle time. One such innovation is the prealerting of emergency department (ED) or stroke unit staff by prehospital personnel of suspected stroke patients. The diagnosis of stroke can sometimes be difficult, with stroke mimics being a recognized issue. The prealert mobilizes ED, stroke and imaging personnel, which, for a true-positive, improves door-to-needle times...
May 19, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
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