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intracranial haemorrhage

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https://www.readbyqxmd.com/read/28634280/surgical-clipping-or-endovascular-coiling-for-unruptured-intracranial-aneurysms-a-pragmatic-randomised-trial
#1
Tim E Darsaut, J Max Findlay, Elsa Magro, Marc Kotowski, Daniel Roy, Alain Weill, Michel W Bojanowski, Chiraz Chaalala, Daniela Iancu, Howard Lesiuk, John Sinclair, Felix Scholtes, Didier Martin, Michael M Chow, Cian J O'Kelly, John H Wong, Ken Butcher, Allan J Fox, Adam S Arthur, Francois Guilbert, Lu Tian, Miguel Chagnon, Suzanne Nolet, Guylaine Gevry, Jean Raymond
BACKGROUND: Unruptured intracranial aneurysms (UIAs) are increasingly diagnosed and are commonly treated using endovascular treatment or microsurgical clipping. The safety and efficacy of treatments have not been compared in a randomised trial. How to treat patients with UIAs suitable for both options remains unknown. METHODS: We randomly allocated clipping or coiling to patients with one or more 3-25 mm UIAs judged treatable both ways. The primary outcome was treatment failure, defined as: initial failure of aneurysm treatment, intracranial haemorrhage or residual aneurysm on 1-year imaging...
June 20, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28623282/a-nationwide-study-of-severe-and-protracted-diarrhoea-in-patients-with-primary-immunodeficiency-diseases
#2
Wen-I Lee, Chien-Chang Chen, Tang-Her Jaing, Liang-Shiou Ou, Chuen Hsueh, Jing-Long Huang
Diarrhoea lasting longer than 14 days and failing to respond to conventional management is defined as severe and protracted diarrhoea (SD). In this study, we investigated the prevalence, pathogens and prognosis of SD in primary immunodeficiency diseases (PIDs). Among 246 patients with predominantly paediatric-onset PIDs from 2003-2015, 21 [Btk (six), IL2RG (four), WASP, CD40L, gp91 (three each), gp47, RAG2 (one each)] and five [CVID (four), SCID (one)] without identified mutations had SD before prophylactic treatment...
June 16, 2017: Scientific Reports
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
#3
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/28606079/costs-of-major-intracranial-gastrointestinal-and-other-bleeding-events-in-patients-with-atrial-fibrillation-a-nationwide-cohort-study
#4
Marie Jakobsen, Christophe Kolodziejczyk, Eskild Klausen Fredslund, Peter Bo Poulsen, Lars Dybro, Søren Paaske Johnsen
BACKGROUND: Use of oral anticoagulation therapy in patients with atrial fibrillation (AF) involves a trade-off between a reduced risk of ischemic stroke and an increased risk of bleeding events. Different anticoagulation therapies have different safety profiles and data on the societal costs of both ischemic stroke and bleeding events are necessary for assessing the cost-effectiveness and budgetary impact of different treatment options. To our knowledge, no previous studies have estimated the societal costs of bleeding events in patients with AF...
June 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28593892/neonatal-hypoglycemia-risk-factors-and-outcomes
#5
Orhideja Stomnaroska, Elizabeta Petkovska, Snezana Jancevska, Dragan Danilovski
BACKGROUND AND AIMS: Severe neonatal hypoglycemia (HG) leads to neurologic damage, mental retardation, epilepsy, personality disorders, impaired cardiac performance and muscle weakness. We aimed to assess the clinical characteristics of children with hypoglycemia in a random population of newborns. PATIENTS, METHODS AND RESULTS: We investigated 84 patients (M:F=35:48) born at the University Clinic for Gynecology and Obstetrics in Skopje (hospitalized in the NICU) who were found to have hypoglycemia...
March 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/28593066/sequence-analysis-of-long-term-readmissions-among-high-impact-users-of-cerebrovascular-patients
#6
Ahsan Rao, Alex Bottle, Ara Darzi, Paul Aylin
OBJECTIVE: Understanding the chronological order of the causes of readmissions may help us assess any repeated chain of events among high-impact users, those with high readmission rate. We aim to perform sequence analysis of administrative data to identify distinct sequences of emergency readmissions among the high-impact users. METHODS: A retrospective cohort of all cerebrovascular patients identified through national administrative data and followed for 4 years...
2017: Stroke Research and Treatment
https://www.readbyqxmd.com/read/28589641/the-yield-of-head-computed-tomography-in-patients-with-new-onset-of-transient-headaches
#7
Niamh Hammond, Annemarei Ranta
BACKGROUND: Headache is a common patient complaint. The threshold for brain imaging in headache is debated, especially when the headache is transient, although even if the headache has resolved at presentation a sentinel bleed heralding a subarachnoid haemorrhage (SAH) often remains a concern. AIMS: To assess the yield of computed tomography (CT) head scan referrals for patients with transient headache symptoms. METHODS: This study looked at six months of CT results assessing for brain pathology with a particular focus on subarachnoid haemorrhage...
June 7, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28575128/neurofibromatosis-type-1-is-not-associated-with-subarachnoid-haemorrhage
#8
Arttu Kurtelius, Roope A Kallionpää, Jukka Huttunen, Terhi J Huttunen, Katariina Helin, Timo Koivisto, Juhana Frösen, Mikael von Und Zu Fraunberg, Sirkku Peltonen, Juha Peltonen, Juha E Jääskeläinen, Antti E Lindgren
BACKGROUND: The prevalence of intracranial aneurysms (IAs) has been proposed to be elevated in the patients with neurofibromatosis type 1 (NF1). Our aims were to determine the prevalence of NF1 in a large Finnish population based cohort of IA patients and, on the other hand, the occurrences of subarachnoid haemorrhage and unruptured intracranial aneurysms in a nationwide population-based cohort of NF1 patients and its matched ten-fold control cohort. METHODS: The Kuopio IA Database (www...
2017: PloS One
https://www.readbyqxmd.com/read/28572224/drug-therapy-in-anticoagulation-which-drug-for-which-patient
#9
Carolyn M Millar, Mike A Laffan
Four non-vitamin K oral anticoagulants (NOACs) are now licensed and available in the UK, offering unprecedented choices in anticoagulant therapy for clinicians and patients. NOACs have many clear benefits over warfarin, the most striking being the reduction in intracranial haemorrhage. However, a number of uncertainties remain: their efficacy in certain situations, utility of drug assays, significance of drug interactions and management of bleeding. In the absence of any direct comparative trials, it is not clear that any of the NOACs is significantly better than the others in any of the licensed indications...
June 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28569277/clinical-stroke-prevention-in-atrial-fibrillation
#10
C Voukalis, E Shantsila, G Y Lip
Oral anticoagulation therapy has reduced the risk of ischaemic stroke and improved the outcomes for patients with atrial fibrillation considerably. The emergence of the non-vitamin K oral anticoagulants as alternatives to vitamin K antagonists has significantly changed the practice of stroke prevention in atrial fibrillation. As the main complication with antithrombotic therapy is bleeding, physicians should always balance the risk of ischaemic stroke against intracranial haemorrhage and intervene where appropriate to reduce both risks...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28561420/cab4b-the-first-human-platelet-antigen-carried-by-gpix-discovered-in-a-context-of-severe-neonatal-thrombocytopenia
#11
V Jallu, T Beranger, F Bianchi, C Casale, C Chenet, N Ferre, S Philippe, J Quesne, C Martageix, R Petermann
BACKGROUND: After 3 miscarriages, a 39-year-old woman gave birth at 1 year interval to 2 severely thrombocytopenic neonates (4 and 33 G/L) with intracranial haemorrhages. Transfusion of platelets concentrates corrected thrombocytopenias. The outcome was favourable for the 1(st) child but the second one died 10 days after caesarean delivery (31 WG + 6 days). METHODS: Serological studies were performed using MAIPA and flow cytometry techniques. Human platelet antigens (HPA) genotyping was done by using the BioArray HPA BeadChip and PCR-SSP techniques...
May 31, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28556351/thrive-score-predicts-clinical-and-radiological-outcome-after-endovascular-therapy-or-thrombolysis-in-patients-with-anterior-circulation-stroke-in-everyday-clinical-practice
#12
A Kastrup, F Brunner, H Hildebrandt, C Roth, M Winterhalter, C Gießing, P Papanagiotou
BACKGROUND AND PURPOSE: Based on the data of several trials the Totaled Health Risks in Vascular Events (THRIVE) score has been shown to predict outcome after either intravenous thrombolysis (IVT) or endovascular therapy (ET) in acute stroke patients. It is unknown whether the THRIVE score can also predict outcome in everyday clinical practice. Using our prospectively obtained stroke database the utility of the THRIVE score to predict clinical and radiological outcome in everyday clinical practice was analysed...
May 29, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28542715/hyperleucocytosis-in-paediatric-acute-myeloid-leukaemia-the-challenge-of-white-blood-cell-counts-above-200%C3%A2-%C3%A3-%C3%A2-10-9-l-the-nopho-experience-1984-2014
#13
Bernward Zeller, Heidi Glosli, Erik Forestier, Shau-Yin Ha, Kirsi Jahnukainen, Ólafur G Jónsson, Birgitte Lausen, Josefine Palle, Henrik Hasle, Jonas Abrahamsson
Hyperleucocytosis in paediatric acute myeloid leukaemia (AML) is associated with increased morbidity and mortality. We studied hyperleucocytosis in 890 patients with AML aged 0-18 years registered in the Nordic Society of Paediatric Haematology and Oncology (NOPHO) registry, with special focus on very high white blood cell counts (WBC >200 × 10/l). Eighty-six patients (10%) had WBC 100-199 × 10(9) /l and 57 (6%) had WBC ≥200 × 10(9) /l. Patients with WBC ≥200 × 10(9) /l had a high frequency of t(9;11) and a paucity of trisomy 8...
May 25, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28532918/subarachnoid-haemorrhage-in-germany-between-2010-2013-estimated-incidence-rates-based-on-a-nationwide-hospital-discharge-registry
#14
Jasper H van Lieshout, Igor Fischer, Marcel A Kamp, A R T Donders, Jan F Cornelius, Hans-Jakob Steiger, Hieronymus D Boogaarts, Athanasios K Petridis
BACKGROUND: Nordic countries are the primary source for nationwide data on the incidence of subarachnoid haemorrhage (SAH). Reliable estimates of national incidence rates of SAH in other countries are lacking, yet studies from Nordic countries with exceptional incidence rate are sometimes disregarded because of concerns regarding external validity. Autopsies are rarely performed for sudden deaths, therefore estimates of the SAH incidence commonly reflect the hospital discharge rates. Our aim was to estimate the nationwide incidence of non-traumatic SAH in Germany using a national hospital discharge register...
May 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28528780/comparative-effectiveness-and-safety-of-apixaban-and-vitamin-k-antagonist-therapy-in-patients-with-nonvalvular-atrial-fibrillation-treated-in-routine-german-practice
#15
Craig I Coleman, W Frank Peacock, Matthias Antz
BACKGROUND: Scarce data comparing real-world outcomes between apixaban and vitamin K antagonist (VKA) users with nonvalvular atrial fibrillation (NVAF) are available. We sought to assess the effectiveness and safety of newly-initiated apixaban vs. VKA in German NVAF patients. MATERIALS AND METHODS: We performed a retrospective analysis in German outpatients using IMS Disease Analyzer data. Adults newly-initiated on apixaban or a VKA from January 2013 to March 2015 with a diagnosis of NVAF on the day of the first qualifying oral anticoagulant (OAC) prescription (index date) or any time during one year prior, and at least one year of follow-up were included...
May 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28523059/efficacy-and-safety-of-optic-nerve-sheath-fenestration-in-patients-with-raised-intracranial-pressure
#16
Muhammad Amer Yaqub, Mohammad Asim Mehboob, Qamar Ul Islam
OBJECTIVE: To evaluate the efficacy and safety of Optic Nerve Sheath Fenestration (ONSF) in patients with raised intracranial pressure (ICP). METHODS: This Quasi Experimental Study was conducted at Armed Forces Institute of Ophthalmology, Rawalpindi from July 2013 to July 2015. Thirty one eyes of 18 patients who underwent ONSF for raised ICP were followed up for one year to ascertain efficacy and safety of ONSF procedure. RESULTS: Thirteen (72...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28510754/the-diagnostic-challenge-of-a-vitamin-k-antagonist-with-dabigatran-use-triggering-massive-intracranial-haemorrhage
#17
A Pausch, St Koch, M Frossard, M Wiegele
No abstract text is available yet for this article.
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28502970/is-regular-screening-for-intracranial-aneurysm-necessary-in-patients-with-autosomal-dominant-polycystic-kidney-disease-a-systematic-review-and-meta-analysis
#18
Zien Zhou, Ying Xu, Candice Delcourt, Jiehui Shan, Qiang Li, Jianrong Xu, Maree L Hackett
BACKGROUND: The prevalence of intracranial aneurysm in patients with autosomal dominant polycystic kidney disease (ADPKD) is higher than that among the general population. We performed a systematic review and meta-analysis on the prevalence and natural history of intracranial aneurysm among patients with ADPKD. METHODS: Medline, Embase, Web of Science and Scopus, from inception to July 2016, were searched for studies reporting the occurrence of intracranial aneurysms among participants with ADPKD...
May 13, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28480741/a-practical-guide-to-the-use-of-anti-epileptic-drugs-by-neurosurgeons
#19
Fardad T Afshari, Sophia Michael, Ismail Ughratdar, Shanika Samarasekera
Initiation of anti-epileptic drugs is increasingly relevant to daily neurosurgical practice. Intracranial pathologies ranging from brain tumours to subarachnoid haemorrhage and traumatic brain injury are commonly associated with the subsequent development of seizures. The scope and range of anti-epileptic drugs available has increased dramatically in recent years and understanding the evidence base behind this class of drugs in addition to their interaction/side effect profiles is essential. In this review we aim to generate a practical guide for neurosurgeons regarding the use of different anti-epileptic medications in common neurosurgical conditions, including considerations for their use in pregnancy...
May 8, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28471350/antiviral-therapy-reduces-risk-of-haemorrhagic-stroke-in-patients-with-hcv-infection-a-nationwide-cohort-study
#20
Ming-Shyan Lin, Chang-Min Chung, Wey-Yil Lin, Kuo-Liang Wei, Jui Wang, Ying-Ying Lee, Jing-Hong Hu, Tao-Hsin Tung, Yu-Sheng Lin
BACKGROUND: The tendency for haemorrhagic stroke in patients with chronic hepatitis C virus (HCV) infection has emerged recently but the finding may be confounded by comorbidities. Proving the causality between HCV infection and haemorrhagic stroke is mandatory. Our study was designed to investigate the incidence of intracranial haemorrhage in HCV-infected patients with and without treatment. METHODS: In the 11-year and population-based retrospective study, we acquired data from the Taiwan National Health Insurance Research Database...
May 4, 2017: Antiviral Therapy
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