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stroke hemorragic

Daniel Caldeira, Cláudio David, João Costa, Joaquim J Ferreira, Fausto J Pinto
The non-vitamin K antagonist oral anticoagulants (NOACs) were approved for non-valvular atrial fibrillation (AF) but this term may be misnomer. Thus, the term non-mechanical and rheumatic mitral valvular (non-MARM) AF was proposed to exclude patients with valvular heart disease (VHD) without contraindications for NOACs. We aimed to review the efficacy and safety of NOACs in patients with AF and VHD compared to Vitamin K Antagonists (VKA). We performed a systematic review with meta-analysis (PROSPERO CRD42015024837) including data from randomized controlled trials (RCTs) retrieved in November 2016...
April 1, 2018: European Heart Journal. Cardiovascular Pharmacotherapy
Danilo Toni, Alessio Pieroni
Neuroimaging has a key role in the assessment and treatment of acute stroke. Cerebral computer tomography is the first step to differentiate hemorragic from ischemic stroke and to detect, in the latter, early signs representative of the lesion severity and predicting a possible hemorrhagic infarction after thrombolytic treatment.Advanced neuroimaging techniques are relevant in the assessment of the ischemic and/or hypo-perfused area, being an essential tool in uncertain situations or when the time of symptoms onset is unavailable, increasing the efficacy and safety of endovenous thrombolysis by enlarging its therapeutic window and leading to more accurate selection of patients to be treated...
January 2017: Journal of Cardiovascular Medicine
T Pepersack
Atrial fibrillation (AF) increases the risk of mortality and stroke. The prevention of these complications is based on oral anticoagulants that are more efficient than salycilates. As compared with antivitamins K agents, new oral anticoagulants are promising for patients presenting non valvular atrial fibrillation because of lower cerebral hemorragic risk (with respect of assessment of renal function and therapeutic compliance). Available studies and recommendations are presented.
September 2015: Revue Médicale de Bruxelles
Stephan von Düring, Stéphanie Bruchez, Laurent Suppan, Marc Niquille
Oxygen adiministration for both medical and traumatic emergencies is regarded as an essential component of resuscitation. However, many recent studies suggest that the use of oxygen should be more restrictive. Detrimental effects of normobaric oxygen therapy in patients suffering from hypercapnic respiratory diseases have been demonstrated, especially because of the suppression of the hypoxic drive. Apart from this particular situation, correction of hypoxemia is still a widely accepted treatment target, although there is growing evidence that hyperoxemia could be harmful in acute coronary syndromes and cardio-respiratory arrests...
August 12, 2015: Revue Médicale Suisse
E R Gasenzer, E A M Neugebauer
The composer Felix Mendelssohn-Bartholdy and his sister, Fanny Hensel, both died in 1847 of intracerebral hemorrhage. Also their father and grandfather had died of cerebral strokes. Their cases show the dramatic progress of an arteriovenous malformation in the nineteenth century, but also the development of new romantic styles in the history of western music. Since the late nineteenth and the early twentieth century, neurology and neurosurgery had developed as highly specialized medical subjects. Today, neurosurgery is a highly developed medical subject, and the neurosurgeon uses high-tech equipment for neurosurgical procedures and intensive care...
May 2014: Acta Neurochirurgica
I S Zozulia, A I Zozulia, O P Onopriienko
Actuality of medical rehabilitation of patients that carried a stroke is important (see text)--by a social problem. The special value a medical rehabilitation has after the consequences of stroke in connection with large (see text) of such patients. Proceeding in a capacity for patients that survived after a stroke, problematic. For determination of volume of rehabilitation interventions it is necessary to take into account weight of motion of stroke, his variants (ischemic, hemorragic) and stages (terms) of development...
2012: Likars'ka Sprava
Tara Gomes, Muhammad M Mamdani, Anne M Holbrook, J Michael Paterson, Chelsea Hellings, David N Juurlink
BACKGROUND: Although warfarin has been extensively studied in clinical trials, little is known about rates of hemorrhage attributable to its use in routine clinical practice. Our objective was to examine incident hemorrhagic events in a large population-based cohort of patients with atrial fibrillation who were starting treatment with warfarin. METHODS: We conducted a population-based cohort study involving residents of Ontario (age ≥ 66 yr) with atrial fibrillation who started taking warfarin between Apr...
February 5, 2013: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Gaetano Lanza, Stefano Ricci, Francesco Speziale, Danilo Toni, Enrico Sbarigia, Carlo Setacci, Carlo Pratesi, Francesco Somalvico, Augusto Zaninelli, Gian Franco Gensini
RATIONALE: In patients with >50% carotid artery stenosis (as measured by North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria) suffering a transient ischemic attack or a minor ipsilateral stroke, carotid endarterectomy exerts maximum benefits, when performed within the first 15 days from the initial ischemic symptom. It is also known that the probability of a major stroke spikes within the first few days after a transient ischemic attack/minor stroke and then flattens out in the following days and weeks...
January 2012: International Journal of Stroke: Official Journal of the International Stroke Society
M Cohen, B Baldin, P Thomas, C Lebrun
INTRODUCTION: Anti-TNF alpha treatments are increasingly prescribed in various rheumatological or gastroenterological inflammatory diseases. Several adverse events, including neurological episodes have been reported in the literature. Relation to treatment is a major concern and guidelines for management of those patients are not available. The aim of our study is to collect and analyze neurological adverse events occurring during anti-TNF alpha therapy, and to propose guidelines for diagnosis of demyelinating-induced diseases...
January 2012: Revue Neurologique
F Apostoae, Liliana Tarţău, Cătălina-Elena Lupuşoru
UNLABELLED: Oral anticoagulants (OAC) are commonly used as a life-long therapy in the prevention of systemic embolism in patients with atrial fibrillation, valvular heart disease, prosthetic heart valves, and in the primary and secondary prevention of venous thromboembolism, in patients with acute myocardial infarction and angina pectoris. Drugs, herbs, and multivitamin supplements can alter the absorption, pharmacokinetics or pharmacodynamics of OAC. AIM: To investigate the possible interactions between oral anticoagulants and different drugs administered in patients in emergency department...
July 2011: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
Emilie Guillard, Bénédicte Nancy, Hervé Floch, Anne Henckes, Guy Cochard, Josiane Arvieux, Charles Christian Arvieux
Iatrogenic gas embolism is a rare but serious problem that has been documented in almost all medical specialties including gynecology. We present a 49-year-old woman undergoing operative hysteroscopy and myomectomy, who sustained sudden hypotension and decrease in the end-tidal carbon dioxid levels during the procedure. Systemic gas embolism was confirmed by echocardiographic evidence of bubbles in both right and left cardiac cavities and a rise of troponin. Hyperbaric oxygen was rapidly administered in addition to maintenance of vital functions and anti-thrombotic prevention with calciparin...
March 2010: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
P Michelet, F Bouzana, D Couret, D Delahaye, G Perrin, L Dourlens, J-P Auffray
OBJECTIVE: Assessment of haemodynamic, respiratory and renal effects of hypertonic saline-hydroxyethyl starch (HyperHES) in critically ill-patients with hemorrhagic shock. PATIENTS AND METHODS: Seventeen mechanically ventilated patients with hemorragic shock benefiting from a cardiovascular monitoring by PiCCO device and requiring rapid volume loading. Two hundred and fifty milliliters of HyperHES were given over 5 minutes. The efficacy of volume loading was assessed by the measure of the systolic arterial pressure (SAP), cardiac index (CI), stroke volume variation (SVV) and the indexed systemic vascular resistance (iSVR)...
January 2010: Annales Françaises D'anesthèsie et de Rèanimation
M Milicevic, J M Krzesinski
The relationships between the brain and arterial hypertension are strong. The brain, through the hypothalamus, can quickly adapt the blood pressure level to maintain the cerebral blood flow. An acute increase in blood pressure, if it overtakes the autoregulatory capacities, needs an urgent intervention to decrease neurological problems such as encephalopathy. In chronic situations, arterial hypertension is a frequent cause of stroke, either ischemic or hemorragic, both in patients free and those who have already suffered from brain damage...
May 2008: Revue Médicale de Liège
Julien Muzard, Stéphane Loyau, Nadine Ajzenberg, Philippe Billiald, Martine Jandrot-Perrus
Coronary syndromes, stroke and other ischaemic arterial diseases are the leading cause of death in the world and will probably remain it at least until 2020. Cardiovascular diseases kill 17 million people each year with an expected increase to 20 million in 2020 and 24 million in 2030. The global impact of recurrence and death during the 6 months following an acute coronary syndrome remains at 8-15% in the present state of medical practice. Acute ischaemic syndromes have a common aetiology that is the formation of a platelet-rich clot at the site of severe coronary stenosis and of eroded atherosclerotic plaques...
2006: Journal de la Société de Biologie
Philippa Lavallée
Stroke patients are at very high risk of recurrent vascular events. Antiplatelet agents (AAP) substantially decrease this risk but still 1 over 5 patients will have an other vascular event. Recent studies didn't show any benefit of AAP association (aspirin, clopidogrel) but other studies targetting higher risk patients are needed. Studies with new AAP are ongoing. Beside vascular risk reduction, other antithrombotic agents are used as thrombolytics in the acute phase of stroke. The rt-PA (recombinant tissue plasminogen activator) administered in the first 3 hours dissolves the clot, preventing death and handicap due to ischemic brain lesion...
September 2006: Thérapie
Elisa Boscolo, Giacomo Pavesi, Paolo Zampieri, Maria Teresa Conconi, Chiara Calore, Renato Scienza, Pier Paolo Parnigotto, Marcella Folin
Cerebral aneurysms and arteriovenous malformations (AVM) are a common cause of stroke and cerebral hemorrage. Both are often discovered when they rupture, causing subarachnoid hemorrhage (SAH). SAH-induced vasospasm is mediated by enhanced vasoconstriction due to endothelin-1 (ET-1). We investigated whether endothelial cells (ECs) obtained from aneurysm and AVM express phenotypic and genotypic alterations contributing to the development of vasospasm after SAH. We isolated ECs from human AVM and aneurysm and then confirmed their EC origin by polymerase chain reaction and immunocytochemistry with endothelial markers...
November 2006: International Journal of Molecular Medicine
P Leclercq, A Thomas, B Sadzot
Rendu-Osler disease or hereditary hemorragic telangiectasia is a group of autosomal dominant diseases characterized by angiodysplasic lesions in the skin, mucous membranes and viscera with risks of recurrent bleedings. Neurological complications have been described in 10-30% of these patients, most often hemorrhagic or septic. More exceptionally, ischemic strokes occur in these patients, particularly if they have pulmonary arteriovenous malformations. We report the observation of a 25 year old man who developed a latero-protuberantial stroke...
July 2005: Revue Médicale de Liège
I D Stulin, S V Tsarenko, O V Levchenko
An original method of impedancemetry designed by the authors and applied in 88 cases of cerebral edema caused by brain aneurysm rupture (n = 23), by acute hemorragic stroke of hypertensive type (n = 13) and craniocerebral injury (n = 52) is described. Diagnostic value of the method, its safety and convenience for clinical practice are demonstrated.
2005: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
T Grisar, P Bottin, V de Borchgrave d'Alténa, C Brichart, C Delcourt, J M Dubru, M Foulon, S Ghariani, C Hotermans, B Legros, M Ossemann, B Sadzot, P Tugendhaft, P Van Bogaert, K van Rijckevorsel, D Verheulpen
In many circumstances antiepileptic drugs are used in patients who have never presented any clinical epileptic seizures. These substances are administered on the assumption of a potential risk for the patients of developing acute or delayed chronic seizures after brain injuries such as trauma, stroke, hemorrages or even neurosurgical interventions. The aim of this paper is to propose therapeutic guidelines for the management of this prophylactic attitude in epilepsy based on basic research and clinical practice in the French community in Belgium...
March 2005: Acta Neurologica Belgica
Takashi Yamanaka, Masayuki Ishii, Hiroko Suzuki
OBJECTIVE: We looked for the patients who were treated by short leg brace (SLB) in our hospital for the effects on the treatment of stroke. METHOD: Patients admitted to our hospital for the purposes of rehabilitation of stroke and had SLB prescription from October 2001 to October 2003 were investigated. A total of 20 patients (19 men, 11 women) were investigated in this study. Average age was 60.8 +/- 8.60 years old. Diagnoses were cerebral hemorrhage (12), brain infarction (7), and subarachnoid hemorrage (2)...
2004: Topics in Stroke Rehabilitation
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