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Hypercoagulable AND Stroke

Matías Otto-Yáñez, Rodrigo Torres-Castro, Joaquín Nieto-Pino, Mercedes Mayos
Stroke, one of the main causes of disability and death worldwide, is frequently associated to the obstructive sleep apnea-hypopnea syndrome. This sleep disorder has been demonstrated to be an independent risk factor for stroke, and therefore its investigation and treatment has been recommended for patients with stroke. Mechanisms relating these two clinical disorders include: oxidative stress, cerebral blood flow alterations, autonomic dysfunction, and hypercoagulability, as well as patent foramen ovale, blood pressure, and heart rhythm disorders...
2018: Medicina
Qi-Xiong Qin, Xue-Min Cheng, Li-Zhi Lu, Yun-Fei Wei, Da-Cheng Wang, Hai-Hua Li, Guo-Hui Li, Hong-Bin Liang, Sheng-Yu Li, Li Chen, Zhi-Jian Liang
AIM: To investigate the specific biomarkers and potential pathogenesis of colorectal cancer-related ischemic stroke (CRCIS). METHODS: A retrospective study was conducted on CRCIS patients (colorectal cancer patients with ischemic stroke without conventional stroke risk factors) registered at seven centers between January 2007 and December 2017. Clinical data and laboratory and imaging findings were compared with age- and sex- matched patients with colorectal cancer (CRC) without ischemic stroke that were admitted to the same hospital during the same period...
November 21, 2018: World Journal of Gastroenterology: WJG
Erica C Camargo, Steven K Feske, Aneesh B Singhal
Pregnancy confers a substantially increased risk of stroke in women. The period of highest risk of stroke is the peripartum/postpartum phase, coinciding with the highest risk for hypertensive disorders of pregnancy and peak gestational hypercoagulability. Hemorrhagic stroke is the most common type of obstetric stroke. Hypertensive disorders of pregnancy are important contributors to obstetric stroke and predispose women to premature cardiovascular disease. The rate of stroke associated with hypertensive disorders of pregnancy has increased in the United States...
February 2019: Neurologic Clinics
Tuğçe Aksu Uzunhan, Nur Aydinli, Mine Çalişkan, Burak Tatli, Meral Özmen
BACKGROUND: Our aim is to retrospectively assess short-term neurological outcomes in pediatric stroke with patient features. METHODS: Children aged 28 days-18 years with arterial ischemic stroke (AIS), cerebral sinovenous thrombosis (CSVT), and hemorrhagic stroke (HS) between 2007 and 2013 were evaluated. Neurological findings within the first three months were accepted as short-term prognosis and modified Rankin scale was used. RESULTS: In the study, 33 patients (62%) with AIS, 12 (23%) with HS, and 8 (15%) with CSVT were included...
November 18, 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
Eiko Higuchi, Sono Toi, Yuka Shirai, Satoko Mizuno, Hiromi Onizuka, Yoji Nagashima, Kazunori Hashimoto, Kazuo Kitagawa
The hypercoagulable state in patients with cancer has been shown to be closely associated with ischemic stroke. However, it is unlikely that benign tumors are related to stroke. The development of benign uterine tumors is common in middle-aged women. Previous studies have shown cases of ischemic stroke with benign uterine tumor, but the causal relationship between these 2 remain unknown. We report a case of recurrent ischemic stroke in a middle-aged woman who had a benign uterine tumor. After excision, there was no recurrence for 2 years...
October 23, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Susanna C Larsson, Matthew Traylor, Hugh S Markus
Vitamin K plays a crucial role in blood coagulation, and hypercoagulability has been linked to atherosclerosis-related vascular disease. We used the Mendelian randomization study design to examine whether circulating vitamin K₁ (phylloquinone) levels are associated with ischemic stroke. Four single-nucleotide polymorphisms associated with vitamin K₁ levels were used as instrumental variables. Summary-level data for large artery atherosclerotic stroke ( n = 4373 cases), small vessel stroke ( n = 5386 cases), cardioembolic stroke ( n = 7193 cases), and any ischemic stroke ( n = 34,217 cases and 404,630 non-cases) were available from the MEGASTROKE consortium...
October 25, 2018: Nutrients
Edmund Kenneth Kerut, William F Campbell, Michael E Hall, Michael R McMullan
A patent foramen ovale (PFO) is implicated in several pathologic processes, including that of cryptogenic stroke (cCVA). Recent trials identify "high-risk" PFOs in patients with cCVA as likely to benefit from percutaneous closure. The younger the patient (<60 years old) the more likely a PFO may be attributable to the cCVA. The RoPE Score index helps determine the likelihood that an existing PFO is related to a cCVA. This may help guide the clinician and patient when contemplating percutaneous PFO closure...
October 10, 2018: Echocardiography
Koki Okazaki, Fumiaki Oka, Hideyuki Ishihara, Michiyasu Suzuki
BACKGROUND: Cerebral infarction associated with a malignant tumor is widely recognized as Trousseau syndrome. In contrast, few cases of cerebral infarction associated with benign tumors have been reported. We present two cases of embolic stroke that seemed to be caused by mucin-producing adenomyosis. CASE PRESENTATION: The patients were women aged 42 and 50 years old. Both patients developed right hemiparesis and aphasia, and cerebral infarctions were detected in the left cerebral hemisphere...
October 4, 2018: BMC Neurology
Imad Uthman, Mohammad Hassan A Noureldine, Guillermo Ruiz-Irastorza, Munther Khamashta
Antiphospholipid syndrome, also known as 'Hughes Syndrome', is an autoimmune disease characterised by a set of clinical manifestations, almost all of which are direct or indirect sequelae of a hypercoagulable state involving the venous, and to a lesser extent the arterial vasculature. The incidence and prevalence of antiphospholipid syndrome are estimated at approximately 5 de novo cases per 100 000 per year and 40-50 cases per 100 000 individuals, respectively. The clinical spectrum of antiphospholipid syndrome involves haematological (thrombocytopaenia, venous thrombosis), obstetrical (recurrent pregnancy loss), neurological (stroke, transient ischaemic attack, migraine, seizures, cognitive dysfunction, chorea, transverse myelitis, multiple sclerosis), cardiovascular (cardiac valve disease), dermatological (livedo reticularis and racemosa, skin ulceration and necrosis), renal (glomerulonephritis, renal thrombotic microangiopathy) and orthopaedic (avascular necrosis of bones, non-traumatic fractures) manifestations, among others...
October 3, 2018: Annals of the Rheumatic Diseases
Marianna Virtanen, Mika Kivimäki
PURPOSE OF REVIEW: To summarize the evidence on the relationship between long working hours and cardiovascular disease, such as coronary heart disease and stroke. RECENT FINDINGS: Large-scale meta-analyses with published and individual participant observational data on more than 740,000 men and women free of cardiovascular disease report a link between long working hours (≥ 55 h a week) and the onset of cardiovascular events. Our meta-analytic update of summary evidence suggests a 1...
October 1, 2018: Current Cardiology Reports
Weibi Chen, Yanbo He, Yingying Su
Ischemic stroke as an initial presentation of malignancy is extremely rare and the underlying etiology is often ignored. The aim of this study is to outline the clues to occult malignancy in patients presenting with cerebral infarction initially. The clinical characteristics of total 19 patients with Trousseau's Syndrome presenting with cerebral infarction initially were analyzed. Among those patients, no conventional vascular risk factors were detected in 68% (13/19) of patients, and infarction occurring in multiple vascular distributions was found in 84% (16/19)...
April 2018: Brain Circulation
Anuradha Mehta, Aanchal Arora, Manoj Sharma, Rupali Malik, Yogesh Chandra Porwal
Chickenpox (varicella) is primarily a disease of childhood which occurs due to infection with varicella-zoster virus (VZV). Primary VZV infection is rare in adults due to exposure in early childhood in our country. In adults, it is associated with some serious systemic and neurological complications which can follow both primary infection and reactivation of VZV. Neurological sequelae caused by primary VZV infection are rare and include encephalitis, aseptic meningitis, myelitis, acute cerebellar ataxia, Reye syndrome, Ramsay Hunt syndrome, and rarely stroke and cerebral venous thrombosis (CVT)...
July 2018: Annals of Indian Academy of Neurology
Joshua A Ronen, Aileen Nguyen, Jerrica N Mueller, Hyonju Lee
Primary angiitis of the central nervous system (PACNS) is a rare disease with various clinical presentations. It is the preferred name for vasculitis that is confined to the central nervous system (CNS) and is often considered a diagnosis of exclusion in vascular or inflammatory CNS diseases. This case describes a 46-year-old right-handed female with a past medical history of hypertension (HTN), hyperlipidemia (HLD), diabetes mellitus type two (DM2), obesity, and hemorrhagic stroke who was transferred from an outside facility after a one-month hospitalization to be evaluated for CNS vasculitis...
July 23, 2018: Curēus
Zhu Shi, Wei C Zheng, Xiao L Fu, Xue W Fang, Pei S Xia, Wei J Yuan
BACKGROUND: Thromboelastography (TEG) provides an integrated measurement of blood coagulation function and has been reported to be a useful tool for predicting clinical outcomes in patients with cardiovascular diseases. We aimed to investigate the application of TEG on admission for predicting early neurological deterioration (END) in patients with acute ischemic stroke and its potential correlation with the evolution of ischemic lesions. METHODS: Among patients consecutively admitted between January 1, 2016, and September 31, 2017, those presenting with mild and moderate acute ischemic stroke (National Institutes of Health Stroke Scale [NIHSS] score ≤14) within 24 h of stroke onset were identified and included in this study...
2018: Cerebrovascular Diseases
Jun Fujinami, Tomoyuki Ohara, Fukiko Kitani-Morii, Yasuhiro Tomii, Naoki Makita, Takehiro Yamada, Takashi Kasai, Yoshinari Nagakane, Masanori Nakagawa, Toshiki Mizuno
BACKGROUND: This study assessed the incidence and predictors of short-term stroke recurrence in ischemic stroke patients with active cancer, and elucidated whether cancer-associated hypercoagulation is related to early recurrent stroke. METHODS: We retrospectively enrolled acute ischemic stroke patients with active cancer admitted to our hospital between 2006 and 2017. Active cancer was defined as diagnosis or treatment for any cancer within 12 months before stroke onset, known recurrent cancer or metastatic disease...
2018: Cerebrovascular Diseases
Hisham Salahuddin, Ajaz Ahmad Sheikh, Sharmeen Hussaini, Cherian Verghese, Gretchen E Tietjen
Plasmapheresis involves the separation of all cellular elements of blood with the help of an extracorporeal semipermeable membrane. Even though plasmapheresis is generally considered safe, there have been anecdotal reports of thrombosis related to this exchange. We present 2 cases of healthy young males developing ischemic strokes within 24 hours of plasmapheresis. Patient A was a 24-year-old man with a family history of Factor V Leiden mutation presented with right-sided weakness 1 hour after donating plasma...
October 2018: American Journal of the Medical Sciences
Vipul Garg, Glenys Poon, Aprine Tan, Kein Boon Poon
BACKGROUND: Paget-Schrotter Syndrome (PSS) also known as "effort thrombosis" is a form of primary thrombosis in the subclavian vein at the costoclavicular junction is usually seen in younger patients after repeated strenuous activity of the shoulders and arms. When occurring in younger patients, PSS presents itself with predisposing factors such as unilateral dull, aching pain in the shoulder or axilla and swelling of the arm and hand. CASE PRESENTATION: We report a rare case of unusual left axillo-subclavian vein thrombosis following narrowing of thoracic outlet due to stress injury of rib fracture likely during gym activity in absence of other clear risk factors and a negative hypercoagulable workup in a 27-year-old man who was admitted as left deltoid rupture 5 days after his usual gym...
2018: International Journal of Surgery Case Reports
Adi Tabib, Issam Hindi, Netanel Karbian, Orly Zelig, Batla Falach, Dror Mevorach
BACKGROUND: Thrombosis is the prognostic factor with the greatest effect on survival in patients with paroxysmal nocturnal hemoglobinuria (PNH), who lack dozens of membrane surface proteins. We recently described a primary homozygous Cys89Tyr congenital nonfunctioning CD59 in humans with clinical manifestation in infancy, associated with chronic hemolysis, recurrent strokes, and relapsing peripheral demyelinating neuropathy. Here we investigated hypercoagulability mechanisms characterizing the syndrome...
August 2018: Thrombosis Research
Elio Clemente Agostoni, Marco Longoni
Migraine is a common type of headache in young adults, with an estimated prevalence of 4% before puberty and as high as 25% in women by their mid to late 30s. About one third of migraineurs experience transient neurological symptoms known as auras, which characterize a variant known as migraine with aura. Many evidences have shown an increased risk of vascular events in patients affected by migraine, particularly among women and among migraine patients with aura. Potential underlying mechanisms include endothelial dysfunction, hypercoagulability, platelet aggregation, vasospasm, cardiovascular risk factors, paradoxical embolism, spreading depolarization, shared genetic risk, use of non-steroidal anti-inflammatory drugs, and immobilization...
June 2018: Neurological Sciences
Brian W Wakefield, Crystal M C Masterson, Manuel T Borges, K Joseph Hurt
Stroke and hepatic vein thrombosis are highly associated with neoplasia but are extremely rare events in young, pregnant women. Rare and recurrent thrombotic events in pregnancy increase the suspicion for occult malignancy. We describe the case of a healthy 31-year-old G2P1 who presented with visual changes and dysarthria during pregnancy. Imaging showed cerebral infarcts. Her thrombophilia evaluation was negative. During delivery, she was diagnosed with fulminant Budd-Chiari Syndrome. Hepatic ultrasound suggested malignancy or metastasis, and postpartum CT scan and biopsy confirmed the diagnosis of Stage IV pancreatic cancer...
2018: Gynecologic and Obstetric Investigation
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