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Hypercoagulable AND Stroke

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https://www.readbyqxmd.com/read/30303254/identification-of-candidates-for-pfo-closure-in-the-echocardiography-laboratory
#1
REVIEW
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
https://www.readbyqxmd.com/read/30286732/cerebral-infarction-associated-with-benign-mucin-producing-adenomyosis-report-of-two-cases
#2
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
https://www.readbyqxmd.com/read/30282668/management-of-antiphospholipid-syndrome
#3
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
https://www.readbyqxmd.com/read/30276493/long-working-hours-and-risk-of-cardiovascular-disease
#4
REVIEW
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
https://www.readbyqxmd.com/read/30276339/multifocal-cerebral-infarction-as-the-first-manifestation-of-occult-malignancy-case-series-of-trousseau-s-syndrome-and-literature-review
#5
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
https://www.readbyqxmd.com/read/30258269/hemorrhagic-stroke-and-cerebral-venous-thrombosis-rare-neurological-sequelae-of-chickenpox-infection
#6
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
https://www.readbyqxmd.com/read/30254820/intracranial-atherosclerosis-versus-primary-angiitis-of-the-central-nervous-system-a-case-report
#7
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
https://www.readbyqxmd.com/read/30199865/hypercoagulation-on-thromboelastography-predicts-early-neurological-deterioration-in-patients-with-acute-ischemic-stroke
#8
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...
September 10, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/30064137/cancer-associated-hypercoagulation-increases-the-risk-of-early-recurrent-stroke-in-patients-with-active-cancer
#9
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
https://www.readbyqxmd.com/read/29980285/ischemic-stroke-after-plasmapheresis
#10
REVIEW
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...
March 29, 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29966955/paget-schroetter-syndrome-as-a-result-of-1st-rib-stress-fracture-due-to-gym-activity-presenting-with-urschel-s-sign-a-case-report-and-review-of-literature
#11
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
https://www.readbyqxmd.com/read/29929138/prothrombotic-mechanisms-in-patients-with-congenital-p-cys89tyr-mutation-in-cd59
#12
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
https://www.readbyqxmd.com/read/29904830/migraine-and-cerebrovascular-disease-still-a-dangerous-connection
#13
REVIEW
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
https://www.readbyqxmd.com/read/29886492/pancreatic-cancer-in-pregnancy-presenting-with-thromboembolic-events-case-report-and-review-of-the-literature
#14
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
https://www.readbyqxmd.com/read/29800263/plasmapheresis-for-management-of-antiphospholipid-syndrome-in-the-neurosurgical-patient
#15
Eric J Arias, Brent Bruck, Ananth K Vellimana, Charles Eby, Matthew R Reynolds, Morey A Blinder, Gregory J Zipfel
BACKGROUND AND IMPORTANCE: Antiphospholipid syndrome (APS) is an autoimmune disorder associated with a hypercoagulable state and increased risk of intraoperative and postoperative thrombosis. Few neurosurgical studies have examined the management of these patients, though the standard of care in most other disciplines involves the use of anticoagulation therapy. However, this is associated with risks such as hemorrhage, thrombosis due to warfarin withdrawal, and is not compatible with operative intervention...
May 24, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29798974/-intimal-rupture-of-the-displastic-middle-cerebral-artery-wall-complicated-by-thrombosis-and-fatal-ischemic-stroke
#16
L A Kalashnikova, R P Chaykovskaya, T S Gulevskaya, L A Dobrynina, M V Gubanova, M V Dreval, M Yu Maksimova
The authors present a clinical-morphological observation of the 47-year old man with a severe fatal ischemic stroke due to middle cerebral artery thrombosis which developed at the site of intimal rupture. The cause of intimal rupture was the arterial wall dysplastic changes. There were no signs of atherosclerosis and hypercoagulation. As the intima rupture did not lead to blood input into arterial wall, but was accompanied by superimposed thrombosis, we suggested to denote such cases as incomplete dissection...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/29710026/-embolic-stroke-immediately-after-initial-administration-of-intravitreal-aflibercept
#17
REVIEW
Hironori Mizutani, Yuichiro Inatomi, Takaomi Singu, Makoto Nakajima, Toshiro Yonehara, Yukio Ando
A 72-year-old man was admitted to our hospital because of right upper limb monoplegia 8 hours after the initial intravitreal injection of aflibercept, which is an inhibitor of vascular endothelial growth factor. Magnetic resonance diffusion-weighted images showed recent ischemic lesions in the left corona radiata and the right superior frontal gyrus. Laboratory findings showed mild hyperfibrinolysis. A patent foramen ovale was diagnosed on transesophageal echocardiography; however, lower-extremity ultrasonography did not detect deep vein thrombosis...
May 25, 2018: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29695176/markers-of-thrombin-generation-are-associated-with-long-term-clinical-outcome-in-patients-with-st-segment-elevation-myocardial-infarction
#18
Charlotte Holst Hansen, Vibeke Ritschel, Geir Øystein Andersen, Sigrun Halvorsen, Jan Eritsland, Harald Arnesen, Ingebjørg Seljeflot
Hypercoagulability in ST-segment elevation myocardial infarction (STEMI) as related to long-term clinical outcome is not clarified. We aimed to investigate whether prothrombin fragment 1+2 (F1+2), d-dimer, and endogenous thrombin potential (ETP) measured in the acute phase of STEMI were associated with outcome. Blood samples were drawn median 24 hours after symptom onset in 987 patients with STEMI. Median follow-up time was 4.6 years. Primary outcome was a composite of all-cause mortality, reinfarction, stroke, unscheduled revascularization, or rehospitalization for heart failure; secondary outcome was total mortality...
October 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29685722/is-von-willebrand-factor-associated-with-stroke-and-death-at-mid-term-in-patients-with-non-valvular-atrial-fibrillation
#19
Yann Ancedy, Emmanuelle Berthelot, Sylvie Lang, Stéphane Ederhy, Louise Boyer-Chatenet, Emanuele Di Angelantonio, Laurie Soulat-Dufour, Arnaud Etienney, Saroumadi Adavane-Scheublé, Franck Boccara, Ariel Cohen
BACKGROUND: Heart failure and atrial fibrillation share common mechanisms that may contribute to hypercoagulability and thrombotic risk. Elevated von Willebrand factor (vWF) concentration has been associated with increased risk of thromboembolism and cardiovascular events. AIM: To investigate whether increased vWF plasma concentration predicts occurrence of a composite endpoint (all-cause death and stroke) in patients with non-valvular atrial fibrillation (NVAF)...
May 2018: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29678837/infections-and-risk-of-peripartum-stroke-during-delivery-admissions
#20
Eliza C Miller, Marisa Gallo, Erin R Kulick, Alexander M Friedman, Mitchell S V Elkind, Amelia K Boehme
BACKGROUND AND PURPOSE: Peripartum strokes during delivery admissions are rare but have high maternal morbidity. Infections have been proposed as a possible stroke trigger. We hypothesized that women who had infections diagnosed at the time of delivery admission would have higher risk of stroke during their delivery hospitalization. METHODS: We conducted a case-control study using state inpatient administrative databases for California (2007-2011), Florida (2009-2011), and New York (2009-2011)...
May 2018: Stroke; a Journal of Cerebral Circulation
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