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Haemorrhage stroke

A Muruganathan, Mangesh Tiwaskar
While the incidence and prevalence of stroke is gradually decreasing in the western world, a parallel increase is seen in the developing world. It is a matter of special concern to us as approximately 20-30% of stroke occur in people younger than 45 years in India. Indians are prone to higher stroke risk because of urbanization, diabetes, cigarette smoking and high incidence of hypertension. Unfortunately, there is an inadequate awareness about the risk of stroke with hypertension among general public. Hypertension is considered to be the most important risk factor for stroke, and all forms of hypertension are associated with an increased risk of both ischemic and haemorrhagic stroke...
September 2016: Journal of the Association of Physicians of India
Albertino Damasceno
Hypertension is the main risk factor for morbidity and mortality in the world. In Sub-Saharan Africa, hypertension, previously almost unknown, is now a major risk factor. A paper recently published showed that mean systolic blood pressure is higher in all regions of Africa compared with other parts of the world, and, most important and contrary to what is happening in the rest of the world, it is increasing in the last years. Another important issue that characterises hypertension in Africa is its extremely low level of awareness and consequently low level of control...
September 2016: Journal of Hypertension
Daniel F Hanley, Richard E Thompson, John Muschelli, Michael Rosenblum, Nichol McBee, Karen Lane, Amanda J Bistran-Hall, Steven W Mayo, Penelope Keyl, Dheeraj Gandhi, Tim C Morgan, Natalie Ullman, W Andrew Mould, J Ricardo Carhuapoma, Carlos Kase, Wendy Ziai, Carol B Thompson, Gayane Yenokyan, Emily Huang, William C Broaddus, R Scott Graham, E Francois Aldrich, Robert Dodd, Cristanne Wijman, Jean-Louis Caron, Judy Huang, Paul Camarata, A David Mendelow, Barbara Gregson, Scott Janis, Paul Vespa, Neil Martin, Issam Awad, Mario Zuccarello
BACKGROUND: Craniotomy, according to the results from trials, does not improve functional outcome after intracerebral haemorrhage. Whether minimally invasive catheter evacuation followed by thrombolysis for clot removal is safe and can achieve a good functional outcome is not known. We investigated the safety and efficacy of alteplase, a recombinant tissue plasminogen activator, in combination with minimally invasive surgery (MIS) in patients with intracerebral haemorrhage. METHODS: MISTIE was an open-label, phase 2 trial that was done in 26 hospitals in the USA, Canada, the UK, and Germany...
November 2016: Lancet Neurology
Yee Sien Ng, Kristin Hx Tan, Cynthia Chen, Gilmore C Senolos, Effie Chew, Gerald Ch Koh
INTRODUCTION: The poststroke acute and rehabilitation length of stay (LOS) are key markers of stroke care efficiency. This study aimed to describe the characteristics and identify the predictors of poststroke acute, rehabilitation and total LOS. This study also defined a subgroup of patients as "short" LOS and compared its complication rates and functional outcomes in rehabilitation with a "long" acute LOS group. MATERIALS AND METHODS: A prospective cohort study (n = 1277) was conducted in a dedicated rehabilitation unit within a tertiary academic acute hospital over a 5-year period between 2004 and 2009...
September 2016: Annals of the Academy of Medicine, Singapore
Laila Staerk, Emil Loldrup Fosbøl, Gregory Y H Lip, Morten Lamberts, Anders Nissen Bonde, Christian Torp-Pedersen, Brice Ozenne, Thomas Alexander Gerds, Gunnar Hilmar Gislason, Jonas Bjerring Olesen
BACKGROUND: Non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) are widely used as stroke prophylaxis in non-valvular atrial fibrillation (AF), but comparative data are sparse. PURPOSE: To compare dabigatran, rivaroxaban, and apixaban vs. VKA and the risk of stroke/thromboembolism (TE) and intracranial bleeding in AF. METHODS: Using Danish nationwide registries (2011-15), anticoagulant-naïve AF patients were identified when initiating VKA or an NOAC...
October 14, 2016: European Heart Journal
Kristina Bergstedt Oscarsson, Alette Brorstad, Maria Baudin, Anne Lindberg, Annika Forssén, Magnus Evander, Marie Eriksson, Clas Ahlm
BACKGROUND: The rodent borne Puumala hantavirus (PUUV) causes haemorrhagic fever with renal syndrome in central and northern Europe. The number of cases has increased and northern Sweden has experienced large outbreaks in 1998 and 2006-2007 which raised questions regarding the level of immunity in the human population. METHODS: A randomly selected population aged between 25 and 74 years from northern Sweden were invited during 2009 to participate in a WHO project for monitoring of trends and determinants in cardiovascular disease...
October 13, 2016: BMC Infectious Diseases
Herbert Tejada-Meza, Pedro J Modrego
Extra-ischaemic (remote) brain heamorrhages after thrombolysis for ischaemic stroke occur in less than 3 % of treated patients, but it worsens prognosis. Little attention has been paid to the location of the haematomas. Among 12 patients with remote brain haemorrhage after thrombolysis, we report three patients with haemorrhage in the cerebellar vermis (25 %), with poor outcome. Previous hypertensive vasculopathy is deemed to be the most plausible cause.
October 5, 2016: Neurological Sciences
Morten Schmidt, Sinna Pilgaard Ulrichsen, Lars Pedersen, Hans Erik Bøtker, Jens Cosedis Nielsen, Henrik Toft Sørensen
BACKGROUND: Long-term nationwide trends in atrial fibrillation (AF) incidence and 5-year outcomes are rare. METHODS: We conducted a population-based cohort study using the Danish National Patient Registry covering all Danish hospitals. We computed standardized incidence rates during 1983-2012. We used Cox regression to estimate hazard ratios (HRs) of heart failure, stroke, and death within 5years, comparing 5-year calendar periods with the earliest period (1983-1987) as reference...
September 21, 2016: International Journal of Cardiology
Christopher W L Armstrong, Erika Bosio, Claire Neil, Simon G A Brown, Graeme J Hankey, Daniel M Fatovich
We previously reported on a 26-year-old patient who presented early during a large and eventually fatal cerebral infarct. Microarray analysis of blood samples from this patient demonstrated initially up-regulated and subsequently down-regulated Granzyme B (GzmB) expression, along with progressive up-regulation of genes for S100 calcium binding protein A12 (S100A12) and matrix metalloproteinase 9 (MMP-9). To confirm these findings, we investigated these parameters in patients with suspected stroke presenting within 6h of symptom onset to a single centre...
September 30, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Hamed Asadi, Hong Kuan Kok, Seamus Looby, Paul Brennan, Alan O'Hare, John Thornton
PURPOSE: This study aims to identify factors influencing outcome in brain arteriovenous malformations (BAVM) treated with endovascular embolisation. We also assessed the feasibility of using machine learning techniques to prognosticate and predict outcome and compared this to conventional statistical analyses. METHODS: A retrospective study of patients undergoing endovascular treatment of BAVM over a 22-year period in a national neuroscience centre was performed...
September 28, 2016: World Neurosurgery
Fazaila Ehsaan, Muhammad Sikander Ghayas Khan, Sumera Nawaz Malik, Sana Kanwal
OBJECTIVE: Purpose of the study is to determine the frequency of dysphagia after stroke and to see the factors associated with it. METHODS: Cross Sectional study design was used by including individuals pre-diagnosed as stroke on the basis of CT scan or MRI findings. Study was conducted in three hospitals of Lahore within six months. Sample size of 150 patients of any age and both gender was taken by using convenient sampling technique. To assess the conscious level, Glasgow coma scale was administered and those who scored mild or moderate on GCS were included in the study...
October 2016: JPMA. the Journal of the Pakistan Medical Association
Yutao Guo, Hao Wang, Tao Tao, Yingchun Tian, Yutang Wang, Yundai Chen, Gregory Y H Lip
BACKGROUND: The clinical epidemiology of stroke has been widely investigated in Caucasian populations, but the changes over time in the proportion of ischaemic to haemorrhagic strokes is less clear, especially in the Chinese population. AIMS: Our objective was to study the determinants and time trends for ischaemic and haemorrhagic stroke, in relation to age, in a large Chinese population cohort. METHODS: Using a medical insurance database in the southwest of China from 2001 to 2012, time trends in age-adjusted ischaemic and haemorrhagic stroke incidence and the contributing risk factors associated with age were investigated...
2016: PloS One
Praveen Indraratna, David H Tian, Tristan D Yan, Mathew P Doyle, Christopher Cao
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become a widely utilized method of treatment of severe aortic valve stenosis. The present meta-analysis included all published relevant randomized controlled trials (RCTs) and aimed to compare the safety and efficacy of TAVI compared to surgical aortic valve replacement (AVR). METHOD: Nine electronic databases were comprehensively searched. Eligible studies were required to be randomized controlled trials which reported comparative endpoints on both TAVI and AVR...
September 15, 2016: International Journal of Cardiology
G Zapata-Wainberg, S Quintas, A Ximénez-Carrillo Rico, L Benavente Fernández, J Masjuan Vallejo, J Gállego Culleré, M Del M Freijó Guerrero, J Egido, J C Gómez Sánchez, A Martínez Domeño, F Purroy, B Vives Pastor, M Rodríguez Yáñez, J Vivancos
INTRODUCTION: Intracranial haemorrhages (ICH) represent a severe and frequently lethal complication in patients treated with vitamin K antagonists (VKA). The purpose of our study is to describe the factors and clinical features associated with mortality in these patients. METHODS: We conducted an observational, retrospective, multi-centre study based on prospective stroke registries in Spain. We included all patients admitted to neurology departments during a one-year period who met the following inclusion criteria: being 18 or older, having a diagnosis of ICH, and receiving VKA...
September 16, 2016: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Albertino Damasceno
Hypertension is the main risk factor for morbidity and mortality in the world. In Sub-Saharan Africa, hypertension, previously almost unknown, is now a major risk factor. A paper recently published showed that mean systolic blood pressure is higher in all regions of Africa compared with other parts of the world, and, most important and contrary to what is happening in the rest of the world, it is increasing in the last years. Another important issue that characterises hypertension in Africa is its extremely low level of awareness and consequently low level of control...
September 2016: Journal of Hypertension
Graeme J Hankey
In the past decade, the definition of stroke has been revised and major advances have been made for its treatment and prevention. For acute ischaemic stroke, the addition of endovascular thrombectomy of proximal large artery occlusion to intravenous alteplase increases functional independence for a further fifth of patients. The benefits of aspirin in preventing early recurrent ischaemic stroke are greater than previously recognised. Other strategies to prevent recurrent stroke now include direct oral anticoagulants as an alternative to warfarin for atrial fibrillation, and carotid stenting as an alternative to endarterectomy for symptomatic carotid stenosis...
September 13, 2016: Lancet
R Loch Macdonald, Tom A Schweizer
Subarachnoid haemorrhage is an uncommon and severe subtype of stroke affecting patients at a mean age of 55 years, leading to loss of many years of productive life. The rupture of an intracranial aneurysm is the underlining cause in 85% of cases. Survival from aneurysmal subarachnoid haemorrhage has increased by 17% in the past few decades, probably because of better diagnosis, early aneurysm repair, prescription of nimodipine, and advanced intensive care support. Nevertheless, survivors commonly have cognitive impairments, which in turn affect patients' daily functionality, working capacity, and quality of life...
September 13, 2016: Lancet
Adrian Wong, Alexander Y L Lau, Jie Yang, Zhaolu Wang, Wenyan Liu, Bonnie Y K Lam, Lisa Au, Lin Shi, Defeng Wang, Winnie C W Chu, Yun-Yun Xiong, Eugene S K Lo, Lorraine S N Law, Thomas W H Leung, Linda C W Lam, Anne Y Y Chan, Yannie O Y Soo, Eric Y L Leung, Lawrence K S Wong, Vincent C T Mok
BACKGROUND: The objectives of this study are 1) to examine the frequencies of neuropsychiatric symptom clusters in patients with stroke or transient ischemic attack (TIA) by cognitive level and stroke subtype; and 2) to evaluate effect of demographic, clinical, and neuroimaging measures of chronic brain changes and amyloid upon neuropsychiatric symptom clusters. METHODS: Hospital-based, cross-sectional study. 518 patients were administered the Neuropsychiatric Inventory (NPI) 3-6 months post index admission...
2016: PloS One
N G Khorev, A P Momot, V O Kon'kova
During the last 10 years, several novel direct oral anticoagulants (NOACs) have entered the clinical arena and were registered in the Russian Federation for use in patients presenting with atrial fibrillation, venous thrombosis, and pulmonary artery thromboembolism. NOACs are classified into two groups: direct thrombin inhibitor (notably dabigatran) and factor Xa inhibitors (including rivaroxaban, apixaban, and edoxaban). Their disadvantage is lack of specific antidotes in case of an emergency situation (injury, infarction, stroke requiring thrombolysis, urgent operation)...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Anoop Dinesh Shah, Spiros Denaxas, Owen Nicholas, Aroon D Hingorani, Harry Hemingway
BACKGROUND: Eosinophil and lymphocyte counts are commonly performed in clinical practice. Previous studies provide conflicting evidence of association with cardiovascular diseases. METHODS: We used linked primary care, hospitalisation, disease registry and mortality data in England (the CALIBER (CArdiovascular disease research using LInked Bespoke studies and Electronic health Records) programme). We included people aged 30 or older without cardiovascular disease at baseline, and used Cox models to estimate cause-specific HRs for the association of eosinophil or lymphocyte counts with the first occurrence of cardiovascular disease...
2016: Open Heart
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