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Intracerebral hemorrhage randomized

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https://www.readbyqxmd.com/read/28887388/minocycline-in-acute-cerebral-hemorrhage-an-early-phase-randomized-trial
#1
Abdelrahman Y Fouda, Andrea S Newsome, Samantha Spellicy, Jennifer L Waller, Wenbo Zhi, David C Hess, Adviye Ergul, David J Edwards, Susan C Fagan, Jeffrey A Switzer
BACKGROUND AND PURPOSE: Minocycline is under investigation as a neurovascular protective agent for stroke. This study evaluated the pharmacokinetic, anti-inflammatory, and safety profile of minocycline after intracerebral hemorrhage. METHODS: This study was a single-site, randomized controlled trial of minocycline conducted from 2013 to 2016. Adults ≥18 years with primary intracerebral hemorrhage who could have study drug administered within 24 hours of onset were included...
September 8, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28878305/effects-of-intensive-blood-pressure-reduction-on-acute-intracerebral-hemorrhage-a-systematic-review-and-meta-analysis
#2
Shun Gong, Chao Lin, Danfeng Zhang, Xiangyi Kong, Jigang Chen, Chunhui Wang, Zhenxing Li, Rongbin Chen, Ping Sheng, Yan Dong, Lijun Hou
Current opinions about the effect of intensive blood pressure (BP) reduction for acute intracerebral hemorrhage (ICH) are inconsistent. We performed a meta-analysis to evaluate the efficacy and safety of intensive BP reduction for acute ICH by analyzing data from several recent randomized controlled trials (RCTs). There were six eligible studies that met the inclusion criteria, for a total of 4,385 acute ICH patients in this meta-analysis. After analyzing these data, we found differences between intensive and standard BP lowering treatment groups in total mortality rates, unfavorable outcomes, hematoma expansion, neurologic deterioration, and severe hypotension were not significant...
September 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28858100/comparison-of-neuroendoscopic-surgery-and-craniotomy-for-supratentorial-hypertensive-intracerebral-hemorrhage-a-meta-analysis
#3
Zengpanpan Ye, Xiaolin Ai, Xin Hu, Fang Fang, Chao You
BACKGROUND: In recent years, neuroendoscopy has been used as a method for treating intracerebral hemorrhages (ICHs). However, the efficacy and safety of neuroendoscopic surgery is still controversial compared with that of craniotomy. Our aim was to compare the outcomes of neuroendoscopic surgery and craniotomy in patients with supratentorial hypertensive ICH using a meta-analysis. METHODS: We searched on PubMed, EMBASE, and Cochrane Central Register of Controlled Trials to identify relevant studies in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28838368/cerebral-amyloid-angiopathy-diagnosis-clinical-implications-and-management-strategies-in-atrial-fibrillation
#4
REVIEW
Christopher V DeSimone, Jonathan Graff-Radford, Majd A El-Harasis, Alejandro A Rabinstein, Samuel J Asirvatham, David R Holmes
With an aging population, clinicians are more frequently encountering patients with atrial fibrillation who are also at risk of intracerebral hemorrhage due to cerebral amyloid angiopathy, the result of β-amyloid deposition in cerebral vessels. Cerebral amyloid angiopathy is common among elderly patients, and is associated with an increased risk of intracerebral bleeding, especially with the use of anticoagulation. Despite this association, this entity is absent in current risk-benefit analysis models, which may result in underestimation of the chance of bleeding in the subset of patients with this disease...
August 29, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28829495/the-expression-and-mechanism-of-bdnf-and-ngb-in-perihematomal-tissue-in-rats-with-intracerebral-hemorrhage
#5
Y-C Guo, X-K Song, Y-F Xu, J-B Ma, J-J Zhang, P-J Han
OBJECTIVE: To analyze how changes in the levels of brain-derived neurotrophic factor (BDNF) and neuroglobin (NGB) affect learning and memory in rats with intracerebral hemorrhage. MATERIALS AND METHODS: Thirty male Sprague-Dawley rats were randomly divided into the control group, sham operation group and model group with 10 rats each. The rats in the control group were untreated, while those in the sham operation group were treated with sterile saline instead of type VII collagenase injection in the globus pallidus...
August 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28747462/mechanical-thrombectomy-outcomes-with-and-without-intravenous-thrombolysis-in-stroke-patients-a-meta-analysis
#6
Eva A Mistry, Akshitkumar M Mistry, Mohammad Obadah Nakawah, Rohan V Chitale, Robert F James, John J Volpi, Matthew R Fusco
BACKGROUND AND PURPOSE: Whether prior intravenous thrombolysis provides any additional benefits to the patients undergoing mechanical thrombectomy for large vessel, acute ischemic stroke remains unclear. METHODS: We conducted a meta-analysis of 13 studies obtained through PubMed and EMBASE database searches to determine whether functional outcome (modified Rankin Scale) at 90 days, successful recanalization rate, and symptomatic intracerebral hemorrhage rate differed between patients who underwent mechanical thrombectomy with (MT+IVT) and without (MT-IVT) pre-treatment with intravenous thrombolysis...
September 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28747441/brain-hemorrhage-recurrence-small-vessel-disease-type-and-cerebral-microbleeds-a-meta-analysis
#7
REVIEW
Andreas Charidimou, Toshio Imaizumi, Solene Moulin, Alexandro Biffi, Neshika Samarasekera, Yusuke Yakushiji, Andre Peeters, Yves Vandermeeren, Patrice Laloux, Jean-Claude Baron, Mar Hernandez-Guillamon, Joan Montaner, Barbara Casolla, Simone M Gregoire, Dong-Wha Kang, Jong S Kim, H Naka, Eric E Smith, Anand Viswanathan, Hans R Jäger, Rustam Al-Shahi Salman, Steven M Greenberg, Charlotte Cordonnier, David J Werring
OBJECTIVE: We evaluated recurrent intracerebral hemorrhage (ICH) risk in ICH survivors, stratified by the presence, distribution, and number of cerebral microbleeds (CMBs) on MRI (i.e., the presumed causal underlying small vessel disease and its severity). METHODS: This was a meta-analysis of prospective cohorts following ICH, with blood-sensitive brain MRI soon after ICH. We estimated annualized recurrent symptomatic ICH rates for each study and compared pooled odds ratios (ORs) of recurrent ICH by CMB presence/absence and presumed etiology based on CMB distribution (strictly lobar CMBs related to probable or possible cerebral amyloid angiopathy [CAA] vs non-CAA) and burden (1, 2-4, 5-10, and >10 CMBs), using random effects models...
August 22, 2017: Neurology
https://www.readbyqxmd.com/read/28739832/influence-of-renal-impairment-on-outcome-for-thrombolysis-treated-acute-ischemic-stroke-enchanted-enhanced-control-of-hypertension-and-thrombolysis-stroke-study-post-hoc-analysis
#8
Susan J Carr, Xia Wang, Veronica V Olavarria, Pablo M Lavados, Jorge A Rodriguez, Jong S Kim, Tsong-Hai Lee, Richard I Lindley, Octavio M Pontes-Neto, Stefano Ricci, Shoichiro Sato, Vijay K Sharma, Mark Woodward, John Chalmers, Craig S Anderson, Thompson G Robinson
BACKGROUND AND PURPOSE: Renal dysfunction (RD) is associated with poor prognosis after stroke. We assessed the effects of RD on outcomes and interaction with low- versus standard-dose alteplase in a post hoc subgroup analysis of the ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study). METHODS: A total of 3220 thrombolysis-eligible patients with acute ischemic stroke (mean age, 66.5 years; 37.8% women) were randomly assigned to low-dose (0...
September 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28730950/statistical-analysis-plan-for-the-head-position-in-stroke-trial-headpost-an-international-cluster-cross-over-randomized-trial
#9
Laurent Billot, Mark Woodward, Hisatomi Arima, Maree L Hackett, Paula Muñoz Venturelli, Pablo M Lavados, Alejandro Brunser, Bin Peng, Liying Cui, Lily Song, Stephane Heritier, Stephen Jan, Sandy Middleton, Verónica V Olavarría, Joyce Lim, Thompson Robinson, Octavio Pontes-Neto, Caroline Watkins, Craig S Anderson
Background There is evidence to indicate that the lying flat head position increases cerebral blood flow and oxygenation in patients with acute ischemic stroke, but how these physiological effects translate into clinical outcomes is uncertain. The Head Position in Stroke Trial aims to determine the comparative effectiveness of lying flat (0°) compared to sitting up (≥30°) head positioning, initiated within 24 h of hospital admission for patients with acute stroke. Design An international, pragmatic, cluster-randomized, crossover, open, blinded outcome assessed clinical trial...
August 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28706113/pd-l1-programmed-death-ligand-1-protects-against-experimental-intracerebral-hemorrhage-induced-brain-injury
#10
Ranran Han, Jiaying Luo, Yanchao Shi, Yang Yao, Junwei Hao
BACKGROUND AND PURPOSE: Intracerebral hemorrhage (ICH) is a neurologically destructive stroke, for which no valid treatment is available. This preclinical study examined the therapeutic effect of PD-L1 (programmed death ligand 1), a B7 family member and a ligand for both PD-1 (programmed death 1) and B7-1 (CD80), in a murine ICH model. METHODS: ICH was induced by injecting autologous blood into 252 male C57BL/6 and Rag1(-/-) mice. One hour later, ICH mice were randomly assigned to receive an intraperitoneal injection of vehicle, PD-L1, or anti-PD-L1 antibody...
August 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28701501/blood-pressure-reduction-and-noncontrast-ct-markers-of-intracerebral-hemorrhage-expansion
#11
RANDOMIZED CONTROLLED TRIAL
Andrea Morotti, Gregoire Boulouis, Javier M Romero, H Bart Brouwers, Michael J Jessel, Anastasia Vashkevich, Kristin Schwab, Mohammad Rauf Afzal, Christy Cassarly, Steven M Greenberg, Reneé Hebert Martin, Adnan I Qureshi, Jonathan Rosand, Joshua N Goldstein
OBJECTIVE: To validate various noncontrast CT (NCCT) predictors of hematoma expansion in a large international cohort of ICH patients and investigate whether intensive blood pressure (BP) treatment reduces ICH growth and improves outcome in patients with these markers. METHODS: We analyzed patients enrolled in the Antihypertensive Treatment of Acute Cerebral Hemorrhage II (ATACH-II) randomized controlled trial. Participants were assigned to intensive (systolic BP <140 mm Hg) vs standard (systolic BP <180 mm Hg) treatment within 4...
August 8, 2017: Neurology
https://www.readbyqxmd.com/read/28681745/a-randomized-controlled-study-of-operative-versus-nonoperative-treatment-for-large-spontaneous-supratentorial-intracerebral-hemorrhage
#12
Mukesh K Bhaskar, Rakesh Kumar, Balakrishna Ojha, Sunil K Singh, Nishant Verma, Rajesh Verma, Anil Chandra, Chhitij Srivastava, Manish Jaiswal, Somil Jaiswal, Harsha Huliyappa
CONTEXT: Spontaneous intracerebral haemorrhage (ICH) accounts for 4-14% of all strokes and has a high mortality rate of 30-50% during the first month. Management of large hematomas is controversial, with some advocating medical management while others favoring surgical evacuation. AIM: This study was undertaken to compare the outcome of patients with a spontaneous supratentorial intracerebral hemorrhage (SSICH) managed with or without surgical evacuation. SETTINGS AND DESIGN: Four hundred and eighty-two SSICH patients admitted from September 2013 to August 2015 were evaluated based on the inclusion and exclusion criteria...
July 2017: Neurology India
https://www.readbyqxmd.com/read/28664399/metformin-attenuates-neurological-deficit-after-intracerebral-hemorrhage-by-inhibiting-apoptosis-oxidative-stress-and-neuroinflammation-in-rats
#13
Boxiang Qi, Libao Hu, Lei Zhu, Lei Shang, Xuecheng Wang, Na Liu, Nana Wen, Yao Hong, Daihua Fang
Intracerebral hemorrhage (ICH) can lead to brain damage and even death, and there is lack of effective therapeutic methods for treating ICH. Although recent studies have focused on the administration of metformin in treating stroke, there is no literature to support whether it can be used to treat ICH. Therefore, the aim of this study was to evaluate the possible effects of metformin on ICH and the underlying mechanisms of those effects. An ICH model was established in adult male Sprague-Dawley rats. Rats were randomly divided into three groups: sham group, ICH group, and ICH+metformin group...
June 29, 2017: Neurochemical Research
https://www.readbyqxmd.com/read/28658126/antihypertensive-treatments-for-spontaneous-intracerebral-hemorrhage-in-patients-with-cerebrovascular-stenosis-a-randomized-clinical-trial-atichst
#14
RANDOMIZED CONTROLLED TRIAL
Zengpanpan Ye, Xiaolin Ai, Jun Zheng, Xin Hu, Sen Lin, Chao You, Hao Li
INTRODUCTION: Antihypertensive treatment is associated with clinical outcomes in patients with spontaneous intracerebral hemorrhage (sICH). ADAPT showed that intensive blood pressure lowering (<140 mm Hg) does not reduce peri-hematoma regional cerebral blood flow (rCBF) in patients with sICH. However, the stenosis of main cerebral arteries that has a high presence in patients with sICH is well-known related to the brain ischemia. The effect of intensive BP lowering for sICH in patients with cerebrovascular stenosis is still unknown...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28655601/the-effect-of-monascin-on-hematoma-clearance-and-edema-after-intracerebral-hemorrhage-in-rats
#15
Juan Wang, Gaiqing Wang, Jinying Yi, Yi Xu, Shuna Duan, Tong Li, Xin-Gang Sun, Liang Dong
BACKGROUND AND PURPOSE: Intracerebral hemorrhage (ICH) is a particularly devastating form of stroke with high mortality and morbidity. Hematomas are the primary cause of neurologic deficits associated with ICH. The products of hematoma are recognized as neurotoxins and the main contributors to edema formation and tissue damage after ICH. Finding a means to efficiently promote absorption of hematoma is a novel clinical challenge for ICH. Peroxisome proliferator-activated receptor gamma (PPARγ) and nuclear factor erythroid 2-related factor 2 (Nrf2), had been shown that, can take potential roles in the endogenous hematoma clearance...
June 24, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28644250/cholesterol-levels-and-hemorrhagic-stroke-risk-in-east-asian-versus-non-east-asian-populations-a-systematic-review-and-meta-analysis
#16
Liang Xie, Wei Wu, Jin Chen, Jianglong Tu, Jun Zhou, Xueliang Qi, Xiaoping Yin
BACKGROUND: The aim of this work was to evaluate the relationships between cholesterol levels and risk of hemorrhagic stroke [including intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH)] in East Asian versus non-East Asian populations. MATERIALS AND METHODS: Relevant prospective studies were identified from systematic searches of PubMed and EMBASE. A random-effects model was used to calculate summary relative risks (RRs) and 95% confidence intervals (CIs) that were used to compare the relationships between cholesterol levels and risk of hemorrhagic stroke in East Asian versus non-East Asian populations...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28630871/a-systematic-review-and-meta-analysis-on-the-treatment-of-cerebral-hemorrhage-with-naoxueshu-oral-liquid
#17
REVIEW
Lijun Wu, Yanda Li, Xiaofeng Wang, Xiaomeng Ren, Haiyan Zhu, Yikun Sun, Yanwei Xing, Lingqun Zhu, Yonghong Gao, Hongcai Shang
NaoXueShu oral liquid invigorates Qi and promotes blood circulation, which is mainly used for treating the acute stage of the meridian of hemorrhagic apoplexy and acute blood stasis syndrome during early convalescence. Its main clinical manifestations include hemiplegia, mouth askew, hemianesthesia, and inarticulateness. It is used mainly in patients with lobar hemorrhage, basal ganglia, and thalamus of the small amount of bleeding without disturbing consciousness of hypertensive cerebral. The purpose of this study was to evaluate the efficacy and adverse effects of NaoXueShu oral liquid on the treatment of cerebral hemorrhage...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28628707/intensive-blood-pressure-reduction-and-spot-sign-in-intracerebral-hemorrhage-a-secondary-analysis-of-a-randomized-clinical-trial
#18
RANDOMIZED CONTROLLED TRIAL
Andrea Morotti, H Bart Brouwers, Javier M Romero, Michael J Jessel, Anastasia Vashkevich, Kristin Schwab, Mohammad Rauf Afzal, Christy Cassarly, Steven M Greenberg, Renee Hebert Martin, Adnan I Qureshi, Jonathan Rosand, Joshua N Goldstein
Importance: The computed tomographic angiography (CTA) spot sign is associated with intracerebral hemorrhage (ICH) expansion and may mark those patients most likely to benefit from intensive blood pressure (BP) reduction. Objective: To investigate whether the spot sign is associated with ICH expansion across a wide range of centers and whether intensive BP reduction decreases hematoma expansion and improves outcome in patients with ICH and a spot sign. Design, Setting, and Participants: SCORE-IT (Spot Sign Score in Restricting ICH Growth) is a preplanned prospective observational study nested in the Antihypertensive Treatment of Acute Cerebral Hemorrhage II (ATACH-II) randomized clinical trial...
August 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28619989/low-versus-standard-dose-alteplase-in-patients-on-prior-antiplatelet-therapy-the-enchanted-trial-enhanced-control-of-hypertension-and-thrombolysis-stroke-study
#19
RANDOMIZED CONTROLLED TRIAL
Thompson G Robinson, Xia Wang, Hisatomi Arima, Philip M Bath, Laurent Billot, Joseph P Broderick, Andrew M Demchuk, Geoffery A Donnan, Jong S Kim, Pablo M Lavados, Tsong-Hai Lee, Richard I Lindley, Sheila C O Martins, Veronica V Olavarria, Jeyaraj D Pandian, Mark W Parsons, Octavio M Pontes-Neto, Stefano Ricci, Shoichiro Sato, Vijay K Sharma, Thang H Nguyen, Ji-Guang Wang, Mark Woodward, John Chalmers, Craig S Anderson
BACKGROUND AND PURPOSE: Many patients receiving thrombolysis for acute ischemic stroke are on prior antiplatelet therapy (APT), which may increase symptomatic intracerebral hemorrhage risk. In a prespecified subgroup analysis, we report comparative effects of different doses of intravenous alteplase according to prior APT use among participants of the international multicenter ENCHANTED study (Enhanced Control of Hypertension and Thrombolysis Stroke Study). METHODS: Among 3285 alteplase-treated patients (mean age, 66...
July 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28605557/practice-patterns-for-neurosurgical-utilization-and-outcome-in-acute-intracerebral-hemorrhage-intensive-blood-pressure-reduction-in-acute-cerebral-hemorrhage-trials-1-and-2-studies
#20
Rui Guo, David J Blacker, Xia Wang, Hisatomi Arima, Pablo M Lavados, Richard I Lindley, John Chalmers, Craig S Anderson, Thompson Robinson
BACKGROUND: The prognosis in acute spontaneous intracerebral hemorrhage (ICH) is related to hematoma volume, where >30 mL is commonly used to define large ICH as a threshold for neurosurgical decompression but without clear supporting evidence. OBJECTIVES: To determine the factors associated with large ICH and neurosurgical intervention among participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials (INTERACT). METHODS: We performed pooled analysis of the pilot INTERACT1 (n = 404) and main INTERACT2 (n = 2839) studies of ICH patients (<6 h of onset) with elevated systolic blood pressure (SBP, 150-220 mm Hg) who were randomized to intensive (target SBP < 140 mm Hg) or contemporaneous guideline-recommended (target SBP < 180 mm Hg) management...
June 10, 2017: Neurosurgery
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