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Intracerebral hemorrhage randomized

Kathryn F Kirchoff-Torres, Ekaterina Bakradze
PURPOSE OF REVIEW: Cerebral hyperperfusion syndrome (CHS) is a rare but significant complication after carotid revascularization and is increasingly recognized after acute stroke treatments. In this review, we discuss the epidemiology and pathophysiology of CHS, clinical presentation including ipsilateral headache, seizures, and focal neurological deficits, and radiographic presentation. We propose preventive therapies with emphasis on acute stroke post-thrombectomy hyperperfusion. RECENT FINDINGS: CHS was first described after carotid revascularization but is now also reported in patients with acute ischemic stroke...
March 19, 2018: Current Pain and Headache Reports
Danfeng Zhang, Jigang Chen, Jiaming Guo, Ying Jiang, Yan Dong, Benjamin Ping-Chi Chen, Junyu Wang, Lijun Hou
BACKGROUND: and Purpose Hematoma expansion (HE) is independently associated with clinical outcome after intracerebral hemorrhage (ICH). Hematoma heterogeneity on noncontrast computed tomography (NCCT) is reported to be predictive of HE, but conclusions are inconsistent. We seek to clarify the relationship between hematoma heterogeneity and HE by pooling the pertinent publications. METHODS: Cochrane library, PubMed and Embase were searched for related studies examining the correlation of HE with hematoma heterogeneity, and secondary endpoint was defined as poor outcome...
March 13, 2018: World Neurosurgery
Xiaowei Li, Jingze Li, Xuehui Yang, Zhaosheng Sun, Jinrong Zhang, Wangmiao Zhao, Shuzhi Dong, Cong Li, Yanqiao Ye, Jianchao Chen, Yongqian Li, Yi Xiang, Jianhui Mao, Guangjie Li, Hong Guo, Wenchao Zhang, Hao Guo, Yazhao Zhang, Mingzhe Zhang, Wanzeng Zhang, Zhanyi Xu, Baoshuai Zhao, Jianhui Wei, Gengshui Zhao, Ronghua Ma, Xiuzhi Shen, Chunyan Ge, Cunling Zheng, Shang Li, Yan Wang
BACKGROUND: Prognosis of spontaneous intracerebral hemorrhage (ICH) remains poor worldwide. AIMS OF THE STUDY: To investigate the effect and optimal protocol for hyperbaric-oxygen therapy (HBOT), and reduce incidence of upper gastrointestinal bleeding (UGIB) in ICH. METHODS: This prospective, randomized, controlled trial included 565 patients with acute severe ICH. Participants were randomly assigned to a sham-control group (Group A) and four intervention groups: Groups B and C with 2...
March 13, 2018: Archives of Medical Research
Danfeng Zhang, Jigang Chen, Qiang Xue, Bingying Du, Ya Li, Tao Chen, Ying Jiang, Lijun Hou, Yan Dong, Junyu Wang
Background and Purpose: Hematoma expansion (HE) is related to clinical deterioration after intracerebral hemorrhage (ICH) and noncontrast computed tomography (NCCT) signs are indicated as predictors for HE but with inconsistent conclusions. We aim to clarify the correlations of NCCT heterogeneity signs with HE by meta-analysis of related studies. Methods: PubMed, Embase, and Cochrane library were searched for eligible studies exploring the relationships between NCCT heterogeneity signs (hypodensity, mixed density, swirl sign, blend sign, and black hole sign) and HE...
2018: BioMed Research International
Maximiliano A Hawkes, Alejandro A Rabinstein
Background: We summarize the existing evidence on the potential benefit of oral anticoagulation (OAC) in intracerebral hemorrhage (ICH) survivors with nonvalvular atrial fibrillation (NVAF). Methods: Systematic review of the literature to address the following issues: (1) prevalence of NVAF in ICH survivors, (2) current prescription of OAC, (3) factors associated with resumption of OAC, (4) risk of ischemic stroke (IS) and recurrent ICH, and (5) ideal timing for restarting OAC in ICH survivors with NVAF...
February 2018: Neurology. Clinical Practice
Zhenlin Xu, Yuanping Yue, Jianling Bai, Chong Shen, Jingjing Yang, Xiaoping Huang, Yang Zhao, Ying Li
OBJECTIVES: To estimate the risk of hemorrhagic stroke associated with current use of oral contraceptives (OCs), and to further depict how the risk was affected by study characteristics. METHODS: We searched PubMed, Embase, and Cochrane Library for relevant articles published up to February 2017 that examined the association between OC use and risk of hemorrhagic stroke. Two investigators independently reviewed articles based on inclusion criteria. The Newcastle-Ottawa scale was employed to evaluate quality of studies...
February 19, 2018: Archives of Gynecology and Obstetrics
Onyinyechi Eke, Mercedeh Shanechi, Michael Gottlieb
Clinical question In patients taking antiplatelet therapy, does a platelet transfusion after acute spontaneous primary intracerebral hemorrhage reduce the risk of death or dependence? Article chosen Baharoglu MI, Cordonnier C, Al-Shahi Salman R, et al. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral hemorrhage associated with antiplatelet therapy (PATCH): a randomized, open-label, phase 3 trial. Lancet 2016;387(10038):2605-13. Study objective The primary objective of this study was to investigate whether a platelet transfusion with standard care, compared with standard care alone, reduced death or dependence after intracerebral hemorrhage associated with antiplatelet therapy use...
February 14, 2018: CJEM
Arina Tamborska, Michael T C Poon, Rustam Al-Shahi Salman
BACKGROUND AND PURPOSE: The absence of treatments for intracerebral hemorrhage with significant consistent benefit in randomized controlled trials (RCTs) could be because of lack of treatment efficacy or the design of RCTs. METHODS: We searched the Cochrane Stroke Group Trials Register in December 2015 for completed and published RCTs reporting clinical outcome in adults with intracerebral hemorrhage. We collected data on publication year and language, study characteristics, and effect size...
February 12, 2018: Stroke; a Journal of Cerebral Circulation
Deena M Nasr, Kelly D Flemming, Giuseppe Lanzino, Harry J Cloft, David F Kallmes, Mohammad Hassan Murad, Waleed Brinjikji
BACKGROUND AND PURPOSE: Vertebrobasilar non-saccular and dolichoectatic aneurysms (VBDA) are a rare type of aneurysm and are generally associated with poor prognosis. In order to better characterize the natural history of VBDAs, we performed a systematic review and meta-analysis of the literature to determine rates of mortality, growth, rupture, ischemia, and intraparenchymal hemorrhage. MATERIALS AND METHODS: We searched the literature for longitudinal natural history studies of VBDA patients reporting clinical and imaging outcomes...
February 13, 2018: Cerebrovascular Diseases
Qian Xu, Shuang-Bo Fan, Yu-Lin Wan, Xian-Lan Liu, Liang Wang
AIMS: Although Hyperbaric oxygen therapy (HyperBOT) attract our attention successfully these days, it is still full of controversy on the treatment of acute stroke. The aim of this study is to assess the potential long-term neurological consequences and safety of using HyperBOT on intracerebral hemorrhage (ICH) in the diabetics. METHODS: In this prospective, randomized controlled trial, 79 diabetes patients suffering from acute ICH were randomized to treat for 60 minutes in a monoplace hyperbaric chamber pressurized with pure oxygen to 2...
February 3, 2018: Diabetes Research and Clinical Practice
Shannon M Fernando, Peter M Reardon, Dar Dowlatshahi, Shane W English, Kednapa Thavorn, Peter Tanuseputro, Jeffrey J Perry, Erin Rosenberg, Eelco F Wijdicks, Daren K Heyland, Kwadwo Kyeremanteng
OBJECTIVES: Spontaneous intracranial hemorrhage, including subarachnoid hemorrhage and intracerebral hemorrhage, is associated with significant morbidity and mortality. Although many of these patients will require ICU admission, little is known regarding their outcomes and the costs incurred. We evaluated this population in order to identify outcomes and cost patterns. DESIGN: Retrospective cohort analysis of a health administrative database. SETTING: Two ICUs within a single hospital system...
February 5, 2018: Critical Care Medicine
Wookjin Yang, Chi Kyung Kim, Do Yeon Kim, Han-Gil Jeong, Seung-Hoon Lee
OBJECTIVE: Although gamma-glutamyl transferase (GGT) is generally regarded as an alternative biomarker for alcohol consumption, its independent role in vascular diseases emerged recently. However, its role in stroke remains unknown. The aim of this study is to clarify the impact of GGT on stroke in a large-sized, national, standardized population cohort in Korea. METHODS: In Korea, the National Health Insurance Service (NHIS) provides full-coverage health insurance service for all citizens...
January 25, 2018: Annals of Neurology
Yan Xu, Ashkan Shoamanesh, Sam Schulman, Dar Dowlatshahi, Rustam Al-Shahi Salman, Ioana Doina Moldovan, Philip Stephen Wells, Fahad AlKherayf
BACKGROUND: While oral anticoagulants (OACs) are highly effective for ischemic stroke prevention in atrial fibrillation, intracerebral hemorrhage (ICH) remains the most feared complication of OAC. Clinical controversy remains regarding OAC resumption and its timing for ICH survivors with atrial fibrillation because the balance between risks and benefits has not been investigated in randomized trials. AIMS/HYPOTHESIS: To survey the practice of stroke neurologists, thrombosis experts and neurosurgeons on OAC re-initiation following OAC-associated ICH...
2018: PloS One
Simone B Schmidt, Willibald Kulig, Ralph Winter, Antje S Vasold, Anette E Knoll, Jens D Rollnik
BACKGROUND & AIMS: Diarrhea has negative consequences for patients, health care staff and health care costs when neurological patients are fed enterally over long periods. We examined the effect of tube feeding with natural foods in reducing the number of fluid stool evacuations and diarrhea in critically ill neurological patients. METHODS: A multicenter, prospective, open-label and randomized controlled trial (RCT) was conducted at facilities in Germany specializing in early rehabilitation after neurological damage...
January 9, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Andreas Charidimou, Sara Shams, Jose R Romero, Jie Ding, Roland Veltkamp, Solveig Horstmann, Gudny Eiriksdottir, Mark A van Buchem, Vilmundur Gudnason, Jayandra J Himali, M Edip Gurol, Anand Viswanathan, Toshio Imaizumi, Meike W Vernooij, Sudha Seshadri, Steven M Greenberg, Oscar R Benavente, Lenore J Launer, Ashkan Shoamanesh
Background Cerebral microbleeds can confer a high risk of intracerebral hemorrhage, ischemic stroke, death and dementia, but estimated risks remain imprecise and often conflicting. We investigated the association between cerebral microbleeds presence and these outcomes in a large meta-analysis of all published cohorts including: ischemic stroke/TIA, memory clinic, "high risk" elderly populations, and healthy individuals in population-based studies. Methods Cohorts (with > 100 participants) that assessed cerebral microbleeds presence on MRI, with subsequent follow-up (≥3 months) were identified...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Anne Sofie Dam Laursen, Christina Catherine Dahm, Søren Paaske Johnsen, Erik Berg Schmidt, Kim Overvad, Marianne Uhre Jakobsen
PURPOSE: The role of dairy fat for the risk of stroke is not yet clear. Adipose tissue reflects long-term fatty acid intake and metabolism. We, therefore, investigated associations for percentages of adipose tissue fatty acids, for which dairy products are a major source (12:0, 14:0, 14:1 cis-9, 15:0, 17:0, 18:1 trans-11 and 18:2 cis-9, trans-11), with incident total stroke and stroke subtypes. METHODS: We conducted a case-cohort study within the Danish Diet, Cancer and Health cohort, including all incident stroke cases (n = 2108) and a random sample of the total cohort (n = 3186)...
January 12, 2018: European Journal of Nutrition
Mark D Haley, Barbara A Gregson, W Andrew Mould, Daniel F Hanley, Alexander David Mendelow
BACKGROUND AND PURPOSE: The ABC/2 method for calculating intracerebral hemorrhage (ICH) volume has been well validated. However, the formula, derived from the volume of an ellipse, assumes the shape of ICH is elliptical. We sought to compare the agreement of the ABC/2 formula with other methods through retrospective analysis of a selection of the STICH II cohort (Early Surgery Versus Initial Conservative Treatment in Patients With Spontaneous Supratentorial Lobar Intracerebral Haematomas)...
February 2018: Stroke; a Journal of Cerebral Circulation
Manuel Cappellari, Gianni Turcato, Stefano Forlivesi, Cecilia Zivelonghi, Paolo Bovi, Bruno Bonetti, Danilo Toni
BACKGROUND AND PURPOSE: Symptomatic intracerebral hemorrhage (sICH) is a rare but the most feared complication of intravenous thrombolysis for ischemic stroke. We aimed to develop and validate a nomogram for individualized prediction of sICH in intravenous thrombolysis-treated stroke patients included in the multicenter SITS-ISTR (Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register). METHODS: All patients registered in the SITS-ISTR by 179 Italian centers between May 2001 and March 2016 were originally included...
February 2018: Stroke; a Journal of Cerebral Circulation
Benjamin Gory, Bertrand Lapergue, Raphael Blanc, Julien Labreuche, Malek Ben Machaa, Alain Duhamel, Gautier Marnat, Suzana Saleme, Vincent Costalat, Serge Bracard, Hubert Desal, Mikael Mazighi, Arturo Consoli, Michel Piotin
BACKGROUND AND PURPOSE: Middle cerebral artery M2-segment occlusions represent an important subgroup of patients with acute stroke with large-vessel occlusion. The safety of mechanical thrombectomy, especially contact aspiration (CA), in such distal intracranial occlusions is still under debate. We compared reperfusion, adverse events, neurological recovery, and functional outcome of patients with isolated M2 occlusions according to the first-line strategy mechanical thrombectomy devices (CA versus stent retriever [SR])...
February 2018: Stroke; a Journal of Cerebral Circulation
Huihui Liu, Huaguang Zheng, Yongjun Cao, Yuesong Pan, David Wang, Runhua Zhang, Shoujiang You, Xinmiao Zhang, Shuya Li, Xu Tong, Chun-Feng Liu, Yilong Wang
BACKGROUND: We performed a meta-analysis to compare the efficacy and safety between low- and standard-dose intravenous (IV) tissue-type plasminogen activator (tPA) for acute ischemic stroke (AIS) patients within 4.5 hours of symptom onset. METHODS: We searched PubMed and EMBASE for relevant studies from inception to June1, 2017. Cohort or randomized controlled studies for AIS within 4.5 hours of symptom onset with comparison between low-dose and standard-dose tPA were included...
April 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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