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Intracerebral hemorrhage randomized

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https://www.readbyqxmd.com/read/29128801/oleuropein-protects-intracerebral-hemorrhage-induced-disruption-of-blood-brain-barrier-through-alleviation-of-oxidative-stress
#1
Jing Shi, Guofeng Wu, Xiaohua Zou, Ke Jiang
BACKGROUND: Intracerebral haemorrhage (ICH) as a devastating form of stroke has remained a public health threat due to lack of FDA-approved therapy. Oxidative stress originated from blood cell degradation products plays a crucial role in the ICH pathogenesis. In this study we evaluated oleuropein, a potent natural antioxidant from olive, in a well-established rat ICH model from overall symptoms to detailed molecular mechanism. METHODS: ICH model was established by collagenase injection to the brain of rats, which were randomly divided into groups with vehicle mock treatment, followed by treatment with different doses of oleuropein via daily intraperitoneal injection post-ICH for 3days...
May 11, 2017: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/29125055/cerebral-amyloid-angiopathy-cerebral-microbleeds-and-implications-for-anticoagulation-decisions-the-need-for-a-balanced-approach
#2
Andreas Charidimou, Ashkan Shoamanesh, Rustam Al-Shahi Salman, Charlotte Cordonnier, Luke A Perry, Kevin N Sheth, Alessandro Biffi, Jonathan Rosand, Anand Viswanathan
Cerebral amyloid angiopathy is a common hemorrhagic small vessel disease of the brain, often associated with high risk of spontaneous lobar intracerebral hemorrhage. When the suspicion of cerebral amyloid angiopathy is raised, clinicians are hesitant in prescribing oral anticoagulation in patients in whom it is otherwise indicated, including the case of non-valvular atrial fibrillation. This is one of the thorniest clinical dilemmas in the field currently. In this short Leading Opinion piece by an international panel of clinicians-researchers active in the field, we present our consistent approach and future outlook on oral anticoagulation post intracerebral hemorrhage and in the setting of clinical-radiologic evidence of cerebral amyloid angiopathy...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29118802/mechanical-thrombectomy-for-middle-cerebral-artery-division-occlusions-a-systematic-review-and-meta-analysis
#3
Hisham Salahuddin, Aixa Espinosa, Mark Buehler, Sadik A Khuder, Abdur R Khan, Gretchen Tietjen, Syed Zaidi, Mouhammad A Jumaa
Background: Middle cerebral artery division (M2) occlusion was significantly underrepresented in recent mechanical thrombectomy (MT) randomized controlled trials, and the approach to this disease remains heterogeneous. Objective: To conduct a systematic review and meta-analysis of outcomes at 90 days among patients undergoing MT for M2 middle cerebral artery (MCA) occlusions. Methods: Five clinical databases were searched from inception through September 2016...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29117953/brain-microbleeds-anticoagulation-and-hemorrhage-risk-meta-analysis-in-stroke-patients-with-af
#4
Andreas Charidimou, Christopher Karayiannis, Tae-Jin Song, Dilek Necioglu Orken, Vincent Thijs, Robin Lemmens, Jinkwon Kim, Su Mei Goh, Thanh G Phan, Cathy Soufan, Ronil V Chandra, Lee-Anne Slater, Shamir Haji, Vincent Mok, Solveig Horstmann, Kam Tat Leung, Yuichiro Kawamura, Nobuyuki Sato, Naoyuki Hasebe, Tsukasa Saito, Lawrence K S Wong, Yannie Soo, Roland Veltkamp, Kelly D Flemming, Toshio Imaizumi, Velandai Srikanth, Ji Hoe Heo
OBJECTIVES: To assess the association between cerebral microbleeds (CMBs) and future spontaneous intracerebral hemorrhage (ICH) risk in ischemic stroke patients with nonvalvular atrial fibrillation (AF) taking oral anticoagulants. METHODS: This was a meta-analysis of cohort studies with >50 patients with recent ischemic stroke and documented AF, brain MRI at baseline, long-term oral anticoagulation treatment, and ≥6 months of follow-up. Authors provided summary-level data on stroke outcomes stratified by CMB status...
November 8, 2017: Neurology
https://www.readbyqxmd.com/read/29114975/real-world-evidence-for-off-label-intravenous-thrombolysis-in-acute-ischemic-stroke
#5
Georgios Tsivgoulis, Vasileios-Arsenios Lioutas
The most feared complication of intravenous tissue-plasminogen-activator (tPA) delivery in patients with acute ischemic stroke (AIS) is symptomatic intracerebral hemorrhage (sICH) which has been the driver behind most of the exclusion criteria in all randomized-controlled clinical trials (RCTs) evaluating the safety and efficacy of intravenous thrombolysis (IVT) for AIS(1) . This article is protected by copyright. All rights reserved.
November 8, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29114095/direct-mechanical-intervention-versus-bridging-therapy-in-stroke-patients-eligible-for-intravenous-thrombolysis-a-pooled-analysis-of-2-registries
#6
Sebastian Bellwald, Ralph Weber, Tomas Dobrocky, Hannes Nordmeyer, Simon Jung, Jeffrie Hadisurya, Pasquale Mordasini, Marie-Luise Mono, Christian P Stracke, Hakan Sarikaya, Corrado Bernasconi, Klaus Berger, Marcel Arnold, René Chapot, Jan Gralla, Urs Fischer
BACKGROUND AND PURPOSE: Randomized controlled trials have shown that mechanical thrombectomy (MT) plus best medical treatment improves outcome in stroke patients with large-vessel occlusion in the anterior circulation. Whether direct MT is equally effective as bridging thrombolysis (intravenous thrombolysis plus MT) in intravenous thrombolysis eligible patients remains unclear. METHODS: We compared clinical and radiological outcomes at 3 months in 249 bridging patients with 111 patients receiving direct MT for large-vessel occlusion anterior circulation stroke from 2 prospective registries (study period Essen: June 2012 to August 2013, Bern February 2009 to August 2014)...
November 7, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29093065/low-dose-aspirin-and-risk-of-intracranial-bleeds-an-observational-study-in-uk-general-practice
#7
Lucía Cea Soriano, David Gaist, Montse Soriano-Gabarró, Susan Bromley, Luis A García Rodríguez
OBJECTIVE: To quantify the risk of intracranial bleeds (ICBs) associated with new use of prophylactic low-dose aspirin using a population-based primary care database in the United Kingdom. METHODS: A cohort of new users of low-dose aspirin (75-300 mg; n = 199,079) aged 40-84 years and a 1:1 matched cohort of nonusers of low-dose aspirin at baseline were followed (maximum 14 years, median 5.4 years) to identify incident cases of ICB, with validation by manual review of patient records or linkage to hospitalization data...
November 1, 2017: Neurology
https://www.readbyqxmd.com/read/29081474/cardiovascular-and-bleeding-risks-in-acute-myocardial-infarction-newly-treated-with-ticagrelor-vs-clopidogrel-in-taiwan
#8
Cheng-Han Lee, Ching-Lan Cheng, Yea-Huei Kao Yang, Ting-Hsing Chao, Ju-Yi Chen, Yi-Heng Li
BACKGROUND: There are few data on ticagrelor in Asian patients. This study evaluated clinical outcomes with ticagrelor and clopidogrel in Taiwanese patients with acute myocardial infarction (AMI).Methods and Results:We used the Taiwan National Health Insurance Research Database to identify 27,339 AMI patients aged ≥18 years between January 2012 and December 2014, and only patients who survived greater than or equal to 30 days after AMI and took dual antiplatelet therapy were included...
October 27, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29073629/early-cognitive-impairment-after-intracerebral-hemorrhage-in-the-interact1-study
#9
Shoujiang You, Xia Wang, Richard I Lindley, Thompson Robinson, Craig S Anderson, Yongjun Cao, John Chalmers
BACKGROUND: Data on cognitive impairment after acute intracerebral hemorrhage (ICH) are limited. This study is aimed at determining the frequency and predictors of cognitive impairment among participants of the pilot phase, Intensive Blood Pressure (BP) Reduction in Acute Cerebral Hemorrhage Trial (INTERACT1). METHODS: INTERACT1 was an open randomized trial of early intensive (target systolic BP <140 mm Hg) compared with contemporaneous guideline-recommended BP lowering in 404 patients with elevated systolic BP (150-220 mm Hg) within 6 h of ICH onset...
October 26, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29069046/analysis-of-three-surgical-treatments-for-spontaneous-supratentorial-intracerebral-hemorrhage
#10
Qiang Cai, Huaping Zhang, Dong Zhao, Zhaohui Yang, Keqi Hu, Long Wang, Wenfei Zhang, Zhibiao Chen, Qianxue Chen
This retrospective study aimed to evaluate the effectiveness and safety of 3 surgical procedures for Spontaneous Supratentorial Intracerebral Hemorrhage (SICH).A total of 63 patients with SICH were randomized into 3 groups. Group A (n = 21) underwent craniotomy surgery, group B (n = 22) underwent burr hole, urokinase infusion and catheter drainage, and group C (n = 20) underwent neuroendoscopic surgery. The hematoma evacuation rate of the operation was analyzed by 3D Slice software and the average surgery time, visualization during operation, decompressive effect, mortality, Glasgow Coma Scale (GCS) improvement, complications include rebleeding, pneumonia, intracranial infection were also compared among 3 groups...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29028130/oral-anticoagulation-and-functional-outcome-after-intracerebral-hemorrhage
#11
Alessandro Biffi, Joji B Kuramatsu, Audrey Leasure, Hooman Kamel, Christina Kourkoulis, Kristin Schwab, Alison M Ayres, Jordan Elm, M Edip Gurol, Steven M Greenberg, Anand Viswanathan, Christopher D Anderson, Stefan Schwab, Jonathan Rosand, Fernando D Testai, Daniel Woo, Hagen B Huttner, Kevin N Sheth
OBJECTIVE: Oral anticoagulation treatment (OAT) resumption is a therapeutic dilemma in intracerebral hemorrhage (ICH) care, particularly for lobar hemorrhages related to amyloid angiopathy. We sought to determine whether OAT resumption after ICH is associated with long-term outcome, accounting for ICH location (ie, lobar vs nonlobar). METHODS: We meta-analyzed individual patient data from: (1) the multicenter RETRACE study (n = 542), (2) a U.S.-based single-center ICH study (n = 261), and (3) the Ethnic/Racial Variations of Intracerebral Hemorrhage study (n = 209)...
October 13, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/29026928/-current-treatment-concepts-in-intracerebral-hemorrhage
#12
REVIEW
H B Huttner, J B Kuramatsu
BACKGROUND AND OBJECTIVE: In recent years, various important studies investigating the management of intracerebral hemorrhage (ICH) have been published. However, these have not entered guideline recommendations yet. Therefore, essential results are summarized here and the findings are integrated into current treatment concepts. MATERIALS AND METHODS: Based on a dedicated literature review and the authors' experience, up-to-date and high-quality investigations were identified...
November 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29021311/acute-ischemic-stroke-with-tandem-lesions-technical-endovascular-management-and-clinical-outcomes-from-the-escape-trial
#13
Zarina Assis, Bijoy K Menon, Mayank Goyal, Andrew M Demchuk, Jai Shankar, Jeremy L Rempel, Daniel Roy, Alexander Y Poppe, Victor Yang, Cheemun Lum, Dar Dowlatshahi, John Thornton, Hana Choe, Paul A Burns, Donald F Frei, Blaise W Baxter, Michael D Hill
BACKGROUND: Tandem occlusions of the extracranial carotid and intracranial carotid or middle cerebral artery have a particularly poor prognosis without treatment. Several management strategies have been used with no clear consensus recommendations. We examined subjects with tandem occlusions enrolled in the ESCAPE trial and their outcomes. METHODS: Data are from the ESCAPE trial. Additional data were sought on interventions for each subject. RESULTS: There were 54 (17%) subjects with tandem extracranial and intracranial occlusions...
October 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28974628/thrombectomy-in-acute-stroke-with-tandem-occlusions-from-dissection-versus-atherosclerotic-cause
#14
RANDOMIZED CONTROLLED TRIAL
Benjamin Gory, Michel Piotin, Diogo C Haussen, Henrik Steglich-Arnholm, Markus Holtmannspötter, Julien Labreuche, Christian Taschner, Sebastian Eiden, Raul G Nogueira, Panagiotis Papanagiotou, Maria Boutchakova, Adnan Siddiqui, Bertrand Lapergue, Franziska Dorn, Christophe Cognard, Monika Killer-Oberpfalzer, Salvatore Mangiafico, Marc Ribo, Daniel Behme, Alejandro M Spiotta, Mikael Mazighi, Francis Turjman
BACKGROUND AND PURPOSE: Tandem steno-occlusive lesions were poorly represented in randomized trials and represent a major challenge for endovascular thrombectomy in acute anterior circulation strokes. The impact of the cervical carotid lesion cause (ie, atherosclerotic versus dissection) on outcome of tandem patients endovascularly treated remains to be assessed. METHODS: We retrospectively analyzed individual data of prospectively collected consecutive tandem patients treated with endovascular thrombectomy...
November 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28973174/low-dose-vs-standard-dose-alteplase-for-patients-with-acute-ischemic-stroke-secondary-analysis-of-the-enchanted-randomized-clinical-trial
#15
Xia Wang, Thompson G Robinson, Tsong-Hai Lee, Qiang Li, Hisatomi Arima, Philip M Bath, Laurent Billot, Joseph Broderick, Andrew M Demchuk, Geoffrey Donnan, Jong S Kim, Pablo Lavados, Richard I Lindley, Sheila O Martins, Veronica V Olavarria, Jeyaraj D Pandian, Mark W Parsons, Octavio M Pontes-Neto, Stefano Ricci, Vijay K Sharma, Nguyen H Thang, Ji-Guang Wang, Mark Woodward, Craig S Anderson, John Chalmers
Importance: A lower dose of intravenous alteplase appears to be a safer treatment option than the standard dose, reducing the risk of symptomatic intracerebral hemorrhage. There is uncertainty, however, over how this effect translates into an overall clinical benefit for patients with acute ischemic stroke (AIS). Objective: To assess whether older, Asian, or severely affected patients with AIS who are considered at high risk of thrombolysis may benefit more from low-dose rather than standard-dose alteplase treatment...
November 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28952914/tenecteplase-versus-alteplase-before-endovascular-thrombectomy-extend-ia-tnk-a-multicenter-randomized-controlled-study
#16
Bruce Cv Campbell, Peter J Mitchell, Leonid Churilov, Nawaf Yassi, Timothy J Kleinig, Bernard Yan, Richard J Dowling, Steven J Bush, Helen M Dewey, Vincent Thijs, Marion Simpson, Mark Brooks, Hamed Asadi, Teddy Y Wu, Darshan G Shah, Tissa Wijeratne, Timothy Ang, Ferdinand Miteff, Christopher Levi, Martin Krause, Timothy J Harrington, Kenneth C Faulder, Brendan S Steinfort, Peter Bailey, Henry Rice, Laetitia de Villiers, Rebecca Scroop, Wayne Collecutt, Andrew A Wong, Alan Coulthard, P A Barber, Ben McGuinness, Deborah Field, Henry Ma, Winston Chong, Ronil V Chandra, Christopher F Bladin, Helen Brown, Kendal Redmond, David Leggett, Geoffrey Cloud, Anoop Madan, Neil Mahant, Bill O'Brien, John Worthington, Geoffrey Parker, Patricia M Desmond, Mark W Parsons, Geoffrey A Donnan, Stephen M Davis
Background and hypothesis Intravenous thrombolysis with alteplase remains standard care prior to thrombectomy for eligible patients within 4.5 h of ischemic stroke onset. However, alteplase only succeeds in reperfusing large vessel arterial occlusion prior to thrombectomy in a minority of patients. We hypothesized that tenecteplase is non-inferior to alteplase in achieving reperfusion at initial angiogram, when administered within 4.5 h of ischemic stroke onset, in patients planned to undergo endovascular therapy...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28929560/minocycline-and-matrix-metalloproteinase-inhibition-in-acute-intracerebral-hemorrhage-a-pilot-study
#17
J J Chang, M Kim-Tenser, B A Emanuel, G M Jones, K Chapple, A Alikhani, N Sanossian, W J Mack, G Tsivgoulis, A V Alexandrov, T Pourmotabbed
BACKGROUND AND PURPOSE: Intracerebral hemorrhage (ICH) is a devastating cerebrovascular disorder with high morbidity and mortality. Minocycline is a matrix metalloproteinase-9 (MMP-9) inhibitor that may attenuate secondary mechanisms of injury in ICH. The feasibility and safety of minocycline in ICH patients were evaluated in a pilot, double-blinded, placebo-controlled randomized clinical trial. METHODS: Patients with acute onset (<12 h from symptom onset) ICH and small initial hematoma volume (<30 ml) were randomized to high-dose (10 mg/kg) intravenous minocycline or placebo...
November 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28887388/minocycline-in-acute-cerebral-hemorrhage-an-early-phase-randomized-trial
#18
RANDOMIZED CONTROLLED TRIAL
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...
October 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
#19
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
#20
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)
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