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Intracerebral hemorrhage randomized

Pradeep Kumar, Shubham Misra, Arun Kumar Yadav, Amit Kumar, Mukesh Sriwastva, Kameshwar Prasad
BACKGROUND: Polymorphisms of -174G/C and -572C/G in the Interleukin-6 (IL-6) promoter gene can affect both transcription and secretion of IL-6 and may be involved in the inflammatory mechanisms in early and delayed phases after intracerebral hemorrhage (ICH). The role of these polymorphisms remains unclear for the pathogenesis of ICH. METHODS: PubMed, EMBASE, MEDLINE and Google Scholar searches were conducted from January 1, 1950 to February 29, 2016 and were supplemented with relevant articles identified in the references...
September 2016: Pulse (Basel, Switzerland)
Kyle B Walsh, Daniel Woo, Padmini Sekar, Jennifer Osborne, Charles J Moomaw, Carl D Langefeld, Opeolu Adeoye
BACKGROUND: -Hypertension is a significant risk factor for intracerebral hemorrhage (ICH). While ethnic/racial disparities related to hypertension and ICH have been reported, these previous studies were limited by a lack of Hispanics and inadequate power to analyze by ICH location. In the current study, while overcoming these prior limitations, we investigated whether there was variation by ethnicity/race of treated and untreated hypertension as risk factors for ICH. METHODS: -The Ethnic/Racial Variations of ICH (ERICH) study is a prospective, multicenter, case-control study of ICH among whites, blacks, and Hispanics...
October 13, 2016: Circulation
Hui-Qin Li, Yan Li, Zi-Xian Chen, Xiao-Guang Zhang, Xia-Wei Zheng, Wen-Ting Yang, Shuang Chen, Guo-Qing Zheng
Spontaneous intracerebral hemorrhage (ICH) is one of the most devastating types of stroke. Here, we aim to demonstrate that electroacupuncture on Baihui (GV20) exerts neuroprotection for acute ICH possibly via the caveolin-1/matrix metalloproteinase/blood-brain barrier permeability pathway. The model of ICH was established by using collagenase VII. Rats were randomly divided into three groups: Sham-operation group, Sham electroacupuncture group, and electroacupuncture group. Each group was further divided into 4 subgroups according to the time points of 6 h, 1 d, 3 d, and 7 d after ICH...
2016: Neural Plasticity
Moritz Scherer, Jonas Cordes, Alexander Younsi, Yasemin-Aylin Sahin, Michael Götz, Markus Möhlenbruch, Christian Stock, Julian Bösel, Andreas Unterberg, Klaus Maier-Hein, Berk Orakcioglu
BACKGROUND AND PURPOSE: ABC/2 is still widely accepted for volume estimations in spontaneous intracerebral hemorrhage (ICH) despite known limitations, which potentially accounts for controversial outcome-study results. The aim of this study was to establish and validate an automatic segmentation algorithm, allowing for quick and accurate quantification of ICH. METHODS: A segmentation algorithm implementing first- and second-order statistics, texture, and threshold features was trained on manual segmentations with a random-forest methodology...
October 4, 2016: Stroke; a Journal of Cerebral Circulation
Liling Zeng, Jianwen Guo, Jing Wang, Qixin Zhang, Haijun Li, Rongming Lin
BACKGROUND: Hypertensive intracerebral hemorrhage (HICH) is one of the most devastating forms of stroke. Currently, no specific therapies for HICH except general medical care. However, in China, medicine of promoting blood circulation (PBC) and removing blood stasis (RBS) are widely and efficiently used to treat HICH and become a potentially effective treatment for the secondary effects of HICH to alleviate brain injury, accelerate neuronal recovery, and improve the prognosis. In order to evaluate the safety and effect of PBC and RBS herbal drugs, we design a prospective, randomized, open, double-blind controlled clinical trial on the hematoma enlargement in HICH patients treating with PBC and RBS herbal medicine within 6 h time window from the symptom onset...
2016: SpringerPlus
Jana Dluha, Stefan Sivak, Egon Kurca, Robert Dusenka, Klaudia Kalmarova, Monika Turcanova Koprusakova, Ema Kantorova, Vladimir Nosal
AIMS: This study aims to compare the safety and efficacy of heparin and nadroparin in order to provide an additional therapeutic option for patients with acute ischemic stroke in, whom systemic thrombolysis was excluded, or thrombectomy could not be performed. METHODS: We describe a prospective randomized double-blind placebo-controlled pilot study in acute ischemic stroke. The therapeutic window was between 4.5 and 24 h after the onset of stroke. During the first 24 h of treatment, the patients divided into 3 groups received placebo, heparin or nadroparin (in therapeutic doses)...
September 19, 2016: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Bo Carlberg
The J curve hypothesis propose that the relation between blood pressure and risk for cardiovascular events is non-linear. Instead of a decreased risk with lower blood pressure, the risk increases at lower blood pressures. This issue has been discussed for many years, and is still a hot topic. The debates have most often had its origin in the question about how far blood pressure should be lowered with antihypertensive drugs.One one hand, we know that many patients with hypertension is not treated to targets according to guidelines and that this contributes to the high risk for cardiovascular diseases in patients with hypertension...
September 2016: Journal of Hypertension
Andreas Charidimou, Ashkan Shoamanesh
OBJECTIVE: We performed a systematic review and meta-analysis to assess whether the presence of cerebral microbleeds (CMBs) on pretreatment MRI of patients with acute ischemic stroke treated with IV thrombolysis is associated with increased risk of symptomatic intracerebral hemorrhage (ICH) and poor functional outcome. METHODS: We searched PubMed for relevant studies and calculated pooled odds ratios (OR) for symptomatic ICH and poor (i.e., modified Rankin Scale score >2) 3- to 6-month functional outcome using random effects models with DerSimonian-Laird weights among individuals with vs without CMBs...
September 14, 2016: Neurology
Susanna M Zuurbier, Jonathan M Coutinho
Cerebral venous thrombosis is an important cause of stroke in the young. Unlike venous thromboembolism (VTE), women are affected three times more often than men by CVT. The most common symptoms are headache, seizures and focal neurological deficits. The diagnosis can be confirmed with MRI, CT-venography, or catheter angiography. An intracerebral hemorrhage is found on cerebral imaging in approximately 40 % of patients, and can range from small juxtacortical hemorrhages to large space-occupying lesions. Many risk factors for CVT have been reported, most of which overlap with those of VTE...
September 15, 2016: Advances in Experimental Medicine and Biology
Amrou Sarraj, Navdeep Sangha, Muhammad Shazam Hussain, Dolora Wisco, Nirav Vora, Lucas Elijovich, Nitin Goyal, Michael Abraham, Manoj Mittal, Lei Feng, Abel Wu, Vallabh Janardhan, Suman Nalluri, Albert J Yoo, Megan George, Randall Edgell, Rutvij J Shah, Clark Sitton, Emilio Supsupin, Suhas Bajgur, M Carter Denny, Peng R Chen, Mark Dannenbaum, Sheryl Martin-Schild, Sean I Savitz, Rishi Gupta
Importance: Randomized clinical trials have shown the superiority of endovascular therapy (EVT) compared with best medical management for acute ischemic strokes with large vessel occlusion (LVO) in the anterior circulation. However, of 1287 patients enrolled in 5 trials, 94 with isolated second (M2) segment occlusions were randomized and 51 of these received EVT, thereby limiting evidence for treating isolated M2 segment occlusions as reflected in American Heart Association guidelines...
September 12, 2016: JAMA Neurology
Edward Chan, Craig S Anderson, Xia Wang, Hisatomi Arima, Anubhav Saxena, Tom J Moullaali, Candice Delcourt, Guojun Wu, Jinchao Wang, Guofang Chen, Pablo M Lavados, Christian Stapf, Thompson Robinson, John Chalmers
BACKGROUND: Intraventricular hemorrhage (IVH) extension is common following acute intracerebral hemorrhage (ICH) and is associated with poor prognosis. AIM: To determine whether intensive blood pressure (BP)-lowering therapy reduces IVH growth. METHODS: Pooled analyses of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials (INTERACT1 and INTERACT2) computed tomography (CT) substudies; multicenter, open, controlled, randomized trials of patients with acute spontaneous ICH and elevated systolic BP, randomly assigned to intensive (<140 mm Hg) or guideline-based (<180 mm Hg) BP management...
September 8, 2016: Cerebrovascular Diseases Extra
Diederik W Dippel, Charles B Majoie, Yvo B Roos, Aad van der Lugt, Robert J van Oostenbrugge, Wim H van Zwam, Hester F Lingsma, Peter J Koudstaal, Kilian M Treurniet, Lucie A van den Berg, Debbie Beumer, Puck S Fransen, Olvert A Berkhemer
BACKGROUND AND PURPOSE: Intra-arterial treatment by means of retrievable stents has been proven safe and effective. In MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands), the choice of the type of thrombectomy device was left to the discretion of the interventionist. The aim of this study was to explore the differences in functional outcome, neurological recovery, reperfusion, extent of infarction, and adverse events according to stent type and make...
October 2016: Stroke; a Journal of Cerebral Circulation
Duncan Wilson, Andreas Charidimou, Gareth Ambler, Zoe V Fox, Simone Gregoire, Phillip Rayson, Toshio Imaizumi, Felix Fluri, Hiromitsu Naka, Solveig Horstmann, Roland Veltkamp, Peter M Rothwell, Vincent I H Kwa, Vincent Thijs, Yong-Seok Lee, Young Dae Kim, Yining Huang, Ka Sing Wong, Hans Rolf Jäger, David J Werring
OBJECTIVE: To determine associations between cerebral microbleed (CMB) burden with recurrent ischemic stroke (IS) and intracerebral hemorrhage (ICH) risk after IS or TIA. METHODS: We identified prospective studies of patients with IS or TIA that investigated CMBs and stroke (ICH and IS) risk during ≥3 months follow-up. Authors provided aggregate summary-level data on stroke outcomes, with CMBs categorized according to burden (single, 2-4, and ≥5 CMBs) and distribution...
October 4, 2016: Neurology
Shangyu Xu, Qiongyi Pang, Zhongxiao Lin, Nu Zhang
Intracerebral hemorrhage (ICH) is an important public health problem associated with high mortality and morbidity. The aim of this study was to evaluate the clinical efficacy of integrated traditional Chinese (TCM) and Western medicine (WM) therapy for acute hypertensive ICH. Randomized controlled trials were searched in PubMed, Medline, Embase, Wanfang and CNKI database published between January 2000 and June 2016. Our results showed that integrated TCM and WM therapy appeared to be able to improve the clinical effect for patients with acute hypertensive ICH...
August 28, 2016: Artificial Cells, Nanomedicine, and Biotechnology
Jessica Kepplinger, Kristian Barlinn, Stefanie Deckert, Madlen Scheibe, Ulf Bodechtel, Jochen Schmitt
OBJECTIVE: The aim of this systematic review and meta-analysis was to evaluate the safety and efficacy of IV thrombolysis (IVT) with tissue plasminogen activator (tPA) delivered through telestroke networks in patients with acute ischemic stroke. METHODS: We conducted a systematic review and meta-analysis according to PRISMA guidelines. Literature searches on MEDLINE, Embase, and CENTRAL databases covered prospective randomized controlled and nonrandomized studies comparing telemedicine-guided IVT to IVT administered at stroke centers and were published from the earliest date available until April 1, 2015...
September 27, 2016: Neurology
X Ye, B Ye
Although the Val34Leu polymorphism in blood coagulation factor XIII-A (FXIII-A) has been implicated in the pathogenesis of intracerebral hemorrhage (ICH), the results of research conducted thus far have been inconclusive. In this meta-analysis, we have assessed the association between the FXIII-A Val34Leu polymorphism and ICH risk. Published reports pertaining to this association were retrieved from the PubMed database, and the data from these studies were pooled and statistically analyzed with Stata 12.0. Summary odds ratios (OR) and 95% confidence intervals (95%CI) were calculated according to a fixed-effect or a random-effect model (as appropriate)...
2016: Genetics and Molecular Research: GMR
Min Chen, Lingfeng Lai, Xifeng Li, Xin Zhang, Xuying He, Wenchao Liu, Ran Li, Xunchang Ke, Chuanyi Fu, Zhiwei Huang, Chuanzhi Duan
Previous studies have demonstrated that baicalein has protective effects against several diseases, which including ischemic stroke. The effect of baicalein on the blood-brain barrier (BBB) in intracerebral hemorrhage (ICH) and its related mechanisms are not well understood. We aimed to investigate the mechanisms by which baicalein may influence the BBB in a rat model of ICH. The rat model of ICH was induced by intravenous injection of collagenase IV into the brain. Animals were randomly divided into three groups: sham operation, vehicle, and baicalein group...
August 12, 2016: Neurochemical Research
Hirotomo Yamanashi, Mai Quang Ngoc, Tran Van Huy, Motoi Suzuki, Akira Tsujino, Michiko Toizumi, Kensuke Takahashi, Vu Dinh Thiem, Dang Duc Anh, Nguyen Thi Hien Anh, Le Huu Tho, Takahiro Maeda, Sharon E Cox, Lay-Myint Yoshida, Koya Ariyoshi
INTRODUCTION: Stroke incidence data with methodologically acceptable design in Southeast Asia countries is limited. This study aimed to determine incidence of age-, sex- and subtype-specific first-ever stroke (FES) in Vietnam. METHODS: We conducted a hospital-based retrospective study, targeting all stroke cases hospitalized at a solo-provider hospital in our study site of Nha Trang from January 2009 to December 2011 with International Classification of Diseases, 10th revision (ICD-10) codes I60-69...
2016: PloS One
Andreas Charidimou, Marco Pasi, Marco Fiorelli, Sara Shams, Rüdiger von Kummer, Leonardo Pantoni, Natalia Rost
BACKGROUND AND PURPOSE: We performed a meta-analysis to assess whether leukoaraiosis on brain computed tomographic scans of acute ischemic stroke patients treated with intravenous thrombolysis is associated with an increased risk of symptomatic intracerebral hemorrhage (sICH) or poor functional outcome at 3 to 6 months after stroke, or both. METHODS: We searched PubMed and pooled relevant data in meta-analyses using random effects models. Using odds ratios (OR), we quantified the strength of association between the presence and severity of leukoaraiosis and post-thrombolysis sICH or 3- to 6-month modified Rankin Score >2...
September 2016: Stroke; a Journal of Cerebral Circulation
Jingxia Guan, Shaofeng Zhang, Qin Zhou, Zhenhua Yuan, Zuneng Lu
OBJECTIVE: To investigate the effect of thrombin preconditioning (TPC) on the intracerebral hemorrhage (ICH)-induced proliferation, migration, and function of subventriclular zone (SVZ) cells and to find new strategies that enhance endogenous neurogenesis after ICH. METHODS: Male Sprague-Dawley rats were randomly divided into 3 groups (ICH, TPC, and control group). Rats of each group were randomly divided into 5 subgroups (3-d, 7-d, 14-d, 21-d, and 28-d subgroup)...
September 2016: Neurological Research
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