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Intracerebral hemorrhage randomized

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https://www.readbyqxmd.com/read/28525977/the-intracerebral-hemorrhage-acutely-decreasing-arterial-pressure-trial-ii-ich-adapt-ii-protocol
#1
Laura Gioia, Ana Klahr, Mahesh Kate, Brian Buck, Dariush Dowlatshahi, Thomas Jeerakathil, Derek Emery, Kenneth Butcher
BACKGROUND: Aggressively lowering blood pressure (BP) in acute intracerebral hemorrhage (ICH) may improve outcome. Although there is no evidence that BP reduction changes cerebral blood flow, retrospective magnetic resonance imaging (MRI) studies have demonstrated sub-acute ischemic lesions in ICH patients. The primary aim of this study is to assess ischemic lesion development in patients randomized to two different BP treatment strategies. We hypothesize aggressive BP reduction is not associated with ischemic injury after ICH...
May 19, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28512445/the-therapeutic-value-of-bone-marrow-derived-endothelial-progenitor-cell-transplantation-after-intracerebral-hemorrhage-in-rats
#2
Rui Zhang, Jing Yang, Jingjing Yuan, Bo Song, Yan Wang, Yuming Xu
AIMS: To study the effect of endothelial progenitor cell (EPC) treatment on intracerebral hemorrhage (ICH) in rats and elucidate possible mechanisms. METHODS: The rats were randomly divided into three groups: (1) EPC group: ICH + EPC, (2) phosphate-buffered saline group: ICH + PBS, and (3) sham group. EPCs were transplanted intravenously 6 h after ICH. Modified neurological severity score was used to evaluate neurological function. Blood-brain barrier (BBB) integrity was evaluated...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28507269/randomized-multicenter-trial-of-artss-2-argatroban-with-recombinant-tissue-plasminogen-activator-for-acute-stroke
#3
Andrew D Barreto, Gary A Ford, Loren Shen, Claudia Pedroza, Jon Tyson, Chunyan Cai, Mohammad H Rahbar, James C Grotta
BACKGROUND AND PURPOSE: We conducted a randomized exploratory study to assess safety and the probability of a favorable outcome with adjunctive argatroban, a direct thrombin-inhibitor, administered to recombinant tissue-type plasminogen activator (r-tPA)-treated ischemic stroke patients. METHODS: Patients treated with standard-dose r-tPA, not receiving endovascular therapy, were randomized to receive no argatroban or argatroban (100 μg/kg bolus) followed by infusion of either 1 (low dose) or 3 μg/kg per minute (high dose) for 48 hours...
May 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28505619/bone-marrow-mesenchymal-stem-cell-transplantation-increases-gap-43-expression-via-erk1-2-and-pi3k-akt-pathways-in-intracerebral-hemorrhage
#4
Jianzhong Cui, Changmeng Cui, Ying Cui, Ran Li, Huaxin Sheng, Xiaohua Jiang, Yanxia Tian, Kaijie Wang, Junling Gao
BACKGROUND/AIMS: Intracerebral hemorrhage (ICH) occurs in hypertensive patients and results in high rates of mortality and disability. This study determined whether bone marrow mesenchymal stem cell (BMSC) transplantation affects axonal regeneration and examined the underlying mechanisms after the administration of PD98059 (p-ERK1/2 inhibitor) or/ and LY294002 (PI3K inhibitor). The hypothesis that was intended to be tested was that BMSC transplantation regulates the expression of growth-associated protein-43 (GAP-43) via the ERK1/2 and PI3K/Akt signaling pathways...
May 12, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28485276/left-atrial-appendage-occlusion-versus-standard-medical-care-in-patients-with-atrial-fibrillation-and-intracerebral-hemorrhage-a-propensity-score-matched-follow-up-study
#5
Jens Erik Nielsen-Kudsk, Søren Paaske Johnsen, Per Wester, Dorte Damgaard, Juhani Airaksinen, Juha Lund, Ole De Backer, Sami Pakarinen, Jacob Odenstedt, Saila Vikman, Magnus Settergren, Ole Kongstad, Mårten Rosenqvist, Derk W Krieger
AIMS: The aim of this study was to investigate the prognosis in patients with atrial fibrillation (AF) and intracerebral hemorrhage (ICH) having a left atrial appendage occlusion (LAAO) versus patients receiving standard medical therapy. METHODS AND RESULTS: A total of 151 patients from the Nordic countries with AF and previous ICH who underwent LAAO using the Amplatzer Cardiac Plug or the Amplatzer Amulet were compared to a propensity score matched group of 151 patients receiving standard medical therapy...
May 9, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28471961/efficacy-and-safety-of-desmoteplase-in-acute-ischemic-stroke-patients-a-systematic-review-and-meta-analysis
#6
Xiaoqiang Li, Li Ling, Chuqiao Li, Qiujie Ma
BACKGROUND: Pending results from double-blind, multicenter, parallel-group, randomized trials, the benefit and safety of the novel plasminogen activator, desmoteplase remain undetermined. The aim of this meta-analysis was to help evaluate desmoteplase's efficacy and safety. METHODS: A thorough search was performed of the Cochrane Library, PubMed, and Embase from the inception of electronic data to March 2017, and double-blind, multicenter, parallel-group, randomized trials were chosen...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28471607/patient-outcomes-with-stent-retriever-thrombectomy-for-anterior-circulation-stroke-a-meta-analysis-and-review-of-the-literature
#7
Rotem Sivan-Hoffmann, Benjamin Gory, Muriel Rabilloud, Dorin N Gherasim, Xavier Armoiry, Roberto Riva, Paul-Emile Labeyrie, Udi Gonike-Sadeh, Islam Eldesouky, Francis Turjman
Mechanical thrombectomy with stent retrievers is now the reference therapy for acute ischemic stroke (AIS) in the anterior circulation in association with thrombolysis. We conducted an extensive systematic review and meta-analysis to evaluate the clinical and angiographic outcomes of stent-retriever thrombectomy in patients with acute anterior circulation stroke. Available literature published to date on observational studies and three randomized trials (MR CLEAN, ESCAPE, and EXTEND-IA) involving the stent-retriever device were reviewed...
September 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28462672/effects-of-deferoxamine-mesylate-on-hematoma-and-perihematoma-edema-after-traumatic-intracerebral-hemorrhage
#8
Jian Yu, Qiang Yuan, Yi-Rui Sun, Xing Wu, Zhou-Ying Du, Zhi-Qi Li, Xue-Hai Wu, Liang-Fu Zhou, Gang Wu, Jin Hu
This study evaluated the effects of deferoxamine mesylate on hematoma and edema absorption after traumatic intracerebral hemorrhage (TICH). Patients with isolated TICH were enrolled prospectively from January 2010 to December 2016. Patients were divided non-randomly into an experimental or control group, as decided by the attending neurosurgeon. Patients in the experimental group received intravenous deferoxamine mesylate (20 mg/kg daily) from the day of admission for five consecutive days. We evaluated the impact of deferoxamine mesylate on the change in edema volume and the absorption of hematoma volume using a propensity score-matched analysis...
May 2, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28454980/are-the-results-of-intravenous-thrombolysis-trials-reproduced-in-clinical-practice-comparison-of-observed-and-expected-outcomes-with-the-stroke-thrombolytic-predictive-instrument-stpi
#9
A Decourcelle, S Moulin, N Dequatre-Ponchelle, M Bodenant, C Rossi, M Girot, H Hénon, E Wiel, R Bordet, P Goldstein, J P Pruvo, C Cordonnier, D Leys
AIM: In patients with cerebral ischemia, intravenous (i.v.) recombinant tissue plasminogen activator (rt-PA) increases survival without handicap or dependency despite an increased risk of bleeding. This study evaluated whether the results of randomized controlled trials are reproduced in clinical practice. METHOD: Data from a registry of consecutive patients treated by rt-PA at Lille University Hospital were retrospectively analyzed for outcomes, using modified Rankin Scale (mRS) scores, at 3 months...
April 25, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28395933/electroacupuncture-improves-neurobehavioral-function-and-brain-injury-in-rat-model-of-intracerebral-hemorrhage
#10
Yan Zhu, Li Deng, Huajun Tang, Xiaoqing Gao, Youhua Wang, Kan Guo, Jiming Kong, Chaoxian Yang
Acupuncture has been widely used as a treatment for stroke in China for a long time. Recently, studies have demonstrated that electroacupuncture (EA) can accelerate intracerebral hemorrhage (ICH)-induced angiogenesis in rats. In the present study, we investigated the effect of EA on neurobehavioral function and brain injury in ICH rats. ICH was induced by stereotactic injection of collagenase type I and heparin into the right caudate putamen. Adult ICH rats were randomly divided into the following three groups: model control group (MC), EA at non-acupoint points group (non-acupoint EA) and EA at Baihui and Dazhui acupoints group (EA)...
April 7, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28389617/a-dedicated-spanish-language-line-increases-enrollment-of-hispanics-into-prehospital-clinical-research
#11
Nerses Sanossian, Lauren Rosenberg, David S Liebeskind, Sidney Starkman, Marc Eckstein, Samuel Stratton, Franklin D Pratt, Scott Hamilton, May Kim-Tenser, Latisha K Sharma, Lucas Restrepo, Miguel Valdes-Suieras, Robin Conwit, Jeffrey L Saver
BACKGROUND AND PURPOSE: Novel methods are needed to reduce the disparity of Hispanic enrollment in stroke clinical trials. Prehospital enrollment using a dedicated Spanish language line may help overcome this bias. METHODS: Subjects or legally authorized representatives provided information on race and ethnicity for all cases enrolled in the FAST-MAG clinical trial (Field Administration of Stroke Therapy-Magnesium), a prehospital phase 3 randomized study of intravenous magnesium for neuroprotection...
May 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28387618/effectiveness-of-endoscopic-surgery-for-supratentorial-hypertensive-intracerebral-hemorrhage-a-comparison-with-craniotomy
#12
Xinghua Xu, Xiaolei Chen, Fangye Li, Xuan Zheng, Qun Wang, Guochen Sun, Jun Zhang, Bainan Xu
OBJECTIVE The goal of this study was to investigate the effectiveness and practicality of endoscopic surgery for treatment of supratentorial hypertensive intracerebral hemorrhage (HICH) compared with traditional craniotomy. METHODS The authors retrospectively analyzed 151 consecutive patients who were operated on for treatment of supratentorial HICH between January 2009 and June 2014 in the Department of Neurosurgery at Chinese PLA General Hospital. Patients were separated into an endoscopy group (82 cases) and a craniotomy group (69 cases), depending on the surgery they received...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28381202/tranexamic-acid-for-acute-intracerebral-hemorrhage-growth-predicted-by-spot-sign-trial-rationale-and-design
#13
Liping Liu, Yilong Wang, Xia Meng, Na Li, Ying Tan, Ximing Nie, Dacheng Liu, Xingquan Zhao
Rationale Acute intracerebral hemorrhage inflicts a high-economic and -health burden. Computed tomography angiography spot sign is a predictor of hematoma expansion, is associated with poor clinical outcome and is an important stratifying variable for patients treated with haemostatic therapy. Aims We aim to compare the effect of treatment with tranexamic acid to placebo for the prevention of hemorrhage growth in patients with high-risk acute intracerebral hemorrhage with a positive spot sign. Design The tranexamic acid for acute intracerebral hemorrhage growth predicted by spot sign (TRAIGE) is a prospective, multicenter, placebo-controlled, double-blind, investigator-led, randomized clinical trial that will include an estimated 240 participants...
April 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28365434/ultra-early-angiographic-vasospasm-after-aneurysmal-subarachnoid-hemorrhage-a%C3%A2-systematic-review-and-meta-analysis
#14
REVIEW
Kevin Phan, Justin M Moore, Christoph J Griessenauer, Joshua Xu, Ian Teng, Adam A Dmytriw, Albert H Chiu, Christopher S Ogilvy, Ajith Thomas
OBJECTIVE: After aneurysmal subarachnoid hemorrhage (aSAH), prognosis is affected heavily by the presence of delayed cerebral ischemia (DCI). There is growing recognition of ultra-early angiographic vasospasm (UEAV) occurring within 48 hours of aSAH; however, its relationship with DCI and ultimately prognosis remains unclear. METHODS: Various databases limited to the English language through September 2016 were searched systematically. Eligible studies were those comparing UEAV with control non-UEAV outcomes and follow-up...
March 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28361971/pg2-for-patients-with-acute-spontaneous-intracerebral-hemorrhage-a-double-blind-randomized-placebo-controlled-study
#15
Chun-Chung Chen, XianXiu Chen, Tsai-Chung Li, Hung-Lin Lin, Yen-Tze Chu, Han-Chung Lee, Yu-Kai Cheng, Der-Cherng Chen, Shiu-Chiu Tsai, Der-Yang Cho, Ching-Liang Hsieh
PG2 is an infusible polysaccharide extracted from Astragalus membranaceus, which is a Chinese herb traditionally used for stroke treatment. We investigated the effect of PG2 on patients with spontaneous acute intracerebral hemorrhage (ICH). A total of 61 patients with acute spontaneous ICH were randomized to either the treatment group (TG, 30 patients), which received 3 doses of PG2 (500 mg, IV) per week for 2 weeks, or the control group (CG, 31 patients), which received PG2 placebo. At 84 days after PG2 administration, the percentage of patients with a good Glasgow outcome scale (GOS 4-5) score in the TG was similar to that in the CG (69...
March 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28343893/local-hemostatic-matrix-for-endoscope-assisted-removal-of-intracerebral-hemorrhage-is-safe-and-effective
#16
Hui-Tzung Luh, Abel Po-Hao Huang, Shih-Hung Yang, Chien-Ming Chen, Der-Yang Cho, Chun-Chung Chen, Lu-Ting Kuo, Chieh-Hsun Li, Kuo-Chuan Wang, Wei-Lung Tseng, Ming-Tai Hsing, Bing-Shiang Yang, Dar-Ming Lai, Jui-Chang Tsai
BACKGROUND/PURPOSE: Minimally invasive endoscope-assisted (MIE) evacuation of spontaneous intracerebral hemorrhage (ICH) is simple and effective, but the limited working space may hinder meticulous hemostasis and might lead to rebleeding. Management of intraoperative hemorrhage is therefore a critical issue of this study. This study presents experience in the treatment of patients with various types of ICH by MIE evacuation followed by direct local injection of FloSeal Hemostatic Matrix (Baxter Healthcare Corp, Fremont, CA, USA) for hemostasis...
March 23, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28303440/the-efficacy-and-safety-of-high-dose-statins-in-acute-phase-of-ischemic-stroke-and-transient-ischemic-attack-a-systematic-review
#17
Jing-Xue Fang, Er-Qiang Wang, Wei Wang, Yang Liu, Gang Cheng
Inconsistent findings in the studies have been observed concerning the higher dose of statins use in the acute phase of ischemic stroke and transient ischemic attack (TIA). Therefore, we performed a systematic review to assess this issue. A computerized literature search in PubMed, Cochrane Library databases, and EMBASE for randomized controlled trials (RCTs) was conducted. The efficacy outcome indicators were National Institutes of Health Stroke Scale (NIHSS) score, infarct volume, and recurrence of stroke; the safety outcome indicators were intracranial hemorrhage events, cardiovascular and cerebrovascular events, and all-cause death...
March 16, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28293215/classification-of-different-degrees-of-disability-following-intracerebral-hemorrhage-a-decision-tree-analysis-from-vista-ich-collaboration
#18
Thanh G Phan, Jian Chen, Richard Beare, Henry Ma, Benjamin Clissold, John Van Ly, Velandai Srikanth
BACKGROUND AND PURPOSE: Prognostication following intracerebral hemorrhage (ICH) has focused on poor outcome at the expense of lumping together mild and moderate disability. We aimed to develop a novel approach at classifying a range of disability following ICH. METHODS: The Virtual International Stroke Trial Archive collaboration database was searched for patients with ICH and known volume of ICH on baseline CT scans. Disability was partitioned into mild [modified Rankin Scale (mRS) at 90 days of 0-2], moderate (mRS = 3-4), and severe disabilities (mRS = 5-6)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28289240/pais-2-paracetamol-acetaminophen-in-stroke-2-results-of-a-randomized-double-blind-placebo-controlled-clinical-trial
#19
Inger R de Ridder, Heleen M den Hertog, H Maarten A van Gemert, A H C M L Tobien Schreuder, Annemieke Ruitenberg, E Lisette Maasland, Ritu Saxena, Jordie H van Tuijl, Ben P W Jansen, Renske M Van den Berg-Vos, Frederique Vermeij, Peter J Koudstaal, L Jaap Kappelle, Ale Algra, H Bart van der Worp, Diederik W J Dippel
BACKGROUND AND PURPOSE: Subfebrile body temperature and fever in the first days after stroke are strongly associated with unfavorable outcome. A subgroup analysis of a previous trial suggested that early treatment with paracetamol may improve functional outcome in patients with acute stroke and a body temperature of ≥36.5°C. In the present trial, we aimed to confirm this finding. METHODS: PAIS 2 (Paracetamol [Acetaminophen] in Stroke 2) was a multicenter, randomized, double-blind, placebo-controlled clinical trial...
March 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28275541/pitchperfect-primary-intracranial-hemorrhage-probability-estimation-using-random-forests-on-ct
#20
John Muschelli, Elizabeth M Sweeney, Natalie L Ullman, Paul Vespa, Daniel F Hanley, Ciprian M Crainiceanu
INTRODUCTION: Intracerebral hemorrhage (ICH), where a blood vessel ruptures into areas of the brain, accounts for approximately 10-15% of all strokes. X-ray computed tomography (CT) scanning is largely used to assess the location and volume of these hemorrhages. Manual segmentation of the CT scan using planimetry by an expert reader is the gold standard for volume estimation, but is time-consuming and has within- and across-reader variability. We propose a fully automated segmentation approach using a random forest algorithm with features extracted from X-ray computed tomography (CT) scans...
2017: NeuroImage: Clinical
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