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hypercoagulable states and stroke

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https://www.readbyqxmd.com/read/29800263/plasmapheresis-for-management-of-antiphospholipid-syndrome-in-the-neurosurgical-patient
#1
Eric J Arias, Brent Bruck, Ananth K Vellimana, Charles Eby, Matthew R Reynolds, Morey A Blinder, Gregory J Zipfel
BACKGROUND AND IMPORTANCE: Antiphospholipid syndrome (APS) is an autoimmune disorder associated with a hypercoagulable state and increased risk of intraoperative and postoperative thrombosis. Few neurosurgical studies have examined the management of these patients, though the standard of care in most other disciplines involves the use of anticoagulation therapy. However, this is associated with risks such as hemorrhage, thrombosis due to warfarin withdrawal, and is not compatible with operative intervention...
May 24, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29710026/-embolic-stroke-immediately-after-initial-administration-of-intravitreal-aflibercept
#2
Hironori Mizutani, Yuichiro Inatomi, Takaomi Singu, Makoto Nakajima, Toshiro Yonehara, Yukio Ando
A 72-year-old man was admitted to our hospital because of right upper limb monoplegia 8 hours after the initial intravitreal injection of aflibercept, which is an inhibitor of vascular endothelial growth factor. Magnetic resonance diffusion-weighted images showed recent ischemic lesions in the left corona radiata and the right superior frontal gyrus. Laboratory findings showed mild hyperfibrinolysis. A patent foramen ovale was diagnosed on transesophageal echocardiography; however, lower-extremity ultrasonography did not detect deep vein thrombosis...
April 28, 2018: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29695176/markers-of-thrombin-generation-are-associated-with-long-term-clinical-outcome-in-patients-with-st-segment-elevation-myocardial-infarction
#3
Charlotte Holst Hansen, Vibeke Ritschel, Geir Øystein Andersen, Sigrun Halvorsen, Jan Eritsland, Harald Arnesen, Ingebjørg Seljeflot
Hypercoagulability in ST-segment elevation myocardial infarction (STEMI) as related to long-term clinical outcome is not clarified. We aimed to investigate whether prothrombin fragment 1+2 (F1+2), d-dimer, and endogenous thrombin potential (ETP) measured in the acute phase of STEMI were associated with outcome. Blood samples were drawn median 24 hours after symptom onset in 987 patients with STEMI. Median follow-up time was 4.6 years. Primary outcome was a composite of all-cause mortality, reinfarction, stroke, unscheduled revascularization, or rehospitalization for heart failure; secondary outcome was total mortality...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29678837/infections-and-risk-of-peripartum-stroke-during-delivery-admissions
#4
Eliza C Miller, Marisa Gallo, Erin R Kulick, Alexander M Friedman, Mitchell S V Elkind, Amelia K Boehme
BACKGROUND AND PURPOSE: Peripartum strokes during delivery admissions are rare but have high maternal morbidity. Infections have been proposed as a possible stroke trigger. We hypothesized that women who had infections diagnosed at the time of delivery admission would have higher risk of stroke during their delivery hospitalization. METHODS: We conducted a case-control study using state inpatient administrative databases for California (2007-2011), Florida (2009-2011), and New York (2009-2011)...
May 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29576872/pfo-closure-in-high-risk-patient-with-paradoxical-arterial-embolism-deep-vein-thrombosis-pulmonary-embolism-and-factor-v-leiden-genetic-mutation
#5
A Parikh, T P Vacek
Occurrence of paradoxical arterial embolism may cause the first symptoms in patients with a coexisting hypercoagulable state and patent foramen ovale (PFO). This can result in significant morbidity and mortality depending on the location of the embolism. The risks and benefits of closure of small PFOs have not been well elucidated in prior studies. We describe a patient with a history of Factor V Leiden heterozygosity who presented with left arm pain secondary to arterial embolism. The patient was a 51-year-old male who initially presented to the emergency department after awaking from sleep with progressive, severe, burning left arm pain...
March 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29501267/paradoxical-cerebral-embolism-after-gastrointestinal-endoscopy-in-a-patient-with-crohn-s-disease
#6
Hajime Ikenouchi, Naoto Sugeno, Takaaki Nakamura, Junpei Kobayashi, Ryuji Oshima, Hiroshi Kuroda, Masashi Aoki
Development of paradoxical cerebral embolism requires both unstable venous thrombosis and right-to-left shunt (RLS). Gastrointestinal endoscopy (GE) has the potential to affect intrathoracic and abdominal venous thrombi and to enhance RLS because the procedure alters intrathoracic and abdominal pressure. We describe a patient with Crohn's disease who developed paradoxical cerebral embolism after GE. Both an unstable venous thrombus in the superior vena cava and RLS through patent foramen ovale were thought to be responsible for the stroke...
February 28, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29480382/prothrombotic-factors-do-not-increase-the-risk-of-recurrent-ischemic-events-after-cryptogenic-stroke-at-young-age-the-future-study
#7
Mijntje M I Schellekens, Mayte E van Alebeek, Renate M Arntz, Nathalie E Synhaeve, Noortje A M M Maaijwee, Hennie C Schoonderwaldt, Maureen J van der Vlugt, Ewoud J van Dijk, Loes C A Rutten-Jacobs, Frank-Erik de Leeuw
BACKGROUND: The role of hypercoagulable states and preceding infections in the etiology of young stroke and their role in developing recurrent ischemic events remains unclear. Our aim is to determine the prevalence of these conditions in patients with cryptogenic stroke at young age and to assess the long-term risk of recurrent ischemic events in patients with and without a hypercoagulable state or a recent pre-stroke infection with Borrelia or Syphilis. PATIENTS AND METHODS: We prospectively included patients with a first-ever transient ischemic attack or ischemic stroke, aged 18-50, admitted to our hospital between 1995 and 2010...
May 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29431623/prevalence-and-risk-factors-for-venous-thromboembolism-in-children-with-sickle-cell-disease-an-administrative-database-study
#8
Riten Kumar, Joseph Stanek, Susan Creary, Amy Dunn, Sarah H O'Brien
A hypercoagulable state resulting in increased venous thromboembolism (VTE) has been described in adults with sickle cell disease (SCD), but similar data for children are lacking. The objective of this retrospective cohort study was to describe the rate of VTE and risk factors associated with VTE in children with SCD across tertiary-care children's hospitals in the United States between the years 2009 and 2015. We used the Pediatric Health Information System database to investigate all pediatric patients with SCD admitted to 1 of 48 participating institutions between 1 January 2009 and 30 September 2015...
February 13, 2018: Blood Advances
https://www.readbyqxmd.com/read/29378443/thrombolysis-in-pregnancy-a-literature-review
#9
Marina Sousa Gomes, Mariana Guimarães, Nuno Montenegro
BACKGROUND: Changes in the coagulation system during pregnancy and puerperium produce a physiological hypercoagulable state. These changes are thought to be the cause of the higher rates of deep vein thrombosis (DVT), pulmonary embolism (PE), stroke, and mechanical prosthetic valve thrombosis (PVT) during pregnancy. Thrombolysis can be a treatment option in this case. However, there are no available data from randomized controlled trials in pregnant patients and information about the security of thrombolytics in pregnancy is missing...
February 11, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29373226/multiple-cerebral-infarctions-due-to-patent-foramen-ovale-in-a-patient-with-eosinophilic-granulomatosis-with-polyangiitis
#10
Kota Maekawa, Masunari Shibata, Masaru Seguchi, Kazuto Kobayashi, Yutaka Naito, Fumitaka Miya
A 51-year-old man was diagnosed with eosinophilic granulomatosis with polyangiitis 6 years ago due to asthma, sinusitis, hypereosinophilia, and peripheral neuropathy based on the diagnostic criteria of American College of Rheumatology, and corticosteroid therapy achieved a remission. One year ago, he was hospitalized due to deep venous thrombosis (DVT) and pulmonary embolism, and rivaroxaban was administrated. He was admitted to our hospital for acute onset of diplopia and right hemiparesis. Peripheral blood examinations disclosed leukocytosis with hypereosinophilia...
January 17, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29370976/risk-factors-in-childhood-arterial-ischaemic-stroke-findings-from-a-population-based-study-in-germany
#11
Lucia Gerstl, Raphael Weinberger, Ruediger von Kries, Florian Heinen, A Sebastian Schroeder, Michaela V Bonfert, Ingo Borggraefe, Moritz Tacke, Katharina Vill, Mirjam N Landgraf, Karin Kurnik, Martin Olivieri
OBJECTIVE: Acute treatment of childhood arterial ischaemic stroke and prevention strategies for recurrent stroke episodes depend strongly on each child's individual risk profile. The aim of this study is to characterize risk factors for childhood stroke, their occurrence in isolation or combination, and to identify possible common risk factor patterns. METHODS: This population-based study was conducted via ESPED, a surveillance unit for rare paediatric diseases in Germany...
May 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29260427/efficacy-and-safety-of-dabigatran-in-patients-with-atrial-fibrillation-scheduled-for-transoesophageal-echocardiogram-guided-direct-electrical-current-cardioversion-a-prospective-propensity-score-matched-cohort-study
#12
Vincenzo Russo, Anna Rago, Andrea Antonio Papa, Antonio D'Onofrio, Paolo Golino, Gerardo Nigro
Patients with atrial fibrillation (AF) are predisposed to a hypercoagulable state and are at an increased risk for thromboembolic events when undergoing procedures. This study investigated the long-term efficacy and safety of newly initiated anticoagulation with dabigatran versus uninterrupted vitamin K antagonist (VKA) therapy in patients with AF scheduled for transesophageal echocardiogram (TEE)-guided direct electrical current cardioversion (DCC). Consecutive adult patients with persistent AF scheduled to undergo DCC were included in the study...
February 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29224120/spontaneous-cervical-artery-dissection-is-accompanied-by-a-hypercoagulable-state-and-simultaneous-inflammatory-condition
#13
Johann Otto Pelz, Kristian Harms, Michael Metze, Dominik Michalski
BACKGROUND: Spontaneous cervical artery dissections (sCAD) are often preceded by infections. However, existing data about inflammatory parameters remained inconsistent. Remarkably, concurrent information about the coagulation system, whose affection seems also reasonable to cause ischaemic events, are still lacking in sCAD patients. Thus, this study explores the association between the inflammatory and coagulation system in patients with sCAD. METHODS: The parameters leukocyte and thrombocyte count, C-reactive protein, fibrinogen, D-dimer, activated partial thromboplastin time (aPTT) and prothrombin time were extracted from hospital-based medical records of patients (n = 60) with sCAD and compared with those of a control group (n = 97) from a prospective observational stroke study...
February 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29120877/antiphospholipid-antibody-syndrome-the-difficulties-of-diagnosis
#14
Kerry L Whitaker
Antiphospholipid antibody syndrome (APS) is an autoantibody-mediated thrombophilic disorder that causes a hypercoagulable state and can lead to venous thromboembolism, stroke, multiple miscarriages, and other pregnancy complications with the presence of antiphospholipid antibodies. This article reviews screening, diagnosis, and management of APS with a focus on the prevention of long-term complications.
December 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/29052104/anticoagulation-prescribing-patterns-in-patients-with-cancer
#15
Elaine Xiang, Tania Ahuja, Veronica Raco, Frank Cirrone, David Green, John Papadopoulos
Cancer is a known hypercoagulable state that leads to an increased risk of venous thromboembolism (VTE). Low molecular weight heparin remains the preferred anticoagulant for VTE in patients with cancer over vitamin K antagonist. However, the preferred anticoagulant in prevention of stroke and systemic embolism in atrial fibrillation (AF) in patients with cancer has yet to be determined. The direct oral anticoagulants (DOACs) are increasingly being utilized; however their role in cancer has only recently been investigated...
January 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29031496/ischemic-stroke-in-a-patient-with-parry-romberg-syndrome
#16
Victoria Ebiana, Sandeep Singh, Shaweta Khosa, Negar Moheb, Bhavesh Trikamji, Neal M Rao, Shri K Mishra
OBJECTIVE: This study aimed to discuss a case of a patient with a known diagnosis of Parry-Romberg syndrome (PRS) presenting with ischemic stroke, the second such reported case. BACKGROUND: PRS is a rare genetic disorder with progressive hemifacial atrophy, which usually presents within the first 2 decades of life. Neurologic manifestations include trigeminal neuralgia with associated deafness, hemifacial pain with associated migraine headaches, seizures, movement disorders, and neuropsychiatric symptoms...
January 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28983441/high-value-care-in-the-evaluation-of-stroke
#17
Prakrity Urja, Eric H Nippoldt, Virginia Barak, Carrie Valenta
Value-based care emphasizes achieving the greatest overall health benefit for every dollar spent. We present an interesting case of stroke, which made us consider how frequently health care providers are utilizing value-based care. A 73-year-old Caucasian, who was initially admitted for a hypertensive emergency, was transferred to our facility for worsening slurring of speech and left-sided weakness. The patient had an extensive chronic cerebrovascular disease, including multiple embolic type strokes, mainly in the distribution of the right temporal-occipital cerebral artery and transient ischemic attacks (TIAs)...
August 1, 2017: Curēus
https://www.readbyqxmd.com/read/28667815/pulmonary-thromboembolism-in-an-emergency-hospital-are-our-patients-different
#18
REVIEW
Ana Maria Balahura, Andrada Guţă, Vlad Mihalcea, Emma Weiss, Maria Dorobanţu, Daniela Bartoş, Elisabeta Bădilă, Gheorghe Andrei Dan
INTRODUCTION: Pulmonary thromboembolism (PTE) represents a medical emergency and is the third most common cause of mortality after myocardial infarction and stroke. The purpose of this study was to describe the characteristics and management of patients with PTE admitted in a referral emergency hospital in Romania. MATERIAL AND METHODS: We retrospectively reviewed all cases of PTE diagnosed in one of the largest emergency hospitals in Bucharest during a 2-year period (January 2014 - December 2016)...
December 1, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28644259/antiphospholipid-syndrome-with-a-distinctive-constellation-of-neurological-manifestations-blue-toes-red-valves-white-retinal-spots
#19
Brandon T Nokes, Oana M Dumitrascu, Fadi E Shamoun, Cumara B OʼCarroll
Antiphospholipid syndrome (APS) encompasses a hypercoagulable state with a markedly increased risk for cerebrovascular complications. In addition to the classic stroke features of APS, however, there are numerous recently described "non-criteria" neurological conditions such as headaches, seizures, and cognitive impairment. We present a case of APS with uncommon neurological manifestations.
July 2017: Neurologist
https://www.readbyqxmd.com/read/28538510/thalidomide-induced-stroke-in-a-child-with-thalassemia-major
#20
Sushil Gunaseelan, Anand Prakash
β-thalassemia major is a hereditary anemia resulting from defects in β-globin production. It is also characterized by a hypercoagulable state with an increased risk of thrombosis. Thalidomide, a drug known for its immunomodulating and antiangiogenic properties, has recently been demonstrated to induce γ-globin gene expression and to increase the proliferation of erythroid cells. An increasing incidence of thromboembolic events in thalidomide-treated patients has been reported. This is often in the context of thalidomide combinations with other drugs, including steroids and particularly anthracycline-based chemotherapy, and with very low incidence of thrombosis with single-agent thalidomide treatment...
November 2017: Journal of Pediatric Hematology/oncology
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