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hemorrhagic stroke

Torunn Varmdal, Imre Janszky, Inger J Bakken, Hanne Ellekjær, Hild Fjærtoft, Siri E Håberg, Kaare H Bønaa
Percutaneous coronary intervention (PCI) is a plausible triggering factor for stroke, yet the magnitude of this excess risk remains unclear. This study aimed to quantify the transient change in risk of stroke for up to 12 weeks after PCI. We applied the case-crossover method, using data from the Norwegian Patient Register on all hospitalizations in Norway in the period of 2008 to 2014. The relative risk (RR) of ischemic stroke was highest during the first 2 days after PCI (RR 17.5, 95% confidence interval [CI] 4...
September 29, 2016: American Journal of Cardiology
J Liu, H Yang, B Yu
OBJECTIVE: The objective of the present study was to determine the correlation between blood calcium level, hematoma volume and stroke severity in the prognosis of acute cerebral hemorrhage patients. PATIENTS AND METHODS: We selected 125 patients with acute cerebral hemorrhage admitted within 24 hours of symptom onset. Blood calcium levels were assessed by standard biochemical methods. Hematoma volume was measured by quantitative computed tomography. NIHSS (National Institutes of Health Stroke Scale) scores at one month, and the differences in survival rate and survival period at follow-up visits were assessed...
October 2016: European Review for Medical and Pharmacological Sciences
Eliza C Miller, Hajere J Gatollari, Gloria Too, Amelia K Boehme, Lisa Leffert, Mitchell S V Elkind, Joshua Z Willey
Importance: Older age is associated with increased risk of pregnancy-associated stroke (PAS). Data are limited on age-specific incidence ratios of PAS compared with stroke risk in nonpregnant women. Objectives: To assess the risk of stroke by age group in pregnant and postpartum women compared with their nonpregnant contemporaries and to compare risk factors across age groups in the exposed (pregnant/postpartum) and unexposed (nonpregnant) populations. Design, Setting, and Participants: International Classification of Diseases, Ninth Revision, billing codes from the calendar year 2003-2012 New York State Department of Health inpatient database and population data were used to identify all women aged 12 to 55 years with cerebrovascular events, including transient ischemic attack, ischemic and hemorrhagic stroke, cerebral venous thrombosis, and nonspecified PAS...
October 24, 2016: JAMA Neurology
Paul S Myles, Julian A Smith, Andrew Forbes, Brendan Silbert, Mohandas Jayarajah, Thomas Painter, D James Cooper, Silvana Marasco, John McNeil, Jean S Bussières, Shay McGuinness, Kelly Byrne, Matthew T V Chan, Giovanni Landoni, Sophie Wallace
Background Tranexamic acid reduces the risk of bleeding among patients undergoing cardiac surgery, but it is unclear whether this leads to improved outcomes. Furthermore, there are concerns that tranexamic acid may have prothrombotic and proconvulsant effects. Methods In a trial with a 2-by-2 factorial design, we randomly assigned patients who were scheduled to undergo coronary-artery surgery and were at risk for perioperative complications to receive aspirin or placebo and tranexamic acid or placebo. The results of the tranexamic acid comparison are reported here...
October 23, 2016: New England Journal of Medicine
Haruki Tokida, Yuhei Kanaya, Yutaka Shimoe, Shigeru Yamori, Koichi Tagawa, Masaru Kuriyama
We report a case of a 55-year-old man who developed acute-onset narrowing of his visual field. He showed right homonymous hemianopsia without any other neurological symptoms and signs. Brain CT and MRI showed localized hemorrhage (about 1.6 ml) in the left lateral geniculate body (LGB). A cerebral angiography showed no vascular anomalies of cerebral vessels, and the left anterior choroidal artery and left lateral posterior choroidal artery could be visualized well. He had hypertension, polycythemia and dyslipidemia and was a habitual smoker and an alcoholic...
October 21, 2016: Rinshō Shinkeigaku, Clinical Neurology
Yoshikazu Sawaguchi, Zuojun Wang
Recombinant tissue-type plasminogen activator (rt-PA) is effective and widely used in the treatment of acute ischemic stroke (AIS). However, symptomatic intracranial hemorrhage (ICH), an adverse reaction of rt-PA, is known to occur depending on underlying diseases and rt-PA doses, and to occur more frequently with a greater delay from stroke onset until initiation of rt-PA. Therefore, limitations on the use of rt-PA, such as having to be started within 4.5 hours of stroke onset, mean that rt-PA is only indicated in some stroke patients...
October 22, 2016: Biological & Pharmaceutical Bulletin
Shyam Sabat, Neil Mannering, Amit Agarwal
Hypertrophic Olivary Degeneration (HOD) is a rare neurological condition caused by trans-synaptic degeneration in the brainstem and cerebellum, resulting in varied clinical symptoms, classical being palatal tremors, along with characteristic imaging presentation. Large number of pathologic lesions can cause this condition, ranging from ischemic stroke to neoplasm. The most common conditions include hemorrhage, vascular malformations and infarct. Magnetic resonance scan (MRI) is the imaging modality of choice which shows signal changes with hypertrophy of the inferior olivary nucleus, as well as the primary underlying pathology...
November 15, 2016: Journal of the Neurological Sciences
Weiping Sun, Ying Xian, Yining Huang, Wei Sun, Ran Liu, Fan Li, Jade W Wei, Ji-Guang Wang, Ming Liu, Yangfeng Wu, Lawrence K S Wong, Craig S Anderson
OBJECTIVE: To evaluate the association of obesity measured by body mass index (BMI) with mortality and functional outcome in patients with acute intracerebral hemorrhage (ICH). METHODS: Data were from 1571 patients with ICH enrolled in a national, multi-centre, prospective, hospital-based register: the ChinaQUEST (Quality Evaluation of Stroke Care and Treatment) study. The outcomes included all-cause mortality at 12months, and death or high dependency at 3 and 12months...
November 15, 2016: Journal of the Neurological Sciences
Sung-Ho Ahn, Bum Joon Kim, Yeon-Jung Kim, Sun U Kwon, Jong S Kim, Dong-Wha Kang
BACKGROUND: It is still controversial whether early fluid-attenuated inversion recovery (FLAIR) hyperintensity within acute ischemic lesions carries the risk of hemorrhagic transformation (HT) after reperfusion therapy. Furthermore, the association between the location of FLAIR hyperintensity and HT has not been investigated. METHODS: We retrospectively reviewed patients who underwent reperfusion therapy within 6 hours of stroke onset and magnetic resonance imaging including a FLAIR sequence before completing reperfusion therapy...
October 19, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Jason Mackey, Jane C Khoury, Kathleen Alwell, Charles J Moomaw, Brett M Kissela, Matthew L Flaherty, Opeolu Adeoye, Daniel Woo, Simona Ferioli, Felipe De Los Rios La Rosa, Sharyl Martini, Pooja Khatri, Joseph P Broderick, Mario Zuccarello, Dawn Kleindorfer
OBJECTIVE: To characterize temporal trends in subarachnoid hemorrhage (SAH) incidence and outcomes over 5 time periods in a large population-based stroke study in the United States. METHODS: All SAHs among residents of the Greater Cincinnati/Northern Kentucky region at least 20 years of age were identified and verified via study physician review in 5 distinct year-long study periods between 1988 and 2010. We abstracted demographics, care patterns, and outcomes, and we compared incidence and case-fatality rates across the study periods...
October 21, 2016: Neurology
Maria Celeste Buompadre, Kathleen Andres, Lee-Anne Slater, Hadi Mohseni-Bod, Anne-Marie Guerguerian, Helen Branson, Suzanne Laughlin, Derek Armstrong, Mahendranath Moharir, Gabrielle deVeber, Tilman Humpl, Osami Honjo, Shaf Keshavjee, Rebecca Ichord, Vitor Pereira, Nomazulu Dlamini
The updated American Heart Association/American Stroke Association guidelines include recommendation for thrombectomy in certain adult stroke cases. The safety and efficacy of thrombectomy in children are unknown. An 8-year-old girl experienced acute stroke symptoms on two occasions while therapeutically anticoagulated on Novalung. Computed tomography scans showed proximal vessel thrombi, which were retrieved using a Trevo device without hemorrhagic complications. Postprocedural assessment found respective decreases in the National Institutes of Health Stroke Scale score from 10 to 4 and 12 to 7...
September 14, 2016: Pediatric Neurology
Wen Yea Hwong, Michiel L Bots, Sharmini Selvarajah, L Jaap Kappelle, Zariah Abdul Aziz, Norsima Nazifah Sidek, Ilonca Vaartjes
BACKGROUND: A shortage of computed tomographic (CT) machines in low and middle income countries often results in delayed CT imaging for patients suspected of a stroke. Yet, time constraint is one of the most important aspects for patients with an ischemic stroke to benefit from thrombolytic therapy. We set out to assess whether application of the Siriraj Stroke Score is able to assist physicians in prioritizing patients with a high probability of having an ischemic stroke for urgent CT imaging...
2016: PloS One
Cristina Rodríguez, Tomás Sobrino, Jesús Agulla, Verónica Bobo-Jiménez, María E Ramos-Araque, Juan J Duarte, José C Gómez-Sánchez, Juan P Bolaños, José Castillo, Ángeles Almeida
Intracerebral hemorrhage (ICH) is a devastating subtype of stroke that lacks effective therapy and reliable prognosis. Neovascularization following ICH is an essential compensatory response that mediates brain repair and modulates the clinical outcome of stroke patients. However, the mechanism that dictates this process is unknown. Bone marrow-derived endothelial progenitor cells (EPCs) promote endothelial repair and contribute to ischemia-induced neovascularization. The human Tp53 gene harbors a common single-nucleotide polymorphism (SNP) at codon 72, which yields an arginine-to-proline amino-acidic substitution (Arg72Pro) that modulates the apoptotic activity of the p53 protein...
October 21, 2016: Cell Death and Differentiation
Ramesh Kumar, Frederic W B Deleyiannis, Corbett Wilkinson, Brent R O'Neill
OBJECTIVE The authors' goals in this study were to describe a series of dog attacks on children that required neurosurgical consultation and to better understand the pattern of injuries inflicted, the circumstances that place children at risk for attack, and the dog breeds involved. In addition, the authors review the surgical and medical management of these patients. METHODS The authors performed a retrospective review of all children requiring neurosurgical consultation for dog bite at a regional Level 1 pediatric trauma center over a 15-year period...
October 21, 2016: Journal of Neurosurgery. Pediatrics
Viraj Suvarna
Stroke prevention in atrial fibrillation (AF) has reached an exciting phase with a plethora of newer, potentially more efficacious and safer agents being introduced for physicians to select from. Dabigatran belongs to a class of anticoagulants called direct thrombin inhibitors, while rivaroxaban, apixaban, and edoxaban are direct Factor Xa inhibitors. Purely from a therapeutic endpoint perspective-based on the action of anticoagulants in reducing cardioembolic stroke-in clinical trials, one should look at whether a new anticoagulant in patients with AF prevents ischemic stroke...
October 2016: Journal of the Association of Physicians of India
Peter N Lee, Alison J Thornton, Barbara A Forey, Jan S Hamling
OBJECTIVES: The study aimed to review the epidemiological evidence relating environmental tobacco smoke exposure to stroke in never smokers. METHODS: The study is similar to our review in 2006, with searches extended to March 2016. RESULTS: Twelve further studies were identified. A total of 28 studies varied considerably in design, exposure indices used, and disease definition. Based on 39 sex-specific estimates and the exposure index current spousal exposure (or nearest equivalent), the meta-analysis gave an overall fixed-effect relative risk estimate of 1...
October 17, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
L Deville, M Konan, A Hij, L Goldwirt, O Peyrony, F Fieux, P Faure, I Madelaine, S Villiers, D Farge-Bancel, C Frère
Direct oral anticoagulants (DAOC) are indicated for the treatment of venous thromboembolism and the prevention of stroke or systemic embolism in patients with non-valvular atrial fibrillation. Given their advantages and friendly use for patient, the prescription of long term DOAC therapy has rapidly increased both as first line treatment while initiating anticoagulation and as a substitute to vitamins K antagonist (VKA) in poorly controlled patients. However, DOAC therapy can also be associated with significant bleeding complications, and in the absence of specific antidote at disposal, treatment of serious hemorrhagic complications under DOAC remains complex...
July 2016: Current Research in Translational Medicine
Maral Ouzounian, Vivek Rao, Cedric Manlhiot, Nachum Abraham, Carolyn David, Christopher M Feindel, Tirone E David
BACKGROUND: Although aortic valve-sparing (AVS) operations are established alternatives to composite valve graft (CVG) procedures for patients with aortic root aneurysms, comparative long-term outcomes are lacking. OBJECTIVES: This study sought to compare the results of patients undergoing AVS procedures with those undergoing CVG operations. METHODS: From 1990 to 2010, a total of 616 patients age <70 years and without aortic stenosis underwent elective aortic root surgery (AVS, n = 253; CVG with a bioprosthesis [bio-CVG], n = 180; CVG with a mechanical prosthesis [m-CVG], n = 183)...
October 25, 2016: Journal of the American College of Cardiology
Joji Hagii, Hirofumi Tomita, Norifumi Metoki, Yoshiko Tamai, Shin Saito, Hiroshi Shiroto, Hiroyasu Hitomi, Takaatsu Kamada, Satoshi Seino, Koki Takahashi, Satoko Sasaki, Minoru Yasujima, Ken Okumura
INTRODUCTION: Patients with intracerebral hemorrhage during rivaroxaban treatment have small hematoma and favorable outcomes compared with those with warfarin. We investigated its possible mechanism, focusing on prothrombin fragment 1+2 (F1+2), a marker of thrombin generation. MATERIALS AND METHODS: In 65 patients with acute cardioembolic stroke (median 77years), rivaroxaban was initiated at 5days after the onset. Plasma F1+2 level (normal range, 69-229pmol/L), prothrombin time (PT), and rivaroxaban concentration evaluated by anti-Xa activity were serially measured...
October 13, 2016: Thrombosis Research
Sergio Amaro, Carlos Laredo, Arturo Renú, Laura Llull, Salvatore Rudilosso, Víctor Obach, Xabier Urra, Anna M Planas, Ángel Chamorro
BACKGROUND AND PURPOSE: Identification of neuroprotective therapies in acute ischemic stroke is imperative. We report a predefined analysis of the URICO-ICTUS trial (Efficacy Study of Combined Treatment With Uric Acid and r-tPA in Acute Ischemic Stroke) assessing the efficacy of uric acid (UA) compared with placebo to prevent early ischemic worsening (EIW) and the relevance of collateral circulation. METHODS: URICO-ICTUS was a double-blind, placebo-controlled, phase 2b trial where a total of 411 patients treated with alteplase within 4...
October 6, 2016: Stroke; a Journal of Cerebral Circulation
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