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intracerebral haemorrhage

Julia Masomi-Bornwassser, Fabio Freguia, Hendrik Müller-Werkmeister, Oliver Kempski, Alf Giese, Naureen Keric
OBJECTIVE: Although fibrinolytic therapy is an upcoming treatment for intracerebral haemorrhage (ICH), standard guidelines are lacking, and some clinical issues persist. Here, we used our recently devised clot model of ICH to systematically analyse effects of irrigation and cerebrospinal fluid (CSF) on fibrinolysis. METHODS: In vitro clots of human blood (25 ml) were generated and a catheter irrigation system was applied to deliver fluid/treatment. Clots were weighed before and after treatment and compared to rtPA treatment alone...
March 21, 2018: Acta Neurochirurgica
Benjamin D Bray, Lizz Paley, Alex Hoffman, Martin James, Patrick Gompertz, Charles D A Wolfe, Harry Hemingway, Anthony G Rudd
BACKGROUND: We aimed to estimate socioeconomic disparities in the incidence of hospitalisation for first-ever stroke, quality of care, and post-stroke survival for the adult population of England. METHODS: In this cohort study, we obtained data collected by a nationwide register on patients aged 18 years or older hospitalised for first-ever acute ischaemic stroke or primary intracerebral haemorrhage in England from July 1, 2013, to March 31, 2016. We classified socioeconomic status at the level of Lower Super Output Areas using the Index of Multiple Deprivation, a neighbourhood measure of deprivation...
March 14, 2018: Lancet. Public Health
Joji B Kuramatsu, Jochen A Sembill, Stefan T Gerner, Maximilian I Sprügel, Manuel Hagen, Sebastian S Roeder, Matthias Endres, Karl Georg Haeusler, Jan Sobesky, Johannes Schurig, Sarah Zweynert, Miriam Bauer, Peter Vajkoczy, Peter A Ringleb, Jan Purrucker, Timolaos Rizos, Jens Volkmann, Wolfgang Müllges, Peter Kraft, Anna-Lena Schubert, Frank Erbguth, Martin Nueckel, Peter D Schellinger, Jörg Glahn, Ulrich J Knappe, Gereon R Fink, Christian Dohmen, Henning Stetefeld, Anna Lena Fisse, Jens Minnerup, Georg Hagemann, Florian Rakers, Heinz Reichmann, Hauke Schneider, Sigrid Wöpking, Albert Christian Ludolph, Sebastian Stösser, Hermann Neugebauer, Joachim Röther, Peter Michels, Michael Schwarz, Gernot Reimann, Hansjörg Bäzner, Henning Schwert, Joseph Claßen, Dominik Michalski, Armin Grau, Frederick Palm, Christian Urbanek, Johannes C Wöhrle, Fahid Alshammari, Markus Horn, Dirk Bahner, Otto W Witte, Albrecht Günther, Gerhard F Hamann, Hannes Lücking, Arnd Dörfler, Stephan Achenbach, Stefan Schwab, Hagen B Huttner
Aims: Evidence is lacking regarding acute anticoagulation management in patients after intracerebral haemorrhage (ICH) with implanted mechanical heart valves (MHVs). Our objective was to investigate anticoagulation reversal and resumption strategies by evaluating incidences of haemorrhagic and thromboembolic complications, thereby defining an optimal time-window when to restart therapeutic anticoagulation (TA) in patients with MHV and ICH. Methods and results: We pooled individual patient-data (n = 2504) from a nationwide multicentre cohort-study (RETRACE, conducted at 22 German centres) and eventually identified MHV-patients (n = 137) with anticoagulation-associated ICH for outcome analyses...
February 24, 2018: European Heart Journal
Turgut Tatlisumak, Brett Cucchiara, Satoshi Kuroda, Scott E Kasner, Jukka Putaala
Nontraumatic intracerebral haemorrhage (ICH) is a common subtype of stroke with a poor prognosis, high mortality and long-term morbidity. The incidence of ICH increases with age. ICH has not been widely investigated in young adults (herein defined as aged ∼18-50 years) despite an annual incidence of ∼5 per 100,000 individuals. Furthermore, ICH characteristics differ between young and elderly patients. Risk factors for ICH are surprisingly common in young adults, in whom ICH is often caused by structural lesions or hypertension, and only rarely by anticoagulation therapy and cerebral amyloid angiopathy (which are common predisposing factors in elderly patients)...
March 9, 2018: Nature Reviews. Neurology
Hongyan Ding, Yanan Xie, Linxin Li, Heling Chu, Yuping Tang, Qiang Dong, Mei Cui
Background and purpose: Clinical features of epileptic seizures after cerebral venous sinus thrombosis (CVST) among Chinese patients are not known, and it is still controversial whether seizures would affect the outcome of CVST. Methods: In a Chinese hospital-based study of consecutive patients with CVST between 2003 and 2015, we described the clinical features of seizures and determined the predictors of seizure onset using multivariable logistic regression analysis...
December 2017: Stroke and Vascular Neurology
Rustam Al-Shahi Salman, Martin S Dennis, Gordon D Murray, Karen Innes, Jonathan Drever, Lynn Dinsmore, Carol Williams, Philip M White, William N Whiteley, Peter A G Sandercock, Cathie L M Sudlow, David E Newby, Nikola Sprigg, David J Werring
BACKGROUND: For adults surviving stroke due to spontaneous (non-traumatic) intracerebral haemorrhage (ICH) who had taken an antithrombotic (i.e. anticoagulant or antiplatelet) drug for the prevention of vaso-occlusive disease before the ICH, it is unclear whether starting antiplatelet drugs results in an increase in the risk of recurrent ICH or a beneficial net reduction of all serious vascular events compared to avoiding antiplatelet drugs. METHODS/DESIGN: The REstart or STop Antithrombotics Randomised Trial (RESTART) is an investigator-led, randomised, open, assessor-blind, parallel-group, randomised trial comparing starting versus avoiding antiplatelet drugs for adults surviving antithrombotic-associated ICH at 122 hospital sites in the United Kingdom...
March 5, 2018: Trials
Zane Jaunmuktane, Annelies Quaegebeur, Ricardo Taipa, Miguel Viana-Baptista, Raquel Barbosa, Carolin Koriath, Raf Sciot, Simon Mead, Sebastian Brandner
Amyloid-β (Aβ) is a peptide deposited in the brain parenchyma in Alzheimer's disease and in cerebral blood vessels, causing cerebral amyloid angiopathy (CAA). Aβ pathology is transmissible experimentally in animals and through medical procedures in humans, such as contaminated growth hormone or dura mater transplantation in the context of iatrogenic prion disease. Here, we present four patients who underwent neurosurgical procedures during childhood or teenage years and presented with intracerebral haemorrhage approximately three decades later, caused by severe CAA...
February 15, 2018: Acta Neuropathologica
Craig S Anderson
No abstract text is available yet for this article.
February 15, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
Hai-Qiao Wang, Gui-Rong Dong, Chun-Ling Bao, Zhi-Hua Jiao
OBJECTIVE: To investigate the immediate effect of scalp acupuncture on walking pattern, using three-dimensional gait analysis (3D-GA), among patients in the subacute stage of intracerebral haemorrhage (ICH). METHODS: A subset of 30 patients with subacute ICH participating in a recently published randomised controlled trial who were able to walk independently were assessed by 3D-GA before and immediately after scalp acupuncture treatment (treatment group) or no intervention (control group) and the results presented here as a secondary analysis...
February 12, 2018: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
Anderson Chun On Tsang, Derek Ping Hong Wong, Wah Cheuk, Kam Fuk Fok
We report a rare delayed complication of de novo pseudoaneurysm formation and rupture after stereotactic radiotherapy for cerebral arteriovenous malformation. The patient presented with intracerebral haemorrhage due to rupture of a pseudoaneurysm in the previously irradiated field, which was excised for histological examination. The literature was reviewed for similar cases.
February 12, 2018: British Journal of Neurosurgery
Loris Poli, Mario Grassi, Marialuisa Zedde, Simona Marcheselli, Giorgio Silvestrelli, Maria Sessa, Andrea Zini, Maurizio Paciaroni, Cristiano Azzini, Massimo Gamba, Antonella Toriello, Rossana Tassi, Elisa Giorli, Rocco Salvatore Calabrò, Marco Ritelli, Alessandro De Vito, Nicola Pugliese, Giuseppe Martini, Alessia Lanari, Corrado Lodigiani, Marina Padroni, Valeria De Giuli, Filomena Caria, Andrea Morotti, Paolo Costa, Davide Strambo, Manuel Corato, Rosario Pascarella, Massimo Del Sette, Giovanni Malferrari, Marina Colombi, Alessandro Padovani, Alessandro Pezzini
Whether to resume antithrombotic treatment after oral anticoagulant-related intracerebral haemorrhage (OAC-ICH) is debatable. In this study, we aimed at investigating long-term outcome associated with OAC resumption after warfarin-related ICH, in comparison with secondary prevention strategies with platelet inhibitors or antithrombotic discontinuation. Participants were patients who sustained an incident ICH during warfarin treatment (2002-2014) included in the Multicenter Study on Cerebral Hemorrhage in Italy...
February 12, 2018: Thrombosis and Haemostasis
Rob A Dineen, Stefan Pszczolkowski, Katie Flaherty, Zhe K Law, Paul S Morgan, Ian Roberts, David J Werring, Rustam Al-Shahi Salman, Tim England, Philip M Bath, Nikola Sprigg
OBJECTIVES: To test whether administration of the antifibrinolytic drug tranexamic acid (TXA) in patients with spontaneous intracerebral haemorrhage (SICH) leads to increased prevalence of diffusion-weighted MRI-defined hyperintense ischaemic lesions (primary hypothesis) or reduced perihaematomal oedema volume, perihaematomal diffusion restriction and residual MRI-defined SICH-related tissue damage (secondary hypotheses). DESIGN: MRI substudy nested within the double-blind randomised controlled Tranexamic Acid for Hyperacute Primary Intracerebral Haemorrhage (TICH)-2 trial (ISRCTN93732214)...
February 3, 2018: BMJ Open
B J H Verhaar, M W Vernooij, G J Biessels, M Muller
- Cerebral microbleeds are associated with a higher risk of intracerebral hemorrhage.- When microbleeds are detected, the possible underlying pathology should be considered; this includes cerebral amyloid angiopathy and other factors that increase the risk of haemorrhage, particularly hypertension. - No randomised trials have yet been conducted into haemorrhagic complications and cerebral infarctions in patients with microbleeds who take vitamin K antagonists. This means that it is not clear whether the intended prevention of cerebral infarctions outweighs the increased risk of haemorrhage associated with use of vitamin K antagonists by these patients...
2018: Nederlands Tijdschrift Voor Geneeskunde
David Turnbull
No abstract text is available yet for this article.
January 29, 2018: Minerva Anestesiologica
Laura Green, Joachim Tan, Joan K Morris, Raza Alikhan, Nicola Curry, Tamara Everington, Rhona Mclean, Khalid Saja, Simon Stanworth, Campbell Tait, Peter MacCallum
The outcomes of patients developing major bleeding on oral anticoagulants remain largely unquantified. Objectives are to: 1) describe the burden of major haemorrhage associated with all available oral anticoagulants in terms of: proportion of bleeds which are intracranial-haemorrhages, in-hospital mortality and duration of hospitalisation following major bleeding; 2) identify risk factors for mortality; 3) compare characteristics of major haemorrhage between warfarin and direct-oral anticoagulants for the subgroup of atrial fibrillation and venous-thromboembolism patients...
January 25, 2018: Haematologica
Mark Peter Maskery, Paul N Cooper, Adrian Pace
Sarcoidosis is an idiopathic multisystem granulomatous disorder of unknown cause. Nervous system involvement (central and/or peripheral) is uncommon, developing in 5%-10%. The presenting symptoms are variable, reflecting the level of involvement, and frequently fluctuate and progress. Diagnosing neurosarcoidosis in people with previously confirmed systemic disease may be relatively straightforward, but diagnosing primary neurosarcoidosis is challenging. Managing neurosarcoidosis is primarily consensus based; corticosteroid is its mainstay, alongside corticosteroid-sparing agents and emerging novel therapies...
January 23, 2018: Practical Neurology
Nina A Hilkens, Charlotte J J van Asch, David J Werring, Duncan Wilson, Gabriël J E Rinkel, Ale Algra, Birgitta K Velthuis, Gérard A P de Kort, Theo D Witkamp, Koen M van Nieuwenhuizen, Frank-Erik de Leeuw, Wouter J Schonewille, Paul L M de Kort, Diederik W J Dippel, Theodora W M Raaymakers, Jeannette Hofmeijer, Marieke J H Wermer, Henk Kerkhoff, Korné Jellema, Irene M Bronner, Michel J M Remmers, Henri Paul Bienfait, Ron J G M Witjes, H Rolf Jäger, Jacoba P Greving, Catharina J M Klijn
OBJECTIVE: A substantial part of non-traumatic intracerebral haemorrhages (ICH) arises from a macrovascular cause, but there is little guidance on selection of patients for additional diagnostic work-up. We aimed to develop and externally validate a model for predicting the probability of a macrovascular cause in patients with non-traumatic ICH. METHODS: The DIagnostic AngioGRAphy to find vascular Malformations (DIAGRAM) study (n=298; 69 macrovascular cause; 23%) is a prospective, multicentre study assessing yield and accuracy of CT angiography (CTA), MRI/ magnetic resonance angiography (MRA) and intra-arterial catheter angiography in diagnosing macrovascular causes in patients with non-traumatic ICH...
January 18, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
Gloria Bedini, Anna Bersano, Elisa R Zanier, Francesca Pischiutta, Eugenio A Parati
BACKGROUND: Spontaneous intracerebral haemorrhage (ICH) is a relatively common fatal disease, with an overall global incidence estimated at 24.6 per 100,000 person-years. Given the high degree of morbidity and mortality associated with ICH, therapies that may have neuroprotective effects are of increasing interest to clinicians. In this last context, cell therapies offer the promise of improving the disease course which cannot be addressed adequately by existing treatments. OBJECTIVE: The aim of this review is to evaluate the protective effects and molecular mechanisms of mesenchymal stem cells (MSCs) on haemorrhagic brain following ICH...
January 10, 2018: Current Medicinal Chemistry
Mark A Rodrigues, Neshika Samarasekera, Christine Lerpiniere, Catherine Humphreys, Mark O McCarron, Philip M White, James A R Nicoll, Cathie L M Sudlow, Charlotte Cordonnier, Joanna M Wardlaw, Colin Smith, Rustam Al-Shahi Salman
BACKGROUND: Identification of lobar spontaneous intracerebral haemorrhage associated with cerebral amyloid angiopathy (CAA) is important because it is associated with a higher risk of recurrent intracerebral haemorrhage than arteriolosclerosis-associated intracerebral haemorrhage. We aimed to develop a prediction model for the identification of CAA-associated lobar intracerebral haemorrhage using CT features and genotype. METHODS: We identified adults with first-ever intracerebral haemorrhage diagnosed by CT, who died and underwent research autopsy as part of the Lothian IntraCerebral Haemorrhage, Pathology, Imaging and Neurological Outcome (LINCHPIN) study, a prospective, population-based, inception cohort...
January 10, 2018: Lancet Neurology
Vignan Yogendrakumar, Eric E Smith, Andrew M Demchuk, Richard I Aviv, David Rodriguez-Luna, Carlos A Molina, Yolanda Silva Blas, Imanuel Dzialowski, Adam Kobayashi, Jean-Martin Boulanger, Cheemun Lum, Gord Gubitz, Vasantha Padma, Jayanta Roy, Carlos S Kase, Rohit Bhatia, Myzoon Ali, Patrick Lyden, Michael D Hill, Dar Dowlatshahi
OBJECTIVES: There are limited data as to what degree of early neurologic change best relates to outcome in acute intracerebral hemorrhage. We aimed to derive and validate a threshold for early postintracerebral hemorrhage change that best predicts 90-day outcomes. DESIGN: Derivation: retrospective analysis of collated clinical stroke trial data (Virtual International Stroke Trials Archive). VALIDATION: retrospective analysis of a prospective multicenter cohort study (Prediction of haematoma growth and outcome in patients with intracerebral haemorrhage using the CT-angiography spot sign [PREDICT])...
January 4, 2018: Critical Care Medicine
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