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Subdural hematoma atrial fibrillation

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https://www.readbyqxmd.com/read/27225288/initial-experience-with-high-risk-patients-excluded-from-clinical-trials-safety-of-short-term-anticoagulation-after-left-atrial-appendage-closure-device
#1
Amr F Barakat, Ayman A Hussein, Walid I Saliba, Mohammed Bassiouny, Khaldoun Tarakji, Mohamed Kanj, Wael Jaber, L Leonardo Rodriguez, Richard Grimm, M Shazam Hussain, Andrew Russman, Ken Uchino, Dolora Wisco, Peter Rasmussen, Mark Bain, John Vargo, Gregory Zuccaro, David Gottesman, Bruce D Lindsay, Oussama M Wazni
BACKGROUND: The implantation of left atrial appendage closure device (WATCHMAN, Boston Scientific, Natick, MA) is an alternative option to oral anticoagulation (OAC) for stroke prevention in atrial fibrillation. Patients require short-term OAC after implantation to avoid device thrombosis. The 2 clinical trials that assessed this device excluded patients thought not to be candidates for OAC. As such, little is known about the safety of this strategy in patients with previous major bleeding events...
June 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27154448/fatal-consequences-of-climbing-a-ladder-under-apixaban-and-drunken
#2
Claudia Stöllberger, Josef Finsterer
BACKGROUND: Apixaban, a factor-Xa-inhibitor, is one of the non-vitamin-K-antagonist oral anticoagulants (NOACs) which are increasingly used in atrial fibrillation (AF). In real life even patients with contraindications to vitamin K antagonists (VKAs) receive NOAC because NOAC are considered as "safer" than VKAs. CASE DESCRIPTION: In a 61-years-old man with hypertension, heart failure and paroxysmal AF apixaban was started. Despite advices from his physicians, he continued alcohol abuse and suffered from recurrent falls...
2016: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/26160466/adverse-outcomes-after-initial-non-surgical-management-of-subdural-hematoma-a-population-based-study
#3
Nicholas A Morris, Alexander E Merkler, Whitney E Parker, Jan Claassen, E Sander Connolly, Kevin N Sheth, Hooman Kamel
BACKGROUND: Little is known about the natural history of non-surgically managed subdural hematoma (SDH). The purpose of this study is to determine rates of adverse events after non-surgical management of SDH and whether these outcomes differ depending on traumatic versus nontraumatic etiology. A retrospective cohort study was conducted using administrative claims data on all emergency department visits and acute care hospitalizations at nonfederal facilities in California from 2005 to 2011, Florida from 2005 to 2012, and New York from 2006 to 2011...
April 2016: Neurocritical Care
https://www.readbyqxmd.com/read/26090890/non-traumatic-spontaneous-spinal-subdural-hematoma-in-a-patient-with-non-valvular-atrial-fibrillation-during-treatment-with-rivaroxaban
#4
Jessica M Castillo, Hayley F Afanador, Efren Manjarrez, Ximena A Morales
BACKGROUND: Spontaneous spinal subdural hematoma (SSDH) is a rare but disabling condition, accounting for only 4.1% of all intraspinal hematomas. Risk factors include arteriovenous malformations, coagulopathy, therapeutic anticoagulation, underlying neoplasms, or following spinal puncture. Vitamin K antagonists, antiplatelet agents, and heparinoids have been associated with SSDHs in prior reports. To the best of our knowledge, no cases have reported this association with the factor Xa inhibitor, rivaroxaban, and SSDHs...
2015: American Journal of Case Reports
https://www.readbyqxmd.com/read/25678908/traumatic-fatal-cerebral-hemorrhage-in-an-old-patient-with-a-history-of-multiple-sclerosis-under-dabigatran-a-case-report-and-review-of-the-literature
#5
Claudia Stöllberger, Andreas Ulram, Adam Bastovansky, Josef Finsterer
One disadvantage of direct anticoagulant drug is the lack of an antidote, which may become relevant in patients with traumatic brain injury. A 77-years old man with atrial fibrillation and syncope received dabigatran despite recurrent falls. Due to a ground-level-fall, he suffered from subarachnoidal and intraparenchymal hemorrhages, subdural hematoma and brain edema with a midline shift. Despite osteoclastic trepanation and hematoma-evacuation he remained comatose and died seven days later without regaining consciousness...
January 2015: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/25643694/risk-factors-for-chronic-subdural-haematoma-formation-do-not-account-for-the-established-male-bias
#6
Laurence A G Marshman, Appukutty Manickam, Danielle Carter
OBJECTIVE: The 'subdural space' is an artefact of inner dural border layer disruption: it is not anatomical but always pathological. A male bias has long been accepted for chronic subdural haematomas (CSDH), and increased male frequencies of trauma and/or alcohol abuse are often cited as likely explanations: however, no study has validated this. We investigated to see which risk factors accounted for the male bias with CSDH. METHODS: Retrospective review of prospectively collected data...
April 2015: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/25506268/efficacy-and-safety-of-novel-oral-anticoagulants-in-clinical-practice-a-report-from-three-centers-in-sweden
#7
Ashkan Labaf, Martin Carlwe, Peter J Svensson
INTRODUCTION: In clinical trials new oral anticoagulants (NOAC) have proved to be as effective as warfarin for thromboprophylaxis in atrial fibrillation. The aim of this study was to evaluate the efficacy and safety of these drugs in clinical practise. METHODS AND RESULTS: All patients treated with new oral anticoagulants at Skåne University hospital and Halland County Hospital Halmstad between 2009 and September 2013 was identified in the Swedish national quality registry for atrial fibrillation and anticoagulation (AuriculA)...
2014: Thrombosis Journal
https://www.readbyqxmd.com/read/25472690/effect-of-addition-of-clopidogrel-to-aspirin-on-subdural-hematoma-meta-analysis-of-randomized-clinical-trials
#8
Majid F Bakheet, Lesly A Pearce, Robert G Hart
BACKGROUND: Clopidogrel combined with aspirin is routinely prescribed after coronary artery stenting, in patients with acute coronary syndromes, and recently to prevent stroke in patients with acute minor ischemic stroke and TIA. Subdural hematomas are an important complication of antithrombotic treatment, but the risk associated with clopidogrel plus aspirin has not been previously defined. PURPOSE: To quantify the risk of subdural hematoma associated with dual antiplatelet therapy with clopidogrel plus aspirin...
June 2015: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/24994722/intracranial-hemorrhage-mortality-in-atrial-fibrillation-patients-treated-with-dabigatran-or-warfarin
#9
Alvaro Alonso, Lindsay G S Bengtson, Richard F MacLehose, Pamela L Lutsey, Lin Y Chen, Kamakshi Lakshminarayan
BACKGROUND AND PURPOSE: In randomized trials, patients with atrial fibrillation (AF) receiving dabigatran, a direct oral anticoagulant, had lower risk of intracranial bleeding (ICB) than those on warfarin. However, concerns exist about potential worse outcomes in dabigatran users if bleeding occurs, given the lack of approved reversal agents. Thus, we examined in-hospital mortality in AF patients with ICB being treated with dabigatran versus warfarin in a real-world population in the United States...
August 2014: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/24919284/-the-cognitively-impaired-patient-suddenly-became-disoriented-dementia-is-not-responsible
#10
Peter Stiefelhagen
No abstract text is available yet for this article.
April 3, 2014: MMW Fortschritte der Medizin
https://www.readbyqxmd.com/read/24876259/vitamin-k-antagonists-and-risk-of-subdural-hematoma-meta-analysis-of-randomized-clinical-trials
#11
COMPARATIVE STUDY
Ben J Connolly, Lesly A Pearce, Robert G Hart
BACKGROUND AND PURPOSE: Subdural hematomas are an important bleeding complication of anticoagulation. We quantify the risk of subdural hematoma associated with anticoagulation with vitamin K antagonists (VKAs) compared with other oral antithrombotic therapies. METHODS: Randomized trials were identified from the Cochrane Central Register of Controlled Trials and were included if published since 1980 and compared oral VKAs with antiplatelet therapy or with direct-acting oral anticoagulants...
June 2014: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/24662438/intracranial-hemorrhage-during-dabigatran-treatment
#12
Motohiro Komori, Masahiro Yasaka, Kazuhito Kokuba, Hideki Matsuoka, Shigeru Fujimoto, Megumu Yoshida, Katsuharu Kameda, Tadahisa Shono, Shinji Nagata, Tetsuro Ago, Takanari Kitazono, Yasushi Okada
BACKGROUND: The incidence of intracranial bleeding during dabigatran treatment is lower than that during warfarin treatment. The characteristics of intracranial hemorrhage during dabigatran therapy, however, remain unclear. METHODS AND RESULTS: The clinical data and treatment summaries of 9 intracranial bleeds that developed during dabigatran treatment in 8 patients with non-valvular atrial fibrillation were retrospectively reviewed. Five patients had small-moderate subdural hematomas, 2 had intracerebral hemorrhage and 1 had traumatic subarachnoid and parenchymal hemorrhage associated with cerebral contusion...
2014: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/24419803/interventional-closure-of-the-left-atrial-appendage-for-stroke-prevention
#13
Yae Matsuo, Marcus Sandri, Norman Mangner, Nicolas Majunke, Ingo Dähnert, Gerhard Schuler, Masahiko Kurabayashi, Sven Möbius-Winkler
BACKGROUND: Transcatheter left atrial appendage (LAA) closure is an alternative therapy for stroke prevention in atrial fibrillation (AF) patients. However; real-world efficacy, safety and complications have yet to be investigated. We sought to determine the procedural outcomes and potential complications of LAA closure in routine clinical practice at a high-volume center. METHODS AND RESULTS: The study group comprised 179 patients (105 males; 72.7±9.0 years) with AF undergoing LAA closure at a single center in Germany...
2014: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/23632243/re-endovascular-recanalization-for-acute-middle-cerebral-artery-reocclusion-after-surgical-embolectomy
#14
Jin Sue Jeon, Seung Hun Sheen, Heung Cheol Kim
A 62-year-old woman with atrial fibrillation underwent burr hole trephination for a chronic subdural hematoma. Two days later the patient suddenly presented with motor dysphasia and slightly decreased motor power. Time of flight MR angiography revealed distal M1 occlusion without diffusion restriction. Stent-assisted mechanical thrombectomy was attempted but failed. Post-procedure MRI illustrated a small area of diffusion restriction within the peri-insular and parietal areas. Immediate surgical embolectomy was performed but reocclusion of M1 was documented in the postoperative angiography...
April 1, 2014: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/23608842/re-endovascular-recanalization-for-acute-middle-cerebral-artery-reocclusion-after-surgical-embolectomy
#15
Jin Sue Jeon, Seung Hun Sheen, Heung Cheol Kim
A 62-year-old woman with atrial fibrillation underwent burr hole trephination for a chronic subdural hematoma. Two days later the patient suddenly presented with motor dysphasia and slightly decreased motor power. Time of flight MR angiography revealed distal M1 occlusion without diffusion restriction. Stent-assisted mechanical thrombectomy was attempted but failed. Post-procedure MRI illustrated a small area of diffusion restriction within the peri-insular and parietal areas. Immediate surgical embolectomy was performed but reocclusion of M1 was documented in the postoperative angiography...
2013: BMJ Case Reports
https://www.readbyqxmd.com/read/23422345/aspirin-therapy-and-risk-of-subdural-hematoma-meta-analysis-of-randomized-clinical-trials
#16
Ben J Connolly, Lesly A Pearce, Tobias Kurth, Carlos S Kase, Robert G Hart
BACKGROUND: Subdural hematomas are an important bleeding complication of antithrombotic therapies. We sought to characterize the risk of subdural hematoma associated with antiplatelet therapy. METHODS: Trials were gathered from the Cochrane Central Register of Controlled Trials and from recent meta-analyses of trials regarding antiplatelet therapy for the primary prevention of stroke. Randomized trials published since 1980 comparing antiplatelet therapy with placebo or control and reporting subdural hematoma were included in the analysis...
May 2013: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/22970730/hemorrhagic-complications-associated-with-dabigatran-use
#17
Betty C Chen, Aaron D Viny, Fiona M Garlich, Paul Basciano, Mary Ann Howland, Silas W Smith, Robert S Hoffman, Lewis S Nelson
OBJECTIVE: Dabigatran is a direct thrombin inhibitor approved for anticoagulation in non-valvular atrial fibrillation and, in some countries, for thromboembolism prophylaxis following select orthopedic surgeries. Despite decreased rates of thromboembolism, bleeding remains a risk due to the inability to conveniently monitor anticoagulant effect and the lack of a reversal agent. CASE SERIES: We present four cases of dabigatran-related bleeding. A 79-year-old man on aspirin, clopidogrel, and dabigatran presented with rectal bleeding and epistaxis...
November 2012: Clinical Toxicology
https://www.readbyqxmd.com/read/22856422/-spontaneous-spinal-subdural-hematoma
#18
Bruno Alpoim, Maria Rodrigues, Pedro Silva, Bruno Carvalho, Paulo Pereira, Rui Vaz
Spontaneous spinal subdural hematomas are rare and may be caused by vascular malformations or bleeding disorders. The diagnosis is based on the conjunction of clinical examination with imaging studies, being MRI the gold standard in detection and surgical planning. The authors report the case of a patient on anticoagulant therapy in the context of atrial fibrillation and mechanical prosthetic mitral and tricuspid valves, presenting with sudden onset of dorsal pain radiated to both lower limbs, paresthesias and progressive paraparesis...
December 2011: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/22854591/traumatic-brain-injury-in-the-elderly-considerations-in-a-series-of-103-patients-older-than-70
#19
P Gaetani, M Revay, S Sciacca, F Pessina, E Aimar, D Levi, E Morenghi
AIM: Mortality and morbidity due to brain injury in the elderly population is a growing clinical problem: among older patients, those >70 years have a considerably higher risk both in terms of mortality and morbidity. Thereafter, the reasons influencing outcome have not been clearly examined: in the present study we addressed these questions considering the main clinical characteristics exerting a significant impact on the outcome of patients aged > 70, with emphasis for the severity of brain injury and anticoagulant (CAW) treatments...
September 2012: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/22669021/subacute-proximal-leg-weakness-after-a-minor-traffic-accident-in-a-patient-treated-with-anticoagulants
#20
Konstantinos Spengos, Evangelos Anagnostou, Sofia Vassilopoulou
One day after a minor accident, an 85-year-old man developed headache and proximal left leg weakness. He was on warfarin due to atrial fibrillation. On hospital admission, a right posterior parasagittal subdural haematoma that was visualised on CT was considered as cause of all symptoms. Although no surgical intervention was performed he stayed for 2 weeks in a neurosurgical ward. Clinical deterioration occurred within the first days as he was not able to stand on his left leg or rise up from the sitting position...
2012: BMJ Case Reports
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