Induced Hypertension for Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage Clinical Sciences

Conclusions—Before this trial, the effectiveness of induced hypertension for DCI in aneurysmal subarachnoid hemorrhage patients was unknown because current literature consists only of uncontrolled case series. The results from our premature halted trial do not add any evidence to support induced hypertension and show that this treatment can lead to serious adverse events.Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT01613235.
Source: Stroke - Category: Neurology Authors: Tags: Treatment, Quality and Outcomes, Cerebrovascular Disease/Stroke Original Contributions Source Type: research

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AbstractUp to date there is no population-based study from Greece providing long-term data on incidence of both all-cause mortality and stroke recurrence for patients with first ever stroke (FES). Adult patients with FES were registered during a 24-month period (2010 –2012) and followed-up for 12 months. We calculated cumulative incidences of stroke mortality and recurrence. Univariable and multivariable Cox proportional hazards regression analyses were used to identify independent determinants of 1-year mortality and 1-year stroke recurrence. We prospectivel y documented 703 first ever stroke cases (mean age 75...
Source: Journal of Neurology - Category: Neurology Source Type: research
AbstractAutonomic dysfunction is common in neuro-critical care patients and may compromise the function of various organs. Among the many diseases causing or being associated with autonomic dysfunction are traumatic brain injury, cerebrovascular diseases, epilepsy, Guillain –Barré syndrome (GBS), alcohol withdrawal syndrome, botulism and tetanus, among many others. Autonomic dysfunction may afflict various organs and may involve hyper- or hypo-activity of the sympathetic or parasympathetic system. In this short overview, we address only a small number of neuro-inten sive care diseases with autonomic dysfunctio...
Source: Clinical Autonomic Research - Category: Research Source Type: research
SAH is a subversive type of stroke that has a mortality rate of almost 50% [1, 2]. Approximately 10% of patients die during the prehospital period, and survivors often suffer long-term neurological or cognitive impairments due to the original hemorrhage and rehemorrhage despite the development of novel treatment strategies [3 –5]. Therefore, clarifying the risk factors of SAH remains important. Except for the most common risk factors of SAH, including hypertension, smoking, and heavy alcohol intake, the relation between diet and SAH has been a recent concern [6].
Source: Nutrition - Category: Nutrition Authors: Source Type: research
Hypertension is the single most important risk factor for hemorrhagic stroke, a leading cause of mortality and disability worldwide. Adherence to antihypertensive medication is essential to achieving strict blood pressure control, but poor adherence is common in clinical practice. We evaluated adherence to antihypertensive medication in patients with acute hemorrhagic stroke and its effects on long-term outcome. This was a retrospective cohort study based on a nationwide health insurance claims database in South Korea. We included 1872 hypertensive patients who were admitted with acute hemorrhagic stroke during 2002 to 201...
Source: Hypertension - Category: Cardiology Authors: Tags: Secondary Prevention, Hypertension, Compliance/Adherence, Intracranial Hemorrhage Original Articles Source Type: research
We report on two patients who presented with headache and mild hypertension after 4-FA use. Patient A developed one-sided weakness and decreased consciousness after a few hours. A computed tomography scan showed a left-sided intracerebral haemorrhage. Because of life-threatening cerebral herniation, haematoma evacuation was performed. Postoperatively, she suffered from a right-sided hemiparalysis and severe aphasia, requiring clinical rehabilitation. Patient B had a subarachnoid haemorrhage without neurological deficits. In total, 939 4-FA-intoxicated patients were registered. These patients used 4-FA alone (44%) or in com...
Source: Journal of Neurology - Category: Neurology Source Type: research
Blood pressure management goals in stroke care You arrive at a small rural emergency healthcare facility to transport a 72-year-old female who presents to the ED with the worst headache of her life. She’s to be transported to a tertiary center with neurosurgical services. Upon further questioning you determine her headache was sudden onset with maximum intensity. When reviewing her history and medications, you note that she’s currently on Coumadin (warfarin) with an international normalized ratio (INR) of 3.5, with the following vital signs noted on the monitor upon entering the room: blood pressure of 209/75 m...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Patient Care Cardiac & Resuscitation Source Type: news
Conclusions—Female sex, higher age, arterial hypertension, smoking, and familial IA are major risk factors for MIA. In addition, MIA patients are at risk for enhanced IA formation. Further studies are needed to evaluate rupture risk and the role of ethnicity, especially in the context of increased MIA identification with improved neurovascular imaging.
Source: Stroke - Category: Neurology Authors: Tags: Risk Factors, Cerebral Aneurysm, Cerebrovascular Disease/Stroke, Aneurysm Original Contributions Source Type: research
We describe a young woman with typical IIH who underwent lumbar puncture and was treated with a short course of high-dose corticosteroids followed by acetazolamide. She subsequently developed CVST, subarachnoid hemorrhage, and stroke. Risk factors that may have resulted in CVST are discussed.
Source: Journal of Neuro-Ophthalmology - Category: Opthalmology Tags: Clinical Observation Source Type: research
There have been several clinical studies examining the factors associated with cardiovascular disease (CVD) in patients with primary aldosteronism (PA); however, their results have left it unclear whether CVD is affected by the plasma aldosterone concentration or hypokalemia. We assessed the PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) and compared the prevalence of CVD among patients with PA with that among age-, sex-, and blood pressure-matched essential hypertension patients and participants with hypertension in a general population cohort. We also performed binary logistic regress...
Source: Hypertension - Category: Cardiology Authors: Tags: Cardiovascular Disease, Risk Factors, Hypertension, Vascular Disease Original Articles Source Type: research
Conclusions—A lack of change in IS and ICH incidence may reflect a trend toward increased incidence of younger strokes. Increased rates of large-artery atherosclerosis and small-vessel occlusion are associated with increased smoking and high blood pressure. Ethnic differences in the proportional distribution of pathological stroke subtypes suggest differential exposure and susceptibility to risk factors.
Source: Stroke - Category: Neurology Authors: Tags: Epidemiology, Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research
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