Alteplase Therapy for Acute Ischemic Stroke in Pregnancy: Two Case Reports and a Systematic Review of the Literature

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Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - Category: Drugs & Pharmacology Authors: Tags: Review of Therapeutics Source Type: research

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Abstract Historically, safety of intravenous recombinant tissue plasminogen activator (IV rt-PA) for the treatment of acute ischemic stroke (AIS) is limited to use within 4.5 hours from symptom onset. Recent studies suggest the treatment window may be extended when patients have salvageable brain tissue on advanced neuroimaging. This paper describes a novel use of IV rt-PA for treatment of AIS in a pregnant patient within an extended-time window (>4.5 hours, and
Source: BJOG : An International Journal of Obstetrics and Gynaecology - Category: OBGYN Authors: Tags: BJOG Source Type: research
We report an extremely rare case of a 27-year-old woman presenting with ischemic stroke as an initial manifestation of moyamoya disease in the first trimester of pregnancy. We conducted an artificial abortion when her neurological symptoms rapidly became refractory to optimal antithrombotic treatments. The progression of neurologic deficits stopped immediately after abortion, resulting in recovery to independence, with slight motor aphasia and right hemiparesis due to improved cerebral flow. We highlight rapid artificial abortion combined with antithrombotic treatment for patients of moyamoya disease with pregnancy-associa...
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Case Report Source Type: research
Sex dimorphisms are important factors that influence the outcomes after ischemic stroke, which include basic health status, cerebrovascular anatomy, hormone levels, and unique factors such as pregnancy and menopause. It is widely recognized that male and female respond differently to stroke. Women aged 45–74 years old showed a lower risk of stroke incidence compared to age-matched man. This kind of protection is lost with aging. Hence, there is increasing requirement to get a more comprehensive understanding of sex-based factors to stroke on stroke incidence, symptoms, and treatments. This review focuses on sex-speci...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory distress syndrome coronavirus 2. This syndrome generally begins with respiratory symptoms that may progress to single-organ dysfunction (ie, respiratory failure) and then to multiorgan failure and death. In nonpregnant patients admitted to the intensive care unit with COVID-19 pneumonia, the frequency of venous thromboembolic disorders is 25% (20 of 81) detected by ultrasound examination of the lower extremities.1 In another series of 184 patients with confirmed COVID-19 pneumonia, 31% of patients had venous or arterial thromboembolism (defined as ac...
Source: American Journal of Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Letter to the Editors Source Type: research
Abstract OBJECTIVE/BACKGROUND: Migraine is associated with ischemic stroke. Women are 3-fold as likely as men to have migraine, and high estrogen states increase the risk of migraine with aura (MWA), venous thromboembolism (VTE), and of stroke. We review the epidemiological and mechanistic evidence of the migraine-stroke relationship and its risk factors, with a focus on women and conditions that exclusively or predominantly affect them.  METHODS: We performed a search of MEDLINE/PubMed database, then a narrative review of the epidemiological evidence of the migraine-stroke relationship as...
Source: Headache - Category: Neurology Authors: Tags: Headache Source Type: research
This article reviews current knowledge on epidemiology, risk factors and causes, diagnostic considerations, management, and prognosis of ischemic stroke in young adults (those 55 years old and younger). RECENT FINDINGS The incidence of ischemic stroke in young adults has been increasing since the 1980s, which has occurred in parallel with increasing prevalence of vascular risk factors and substance abuse among the younger population. Young adults have a considerably wider range of risk factors than older patients, including age-specific factors such as pregnancy/puerperium and oral contraceptive use. Behavioral risk fac...
Source: CONTINUUM: Lifelong Learning in Neurology - Category: Neurology Tags: REVIEW ARTICLES Source Type: research
RARITAN, NJ, March 28, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson today announced the VOYAGER PAD study met its primary efficacy and principal safety endpoints, demonstrating the XARELTO® (rivaroxaban) vascular dose (2.5 mg twice daily) plus aspirin (100 mg once daily) was superior to aspirin alone in reducing the risk of major adverse limb and cardiovascular (CV) events by 15 percent in patients with symptomatic peripheral artery disease (PAD) after lower-extremity revascularization, with similar rates of TIMI[1] major bleeding. VOYAGER PAD is the only study to show a significant benefit...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
Publication date: November 2019Source: Revista Portuguesa de Cardiologia (English Edition), Volume 38, Issue 11Author(s): Gonçalo J. Morgado, Inês R. Cruz, Ana Catarina Gomes, Ana Rita Almeida, Maria José Loureiro, Carlos Cotrim, Hélder Pereira
Source: Revista Portuguesa de Cardiologia - Category: Cardiology Source Type: research
Publication date: November 2019Source: Revista Portuguesa de Cardiologia (English Edition), Volume 38, Issue 11Author(s): Ahmet Guner, Macit Kalçık, Emrah Bayam, Semih Kalkan, Mehmet Ozkan
Source: Revista Portuguesa de Cardiologia - Category: Cardiology Source Type: research
We report a case of PRES with stroke in an adult with intrauterine fetal death (IUFD). Patient concerns: A 35-year-old Asian woman with twin pregnancy underwent cesarean section at 32 weeks of gestation because of IUFD. She presented with focal seizures and visual field defect 2 days after undergoing cesarean section. Her blood pressure and kidney, liver, and coagulation functions were normal without proteinuria. Diagnosis: PRES was diagnosed based on a series of brain magnetic resonance imaging findings. Ischemic infarction in the right frontal lobe eventually developed to encephalomalacia. Interventions: The pat...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
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