The risk of symptomatic intracranial hemorrhage after thrombolysis for acute stroke: Current concepts and perspectives

Conclusions: In addition to the already known risk factors considered in the standard protocols, an individualized evaluation of risks is needed to minimize the risk of brain hemorrhage after thrombolysis for ischemic stroke.
Source: Annals of Indian Academy of Neurology - Category: Neurology Authors: Source Type: research

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AbstractPurpose of reviewHyperlipidemia is a key therapeutic target for stroke risk modification. The goal of this review is to highlight available treatment options and review their efficacy in the setting of general cardiovascular disease and after most subtypes of ischemic stroke and hemorrhagic stroke.Recent findingsStatins remain first-line in the management of hyperlipidemia to prevent stroke. In recent trials of patients with pre-existing atherosclerotic vascular disease, new agents, most notably PCSK9 inhibitors and ezetimibe, added additional stroke risk reduction when combined with statins.SummaryRisk of stroke c...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
ConclusionBoth neurologic and medical complications were common in majority of stroke patients. But the management protocol for stroke patients was sub-optimal and lagging behind the recommended guidelines due to lack of skilled personnel, appropriate treatment and diagnostic agents. The clinical team involved in the care of stroke patients should make preparations to take preventive measures that will save a lot of lives.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
Publication date: Available online 11 October 2019Source: Life SciencesAuthor(s): Jenq-Lin Yang, Yun-Ru Yang, Shang-Der ChenAbstractStroke is the major cause of adult disability and the second or third leading cause of death in developed countries. The treatment options for stroke (thrombolysis or thrombectomy) are restricted to a small subset of patients with acute ischemic stroke because of the limited time for an efficacious response and the strict criteria applied to minimize the risk of cerebral hemorrhage. Attempts to develop new treatments, such as neuroprotectants, for acute ischemic stroke have been costly and tim...
Source: Life Sciences - Category: Biology Source Type: research
ConclusionThese results illustrate areas in which we can improve education post-stroke, including ensuring patients receive individualised information about the aetiology of their stroke, risk factors and the importance of new medications. It also highlights the importance of ensuring advice regarding driving is clearly explained and documented.
Source: Age and Ageing - Category: Geriatrics Source Type: research
Publication date: Available online 11 September 2019Source: Journal of Clinical NeuroscienceAuthor(s): Yousheng Wu, Dan Lu, Anding XuAbstractThrombolysis-induced haemorrhagic transformation is the most challenging preventable complication in thrombolytic therapy. This condition is often associated with poor functional outcome and long-term disease burden. Statins, or 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, are controversially suggested to either increase or decrease the odds of better primary outcomes compared to treatment without statins after thrombolysis in patients or animals; statins are ...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Conclusions: Among patients with incident PD, a higher serum Lp(a) level may predict a lower risk of hemorrhagic stroke. PMID: 31498021 [PubMed - in process]
Source: Renal Failure - Category: Urology & Nephrology Tags: Ren Fail Source Type: research
Wang Zhao, Zhi-Jie Xiao, Shui-Ping ZhaoNeurology India 2019 67(4):983-992 Statins are effective cholesterol-lowering drugs for reducing the risks of mortality and morbidity of cardiovascular diseases. Increasing evidence has shown that statin use is associated with a significant beneficial effect in patients with ischemic stroke. Both pre-stroke and post-stroke statin use has been found to be beneficial in ischemic stroke. Furthermore, good adherence is associated with a better clinical outcome, and statin withdrawal is associated with a poor functional outcome in patients with ischemic stroke. High-intensity statin thera...
Source: Neurology India - Category: Neurology Authors: Source Type: research
This study investigated the effects of statin in AF patients who experienced acute ischemic stroke.MethodsData from patients with AF experiencing first-ever ischemic stroke between 2001 and 2010 were collected from the Taiwan National Health Insurance Research Database and categorized into non-statin and statin groups. The statin group was further divided into pre-stroke statin (those who began statin therapy before stroke) and post-stroke statin (those who began statin therapy after stroke) groups. The risks for recurrent ischemic stroke, coronary artery disease (CAD), intracranial hemorrhage (ICH), and 1-year mortality w...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
AbstractIntroductionDrug utilization and outcomes research in multi-ethnic Asian stroke populations is lacking.ObjectivesOur objective was to examine temporal trends and predictors of drug utilization and outcomes in a multi-ethnic Asian stroke population.MethodsThis registry-based study included ischemic and hemorrhagic first-ever stroke patients hospitalized between 2009 and 2016. Utilization of medications included in-hospital thrombolytic agents, early antithrombotics (antiplatelets, anticoagulants) within 48  h of admission, and antithrombotics and statins at discharge. Outcomes analyzed were in-hospital all-caus...
Source: CNS Drugs - Category: Neurology Source Type: research
Intracerebral hemorrhage (ICH) has a higher mortality than ischemic stroke. Statin is beneficial for stroke, but high potency statin treatment has been associated with the risk of hemorrhagic stroke. The aim of this study was to assess the impact of initiating statin therapy after ICH on cardiovascular outcomes.
Source: Atherosclerosis - Category: Cardiology Authors: Source Type: research
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