Antiplatelet Therapy in Cerebral Small Vessel Disease

AbstractPurpose of ReviewWe critically evaluate the evidence for the use of antiplatelet therapy for stroke prevention following lacunar stroke and in patients with hemorrhage-prone cerebral small vessel disease.Recent FindingsPooled lacunar stroke subgroup analyses of all relevant randomized controlled trials to date suggest a 22% relative risk reduction in recurrent stroke by single antiplatelet therapy (RR 0.77, 95% CI 0.62 –0.97) compared with placebo, no consistent suggestion of variable efficacy amongst specific antiplatelet agents, and the absence of clear benefit with dual over single antiplatelet therapy. Current data does not support withholding antiplatelet therapy where otherwise indicated in patients with c erebral microbleeds on MRI or those who have suffered intracerebral hemorrhage.SummaryAntiplatelet monotherapy appears to provide persistent secondary stroke prevention in patients with lacunar stroke. Whether phosphodiesterase inhibitors, particularly cilostazol, provide additional advantage in patients with cerebral small vessel disease is worthy of further investigation.
Source: Current Neurology and Neuroscience Reports - Category: Neuroscience Source Type: research

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Authors: Susmitha K, Chandrasekhar V, Kiran G, Divya A, Rani GS, Sarangapani M Abstract Stroke is becoming a main cause of early death and disability in developing countries like India, and it is mostly enhanced by increased predominance of major risk factors. A detailed knowledge about the nature and magnitude of the stroke cases in this particular area is not only important for acute treatment but also it helps to prevent hospital admissions due to reoccurring stroke. The present study was conducted in the Department of Stroke at MGM Hospital, Warangal, India, to study the patterns of stroke admissions. All the c...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
Strokes remain a leading cause of morbidity and mortality in patients with ventricular assist devices (VADs). Varying study populations, event definitions, and reporting methods make direct comparison of neurologic event risk across clinical trials and registries challenging. We aim to highlight important differences among major VAD studies and standardize rates of neurologic events to facilitate a comprehensive and objective comparison. We systematically identified and analyzed key clinical trials and registries evaluating the HeartMate II (HMII), HeartMate 3 (HM3), and HVAD devices. Reported neurologic events were nonexc...
Source: ASAIO Journal - Category: Medical Devices Tags: Adult Circulatory Support Source Type: research
In this study, the CRI accurately reflected acute hemodynamic changes associated with TcPVR. Further re search is justified to determine if the CRI can be useful as an early warning tool in patients with CHD at risk for decompensation during and after cardiac procedures.
Source: Pediatric Cardiology - Category: Cardiology Source Type: research
This study analyzed if the variation between TT genotype and the other genotypes (CT and CC), in -589 (rs2243250) polymorphism of IL4 gene, has association with the prognosis of hemorrhagic stroke (HS) and with clinical aspects which are risk factors for cerebrovascular diseases. The result of this study shows that there is no statistical association of the IL4 polymorphism with either prognosis or clinical aspects in HS patients.RESUMEN La interleucina-4 (IL-4) tiene gran importancia en los procesos inflamatorios en casos de accidente cerebrovascular (ACV), puesto que hace que las microgl ías sean polarizadas hacia...
Source: Jornal Brasileiro de Patologia e Medicina Laboratorial - Category: Pathology Source Type: research
(University of Texas Health Science Center at Houston) Results of an Electronic Health Record (EHR) study assessing the most commonly used medications for raising blood pressure in patients with nontraumatic subarachnoid hemorrhage (SAH), a rare type of stroke, have been published in Neurosurgical Focus by scientists at The University of Texas Health Science Center at Houston (UTHealth).
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
Cerebral stroke occurs following ischemic and hemorrhagic lesions in the brain. Survival and recovery of stroke patients depend on the severity of the initial injury but also the therapeutic approaches applied...
Source: BMC Neuroscience - Category: Neuroscience Authors: Tags: Research article Source Type: research
Abstract AIM OF STUDY: We investigated sex differences i n i schaemic s troke p atients t reated w ith i ntravenous a lteplase. CLINICAL RATIONALE FOR STUDY: We suggest that it is necessary to improve care for women with atrial fibrillation. Our data suggests that closer evaluation of treatment for ischaemic stroke in men and women is needed, preferably in the form of a prospective study. MATERIALS AND METHODS: This was a multicentre analysis of 1,830 ischaemic stroke patients treated with alteplase from 2004 to 2012. Data was prospectively collected in the Safe Implementation of Treatments in Stroke (SI...
Source: Neurologia i Neurochirurgia Polska - Category: Neurology Authors: Tags: Neurol Neurochir Pol Source Type: research
AbstractDiabetes is a well ‐established risk factor for both ischemic and hemorrhagic stroke. Individuals with diabetes not only have a higher risk of stroke, they also have worse clinical outcomes after stroke, including poorer neurological recovery, higher rates of stroke recurrence and mortality. In addition to optimizin g glycemia, control of cardiovascular risk factors like hypertension and dyslipidemia is crucial in stroke prevention in subjects with diabetes.
Source: Journal of Diabetes Investigation - Category: Endocrinology Authors: Tags: EDITORIAL Source Type: research
CONCLUSION: This study describes the current status of acute stroke care in Korea. Despite quite acceptable quality of stroke care, it suggests regional and hospital disparities. Expansion of stroke units, stroke center certification or accreditation, and connections between stroke centers and emergency medical services are highly recommended. PMID: 32449325 [PubMed - in process]
Source: Journal of Korean Medical Science - Category: Biomedical Science Tags: J Korean Med Sci Source Type: research
AbstractBackgroundStereotactic minimally invasive surgery (sMIS) has been used in the treatment of intracerebral hemorrhage (ICH) in recent years and has obtained promising results. However, the outcomes of patients are associated with many factors. The aim of the present study was to retrospectively observe the relationship between hematoma shape features and the outcome of patients with spontaneous ICH following sMIS.MethodsOne hundred eighty-three patients with hypertensive ICH who underwent sMIS were enrolled. Based on hematoma shape features, the patients were assigned to a regular-shaped hematoma group (RSH group, in...
Source: Neurocritical Care - Category: Neurology Source Type: research
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