Multicenter Study on the Efficacy of Transcranial Direct Current Stimulation (tDCS) in Post-stroke Motor Recovery
Conditions: Stroke, Ischemic; Stroke Hemorrhagic Interventions: Device: Anodal transcranial direct current stimulation (A-tDCS); Device: Cathodal transcranial direct current stimulation (C-tDCS); Device: Sham stimulation (sham-tDCS); Behavioral: Neuromotor training Sponsors: IRCCS Centro San Giovanni di Dio Fatebenefratelli; San Gerardo Hospital; Maggiore Bellaria Hospital, Bologna; Azienda Ospedaliero, Universitaria Pisana; Fondazione Don Carlo Gnocchi Onlus; Azienda Ospedaliera Universitaria Integrata Verona; Azienda Unità Sa nitaria Locale di Piacenza; Azienda Ospedaliero Universitaria di Cagliari; Ospedale Policlinico San Martino; I.R.C.C.S. Fondazione Santa Lucia; Catholic University of the Sacred Heart; Istituti Clinici Zucchi Recruiting
Conclusions: High NPR was associated with the increased risk of HT especially PH in patients with acute ischemic stroke.
ConclusionsNew onset of neurologic deterioration is rare 12 –24 h after treatment of acute stroke. Stable patients with low NIHSS scores and no ICU needs may not require intensive monitoring greater than 12 h post-treatment.
AbstractSpreading depolarization is observed as a large negative shift of the direct current potential, swelling of neuronal somas, and dendritic beading in the brain ’s gray matter and represents a state of a potentially reversible mass injury. Its hallmark is the abrupt, massive ion translocation between intraneuronal and extracellular compartment that causes water uptake (= cytotoxic edema) and massive glutamate release. Dependent on the tissue’s energy st atus, spreading depolarization can co-occur with different depression or silencing patterns of spontaneous activity. In adequately supplied tissue, spread...
Conclusions: Stroke is uncommon in cirrhotic patients. However, considering a positive relationship of liver cirrhosis with subarachnoid and intracranial hemorrhage, the prophylactic strategy may be selectively adopted in cirrhotic patients.
ConclusionsIn AF patients who survived an ICH, restarting OAC was not associated with a greater risk of recurrent ICH. Evidence from randomized controlled studies is needed to further clarify the clinical benefit of restarting OAC in this high-risk population. Further evaluation of which individuals benefit from restarting OAC is also needed to provide more clinical guidance.
AbstractBackground and AimStroke remains a significant complication of left ventricular assist device (LVAD) therapy. We performed a single ‐center retrospective study evaluating patients undergoing first‐time HeartWare HVAD (Medtronic Inc) or HeartMate 3 (Abbott Inc) implantation from September 2009‐February 2018.MethodsExclusion criteria were age24 hours with corresponding radiographic evidence. Risk factors evaluated included demographics, medical comorbidities, heart failure etiology, LVAD indication, INTERMACS profile, and device type. Univariate predictors (P
ConclusionCognitive impairment and dementia affected almost one-third of patients, whether assessed pre or post ICH.
CONCLUSIONS: Compared to warfarin, NOACs were associated with a significantly lower risk of adverse events, with heterogeneity in treatment effects among different age strata. Overall, the clear safety signal in favor of NOACs over warfarin was evident irrespective of age strata, being most marked in the most elderly. PMID: 31809694 [PubMed - as supplied by publisher]
AbstractThe best strategy in atrial fibrillation (AF) after > 12 months after an acute coronary syndrome or in patients with chronic coronary syndrome without an indication for interventional revascularization remains unclear. European guidelines generally recommend therapy with oral anticoagulation (OAC) alone, whereas North American guidelines advise com bination therapy consisting of OAC plus antiplatelet therapy in some patients. We performed a meta-analysis of available trials comparing these treatment strategies. The primary endpoint was major adverse cardiac events (MACE), secondary endp...
AbstractIntroductionSymptomatic intracerebral hemorrhage (sICH) following systemic thrombolysis for ischemic stroke is often devastating, and open surgical evacuation is considered dangerous due to the increased risk of perioperative bleeding, and stereotactic placement of a catheter is too time-consuming. We therefore evaluated the feasibility of a free-hand bedside catheter technique for emergency hematoma evacuation.MethodsPatients who had a supratentorial sICH after thrombolysis, a hematoma volume > 30 ml, and an ensuing reduction in vigilance were consecutively treated with acute minimally inva...