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Efficacy and safety of ticagrelor versus aspirin and clopidogrel for stroke prevention in patients with vascular disease: a systematic review and meta-analysis
Introduction: Currently, it is still controversial to treat stroke with ticagrelor alone. The purpose of our study was to systematically review and analyze the efficacy and safety of ticagrelor on cerebrovascular outcomes in patients with vascular risk factors. Methods: The PubMed, Cochrane Library, and EMBASE databases were systematically searched using the keywords stroke, ticagrelor, clopidogrel, and aspirin to identify randomized controlled trials (RCT). Primary outcomes included reported stroke, ischemic stroke and complex events; the secondary outcome was hemorrhagic stroke. The safety outcomes included major bleedi...
Source: European Neurology - April 17, 2023 Category: Neurology Source Type: research

Effects of Direct Oral Anticoagulants ’ Nonrecommended Dose in Atrial Fibrillation: A Meta-Analysis
Background: The efficacy and safety profiles of nonrecommended direct oral anticoagulant (DOAC) doses in patients with nonvalvular atrial fibrillation (NVAF) are still undefined.Summary: We searched for randomized controlled trials and observational studies that compared nonrecommended versus recommended doses of DOACs, published up to December 2021. Primary study outcomes were ischemic stroke/transient ischemic attack/systemic embolism (IS/TIA/SE) and major bleeding (MB). All-cause mortality was a secondary outcome. We determined pooled odds ratios (ORs) between groups of patients with a random-effect model. Twenty-three ...
Source: European Neurology - September 13, 2022 Category: Neurology Source Type: research

Treatments in Ischemic Stroke: Current and Future
Background and Aim: Despite progress made over the last 30 years, stroke is still a leading cause of disability and mortality; likewise, its burden is expected to increase over the next decades, due to population growth and aging. The development of drugs with better safety-efficacy profiles as well as strategies able to improve ischemic stroke management from the pre-hospital setting is needed.Summary: The pathophysiology of ischemic stroke involves multiple pathways resulting in cerebral artery obstruction and brain tissue ischemia. To date, the only approved drug for acute ischemic stroke is intravenous thrombolytic alt...
Source: European Neurology - August 2, 2022 Category: Neurology Source Type: research

Neurological Perspectives of Neurogenic Pulmonary Edema
Background: Neurogenic pulmonary edema (NPE) is characterized by acute respiratory distress triggered by acute, severe compromise of the central nervous system (CNS). This review aims at summarizing and discussing recent and previous findings about the type and frequency of CNS triggers of NPE, pathogenesis, diagnosis, treatment, and outcome of patients experiencing NPE.Key Messages: NPE is diagnosed in the presence of pink, frothy sputum, pulmonary edema, bilateral opacities on X-ray, PaO2:PiO2 #x3c;200 mm Hg, acute CNS compromise with increased intra-cranial pressure, rapid resolution within 48 –72 h, and the absence o...
Source: European Neurology - May 22, 2019 Category: Neurology Source Type: research

Thalamic Lesions Caused by Deep Cerebral Venous Thrombosis: A Retrospective Study
Conclusion: Thalamic lesion can be caused by DCVT with neuropsychological and radiological features that should be considered in the differential diagnosis of intracranial artery occlusion or bleeding, especially in young patients. In this small group, most patients survived with few or mild defects.Eur Neurol 2015;74:118-126
Source: European Neurology - September 9, 2015 Category: Neurology Source Type: research

Ultrastructural Changes of Brain Tissues Surrounding Hematomas after Intracerebral Hemorrhage
In this study, cerebral ultrastructure surrounding hematoma and its correlation with clinical severity were investigated in ICH patients. Thirty patients with basal ganglia hemorrhage and 6 control subjects were enrolled. Surgical evacuation was performed for patients with a blood loss>30 ml. Stroke severity was assessed using the Glasgow Coma Scale (GCS) and the National Institute of Health Stroke Scale (NIHSS). Transmission electron microscopy (TEM) was used to evaluate the ultrastructural characteristics of tissue specimens. Neural cells surrounding the hematomas showed evidence of cell swelling and necrosis. Decreased ...
Source: European Neurology - July 1, 2015 Category: Neurology Source Type: research

Reasons Underlying Non-Adherence to and Discontinuation of Anticoagulation in Secondary Stroke Prevention among Patients with Atrial Fibrillation
Conclusion: Nonadherence to OAC in stroke patients results from fear of potential complications or inconvenience and physicians' concerns regarding functional status. OAC should be initiated wherever possible during the in-hospital stay.Eur Neurol 2015;73:184-191
Source: European Neurology - January 24, 2015 Category: Neurology Source Type: research