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Endovascular Treatment and the Outcomes of Atherosclerotic Intracranial Stenosis in Patients With Hyperacute Stroke
CONCLUSION: Emergent intracranial angioplasty with or without stenting is safe and feasible and yields a high rate of revascularization and favorable outcome in patients with hyperacute stroke and underlying ICAS. Patients with underlying ICAS have less severe infarctions at presentation and higher successful revascularization after multimodal endovascular therapy in the setting of hyperacute stroke compared with those with other stroke subtypes. ABBREVIATIONS: ICAS, intracranial atherosclerotic stenosis MAT, manual aspiration thrombectomy mRS, modified Rankin Scale NIHSS, National Institutes of Health Stroke Scale SAMMPRI...
Source: Neurosurgery - May 19, 2015 Category: Neurosurgery Tags: Research-Human-Clinical Studies Source Type: research

The clinical management of cerebral venous sinus thrombosis. a uk survey
Conclusion Overall respondents were confident in the use of heparin for the treatment of CVST. Respondents used LMWH predominantly, in keeping with EFNS guidance, yet in contrast to a previous European survey.1
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Lavin, T., Punter, M., Holland, M. Tags: Stroke ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Prognostic significance of delayed intraventricular haemorrhage in the INTERACT studies
Conclusions Although linked to factors determining greater ICH growth including poor SBP control, dIVH is independently associated with poor outcome in acute small to moderate-size ICH. Trial registration numbers NCT00226096 and NCT00716079.
Source: Journal of Neurology, Neurosurgery and Psychiatry - December 14, 2016 Category: Neurosurgery Authors: Moullaali, T. J., Sato, S., Wang, X., Rabinstein, A. A., Arima, H., Carcel, C., Chen, G., Robinson, T., Heeley, E., Chan, E., Delcourt, C., Stapf, C., Cordonnier, C., Lindley, R. I., Chalmers, J., Anderson, C. S., for the INTERACT Investigators Tags: Stroke, Hypertension Cerebrovascular disease Source Type: research

Risk of intracranial hemorrhage after carotid artery stenting versus endarterectomy: a population-based study.
CONCLUSIONS CAS is associated with a rare but higher risk of ICH relative to CEA. Future research is needed to devise strategies that minimize the risk of this serious complication after carotid artery revascularization. PMID: 29393758 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery - February 2, 2018 Category: Neurosurgery Authors: Hussain MA, Alali AS, Mamdani M, Tu JV, Saposnik G, Salata K, Nathens AB, de Mestral C, Bhatt DL, Verma S, Al-Omran M Tags: J Neurosurg Source Type: research

Dabigatran, intracranial hemorrhage, and the neurosurgeon.
Abstract Dabigatran etexilate (Pradaxa) is a novel oral anticoagulant that has gained FDA approval for the prevention of ischemic stroke and systemic embolism in patients with nonvalvular atrial fibrillation. In randomized trials, the incidence of hemorrhagic events has been demonstrated to be lower in patients treated with dabigatran compared with the traditional anticoagulant warfarin. However, dabigatran does not have reliable laboratory tests to measure levels of anticoagulation and there is no pharmacological antidote. These drawbacks are challenging in the setting of intracerebral hemorrhage. In this article...
Source: Neurosurgical Focus - May 1, 2013 Category: Neurosurgery Authors: Awad AJ, Walcott BP, Stapleton CJ, Yanamadala V, Nahed BV, Coumans JV Tags: Neurosurg Focus Source Type: research

Spontaneous Cerebellar Hemorrhage in a Patient Taking Apixaban
Conclusions Recent FDA approval of several novel oral anticoagulants for use in patients with atrial fibrillation has resulted in a significant number of patients formerly treated with warfarin being switched to these newer agents. There remains a lack of clear guidelines for the management of hemorrhagic complications. This case report describes one management strategy and highlights the paucity of current evidence to support critical clinical decisions.
Source: Interdisciplinary Neurosurgery - December 24, 2014 Category: Neurosurgery Source Type: research

Rivaroxaban and intracranial haemorrhage after mild traumatic brain injury: A dangerous combination?
The novel direct anticoagulant rivaroxaban has been approved in 2011 for the prophylaxis of thromboembolic events in patients with atrial fibrillation. Its mechanisms of action involve direct inhibition of factor Xa and a large multicentre trial has demonstrated at least non-inferiority compared with warfarin regarding the prevention of ischemic stroke [1]. This trial has also demonstrated that the risk of major bleeding was not increased with rivaroxaban and indeed, intracranial and fatal bleeding occurred less frequently in rivaroxaban-treated patients.
Source: Clinical Neurology and Neurosurgery - May 30, 2015 Category: Neurosurgery Authors: Christopher Beynon, Anna Potzy, Oliver W. Sakowitz, Andreas W. Unterberg Source Type: research

Administration of 4-Factor Prothrombin Complex Concentrate as an Antidote for Intracranial Bleeding in Patients taking Direct Factor Xa Inhibitors
Conclusion Despite no studies demonstrating the efficacy of 4-factor PCC administration for reversal of coagulopathy in patients on direct factor Xa inhibitors, our early experience demonstrates it to be safe, while potentially reducing hemorrhagic complications and hematoma expansion in this critically-ill population.
Source: World Neurosurgery - September 2, 2015 Category: Neurosurgery Source Type: research