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Short-term Bleeding Events Observed with Clopidogrel Loading in Acute Ischemic Stroke Patients
Discussion: Contrary to our original hypothesis, patients with AIS receiving clopidogrel loading doses within 24 hours of symptom onset did not appear to experience a higher rate of new serious bleeding events during acute hospitalization when compared with patients who did not receive loading doses. The Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke trial is expected to provide insight into the safety of clopidogrel loading as an acute intervention after cerebral ischemia.
Source: Journal of Stroke and Cerebrovascular Diseases - April 1, 2013 Category: Neurology Authors: Lester Y. Leung, Karen C. Albright, Amelia K. Boehme, Joseph Tarsia, Kamal R. Shah, James E. Siegler, Erica M. Jones, Gayle R. Pletsch, Timothy M. Beasley, Sheryl Martin-Schild Tags: Original Articles Source Type: research

A Comparative Study of Dual versus Monoantiplatelet Therapy in Patients with Acute Large-Artery Atherosclerosis Stroke
Background: Antiplatelet drugs are recommended for patients with acute noncardioembolic stroke. However, few randomized clinical trials have investigated the safety and efficacy of dual antiplatelet therapy for these patients. The aim of this study was to evaluate the effects of treatment with clopidogrel and aspirin (combination therapy) and aspirin alone (monotherapy) on neurologic deterioration, platelet activation, and other short-term outcomes in patients with acute large-artery atherosclerosis stroke.Materials and Methods: Altogether 574 patients with acute (≤2 days) large-artery atherosclerosis stroke were random...
Source: Journal of Stroke and Cerebrovascular Diseases - April 15, 2014 Category: Neurology Authors: Xingyang Yi, Jing Lin, Chun Wang, Biao Zhang, Wanzhang Chi Tags: Original Articles Source Type: research

Warfarin versus Aspirin for Prevention of Stroke in Heart Failure: A Meta-analysis of Randomized Controlled Clinical Trials
Conclusions: Compared with aspirin, warfarin reduced the risk of stroke while conferring an increased risk of major hemorrhage. Warfarin does not increase mortality or confer an increased risk of ICH compared with aspirin.
Source: Journal of Stroke and Cerebrovascular Diseases - November 21, 2012 Category: Neurology Authors: Gyanendra Kumar, Munish Kumar Goyal Tags: Original Articles Source Type: research

Hemorrhagic Risk of Emergent Endovascular Treatment Plus Stenting in Patients with Acute Ischemic Stroke
Conclusions: Our findings suggest that emergent stenting in endovascular treatment of AIS is associated with SICH.
Source: Journal of Stroke and Cerebrovascular Diseases - January 24, 2013 Category: Neurology Authors: Laura Dorado, Carlos Castaño, Mònica Millán, Aitziber Aleu, Natàlia Pérez de la Ossa, Meritxell Gomis, Elena López-Cancio, Elio Vivas, Ana Rodriguez-Campello, Mar Castellanos, Antoni Dávalos Tags: Original Articles Source Type: research

Numerous Fusiform and Saccular Cerebral Aneurysms in Central Nervous System Lupus Presenting with Ischemic Stroke
We report a patient with an active SLE flare who presented with a recurrent ischemic stroke and was found to have numerous unruptured fusiform and saccular aneurysms in multiple vascular territories. He was treated with high-dose steroid and rituximab along with aspirin and blood pressure control for stroke prevention.
Source: Journal of Stroke and Cerebrovascular Diseases - May 4, 2017 Category: Neurology Authors: Shahram Majidi, Christopher R. Leon Guerrero, Shreya Gandhy, Kathleen M. Burger, Dimitri Sigounas Tags: Case Studies Source Type: research

Cerebral Microbleeds Meta-analyses of Prospective Studies: The Need to Consider Both Ischemic and Hemorrhagic Stroke Outcomes
I read with interest the recent meta-analysis by Wang et al,1 reporting a high risk of intracerebral hemorrhage (ICH) in ischemic stroke/transient ischemic attack patients with cerebral microbleeds—especially those with multiple lesions or taking aspirin. The paper largely corroborates findings of a previous meta-analysis on the topic,2 but also presents some clinically relevant new observations. A key new result is that the presence of a single microbleed (compared to no microbleeds) does not seem to significantly increase the risk of future ICH in this patient population (relative risk: 2.33, 95% confidence interval: ...
Source: Journal of Stroke and Cerebrovascular Diseases - January 13, 2016 Category: Neurology Authors: Andreas Charidimou Tags: Letter to the Editor Source Type: research

Antiplatelet Therapy as a Risk Factor for Microbleeds in Intracerebral Hemorrhage Patients: Analysis Using Specific Antiplatelet Agents
Conclusions: Attention to microbleed-positive patients is necessary for the safe use of aspirin in order to avoid antiplatelet-associated hemorrhages, but prospective studies are needed to verify our results.
Source: Journal of Stroke and Cerebrovascular Diseases - July 12, 2012 Category: Neurology Authors: Hiromitsu Naka, Eiichi Nomura, Jyuri Kitamura, Eiji Imamura, Shinichi Wakabayashi, Masayasu Matsumoto Tags: Original Articles Source Type: research

Risk of Stroke vs. Intracerebral Hemorrhage in Patients with Non-Valvular Atrial Fibrillation Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Comparing Dual vs. Triple Antithrombotic Therapy
About 15% of patients with non-valvular atrial fibrillation might require percutaneous coronary interventions (PCIs) with stent placement to treat obstructive coronary artery disease. Dual antiplatelet therapy (DAPT) with acetylsalicylic acid (aspirin) and P2Y12 antagonist is recommended after PCI. Patients requiring DAPT also require treatment with oral anticoagulation for atrial fibrillation. We conducted a meta-analysis to identify the antithrombotic regimen associated with the lowest rate of bleeding and thromboembolic events in non-valvular atrial fibrillation after PCI.
Source: Journal of Stroke and Cerebrovascular Diseases - February 9, 2021 Category: Neurology Authors: Aaron Desai, Cesar Escamilla-Ocanas, Deepika Dilip, Hamidreza Saber, Rahul Damani Source Type: research

Associations of Durations of Antiplatelet Use and Vascular Risk Factors with the Presence of Cerebral Microbleeds
In conclusion, we found a significant association between aspirin use and deep or infratentorial microbleeds, but this association may reflect the presence of hypertension as a confounding factor.
Source: Journal of Stroke and Cerebrovascular Diseases - April 30, 2013 Category: Neurology Authors: Kazuo Yamashiro, Ryota Tanaka, Yasuyuki Okuma, Yuji Ueno, Yasutaka Tanaka, Nobutaka Hattori, Takao Urabe Tags: Original Articles Source Type: research

Do the Antithrombotic Therapy at the Time of Intracerebral Hemorrhage Influence Clinical Outcome? Analysis between the Difference of Antiplatelet and Anticoagulant Agents and Clinical Course
Background: It is controversial whether taking antiplatelet agents (APs) or anticoagulant agents (ACs) could influence clinical outcome after intracerebral hemorrhage (ICH).Methods: We retrospectively investigated 557 ICH patients between September 2008 and August 2013. We reviewed patients' characteristics, hematoma volume, deterioration (hematoma expansion, surgical hematoma evacuation, or death), and clinical outcome in modified Rankin Scale.Results: A total of 397 were classified as neither AP nor AC (“Nothing”), 81 as single AP (44 as aspirin [ASA], 22 as clopidogrel or ticlopidine [CLP/TIC], 7 as cilostazol, 8 as...
Source: Journal of Stroke and Cerebrovascular Diseases - June 23, 2014 Category: Neurology Authors: Takeshi Okada, Taizen Nakase, Masahiro Sasaki, Tatsuya Ishikawa Tags: Original Articles Source Type: research

Puerperal Extracranial Vertebral Artery Dissection and Nonaneurysmal Subarachnoid Hemorrhage
Previously reported only a few times before, we present a case of extracranial vertebral dissection and spontaneous frontoparietal subarachnoid hemorrhage (SAH) in the puerperium, discussing possible mechanisms and difficulties in management. A 35-year-old woman presented 10 days postcaesarean section with neck pain and vertigo with normal initial investigations. Following recurrent vertigo, headache, and ataxia, imaging revealed a frontoparietal SAH and vertebral artery dissection. The patient was consequently treated with aspirin, and then following a return of symptoms 3 weeks later, warfarin therapy was continued for 6 months.
Source: Journal of Stroke and Cerebrovascular Diseases - December 14, 2015 Category: Neurology Authors: James W. Garrard, Renata F. Simm, Edson Bor-Seng-Shu, Ricardo C. Nogueira Tags: Case Studies Source Type: research

Big Data Analysis of the Risk of Intracranial Hemorrhage in Korean Populations Taking Low-Dose Aspirin
In this study, the risk of intracranial hemorrhage in patients taking low-dose aspirin was assessed.
Source: Journal of Stroke and Cerebrovascular Diseases - June 11, 2021 Category: Neurology Authors: Tae Gon Kim, Soyoung Yu Source Type: research