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Warfarin-associated Intracerebral Hemorrhage is Increasing in Prevalence in the United States
Background: Warfarin-associated intracerebral hemorrhage (WAICH) is expected to increase in prevalence as the population ages. We sought to evaluate national trends, characteristics, and in-hospital outcomes among intracerebral hemorrhage (ICH) patients taking warfarin at baseline.Methods: We reviewed the Nationwide Inpatient Sample to identify all admissions with primary diagnosis of ICH by International Classification of Diseases, Ninth Revision code (431) from 2005 to 2008. We identified premorbid warfarin use by the V code (V58.93) and calculated the proportion of WAICH among all ICH patients in each year. We employed ...
Source: Journal of Stroke and Cerebrovascular Diseases - January 3, 2013 Category: Neurology Authors: Eric M. Liotta, Shyam Prabhakaran Tags: Original Articles Source Type: research

Antihypertensives Are Administered Selectively in Emergency Department Patients with Subarachnoid Hemorrhage
Elevated blood pressure is common in patients with acute subarachnoid hemorrhage (SAH). American Heart Association guidelines do not specify a blood pressure target, but limited data suggest that systolic blood pressure (SBP) ≥160 mmHg is associated with increased risk of rebleeding and neurologic decline. In a population-based study, we determined the frequency of antihypertensive therapy in emergency department (ED) patients with SAH and the proportion of those patients with SBP ≥160 mmHg who received this therapy. In 2005, nontraumatic SAH cases were retrospectively ascertained at 16 hospitals in our region by scree...
Source: Journal of Stroke and Cerebrovascular Diseases - April 12, 2012 Category: Neurology Authors: Virginia Culyer, Erin McDonough, Christopher J. Lindsell, Kathleen Alwell, Charles J. Moomaw, Brett M. Kissela, Matthew L. Flaherty, Pooja Khatri, Daniel Woo, Simona Ferioli, Joseph P. Broderick, Dawn Kleindorfer, Opeolu Adeoye Tags: Original Articles Source Type: research

A Ruptured Aneurysm Arising at the Leptomeningeal Collateral Circulation from the Extracranial Vertebral Artery to the Posterior Inferior Cerebellar Artery Associated with Bilateral Vertebral Artery Occlusion
We report an extremely rare case of a small ruptured aneurysm of the leptomeningeal collateral circulation from the vertebral artery (VA) to the posterior inferior cerebellar artery (PICA); this aneurysm was associated with bilateral VA occlusion. A 72-year-old woman with sudden headache, nausea, and subarachnoid hemorrhage (SAH) was admitted to our hospital. On admission, no evidence of cerebral signs or cranial nerve palsy was found. Computed tomography imaging showed SAH predominantly in the posterior fossa, and digital subtraction angiography revealed bilateral VA occlusion and the left VA aneurysm located proximal to ...
Source: Journal of Stroke and Cerebrovascular Diseases - December 9, 2013 Category: Neurology Authors: Masashi Chonan, Shinjitu Nishimura, Naoto Kimura, Masayuki Ezura, Hiroshi Uenohara, Teiji Tominaga Tags: Case Reports Source Type: research

The SAH Score: A Comprehensive Communication Tool
Background: The Hunt and Hess grade and World Federation of Neurological Surgeons (WFNS) scale are commonly used to predict mortality after aneurysmal subarachnoid hemorrhage (aSAH). Our objective was to improve the accuracy of mortality prediction compared with the aforementioned scales by creating the “SAH score.”Methods: The aSAH database at our institution was analyzed for factors affecting in-hospital mortality using multiple logistic regression analysis. Scores were weighted based on relative risk of mortality after stratification of each of these variables. Glasgow Coma Scale (GCS) was subdivided into groups of ...
Source: Journal of Stroke and Cerebrovascular Diseases - October 7, 2013 Category: Neurology Authors: Neeraj S. Naval, Robert G. Kowalski, Tiffany R. Chang, Filissa Caserta, J. Ricardo Carhuapoma, Rafael J. Tamargo Tags: Original Articles Source Type: research

Incidence, Epidemiology, and Treatment of Aneurysmal Subarachnoid Hemorrhage in 12 Midwest Communities
Only 8 studies have investigated the incidence and epidemiology of aneurysmal subarachnoid hemorrhage (aSAH) in the United States. This is the first investigation in Indiana, which has some of the highest rates of tobacco smoking and obesity in the nation. The authors prospectively identified 441 consecutive patients with aSAH from 2005 to 2010 at 2 hospitals where the majority of cases are treated. Incidence calculations were based on US Census populations. Epidemiologic variables included demography; risk factors; Hunt and Hess scale; Fisher grade; number, location, and size of aneurysms; treatment type; and complication...
Source: Journal of Stroke and Cerebrovascular Diseases - October 21, 2013 Category: Neurology Authors: Mary Ziemba-Davis, Bradley N. Bohnstedt, Troy D. Payner, Thomas J. Leipzig, Erin Palmer, Aaron A. Cohen-Gadol Tags: Original Articles Source Type: research

Acquired Hemophilia A Associated with Internal Border-zone Infarction Triggered by Major Hemorrhage of Thigh and Leg: A Case Report
We describe a first case of internal border-zone infarction (I-BZI) complicated with acquired hemophilia A. A 79-year-old man was introduced from other hospital by cerebral infarction and severe anemia. His left thigh and leg were swollen with subcutaneous bleeding. Activated partial thromboplastin time was 99.4 seconds. Factor VIII activity was less than 1% and Factor VIII inhibitor concentration was 85 BU, respectively.
Source: Journal of Stroke and Cerebrovascular Diseases - October 10, 2014 Category: Neurology Authors: Masayuki Miyazaki, Shuuhei Nagami, Hisao Shimizu, Nobuyuki Takahashi Tags: Case Report Source Type: research

A Case of Neurofibromatosis Type 1 Complicated with Repeated Intracerebral Hemorrhage due to Quasi-Moyamoya Disease
We report a case of quasi-MMD complicated with repeated intracerebral hemorrhage during long-term follow-up for cerebral ischemia. A 35-year-old woman who had a diagnosis of neurofibromatosis type 1 visited our hospital because of incidentally found cerebral infarction.
Source: Journal of Stroke and Cerebrovascular Diseases - March 24, 2015 Category: Neurology Authors: Kentaro Hayashi, Yoichi Morofuji, Nobutaka Horie, Tsuyoshi Izumo Tags: Case Report Source Type: research

Cerebral Vasospasm and Delayed Cerebral Ischemia after Warfarin-Induced Subarachnoid Hemorrhage
Subarachnoid hemorrhage (SAH) associated with anticoagulation is a rare event. About 30% of in-hospital patients with aneurysmal SAH develop delayed cerebral ischemia (DCI); however, the occurrence of vasospasm and DCI in patients with nonaneurysmal SAH is still controversial.
Source: Journal of Stroke and Cerebrovascular Diseases - July 18, 2015 Category: Neurology Authors: Irapuá Ferreira Ricarte, Fabrício G. Calente, Maramélia M. Alves, Daniela L. Gomes, Raul A. Valiente, Flávio A. Carvalho, Gisele S. Silva Tags: Case Report Source Type: research

Dysphagia Following Putaminal Hemorrhage at a Rehabilitation Hospital
Dysphagia occurs frequently during the acute phase of cerebral hemorrhage; however, there are few reports of dysphagia associated with cerebral hemorrhage in the subacute and chronic phase. We focused on putaminal hemorrhage at a rehabilitation hospital and evaluated the relationships between the frequencies of dysphagia, focus, and hematoma volume and type.
Source: Journal of Stroke and Cerebrovascular Diseases - November 25, 2015 Category: Neurology Authors: Shinichiro Maeshima, Hideto Okazaki, Sayaka Okamoto, Shiho Mizuno, Naoki Asano, Tetsuya Tsunoda, Mitsuko Masaki, Shinichiro Tanaka, Shigeru Sonoda Source Type: research

Postprandial Hypotension and Coma Following Subarachnoid Hemorrhage in a Patient with Parkinson's Disease
A 79-year-old woman with a history of Parkinson's disease was admitted to our hospital because of a subarachnoid hemorrhage. She underwent clipping the next day. On postoperative days 7-9, she exhibited hypotension and disturbance of consciousness after each meal. The administration of midodrine relieved the hypotension, and postprandial coma was no longer observed. In this case, the autonomic dysfunction in Parkinson's disease and impairment of cerebral autoregulation during cerebral vasospasm may have been involved in the postprandial hypotension (PPH) and coma.
Source: Journal of Stroke and Cerebrovascular Diseases - February 13, 2016 Category: Neurology Authors: Jun Watanabe, Jun Maruya, Kenjyu Hara, Keiichi Nishimaki Tags: Case Studies Source Type: research

Concurrence of Aneurysmal Subarachnoid Hemorrhage and Stanford Type A Acute Aortic Dissection
We report a rare case of concurrent aneurysmal subarachnoid hemorrhage (SAH) and acute aortic dissection (AAD). A 38-year-old man visited our hospital complaining of severe headache, and brain computed tomography (CT) revealed the presence of SAH. Thoracic to neck computed tomography angiography (CTA), performed in addition to brain CTA, suggested a tear in the aortic arch, and subsequent CT aortography established the diagnosis of Stanford type A AAD. The AAD in our patient, who reported no episodes of chest or back pain, was detected incidentally by thoracic to neck CTA.
Source: Journal of Stroke and Cerebrovascular Diseases - April 11, 2016 Category: Neurology Authors: Joji Inamasu, Takeya Suzuki, Akira Wakako, Akiyo Sadato, Yuichi Hirose Tags: Case Studies Source Type: research

Electrocardiographic Abnormalities Predict Adverse Clinical Outcomes in Patients with Subarachnoid Hemorrhage
We conducted a retrospective cohort study of a large sample to assess whether electrocardiographic (ECG) abnormalities are independently associated with the occurrence of neurogenic pulmonary edema (NPE), delayed cerebral ischemia (DCI), and in-hospital death after nontraumatic subarachnoid hemorrhage (SAH).
Source: Journal of Stroke and Cerebrovascular Diseases - July 28, 2016 Category: Neurology Authors: Limin Zhang, Sihua Qi Source Type: research

Progressive Bilateral Vertebral Artery Dissection in a Case of Osteogenesis Imperfecta
A 32-year-old woman with osteogenesis imperfecta (OI) was admitted to the hospital because of a right-sided occipital headache and facial paresthesia. She was diagnosed with lateral medullary syndrome due to right vertebral artery (VA) dissection. She was treated conservatively without antithrombotic therapy. She developed subarachnoid hemorrhage because of contralateral VA dissection 18 days later. This clinical course may reflect the underlying weakness of the vessel wall in OI. In patients with OI, occlusion of a unilateral VA could cause dissection and subsequent rupture of the contralateral VA.
Source: Journal of Stroke and Cerebrovascular Diseases - January 11, 2017 Category: Neurology Authors: Yuji Kato, Harumitsu Nagoya, Tetsuya Abe, Takeshi Hayashi, Masanori Yasuda, Akira Uchino, Norio Tanahashi, Masaki Takao Tags: Case Studies Source Type: research

Variability in the Use of Platelet Transfusion in Patients with Intracerebral Hemorrhage: Observations from the Ethnic/Racial Variations of Intracerebral Hemorrhage Study
We examined platelet transfusion (PTx) in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study, hypothesizing that rates of PTx would vary among hospitals and depend on whether patients were on an antiplatelet therapy or underwent intracerebral hemorrhage (ICH) surgical treatment.
Source: Journal of Stroke and Cerebrovascular Diseases - June 29, 2017 Category: Neurology Authors: Waldo R. Guerrero, Nicole R. Gonzales, Padmini Sekar, Jorge Kawano-Castillo, Charles J. Moomaw, Bradford B. Worrall, Carl D. Langefeld, Sharyl R. Martini, Matthew L. Flaherty, Kevin N. Sheth, Jennifer Osborne, Daniel Woo Source Type: research

Short-Term Outcome of Spontaneous Intracerebral Hemorrhage in Algarve, Portugal: Retrospective Hospital-Based Study
The objective of this study was to describe the predictors of 30-day in-hospital SICH mortality in Algarve, the southernmost region of Portugal.
Source: Journal of Stroke and Cerebrovascular Diseases - October 25, 2017 Category: Neurology Authors: Hipolito Nzwalo, Jerina Nogueira, Ana Catarina F élix, Patrícia Guilherme, Pedro Abreu, Teresa Figueiredo, Fátima Ferreira, Ana Marreiros, Lars Thomassen, Nicola Logallo Source Type: research

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