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Factors Associated with Proximal Carotid Axis Occlusion in Patients with Acute Stroke and Atrial Fibrillation
Conclusions: Female sex, advanced age, history of systemic embolism, and higher BNP level were independently associated with more proximal carotid axis occlusion. Patients with AF having these factors may be prone to have relatively large thrombi in the heart.
Source: Journal of Stroke and Cerebrovascular Diseases - October 7, 2013 Category: Neurology Authors: Yuki Sakamoto, Shoichiro Sato, Yuka Kuronuma, Kazuyuki Nagatsuka, Kazuo Minematsu, Kazunori Toyoda Tags: Original Articles Source Type: research

Stroke Care during the COVID-19 Pandemic: International Expert Panel Review
This study, prepared by a large international panel of stroke experts, assesses the rapidly growing research and personal experience with COVID-19 stroke and offers recommendations for stroke management in this challenging new setting: modifications needed for prehospital emergency rescue and hyperacute care; inpatient intensive or stroke units; posthospitalization rehabilitation; follow-up including at-risk family and community; and multispecialty departmental developments in the allied professions.Summary: The severe acute respiratory syndrome coronavirus 2 uses spike proteins binding to tissue angiotensin-converting enz...
Source: Cerebrovascular Diseases - March 23, 2021 Category: Neurology Source Type: research

Safety of intravenous thrombolysis for ischemic stroke in patients treated with warfarin
ObjectiveControversy surrounds the safety of intravenous (IV) tissue plasminogen activator (tPA) in ischemic stroke patients treated with warfarin. The European tPA license precludes its use in anticoagulated patients altogether. American guidelines accept IV tPA use with an international normalized ratio (INR) ≤ 1.7. The influence of warfarin on symptomatic intracerebral hemorrhage (SICH), arterial recanalization, and long‐term functional outcome in stroke thrombolysis remains unclear. MethodsWe analyzed data from 45,074 patients treated with IV tPA enrolled in the Safe Implementation of Thrombolysis in Stroke (SITS) ...
Source: Annals of Neurology - September 4, 2013 Category: Neurology Authors: Michael V. Mazya, Kennedy R. Lees, Romesh Markus, Risto O. Roine, Raymond C. S. Seet, Nils Wahlgren, Niaz Ahmed, Tags: Original Article Source Type: research

Dabigatran etexilate: management in acute ischemic stroke.
Abstract A 54-year-old man treated with dabigatran experienced new onset of a stroke with a score of 9 on the National Institutes of Health Stroke Scale. Administration of recombinant tissue plasminogen activator (rtPA) was not recommended because of the dabigatran therapy. Angiography showed occlusion of the left middle cerebral artery by an embolic thrombus. Suction thrombectomy achieved flow through the inferior division of the artery. Computed tomography of the head showed possible intracranial hemorrhage, and dabigatran reversal was attempted with prothrombin complex concentrate and recombinant factor VIIa. C...
Source: American Journal of Critical Care - March 1, 2013 Category: Nursing Authors: Javedani PP, Horowitz BZ, Clark WM, Lutsep HL Tags: Am J Crit Care Source Type: research

An overlooked cause in a patient with recurrent ischemic stroke: A case report
Rationale: The majority of ischemic strokes are due to cardioembolism, large vessel atherothromboembolism, small vessel occlusive disease, or other unusual mechanisms. In most clinical settings, many strokes without a well-defined etiology requires a thorough diagnostic evaluation, otherwise the underlying cause might be easily overlooked. Here we report on the rare cause of a patient with recurrent stroke. Patient concerns: A 50-year-old female patient had a 4-year history of recurrent acute onset of neurological deficits. Diagnoses: Contrast transcranial Doppler ultrasound detected a typical “curtain” appeara...
Source: Medicine - March 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Oral direct thrombin inhibitor as an alternative in the management of cerebral venous thrombosis: a series of 15 patients
ConclusionsWe report the largest series of cerebral vein thrombosis patients treated with dabigatran. Clinical outcome was excellent in most patients and not different from other studies. Dabigatran could possibly be considered an alternative to warfarin; nevertheless, further prospective assessment with randomized controlled studies is warranted.
Source: International Journal of Stroke - February 1, 2015 Category: Neurology Authors: Marcelo D. Mendonça, Raquel Barbosa, Vera Cruz‐e‐Silva, Sofia Calado, Miguel Viana‐Baptista Tags: Research Source Type: research

Validation of the 9-Point and 24-Point Hematoma Expansion Prediction Scores and Derivation of the PREDICT A/B Scores Clinical Sciences
Conclusions— The 9- and 24-point expansion scores demonstrate acceptable discrimination in an independent multicenter cohort; however, calibration was suboptimal for the 9-point score. The PREDICT A score showed improved discrimination for HE prediction but requires independent validation.
Source: Stroke - October 26, 2015 Category: Neurology Authors: Huynh, T. J., Aviv, R. I., Dowlatshahi, D., Gladstone, D. J., Laupacis, A., Kiss, A., Hill, M. D., Molina, C. A., Rodriguez-Luna, D., Dzialowski, I., Silva, Y., Kobayashi, A., Lum, C., Boulanger, J.-M., Gubitz, G., Bhatia, R., Padma, V., Roy, J., Kase, C. Tags: Acute Cerebral Hemorrhage, Angiography, Computerized tomography and Magnetic Resonance Imaging, Intracerebral Hemorrhage, Anticoagulants Clinical Sciences Source Type: research

E-114 Rescue suction mechanical thrombectomy of medium-small vessel occlusion in a pediatric patient presented with acute ischemic stroke
ConclusionEndovascular aspiration mechanical thrombectomy of MSVO is feasible in pediatric patients presenting with AIS and associated with good functional outcome. Additionally, when acute ongoing neurological deficit is present and CTA is inconclusive, a digital subtraction angiography is deemed needed to identify MSVO as the yields of CTA diminishes significantly beyond LVO. Further studies are required.Disclosures R. Hart: None. A. Singh: None. C. Manzanero: None. Y. Lodi: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Hart, R., Singh, A., Manzanero, C., Lodi, Y. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

Antithrombotic Therapy.
Authors: Kwon SU, Kim JS Abstract Symptomatic cerebral atherosclerosis including intracranial atherosclerosis (ICAS) is associated with a high risk of recurrent stroke. Antithrombotic agents are the mainstay of therapy in these patients. Several studies have found anticoagulation (warfarin) to increase the risk of bleeding events and have an efficacy no better than that of aspirin. Therefore, anticoagulants are not widely used unless patients develop recurrent ischemic symptoms despite receiving antiplatelet therapy. Because ICAS progression is not uncommon and the risk of stroke recurrence is high when aspirin mon...
Source: Frontiers of Neurology and Neuroscience - December 15, 2016 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

Imaging the aortic arch to improve diagnostic and prognostic accuracy in transient ischemic attack patients
This study raises a final relevant question: since the prognosis of TIA patients worsens in proportion to the severity of AAA, what therapeutic options are available for these patients? The clinical guidelines recommend risk factor modification and therapy with statins (Class IIa, level of evidence C), an approach consistent with treatment of any patient affected by atherosclerosis. Treatment with coumadin or anti-platelet agents can be considered in patients with AAA >4 mm, i.e. severe AAA, but it remains very controversial because of a potential risk of thrombo-embolism (Class IIb, level of evidence C) . Finally, surgi...
Source: Atherosclerosis - November 25, 2013 Category: Cardiology Authors: Paolo Raggi Tags: Invited Commentaries Source Type: research

E-248 Postpartum vertebral artery dissections: a report of 7 cases and literature review
ConclusionA limited cohort of 33 ppVADs exist in the literature. This study contributes 7 additional cases and suggests that, despite heterogenous management of ppVAD, the resulting outcomes were favorable.Disclosures V. Lazarov: None. A. Monteiro: None. F. Almayman: None. M. Waqas: None. J. Cappuzzo: None. E. Levy: None. A. Siddiqui: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Lazarov, V., Monteiro, A., Almayman, F., Waqas, M., Cappuzzo, J., Levy, E., Siddiqui, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

Aortic Sarcoma Mimicking a Thrombus Filling Vascular Lumen: A Rare Cause of Cerebral Infarction (P4.364)
Conclusion- Primary aortic sarcoma is an extremely rare cause of stroke. This sarcoma may be misinterpreted as a thrombus filling vascular lumen on CT angiography, but no elevation of D-dimer is incompatible with a large thrombus. The final diagnosis can be made by surgical biopsy.Disclosure: Dr. Kim has nothing to disclose. Dr. Jeon has nothing to disclose. Dr. Park has nothing to disclose. Dr. Kim has nothing to disclose. Dr. Kim has nothing to disclose. Dr. Kwon has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Kim, H., Jeon, S.-B., Park, K.-W., Kim, H., Kim, B. J., Kwon, S. Tags: Cerebrovascular Case Reports Source Type: research

Arrive: A retrospective registry of Indian patients with venous thromboembolism
Conclusion: Acute DVT alone was responsible for the substantial burden of VTE in Indian patients. Bleeding was not the limiting factor for anticoagulant treatment in most patients.
Source: Indian Journal of Critical Care Medicine - March 8, 2016 Category: Intensive Care Authors: Dhanesh R KamerkarM Joseph JohnSanjay C DesaiLiesel C DsilvaSadhna J Joglekar Source Type: research

Rationale and design of a randomized trial of apixaban vs warfarin to evaluate atherosclerotic calcification and vulnerable plaque progression
This study is a single‐center, prospective, randomized, open‐label study. From May 2014 to December 2015, 66 patients with nonvalvular AF who experienced VKA therapy were enrolled. Patients were randomized into either warfarin or apixaban cohorts and followed for 52 weeks. The primary objective is to compare the rate of change in coronary artery calcification (CAC) from baseline to follow‐up in apixaban vs warfarin cohorts. The key secondary objective is to compare the rate of incident plaques and quantitative changes in plaque types between patients randomized to either warfarin or apixaban cohorts using serial coro...
Source: Clinical Cardiology - July 1, 2017 Category: Cardiology Authors: Kazuhiro Osawa, Rine Nakanishi, Theingi Tiffany Win, Dong Li, Sina Rahmani, Negin Nezarat, Nasim Sheidaee, Matthew J. Budoff Tags: TRIAL DESIGNS Source Type: research

P030  Antiphospholipid syndrome and giant cell arteritis: a coincidence or connection?
Conclusion In summary, this is a case of GCA and APS, treated with prednisolone, aspirin, warfarin and tocilizumab. There is increasing evidence describing the presence of antiphospholipid antibodies in patients with vasculitis. However, the role of these antibodies in GCA and the clinical significance rema ins unclear. This case reports highlights the need for physicians to consider APS in patients who have a history of GCA and subsequently develop arterial or venous embolic events.Disclosure L. Sammut: None.E. Htut: None.
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research

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