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Total 43 results found since Jan 2013.

Editors' Note
: In "Risks and benefits of clopidogrel–aspirin in minor stroke or TIA: Time course analysis of CHANCE," authors Pan et al. compared the use of dual antiplatelet therapy (DAPT) with aspirin alone for secondary stroke prevention in patients after a minor stroke or TIA. Drs. Gutierrez and Lekic point out that DAPT appeared to have a greater benefit than aspirin alone in patients with intracranial arterial stenosis (ICAS) in the first 2 weeks and ask the authors to provide a time-course analysis for the risk of ischemic stroke and hemorrhage by ICAS status.
Source: Neurology - November 13, 2017 Category: Neurology Authors: Alcauskas, M., Galetta, S. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research

Letter re: Risks and benefits of clopidogrel-aspirin in minor stroke or TIA: Time course analysis of CHANCE
We read with interest the article by Pan et al.,1 which reported that the use of dual antiplatelet therapy (DAPT) showed an early benefit, compared to aspirin alone, for secondary ischemic stroke prevention after a minor stroke or TIA. The absolute risk reduction in the first week after the indexed event was 4.5%.1 The authors previously reported a nonsignificant absolute risk reduction in recurrent ischemic stroke of 2.3% with DAPT compared to aspirin alone in Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) participants with intracranial arterial stenosis (ICAS) over the 90-day fo...
Source: Neurology - November 13, 2017 Category: Neurology Authors: Gutierrez, J., Lekic, T. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research

Author response: Risks and benefits of clopidogrel-aspirin in minor stroke or TIA: Time course analysis of CHANCE
We appreciate Drs. Gutierrez and Lekic's emphasis on the time-course analysis of dual antiplatelet therapy (DAPT) by intracranial arterial stenosis (ICAS) in their comments on our article.1 Only 1,089 patients were included in the imaging substudy.2 In patients with ICAS, 19 (8.2%), 3 (1.3%), and 0 ischemic strokes in the DAPT group (n = 231) vs 25 (10.0%), 6 (2.4%), and 0 in the aspirin alone group (n = 250), and 4 (1.7%), 0, and 2 (0.9%) bleeding in the DAPT group vs 1 (0.4%), 0, and 0 in the aspirin alone group, occurred at the first, second, and third week, respectively. In patients without ICAS, 11 (3.7%), 1 (0.3%), a...
Source: Neurology - November 13, 2017 Category: Neurology Authors: Pan, Y., Wang, Y., Wang, Y. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research

Predicting major bleeding in patients with noncardioembolic stroke on antiplatelets: S2TOP-BLEED
Conclusions: The S2TOP-BLEED score can be used to estimate 3-year major bleeding risk in patients with a TIA or ischemic stroke who use antiplatelet agents, based on readily available characteristics. The discriminatory performance may be improved by identifying stronger predictors of major bleeding.
Source: Neurology - August 28, 2017 Category: Neurology Authors: Hilkens, N. A., Algra, A., Diener, H.-C., Reitsma, J. B., Bath, P. M., Csiba, L., Hacke, W., Kappelle, L. J., Koudstaal, P. J., Leys, D., Mas, J.-L., Sacco, R. L., Amarenco, P., Sissani, L., Greving, J. P., For the Cerebrovascular Antiplatelet Trialists' Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Risk factors in epidemiology, Infarction ARTICLE Source Type: research

Clinical Reasoning: Two see or not two see--Is it really double vision?
A 57-year-old right-handed woman presented to the emergency department with complaints of double vision and intractable nausea that began abruptly 2 days earlier. Her visual symptoms were characterized as seeing overlapping or separate horizontally or diagonally displaced objects. She had no history of headaches or stroke. Her cerebrovascular risk factors included hypertension, type II diabetes, coronary artery disease, and cigarette smoking. Her medications included clopidogrel, lisinopril, paroxetine, and oxycodone. Her family history was notable for late-onset ischemic heart disease in her parents with no first-degree r...
Source: Neurology - August 7, 2017 Category: Neurology Authors: Murphy, R. R., Al Sawaf, A., Rose, D. R., Goldstein, L. B., Smith, C. D. Tags: Clinical neurology examination, Diplopia (double vision), Visual fields, Visual processing, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research

Risks and benefits of clopidogrel-aspirin in minor stroke or TIA: Time course analysis of CHANCE
Conclusions: Clopidogrel–aspirin treatment may have a benefit of reducing stroke risk outweighing the potential risk of increased bleeding especially within the first 2 weeks compared with aspirin alone in patients with minor stroke or TIA. Clinicaltrials.gov identifier: NCT00979589. Classification of evidence: This study provides Class II evidence that for patients with minor stroke or TIA, the reduction of stroke risk from clopidogrel plus aspirin within the first 2 weeks outweighs the risk of bleeding compared with aspirin alone.
Source: Neurology - May 15, 2017 Category: Neurology Authors: Pan, Y., Jing, J., Chen, W., Meng, X., Li, H., Zhao, X., Liu, L., Wang, D., Johnston, S. C., Wang, Y., Wang, Y., On behalf of the CHANCE investigators Tags: All Cerebrovascular disease/Stroke, Clinical trials Randomized controlled (CONSORT agreement) ARTICLE Source Type: research

Patient is Taking Antiplatelet at home-Does This Increase the Risk of Post Intravenous Thrombolysis Intracranial Hemorrhage? (P4.268)
Conclusions:Patients with AIS receiving long-term antiplatelet medications were not at greater risk of developing sICH after IVT, neither did increase the chance of poor functional outcome.Disclosure: Dr. Mehla has nothing to disclose. Dr. Lail has nothing to disclose. Dr. Shah has nothing to disclose. Dr. Vaughn has nothing to disclose. Dr. Crumlish has nothing to disclose. Dr. Deline has nothing to disclose. Dr. Ching has nothing to disclose. Dr. Sawyer has nothing to disclose. Dr. Mowla has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Mehla, S., Lail, N., Shah, H., Vaughn, C., Crumlish, A., Deline, C., Ching, M., Sawyer, R., Mowla, A. Tags: Thrombolysis and Acute Evaluation in Ischemic Stroke Source Type: research

Safety of OnabotulinumtoxinA Treatment With Concomitant Antithrombotic Therapy in Patients With Post-stroke Spasticity: A Pooled Analysis of Randomized, Double-Blind Studies (S56.008)
Conclusions:There is no apparent increased risk of bleeding complications in patients on antithrombotics following IM onabotA treatment; nonetheless, careful observation of the injection site and patient education of the potential for bleeding complications remain warranted.Study Supported by: Allergan plc, Dublin, IrelandDisclosure: Dr. Dimitrova has received personal compensation for activities with Allergan as an employee. Dr. Dimitrova holds stock and/or stock options in Allergan. Dr. James has received personal compensation for activities with Allergan and Chase Pharmaceuticals as an employee. Dr. Liu has received per...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Dimitrova, R., James, L., Liu, C., Orejudos, A., Yushmanova, I., Brin, M. Tags: Movement Disorders: Huntington ' s Disease and Drug-Induced Dyskinesias Source Type: research

THE SINGLE NUCLEOTIDE POLYMORPHISMS (SNPs) IN CYTOCHROME P450 2C19 AND CLOPIDOGREL RESISTANCE IN INDIAN POPULATION (P1.256)
Conclusions:There is high prevalence of CYP2C19*2 allele in Indian population resulting in clopidogrel resistance/treatment failure.Disclosure: Dr. Shivaraman M M has nothing to disclose. Dr. Nazarene has nothing to disclose. Dr. Ranganathan has nothing to disclose. Dr. Ravi Chandar has nothing to disclose. Dr. S has nothing to disclose. Dr. Shankar has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Shivaraman, M. A., Nazarene, A., Ranganathan, L. N., Chandar, C. S. R., Kumar, S. P., Shankar, G. Tags: Genetic Stroke Syndromes, Biomarkers, and Translational/Basic Research Source Type: research

Purinoreceptors and VZV Vasculopathy (P1.263)
Conclusions:Overall, VZV infection caused a transient rise in extracellular ATP. Importantly, we found that aside from its known antiplatelet effects, P2Y12 antagonist clopidogrel also inhibits VZV infection, independent of downstream inhibition of glycoprotein IIB/IIIA, and may serve as an alternative antiviral therapy for VZV vasculopathy.Disclosure: Dr. Wyborny has nothing to disclose. Dr. Choe has nothing to disclose. Dr. Totaro has received personal compensation for activities with Bayer Schering Pharma, Biogen Idec, Merck Serono, Novartis, Sanofi-Aventis, and Teva as a speaker. Dr. Gerasimovskaya has nothing to discl...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Wyborny, A., Choe, A., Traktinskiy, I., Gerasimovskaya, E., Gilden, D., Nagel, M. Tags: Genetic Stroke Syndromes, Biomarkers, and Translational/Basic Research Source Type: research

Evaluation of Antithrombotic Bridging Methods in Acute Ischemic Stroke Patients with Atrial Fibrillation (P6.281)
Conclusions:Preliminary data supports against bridging with parenteral anticoagulation in acute ischemic stroke and AF, with a higher incidence of complications observed overall. Higher incidence of extracranial complications observed with bridging anticoagulation and higher incidence of intracranial complications observed from bridging antiplatelet therapy. This finding may be related to the limited number of patients included. A future goal for this project will be to expand the number of charts reviewed to strengthen the validity of these results.Disclosure: Dr. Swafford has nothing to disclose. Dr. Lee has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Swafford, K., Lee, J. Tags: Prevention of Cerebrovascular Disease Source Type: research

Rates of Adverse Events in the Very Old: A Community Anticoagulation Clinic Study (P6.291)
Conclusions:The very old still achieve minimum TTR to experience anticoagulation benefits. Patients older than 95 are at appreciably increased risk of hemorrhage, while ischemic events were overrepresented in ages 90–95. Future work aims to determine risk factors for thrombotic and hemorrhagic events in the very old.Disclosure: Dr. Stanley has nothing to disclose. Dr. Knight has nothing to disclose. Dr. Stein has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Stanley, M., Knight, C., Stein, R. Tags: Prevention of Cerebrovascular Disease Source Type: research

Hyperacute Carotid Stenting for Acute Ischemic Stroke After Systemic Thrombolysis with IV rt-PA (P1.282)
Conclusions:These 2 cases demonstrate a successful use of hyperacute carotid stenting and antiplatelet load in patients who received systemic thrombolysis with IV rt-PA. Both had excellent outcomes and no complications. This management may be considered in patients with similar clinical and imaging characteristics.Disclosure: Dr. Marulanda-Londoño has nothing to disclose. Dr. DeLeon-Bendetti has nothing to disclose. Dr. Ortiz has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Marulanda-Londono, E., DeLeon-Bendetti, A., Ortiz, G. Tags: Cerebrovascular Disease Case Reports I Source Type: research

Acute Ischemic Stroke as a Presenting Feature of Multiple Myeloma (P3.279)
Conclusions:Stroke is a leading and preventable cause of disability in the US adult population. The majority of strokes are due to atherosclerotic vascular or cardioembolic disease. Understanding the diagnostic work up of stroke and recognizing rare etiologies like MM is important for stroke prevention. This brings to light the importance of recognizing stroke as an initial presenting feature of multiple myeloma and of multiple myeloma as an important treatable etiology of stroke.Disclosure: Dr. Chung has nothing to disclose. Dr. Ramamoorthy has nothing to disclose. Dr. Kar has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Chung, S., Ramamoorthy, R., Kar, J. Tags: Cerebrovascular Disease Case Reports II Source Type: research

Association of multiple infarctions and ICAS with outcomes of minor stroke and TIA
Conclusions: The presence of multiple infarctions and ICAS were both associated with an increased risk of 90-day ischemic stroke in patients with minor stroke or TIA, while the presence of both imaging features had a combined effect. ClinicalTrials.gov identifier: NCT00979589.
Source: Neurology - March 12, 2017 Category: Neurology Authors: Pan, Y., Meng, X., Jing, J., Li, H., Zhao, X., Liu, L., Wang, D., Johnston, S. C., Wang, Y., Wang, Y., On behalf of the CHANCE Investigators Tags: All Cerebrovascular disease/Stroke, Clinical trials Observational study (Cohort, Case control) ARTICLE Source Type: research