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Source: Neurology
Condition: Bleeding
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Total 54 results found since Jan 2013.

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

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

What are the barriers for use of pharmacological prophylaxis (PP) to prevent deep vein thrombosis (DVT) in spontaneous intracranial bleeding (sICH)? (P2.253)
Conclusions:Following this QI project, we started a new pilot study where DVT prophylaxis advisor was included in all stroke admission orders. The pilot project was successful and DVT prophylaxis advisor is now included permanently to all stroke admission orders including the intracranial hemorrhage. We hope this will ensure patients are started on prophylactic anticoagulation per guidelines.Disclosure: Dr. Jayaraman has nothing to disclose. Dr. Sapnar has nothing to disclose. Dr. Joe has nothing to disclose. Dr. Edara has nothing to disclose. Dr. Yaddanapudi has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Jayaraman, D. K., Sapnar, S., Joe, J., Edara, A., Yaddanapudi, S. Tags: Intracerebral Hemorrhage Source Type: research

Treatment Patterns and Outcomes of Patients Receiving Direct Oral Anticoagulants or Low Molecular Weight Heparin who Experienced Life-threatening Intracranial Hemorrhage (P5.053)
Conclusions:This study provides a real-world picture of patients receiving FXa inhibitors or LMWH, experiencing life-threatening intracranial bleeds. Despite efforts to restore hemostasis, mortality remained high and substantial healthcare resources were expended. This highlights the need to develop specific strategies for management of ICH in this patient population.Study Supported by: Portola Pharmaceuticals, Inc.Disclosure: Dr. Milling has received personal compensation for activities with CSI Behring, Janssen, BI, and Portola. Dr. Feronti has received research support from Portola. Dr. Clark has received research perso...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Milling, T. J., Feronti, C., Clark, C. L., Fermann, G. J., Song, S. S., Torbati, S. S., Weiss, J., Patel, D., Neuman, W. R. Tags: Neurocritical Care: Intracerebral Hemorrhage Source Type: research

Effectiveness and Safety of Apixaban and Rivaroxaban Versus Warfarin for the Secondary Prevention of Stroke or Systemic Embolism Among Nonvalvular Atrial Fibrillation Patients (S51.001)
Conclusions:Among NVAF patients with a prior history of SSE, rivaroxaban reduced ischemic stroke and ICH risk versus warfarin and did not significantly impact major bleeding. Apixaban did not significantly alter patients’ risk of SSE or major bleeding compared to warfarin in this high-risk population.Study Supported by: Bayer Pharma AGDisclosure: Dr. Coleman has received personal compensation for activities with Janssen Scientific affairs, LLC, Bayer Pharma AG, and BIPI . Dr. Coleman has received research support from Janssen Scientific Affairs, LLC, and Bayer Pharma AG. Dr. Bunz has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Coleman, C., Bunz, T. Tags: Cerebrovascular Disease and Interventional Neurology: Stroke Prevention and Translation Source Type: research

Using Artificial Intelligence to Reduce Risk of Non-Adherence in Patients on Anticoagulation Therapy (S53.002)
Conclusions:Elderly stroke patients, many with little experience using a smartphone, successfully used an AI application to monitor and increase adherence to anticoagulation therapy over 12 weeks. Patients monitored by the AI Platform demonstrated a 50% absolute improvement in adherence based on plasma drug levels. Continuous monitoring has the potential to increase adherence, change patient behavior and reduce the risks associated with non-adherence, particularly in patients on DOAC therapy.Study Supported by:AcknowledgmentFunding was received from the National Center for Advancing Translational Sciences (NCATS), grant nu...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Labovitz, D., Shafner, L., Virmani, D., Hanina, A. Tags: General Neurology: Mechanisms and Diagnosis in Overlapping Medical and Neurological Diseases 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

Aspirin use is associated with decreased initial stroke severity in patients with acute ischemic stroke: Pilot study (P6.293)
Conclusions:Aspirin appears to decrease the severity of AIS in a dose response fashion. We were unable to observe the effect of aspirin in the acetylation of albumin. Acetylation of additional proteins will be studied in an attempt to identify patients who respond best to aspirin.Disclosure: Dr. Jensen has nothing to disclose. Dr. Leonard has nothing to disclose. Dr. Bar-Or has nothing to disclose. Dr. Rael has nothing to disclose. Dr. Bartt has nothing to disclose. Dr. Wagner has received personal compensation for activities with Genentech as a speaker. Dr. Bar-Or has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Jensen, J., Leonard, J., Bar-Or, R., Rael, L., Bartt, R., Wagner, J., Bar-Or, D. Tags: Prevention of Cerebrovascular Disease Source Type: research

Outcomes of Endovascular Thrombectomy with and without thrombolysis for acute large artery ischaemic stroke at a Tertiary Stroke Centre (P5.259)
Conclusions:Our study supports the use of direct EVT for patients in whom alteplase is contraindicated. We observed no additional benefit of adding intravenous thrombolysis to EVT but the estimates are imprecise due to small numbers. Nevertheless, the results are consistent with observational data from other centres, and support a randomised controlled trial of EVT vs. EVT with bridging alteplase.Disclosure: Dr. Wee has nothing to disclose. Dr. Hankey has received personal compensation for activities with Bayer Pharmaceuticals and theheart.org (Medscape) as a speaker.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Wee, C. K., Hankey, G. Tags: Acute Cerebrovascular Interventional Therapies Source Type: research

Percutaneous Endoscopic Gastrostomy in Patients with Acute Neurologic Injury (P3.040)
Conclusions:In the acute neurologically injured patient. PEG tubes were associated with a 19% complication rate, with an 8% risk of severe complications. Clinicians recommending PEGs in neurologically ill patients should be aware of the potentially high rates of complications.Disclosure: Dr. Vu has nothing to disclose. Dr. Xavier has nothing to disclose. Dr. Woellner has nothing to disclose. Dr. Choi has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Vu, K. Y. T., Xavier, A., Woellner, J., Choi, H. Tags: Practice, Policy, and Ethics III Source Type: research

Natural history of cavernous malformation: Systematic review and meta-analysis of 25 studies
Conclusions: The incidence of symptomatic hemorrhage or rehemorrhage is higher in brainstem lesions. First symptomatic hemorrhage increases the chance of symptomatic rehemorrhage, which decreases after 2 years.
Source: Neurology - May 22, 2016 Category: Neurology Authors: Taslimi, S., Modabbernia, A., Amin-Hanjani, S., Barker, F. G., Macdonald, R. L. Tags: Other cerebrovascular disease/ Stroke, All Cerebrovascular disease/Stroke, Incidence studies, Natural history studies (prognosis), Intracerebral hemorrhage ARTICLE Source Type: research

Statins and poststroke intracerebral hemorrhage: Concern but increasing reassurance
Post hoc analyses of data from randomized controlled trials can generate useful hypotheses, but need to be considered exploratory. When conducted, such evaluations should adhere to specified criteria and test for a treatment by subgroup interaction for the trial's primary endpoint.1 The best way to proceed if unexpected but potentially important outcomes occur is less clear. Concern that treatment with HMG-CoA reductase inhibitors (i.e., statins) might increase the risk of poststroke intracerebral hemorrhage (ICH) arose from an unanticipated observation in the Stroke Prevention with Aggressive Reduction in Cholesterol Leve...
Source: Neurology - April 24, 2016 Category: Neurology Authors: Goldstein, L. B., Nederkoorn, P. J. Tags: All Cerebrovascular disease/Stroke, Intracerebral hemorrhage EDITORIALS Source Type: research

Alcoholism and In-Hospital Mortality among Hemorrhagic Stroke Patients in Puerto Rico (P1.263)
Conclusions: The adjusted OR of 3.18 suggests a positive association and in-patient hemorrhagic stroke mortality. However the small sample size and low power limit the ability to delineate a clear statistical association, thereby warranting further study into this subject matter as alcoholism is a modifiable risk factor and early interventions may lower hemorrhagic stroke mortality in this population.Disclosure: Dr. Smirnoff has nothing to disclose. Dr. Moses has nothing to disclose. Dr. Zevallos has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Smirnoff, L., Moses, A., Zevallos, J. C. Tags: Cerebrovascular Disease: Health Disparities Source Type: research

Outcomes After Thrombolysis for Acute Ischemic Stroke for Adults 65 and Older: A Nationwide Inpatient Sample Analysis (P1.267)
Conclusions: This analysis suggests clinical outcomes for older adult patients who receive IVtPA for AIS are worse compared to those who do not. Nuanced investigation must be done to confirm findings, and to address potential changes in current treatment strategies for this population.Disclosure: Dr. Song has nothing to disclose. Dr. Ouyang has nothing to disclose. Dr. Cherian has nothing to disclose. Dr. Cutting has nothing to disclose. Dr. Lee has nothing to disclose. Dr. Conners has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Song, S., Ouyang, B., Cherian, L., Cutting, S., Lee, V., Conners, J. Tags: Cerebrovascular Disease: Health Disparities Source Type: research

Antithrombotic Strategy in Cerebral Venous Thrombosis: Differences Between Neurologists and Haematologists in a Canadian Survey (I2.010)
Conclusions: In this cohort, there are differences between neurologists and hematologists with regards to initial choice of anticoagulant. It is possible that more complex presenting cases of CVT with concurrent venous infarction, hemorrhage or seizure may present to neurologists as compared to hematologists. Thus, an initial preference for UFH may reflect a desire for a reversible agent with a short half-life in the event of bleeding complications in an unstable patient. Our study is limited by response bias, though our response rate of 28[percnt] is comparable to other contemporary web-based physician surveys. The majori...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Alshimemeri, S., Camden, M.-C., Lui, G., Lee, A., Field, T. Tags: Stroke in the Elderly and Young: Challenges for the Next Decade Poster Presentations Source Type: research