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Source: Neurology
Condition: Bleeding

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Total 78 results found since Jan 2013.

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

Individualized risk prediction of major bleeding in secondary stroke prevention: Are we there yet?
In most patients diagnosed with a TIA or ischemic stroke, secondary stroke prevention relies on antiplatelet therapy unless anticoagulation is indicated. Aspirin has the largest evidence base and reduces the risk of early recurrent ischemic stroke without a major risk of early hemorrhagic complications.1 Because antiplatelet therapy typically continues for many years, clinicians and patients need an estimation of the annual bleeding risk to accurately assess future risk. In a meta-analysis of 25 randomized trials of antiplatelet therapy in primary or secondary prevention of cardiovascular disease, aspirin increased the abs...
Source: Neurology - August 28, 2017 Category: Neurology Authors: Lemmens, R., Al-Shahi Salman, R. Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Risk factors in epidemiology, Infarction EDITORIALS 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

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

Resumption of Antithrombotic Therapy in LVAD-associated Intracranial Hemorrhages (P2.273)
Conclusions:Among survivors of LVAD-associated ICH, those who resumed both antiplatelet plus warfarin therapy had fewer ischemic, but more hemorrhagic events than those who resumed antiplatelet therapy alone.Disclosure: Dr. Cho has nothing to disclose. Dr. Frontera has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Cho, S.-M., Frontera, J. Tags: Intracerebral Hemorrhage 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

Intravenous Thrombolysis for Acute Ischemic Stroke in Patients with Thrombocytopenia (P4.264)
Conclusions:IV rtPA for AIS might be safe in patients with platelet count <100,000/mm3 and it is reasonable not to delay IV rtPA administration while waiting for the platelet count result, unless there is strong suspicion for abnormal platelet count .Disclosure: Dr. Mowla has nothing to disclose. Dr. Kamal has nothing to disclose. Dr. Lail has nothing to disclose. Dr. Vaughn has nothing to disclose. Dr. Mehla has nothing to disclose. Dr. Deline has nothing to disclose. Dr. Ching has nothing to disclose. Dr. Crumlish has nothing to disclose. Dr. Sawyer has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Mowla, A., Kamal, H., Lail, N., Vaughn, C., Mehla, S., Deline, C., Ching, M., Crumlish, A., Sawyer, R. Tags: Thrombolysis and Acute Evaluation in Ischemic Stroke Source Type: research

Intravenous Thrombolysis in Anticoagulated and Thrombocytopenic Ischemic Stroke Patients Does Not Increase the Risk of Intracerebral Hemorrhage (P4.271)
Conclusions:These data suggest that IV rt-PA can be safely administered in coagulopathic and thrombocytopenic patients. Although rates of sICH and mortality were similar to the NINDS cohort, caution may be needed to identify certain hemorrhagic risk factors. Routine exclusion of anticoagulated or thrombocytopenic patients is not supported and the use of IV rt-PA in these patients may increase the eligibility for acute stroke therapy, particularly at institutions where IA therapy is unavailable.Disclosure: Dr. Barazangi has received personal compensation for activities with Genentech. Dr. Sorensen has nothing to disclose. D...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Barazangi, N., Sorensen, S., Chen, C., Wong, C., Yee, A., Ke, M., Rose, J., Grosvenor, D., Bedenk, A., Fernandes, J., Tong, D. Tags: Thrombolysis and Acute Evaluation in Ischemic Stroke 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

Atypical presentation of Sturge-Weber Syndrome. (P3.289)
Conclusions:This is an unusual presentation of SWS. Commonly, patients present at early age with seizure and unlike our case patient presented with SAH and stroke like symptoms.Disclosure: Dr. Lee has nothing to disclose. Dr. E-Ghanmh has nothing to disclose. Dr. Said Said has nothing to disclose. Dr. Wu has nothing to disclose. Dr. Muhammad has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Lee, A., E-Ghanmh, M., Said, S. S., Wu, N., Muhammad, I. Tags: Cerebrovascular Disease Case Reports II 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