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Total 12509 results found since Jan 2013.

Preexisting Cerebral Microbleeds on Susceptibility-Weighted Magnetic Resonance Imaging and Post-Thrombolysis Bleeding Risk in 392 Patients Clinical Sciences
Conclusions— CMB detected on pretreatment susceptibility-weighted MRI did not increase the risk for ICH or worsen outcome, even when CMB burden, predominant location, or presumed pathogenesis was considered. There was only a small increased risk for ICH outside the infarct with increasing CMB burden that does not advise against thrombolysis in such patients.
Source: Stroke - May 27, 2014 Category: Neurology Authors: Gratz, P. P., El-Koussy, M., Hsieh, K., von Arx, S., Mono, M.-L., Heldner, M. R., Fischer, U., Mattle, H. P., Zubler, C., Schroth, G., Gralla, J., Arnold, M., Jung, S. Tags: Acute Stroke Syndromes, Emergency treatment of Stroke, Thrombolysis Clinical Sciences Source Type: research

Dual antiplatelet therapy in recurrent stroke prevention: do the benefits outweigh the risks?
This study assessed seven randomised controlled trials, comprising 39 574 patients and comparing dual versus single antiplatelet therapies. Medications used included aspirin (50–325 mg daily), clopidogrel (75 mg daily), aspirin plus dipyridamole (50/400 mg daily) and ticlopidine (100 mg daily). Patients had a history of ischaemic stroke (three trials) or TIA (four...
Source: Evidence-Based Medicine - July 18, 2014 Category: Internal Medicine Authors: Farooq, M. U., Gorelick, P. B. Tags: Clinical trials (epidemiology), Stroke Therapeutics Source Type: research

Predictors of Mortality in Patients With Lacunar Stroke in the Secondary Prevention of Small Subcortical Strokes Trial Clinical Sciences
Conclusions— Unexpected interactions between assigned antiplatelet therapy and each of ischemic heart disease and normal/prehypertensive status accounted for increased mortality among patients with recent lacunar stroke given dual antiplatelet therapy. Despite extensive exploratory analyses, the mechanisms underlying these interactions are uncertain. Clinical Trial Registration— URL: http://www.SPS3ClinicalTrials.gov. Unique identifier: NCT00059306.
Source: Stroke - September 22, 2014 Category: Neurology Authors: Sharma, M., Pearce, L. A., Benavente, O. R., Anderson, D. C., Connolly, S. J., Palacio, S., Coffey, C. S., Hart, R. G. Tags: Cerebral Lacunes, Antiplatelets Clinical Sciences Source Type: research

Chronic Kidney Disease and Bleeding Complications After Intravenous Thrombolytic Therapy for Acute Ischemic Stroke Original Articles
Conclusions— Presence of CKD among patients with IS treated with intravenous tissue-type plasminogen activator is associated with higher unadjusted odds of symptomatic intracranial hemorrhage or serious systemic hemorrhage, but this is explained by non-CKD related factors.
Source: Circulation: Cardiovascular Quality and Outcomes - November 18, 2014 Category: Cardiology Authors: Ovbiagele, B., Smith, E. E., Schwamm, L. H., Grau-Sepulveda, M. V., Saver, J. L., Bhatt, D. L., Hernandez, A. F., Peterson, E. D., Fonarow, G. C. Tags: Cerebrovascular disease/stroke, Risk Factors, Acute Cerebral Infarction, Thrombolysis Original Articles Source Type: research

Pathophysiological Role of Global Cerebral Ischemia following Subarachnoid Hemorrhage: The Current Experimental Evidence.
Authors: Plesnila N Abstract Subarachnoid hemorrhage (SAH) is the subtype of stroke with one of the highest mortality rates and the least well-understood pathophysiologies. One of the very early events which may occur after SAH is a significant decrease of cerebral perfusion pressure (CPP) caused by the excessive increase of intracranial pressure during the initial bleeding. A severely decreased CPP results in global cerebral ischemia, an event also occurring after cardiac arrest. The aim of the current paper is to review the pathophysiological events occurring in experimental models of SAH and global cerebral isch...
Source: Stroke Research and Treatment - December 2, 2014 Category: Neurology Tags: Stroke Res Treat Source Type: research

Using the Watchman device to close the left atrial appendage reduces risk of stroke in atrial fibrillation, compared to using warfarin
Commentary to: Reddy VY, Sievert H, Halperin J, et al.; PROTECT AF Steering Committee and Investigators. Percutaneous left atrial appendage closure vs warfarin for atrial fibrillation: a randomized clinical trial. JAMA 2014;312:1988–98 . Context Atrial fibrillation (AF) is a common arrhythmia in clinical practice. The major complication of AF is thromboembolic stroke. Patients with AF have a fivefold higher risk of stroke and a twofold increase in mortality.1 As complete cure for AF is never certain, the aims of AF therapy are symptom relief and prevention of thromboembolic events. The latter can be managed by vitami...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Swaans, M. J., Alipour, A., Boersma, L. V. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Arrhythmias Therapeutics/Prevention Source Type: research

What causes intracerebral bleeding after thrombolysis for acute ischaemic stroke? Recent insights into mechanisms and potential biomarkers
The overall population benefit of intravascular recombinant tissue plasminogen activator (rtPA) on functional outcome in ischaemic stroke is clear, but there are some treated patients who are harmed by early symptomatic intracranial haemorrhage (ICH). Although several clinical and radiological factors increase the risk of rtPA-related ICH, none of the currently available risk prediction tools are yet useful for practical clinical decision-making, probably reflecting our limited understanding of the underlying mechanisms. Finding new methods to identify patients at highest risk of rtPA-related ICH, or new measures to limit ...
Source: Journal of Neurology, Neurosurgery and Psychiatry - September 13, 2015 Category: Neurosurgery Authors: Karaszewski, B., Houlden, H., Smith, E. E., Markus, H. S., Charidimou, A., Levi, C., Werring, D. J. Tags: Stroke Cerebrovascular disease Source Type: research

Relationship of Age With Stroke and Death in Anticoagulated Patients With Nonvalvular Atrial Fibrillation: AMADEUS Trial Clinical Sciences
Conclusions— Elderly patients with atrial fibrillation have higher absolute risks of cardiovascular death, SSE, and bleeding, but relative risks of clinically relevant bleeding are not significantly different with increasing age strata. A significant inverse relationship between time in therapeutic range and bleeding and cardiovascular death/SSE emphasizes the importance of good quality anticoagulation control.
Source: Stroke - October 26, 2015 Category: Neurology Authors: Senoo, K., Lip, G. Y. H. Tags: Coumarins, Anticoagulants Clinical Sciences Source Type: research

Cardiovascular, Bleeding, and Mortality Risks of Dabigatran in Asians With Nonvalvular Atrial Fibrillation Clinical Sciences
Conclusions— In real-world practice, dabigatran was associated with a reduced risk of ischemic stroke, intracranial hemorrhage, all hospitalized major bleeding, and all-cause mortality compared with warfarin in Asian patients with nonvalvular atrial fibrillation. Dabigatran did not increase the risk of major gastrointestinal bleeding or myocardial infarction compared with warfarin.
Source: Stroke - January 25, 2016 Category: Neurology Authors: Chan, Y.-H., Yen, K.-C., See, L.-C., Chang, S.-H., Wu, L.-S., Lee, H.-F., Tu, H.-T., Yeh, Y.-H., Kuo, C.-T. Tags: Atrial Fibrillation, Cardiovascular Disease, Race and Ethnicity, Intracranial Hemorrhage, Ischemic Stroke Clinical Sciences Source Type: research

How temporal evolution of intracranial collaterals in acute stroke affects clinical outcomes
Conclusions: Not all collateral recruitment is beneficial; delayed collateral recruitment may be different from early recruitment and can result in worse outcomes and higher mortality. Prethrombolysis collateral status and recanalization are determinants of how intracranial collateral evolution affects functional outcomes.
Source: Neurology - February 1, 2016 Category: Neurology Authors: Yeo, L. L. L., Paliwal, P., Low, A. F., Tay, E. L. W., Gopinathan, A., Nadarajah, M., Ting, E., Venketasubramanian, N., Seet, R. C. S., Ahmad, A., Chan, B. P. L., Teoh, H. L., Soon, D., Rathakrishnan, R., Sharma, V. K. Tags: CT, All Cerebrovascular disease/Stroke, Infarction ARTICLE Source Type: research

Risk Reduction of Cerebral Stroke After Stereotactic Radiosurgery for Small Unruptured Brain Arteriovenous Malformations Clinical Sciences
Conclusions— SRS can significantly reduce the risk of stroke in the patients with small unruptured arteriovenous malformations. To definitively determine the clinical benefits of SRS, a longer follow-up will be necessary. However, based on our results, we can recommend SRS for patients who face a latent risk for stroke from this intractable vascular disease.
Source: Stroke - April 24, 2016 Category: Neurology Authors: Hanakita, S., Shin, M., Koga, T., Igaki, H., Saito, N. Tags: Cerebrovascular Malformations, Vascular Disease Clinical Sciences Source Type: research

Efficacy and Safety of Edoxaban in Elderly Patients With Atrial Fibrillation in the ENGAGE AF-TIMI 48 Trial Stroke
Conclusions Age has a greater influence on major bleeding than thromboembolic risk in patients with atrial fibrillation. Given the higher rates of bleeding and death with increasing age, treatment of elderly patients with edoxaban provides an even greater absolute reduction in safety events over warfarin, compared to treatment with edoxaban versus warfarin in younger patients. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT00781391.
Source: JAHA:Journal of the American Heart Association - May 19, 2016 Category: Cardiology Authors: Kato, E. T., Giugliano, R. P., Ruff, C. T., Koretsune, Y., Yamashita, T., Kiss, R. G., Nordio, F., Murphy, S. A., Kimura, T., Jin, J., Lanz, H., Mercuri, M., Braunwald, E., Antman, E. M. Tags: Atrial Fibrillation, Complications, Mortality/Survival, Intracranial Hemorrhage, Ischemic Stroke Source Type: research

New imaging method may predict risk of post-treatment brain bleeding after stroke
In a study of stroke patients, investigators confirmed through MRI brain scans that there was an association between the extent of disruption to the brain’s protective blood-brain barrier and the severity of bleeding following invasive stroke therapy. The results of the National Institutes of Health-funded study were published in Neurology.
Source: NINDS Press Releases and News: National Institute of Neurological Disorders and Stroke - June 17, 2016 Category: Neurology Source Type: news

Remote Intracerebral Hemorrhage After Intravenous Thrombolysis: Results From a Multicenter Study Clinical Sciences
Conclusions— The occurrence of rPH after intravenous thrombolysis with recombinant tissue-type plasminogen activator in patients with ischemic stroke is associated with lobar cerebral microbleeds and multiple ischemic lesions in different regions.
Source: Stroke - July 24, 2016 Category: Neurology Authors: Prats-Sanchez, L., Camps-Renom, P., Sotoca-Fernandez, J., Delgado-Mederos, R., Martinez-Domeno, A., Marin, R., Almendrote, M., Dorado, L., Gomis, M., Codas, J., Llull, L., Gomez Gonzalez, A., Roquer, J., Purroy, F., Gomez-Choco, M., Canovas, D., Cocho, D. Tags: Cerebrovascular Disease/Stroke, Intracranial Hemorrhage Clinical Sciences Source Type: research

Stroke and Mortality Risk in Patients With Various Patterns of Atrial Fibrillation: Results From the ENGAGE AF-TIMI 48 Trial (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48) Original Article
Conclusions— In ENGAGE AF-TIMI 48 trial, patients with paroxysmal AF suffered fewer thromboembolic events and deaths compared with those with persistent and permanent AF. The efficacy and safety profile of edoxaban as compared with warfarin was consistent across the 3 patterns of AF. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00781391.
Source: Circulation: Arrhythmia and Electrophysiology - January 10, 2017 Category: Cardiology Authors: Link, M. S., Giugliano, R. P., Ruff, C. T., Scirica, B. M., Huikuri, H., Oto, A., Crompton, A. E., Murphy, S. A., Lanz, H., Mercuri, M. F., Antman, E. M., Braunwald, E., on behalf of the ENGAGE AF-TIMI 48 Investigators Tags: Arrhythmias, Atrial Fibrillation, Ischemic Stroke, Transient Ischemic Attack (TIA) Original Article Source Type: research