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Specialty: Internal Medicine
Condition: Hemorrhagic Stroke

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Total 363 results found since Jan 2013.

WATCHMAN device-related thrombus successfully treated with apixaban: A case report
Rationale: Among atrial fibrillation patients with high risk of bleeding, left atrial appendage occlusion has emerged as an alternative to long-term oral anticoagulation therapy for stroke prevention. Device-related thrombus remains a major concern because it may result in recurrent embolic events. To date, there is no consensus on the optimal method of treating device-related-thrombus. Patient concerns: A 78-year-old man with atrial fibrillation had an episode of intracranial hemorrhage while taking warfarin. He subsequently underwent percutaneous placement of a 30-mm Watchman device to the left atrial appendage. He ...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Outcomes of endovascular treatment for acute large ‐vessel ischaemic stroke more than 6 h after symptom onset
ConclusionsIn appropriately selected patients, EVT >6 h was associated with comparable outcomes to those treated <6 h. These data support a physiological approach to patient selection.
Source: Journal of Internal Medicine - September 25, 2017 Category: Internal Medicine Authors: R. Motyer, H. K. Kok, H. Asadi, A. O'Hare, P. Brennan, S. Power, S. Looby, P. Nicholson, D. Williams, S. Murphy, M. D. Hill, M. Goyal, J. McManus, P. O'Brien, J. Thornton Tags: Original Article Source Type: research

Urolithiasis is associated with an increased risk of stroke: A population ‐based 5‐year follow‐up study
ConclusionsIn conclusion, the present study detected an increased risk of both ischemic and hemorrhagic stroke in patients with urolithiasis, particularly in those older than 40 years old.
Source: Internal Medicine Journal - September 11, 2017 Category: Internal Medicine Authors: Ping ‐Song Chou, Wei‐Pin Chang, Yii‐Her Chou Tags: Original Article Source Type: research

Reflection on Stroke Deaths and end ‐of‐life stroke care
ConclusionIn this cohort, palliative care referral and EOLCP were commenced in less than 50% of patients, highlighting significant variations in clinical care. These data support the need to promote awareness of ACP, particularly in patients with prior stroke or significant co‐morbidities. This may help reduce potentially futile invasive investigations and treatment.
Source: Internal Medicine Journal - September 11, 2017 Category: Internal Medicine Authors: Syed Zujajuddin Quadri, Thang Huynh, Cecilia Cappelen ‐Smith, Nirupama Wijesuriya, Abul Mamun, Roy Beran, Alan Mcdougall, Dennis Cordato Tags: Original Article Source Type: research

Outcomes of endovascular treatment for acute large vessel ischemic stroke more than 6 hours after symptom onset
ConclusionsIn appropriately selected patients, EVT >6 hours was associated with comparable outcomes to those treated <6 hours. These data support a physiological approach to patient selection.This article is protected by copyright. All rights reserved.
Source: Journal of Internal Medicine - September 5, 2017 Category: Internal Medicine Authors: Ronan Motyer, Hong Kuan Kok, Hamed Asadi, Alan O'Hare, Paul Brennan, Sarah Power, Seamus Looby, Patrick Nicholson, David Williams, Sean Murphy, Michael D. Hill, Mayank Goyal, John McManus, Paul O'Brien, John Thornton Tags: Original Article Source Type: research

A nearly full-recovery from AVM hemorrhagic stroke 17 years after insult using a new integrated neurodevelopmental approach: A case report
This study investigated a novel approach to chronic-phase stroke rehabilitation using traditional child motor-learning techniques, play, and proprioceptive-building activities in addition to current stroke rehabilitation techniques. During an initial six-month period, followed by a three-year period, the participant used motor-developmental learning activities as well as traditional strength, gait, and balance training. During the initial phase of treatment, clinically-significant improvements were recorded along with self-reported lifestyle enhancements. These gains continued throughout the three-and-a-half year process. ...
Source: Medicine - September 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Recovery of an injured corticobulbar tract in a patient with stroke: A case report
Rationale: The corticobulbar tract (CBT) is known to be involved in the motor function of the non-oculomotor cranial nuclei and controls the muscles of the face, head, and neck. Several studies have reported injury of the CBT in patients with brain injury, however, little is known about recovery of the injured CBT. Patient concerns: A 59-year-old right-handed male underwent decompressive craniectomy for management of brain swelling and intracerebral hemorrhage following an infarction in the left middle cerebral artery territory. Initially, the patient had showed severe dysphagia and had to be fed using a Levin tube. Five ...
Source: Medicine - September 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

All Types of Hemorrhagic Stroke Are Not Created Equally
To the Editor The decision to initiate oral anticoagulation (OAC) posthemorrhagic stroke or traumatic intracerebral hemorrhage (ICH) in those with atrial fibrillation (AF) is a gray area in clinical practice. By showing that the decision to resume OAC may have a favorable risk-benefit ratio, the article by Nielsen et al published in a recent issue ofJAMA Internal Medicine brings us closer to understanding if and when to do this. However, important questions remain, which may be difficult to clarify using such an observational approach.
Source: JAMA Internal Medicine - September 1, 2017 Category: Internal Medicine Source Type: research

All Types of Hemorrhagic Stroke Are Not Created Equally —Reply
In Reply Decision making on the use of oral anticoagulant treatment in patients with atrial fibrillation is often uncomplicated due to the positive risk-benefit ratio, ie, balancing risk of bleeding against benefit from thromboprophylaxis. Observational data on patients with atrial fibrillation sustaining an intracranial hemorrhage are increasing, recognizing the treatment conundrum of resuming oral anticoagulant treatment since the risk-benefit ratio of treatment is shifted substantially.
Source: JAMA Internal Medicine - September 1, 2017 Category: Internal Medicine Source Type: research

Role of lipids and intraplaque hypoxia in the formation of neovascularization in atherosclerosis.
Authors: Chistiakov DA, Melnichenko AA, Myasoedova VA, Grechko AV, Orekhov AN Abstract According to the current paradigm, chronic vascular inflammation plays a central role in the pathogenesis of atherosclerosis. The plaque progression is typically completed with rupture and subsequent acute cardiovascular complications. Previously, the role of adventitial vasa vasorum in atherogenesis was underestimated. However, investigators then revealed that vasa vasorum neovascularization can be observed when no clinical manifestation of atherosclerosis is present. Vasa vasorum is involved in various proatherogenic processes ...
Source: Annals of Medicine - August 13, 2017 Category: Internal Medicine Tags: Ann Med Source Type: research

Successful Delayed Aortic Surgery for a Patient with Ischemic Stroke Secondary to Aortic Dissection.
Authors: Morihara R, Yamashita T, Deguchi K, Tsunoda K, Manabe Y, Takahashi Y, Yunoki T, Sato K, Nakano Y, Kono S, Ohta Y, Hishikawa N, Abe K Abstract The diagnosis of aortic dissection (AD) is sometimes difficult within the limited time window of recombinant tissue plasminogen activator (tPA) for ischemic stroke (IS). A 60-year-old man developed sudden left hemiparesis due to IS. During tPA infusion, his blood pressure dropped and consciousness declined. After transfer to our hospital, carotid duplex ultrasonography led to a diagnosis of AD. Emergency surgery was postponed because of the risk of hemorrhagic transf...
Source: Internal Medicine - August 12, 2017 Category: Internal Medicine Tags: Intern Med Source Type: research

Association of ventricular arrhythmia and in-hospital mortality in stroke patients in Florida: A nonconcurrent prospective study
Abstract: Stroke remains one of the leading causes of death in the United States. Current evidence identified electrocardiographic abnormalities and cardiac arrhythmias in 50% of patients with an acute stroke. The purpose of this study was to assess whether the presence of ventricular arrhythmia (VA) in adult patients hospitalized in Florida with acute stroke increased the risk of in-hospital mortality. Secondary data analysis of 215,150 patients with ischemic and hemorrhagic stroke hospitalized in the state of Florida collected by the Florida Agency for Healthcare Administration from 2008 to 2012. The main outcome for th...
Source: Medicine - July 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Blood protein biomarkers as diagnostic tool for ischemic stroke: a systematic review.
CONCLUSION: The blood protein biomarkers, brain natriuretic peptide (BNP) and S100B, were promising biomarkers in diagnosing ischemic stroke. They could be used in cases of diagnostic uncertainty and/or when less experienced healthcare personnel are involved. PMID: 28598212 [PubMed - as supplied by publisher]
Source: Future Medicine: Biomarkers in Medicine - June 11, 2017 Category: Internal Medicine Tags: Biomark Med Source Type: research

In patients with intracerebral haemorrhage and concomitant atrial fibrillation, optimal timing of reinitiating anticoagulants may be 7-8 weeks after ICH
Commentary on: Pennlert J, et al. Optimal timing of anticoagulant treatment after intracerebral haemorrhage in patients with atrial fibrillation. Stroke 2017:48;314–320. Context In patients with intracerebral haemorrhage (ICH) and a concomitant diagnosis of atrial fibrillation (AF), the clinical dilemma arises whether anticoagulant treatment should be (re)started and when.1 In the absence of results from randomised controlled trials, guidelines provide no firm recommendations. Several observational studies have suggested that reintroduction of oral anticoagulants may be associated with a reduction in thrombotic ...
Source: Evidence-Based Medicine - June 9, 2017 Category: Internal Medicine Authors: Klijn, C. J., Schreuder, F. H. Tags: Therapeutics/Prevention Source Type: research

Incidence of constipation in stroke patients: A systematic review and meta-analysis
Abstract: There is growing awareness of a link between the gut and cardiovascular disease. Constipation is common among individuals who have had a stroke, and it negatively affects social functioning and quality of life. However, no systematic study on the incidence of constipation in stroke patients has been reported. We selected studies included in Medline, Embase, Cochrane database, and Web of Science. Studies were included if they reported the incidence in stroke patients. Two authors selected the studies, extracted the data independently, and assessed these. Subgroup analyses were conducted according to the stroke su...
Source: Medicine - June 1, 2017 Category: Internal Medicine Tags: Research Article: Meta-Analysis of Observational Studies in Epidemiology Source Type: research