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Specialty: Internal Medicine
Condition: Hemorrhagic Stroke

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Total 363 results found since Jan 2013.

Effectiveness and safety of valsartan/amlodipine in hypertensive patients with stroke: China Status II subanalysis
Abstract: High blood pressure (BP) is a major risk factor associated with stroke in China. This is a subanalysis of patients from the China Status II study, aimed to evaluate the effectiveness and safety of valsartan/amlodipine (Val/Aml) single-pill combination (SPC) in hypertensive patients with different stroke subtypes (hemorrhagic, ischemic, or mixed). China Status II was a multicenter, postmarketing, prospective observational study in hypertensive patients uncontrolled on monotherapy. The study was an 8-week open-label treatment period with 2 4-week follow-ups. Change in BP from baseline to weeks 4 and 8, BP control ...
Source: Medicine - June 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

The potential impact of sleep-related movement disorders on stroke risk: a population-based longitudinal study
ConclusionsPatients with SRMD were found to have an increased risk of all-cause stroke along with a higher possibility of hemorrhagic stroke over ischemic stroke.
Source: QJM - May 8, 2017 Category: Internal Medicine Source Type: research

Efficacy and safety of desmoteplase in acute ischemic stroke patients: A systematic review and meta-analysis
Conclusion: Intravenous desmoteplase is associated with a favorable reperfusion efficacy and acceptable safety in ischemic stroke treatment>3 hours after symptom onset. Well-designed randomized controlled trials with larger patient cohorts and a moderate dose of drugs are needed to further evaluate the true efficacy of desmoteplase in stroke patients. Trial Registration: URL: http://www.crd.york.ac.uk/PROSPERO ; PROSPERO registration number: CRD42016037667).
Source: Medicine - May 1, 2017 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Dabigatran Compared With Rivaroxaban vs Warfarin
To the Editor In a recent issue ofJAMA Internal Medicine, Graham et al reported that rivaroxaban use increased risks of major bleeding with nonsignificant reduction in thromboembolic stroke and increased mortality compared with dabigatran in elderly Medicare beneficiaries newly treated with dabigatran or rivaroxaban for nonvalvular atrial fibrillation (November 2011-June 2014). However, dabigatran event rates were lower than reported by Graham et al in a larger group of elderly Medicare beneficiaries newly treated with dabigatran or warfarin for nonvalvular atrial fibrillation with longer follow-up during a partially overl...
Source: JAMA Internal Medicine - May 1, 2017 Category: Internal Medicine Source Type: research

Posterior reversible encephalopathy syndrome in a postpartum hemorrhagic woman without hypertension: A case report
Rationale: Posterior reversible encephalopathy syndrome (PRES), which diagnosis is based on clinical symptoms and radiological features, is a neurotoxic disease characterized by a set of clinical manifestations, such as seizure, headache, visual, and/or consciousness disturbance. It is the first case of PRES followed by postpartum hemorrhage (PPH) without underlying disease. Patient concerns: A 37-year-old healthy woman had PPH after caesarean section. Six days after delivery, headache occurred suddenly, followed by episodes of clonus seizure. Diagnoses: Brain computed tomography showed ischemic stroke. However, magnetic...
Source: Medicine - April 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Resumption of Warfarin Treatment After Hemorrhagic Stroke or ICH
This cohort study uses data from 3 Danish national registries to investigate the prognosis associated with resuming warfarin treatment in patients with atrial firbrillation who sustain a hemorrhagic stroke or traumatic intracranial hemorrhage.
Source: JAMA Internal Medicine - February 20, 2017 Category: Internal Medicine Source Type: research

Recurrent contrast ‐induced encephalopathy following coronary angiography
Contrast‐induced encephalopathy (CIE) is an acute and reversible neurological disturbance associated with the intra‐arterial administration of iodinated contrast medium during cardiac catheterisation. It may manifest with encephalopathy, motor and sensory disturbances; vision disturbances, including cortical blindness, ophthalmoplegia, aphasia; and seizures. Disruption of the blood–brain barrier and direct neuronal toxicity are believed to be implicated in the pathophysiology of the syndrome. Symptoms appear soon after contrast administration and resolve completely within 24–48 h. Risk factors may include hypertens...
Source: Internal Medicine Journal - February 14, 2017 Category: Internal Medicine Authors: Roberto Spina, Neil Simon, Romesh Markus, David W. M. Muller, Krishna Kathir Tags: Brief Communication Source Type: research

Management of acute ischaemic stroke in patients with dementia
Abstract An estimated 10% of stroke patients have an underlying dementia. As a consequence, health professionals often face the challenge of managing patients with dementia presenting with an acute stroke. Patients with dementia are less likely to receive thrombolysis (0.56–10% vs. 1–16% thrombolysis rates in the general population), be admitted to a stroke unit or receive some types of care. Anticoagulation for secondary stroke prevention is sometimes withheld, despite dementia not being listed as an exclusion criterion in current guidelines. Studies in this population are scarce, and results have been contradictory. ...
Source: Journal of Internal Medicine - February 1, 2017 Category: Internal Medicine Authors: A. Subic, P. Cermakova, B. Norrving, B. Winblad, M. Euler, M. G. Kramberger, M. Eriksdotter, S. Garcia ‐Ptacek Tags: Review Source Type: research

Restoration of the ascending reticular activating system compressed by hematoma in a stroke patient
In conclusion, restoration of nonreconstructed neural tracts of the lower ARAS with the resolution of the hematoma and perihematomal edema was demonstrated in a stroke patient, using DTT.
Source: Medicine - February 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Stroke in the acute setting
Acute stroke and transient ischaemic attack (TIA) are focal neurological syndromes of vascular origin and should be treated as medical emergencies. Brain imaging with computed tomography or magnetic resonance imaging is required to distinguish ischaemic stroke from intracerebral haemorrhage, recognize non-stroke pathologies that mimic stroke and guide investigation into the underlying mechanism. Acute interventions of benefit in ischaemic stroke include intravenous thrombolysis with alteplase given within 4.5 hours of onset, endovascular thrombectomy within 6 hours of onset in selected patients, stroke unit care and aspirin.
Source: Medicine - January 22, 2017 Category: Internal Medicine Authors: Keith W. Muir Tags: Acute medicine II Source Type: research

Effect of renal function on whole blood and fibrin clot formation in atrial fibrillation patients on warfarin.
CONCLUSION: In warfarinised AF patients, renal function is linked to whole blood clot and fibrin clot formation, structure and dissolution, but has no effect on the INR. Key messages Despite oral anticoagulation, patients with atrial fibrillation (AF) still suffer from stroke and venous thromboembolism. The effect of renal function in warfarinised patients with AF is unknown and may account for excess thrombosis and/or haemorrhage. Using two different laboratory methods, our data point to an effect of renal function on clot structure and function that is independent of an effect of warfarin. PMID: 27043881 [PubMed - indexed for MEDLINE]
Source: Annals of Medicine - January 20, 2017 Category: Internal Medicine Tags: Ann Med Source Type: research

Underuse of screening in Osler –Weber–Rendu syndrome
<span class="paragraphSection">According to the view expressed by the authors the management of Hereditary Haemorrhagic Telangiectasia (HHT) should include prevention of complications of vascular lesions.<a href="#hcw221-B1" class="reflinks"><sup>1</sup></a> Accordingly, the opportunity should have been taken to screen the patient for pulmonary arteriovenous malformations (PAVM), the latter a feature in 15 –50% of patients with HHT.<a href="#hcw221-B2" class="reflinks"><sup>2</sup></a> With transthoracic contrast echocardiography as the imaging modality, the Internati...
Source: QJM - January 12, 2017 Category: Internal Medicine Source Type: research

Antithrombotic treatment in anticoagulated atrial fibrillation patients undergoing percutaneous coronary intervention.
Abstract Coronary artery disease coexists in a clinically relevant number of patients with atrial fibrillation and it often requires percutaneous coronary intervention. These patients represent a particular challenge for clinicians in terms of antithrombotic management. They require combined antiplatelet-anticoagulant therapy to reduce the risk of recurrent ischemic cardiac events and stroke; however, this antithrombotic strategy is associated with an increased risk of bleeding complications. In the absence of randomized, controlled clinical trials, the majority of current recommendations rely on the results of co...
Source: European Journal of Internal Medicine - January 4, 2017 Category: Internal Medicine Authors: Dézsi CA, Dézsi BB, Dézsi DA Tags: Eur J Intern Med Source Type: research

Update in the Management of Cerebrovascular Accidents
Publication date: Available online 24 December 2016 Source:Hospital Medicine Clinics Author(s): Andreas Varkaris, Anastasia Katsiampoura, Tim Kelliher, Chi-Cheng HuangTeaser Ischemic stroke is an acute neurologic deficit that results from focal cerebral ischemia leading to permanent tissue damage (infarction). The cause is commonly associated with atherothrombotic occlusion of large arteries; cerebral embolism (embolic infarction); nonthrombotic occlusion of small, deep cerebral arteries (lacunar infarction); and proximal arterial stenosis with hypotension that decreases cerebral blood flow in arterial watershed zones (he...
Source: Hospital Medicine Clinics - December 23, 2016 Category: Internal Medicine Source Type: research

Change of ascending reticular activating system with recovery from vegetative state to minimally conscious state in a stroke patient
We report on a stroke patient who showed change of the ascending reticular activating system (ARAS) concurrent with recovery from a vegetative state (VS) to a minimally conscious state (MCS), which was demonstrated on diffusion tensor tractography (DTT). Patient concerns: A 59-year-old male patient underwent CT-guided stereotactic drainage 3 times for management of intracerebral hemorrhage and intraventricular hemorrhage. Diagnosis: After 4 months from onset, when starting rehabilitation, the patient showed impaired consciousness, with a Glasgow Coma Scale (GCS) score of 6 and a Coma Recovery Scale-Revised score of 2. At...
Source: Medicine - December 1, 2016 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research