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Non-Vitamin K Oral Anticoagulants (NOACs) and Their Reversal
AbstractPurpose of ReviewAn 80-year-old man presents with an acute right hemiparesis and National Institutes of Health Stroke Scale (NIHSS) of 25, 14  h after taking dabigatran. Activated partial thromboplastin time (aPTT) is 42.8 s. Arteriogram demonstrates left internal carotid artery thrombosis. What is the appropriate management of this patient with acute ischemic stroke while on a NOAC?Recent FindingsIdarucizumab is a reversal agent approved for dabigatran, and two more reversal agents, andexanet alfa and aripazine, are currently in development for NOACs.SummaryIn this article, we review currently available NOACs, t...
Source: Current Neurology and Neuroscience Reports - July 22, 2017 Category: Neuroscience Source Type: research

Evaluation of the role of susceptibility-weighted imaging in thrombolytic therapy for acute ischemic stroke
Publication date: Available online 20 February 2017 Source:Journal of Clinical Neuroscience Author(s): Guangjian Zhao, Ling Sun, Ziran Wang, Liquan Wang, Zhongrong Cheng, Hongyan Lei, Daiqun Yang, Yansen Cui, Shirui Zhang We inspected low-intensity venous signals and microbleeds in patients with acute ischemic stroke (AIS) using susceptibility-weighted imaging (SWI) before and after administration of within-thrombolytic-time-window thrombolytic therapies, and observed their prognosis and safety, in order to guide individualized thrombolytic therapies. Patients with AIS were divided into groups A or B according to the pres...
Source: Journal of Clinical Neuroscience - February 20, 2017 Category: Neuroscience Source Type: research

International benchmarking for acute thrombolytic therapy implementation in Australia and Japan
Publication date: July 2016 Source:Journal of Clinical Neuroscience, Volume 29 Author(s): Hiroyuki Kawano, Christopher Levi, Yuichiro Inatomi, Heather Pagram, Erin Kerr, Andrew Bivard, Neil Spratt, Ferdinand Miteff, Toshiro Yonehara, Yukio Ando, Mark Parsons Although a wide range of strategies have been established to improve intravenous tissue plasminogen activator (IV-tPA) treatment rates, international benchmarking has not been regularly used as a systems improvement tool. We compared acute stroke codes (ASC) between two hospitals in Australia and Japan to study the activation process and potentially improv...
Source: Journal of Clinical Neuroscience - May 29, 2016 Category: Neuroscience Source Type: research

Factors Associated with Thrombolysis Outcome in Ischemic Stroke Patients with Atrial Fibrillation
In this study, we investigated factors that influence the effect of intravenous thrombolysis in these patients. Our results showed that thrombolysis was independently associated with a favorable outcome (P < 0.001) and did not influence the mortality of AF-related ischemic stroke, although it increased the risk of hemorrhage within 24 h after treatment. Risk factors for a poor outcome at admission were: heart failure (P = 0.045); high systolic pressure (P = 0.039); high blood glucose (P = 0.030); and a high National Institutes of Health Stroke Scale (NIHSS) score (P < 0.001). Moreover, high systolic pressur...
Source: Neuroscience Bulletin - March 7, 2016 Category: Neuroscience Source Type: research

Direct admission to stroke centers reduces treatment delay and improves clinical outcome after intravenous thrombolysis
Publication date: Available online 9 January 2016 Source:Journal of Clinical Neuroscience Author(s): Dae-Hyun Kim, Hee-Joon Bae, Moon-Ku Han, Beom Joon Kim, Sang-Soon Park, Tai Hwan Park, Kyung Bok Lee, Kyusik Kang, Jong-Moo Park, Youngchai Ko, Soo Joo Lee, Jay Chol Choi, Joon-Tae Kim, Ki-Hyun Cho, Keun-Sik Hong, Yong-Jin Cho, Dong-Eog Kim, Jun Lee, Juneyoung Lee, Mi Sun Oh, Kyung-Ho Yu, Byung-Chul Lee, Hyun-Wook Nah, Jae-Kwan Cha We aimed to examine whether direct access to hospitals offering intravenous thrombolysis is associated with functional outcomes in patients with acute ischemic stroke tr...
Source: Journal of Clinical Neuroscience - January 11, 2016 Category: Neuroscience Source Type: research