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Survey on APS diagnosis and antithrombotic treatment in patients with ischaemic stroke, other brain ischaemic injury or arterial thromboembolism in other sites: Communication from ISTH SSC Subcommittee on Lupus Anticoagulant/Antiphospholipid Antibodies (LA/aPL)
CONCLUSIONS: Much of the variation in practice reflects the lack of evidence-based recommendations. The survey results should inform the development of a more uniform multidisciplinary consensus approach to diagnosis and antithrombotic treatment.PMID:37391096 | DOI:10.1016/j.jtha.2023.06.020
Source: Thrombosis and Haemostasis - June 30, 2023 Category: Hematology Authors: Hannah Cohen David J Werring Arvind Chandretheva Prabal Mittal Katrien M J Devreese David A Isenberg ISTH SSC LA/aPL Subcommittee Study Group Source Type: research

Thrombocytopenia with acute ischemic stroke and bleeding in a patient newly vaccinated with an adenoviral vector-based COVID-19 vaccine
We describe the first Danish case of presumed inflammatory and thrombotic response to vaccination with an adenoviral (ChAdOx1) vector based COVID-19 vaccine (AZD1222). The case describes a 60-year old woman, who was admitted with intractable abdominal pain seven days after receiving the vaccine. Computer Tomography (CT) of the abdomen revealed bilateral adrenal hemorrhages. On the following day she developed a massive right sided ischemic stroke and Magnetic Resonance Imaging (MRI) angiography showed occlusion of the right internal carotid artery. The ischemic area was deemed too large to offer reperfusion therapy. During ...
Source: Thrombosis and Haemostasis - April 20, 2021 Category: Hematology Authors: Rolf Ankerlund Blauenfeldt S øren Risom Kristensen Siw Leiknes Ernstsen Claudia Christina Hilt Kristensen Claus Ziegler Simonsen Anne-Mette Hvas Source Type: research

Differences between predictive factors for early neurological deterioration due to hemorrhagic and ischemic insults following intravenous recombinant tissue plasminogen activator
AbstractEarly neurological deterioration (END) following intravenous recombinant tissue plasminogen activator (rt-PA) treatment is a serious clinical event that can be caused by hemorrhagic or ischemic insult. We investigated the differences in predictive factors for END due to hemorrhagic and END due to ischemic insults. Consecutive patients from four hospitals who received 0.6  mg/kg intravenous rt-PA for acute ischemic stroke were retrospectively recruited. END was defined as a National Institutes of Health Stroke Scale (NIHSS) score ≥ 4 points within 24 h compared with baseline. END was classified into those du...
Source: Journal of Thrombosis and Thrombolysis - December 16, 2019 Category: Hematology Source Type: research

Modified diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score including deep white matter lesions predicts symptomatic intracerebral hemorrhage following intravenous thrombolysis
AbstractThe Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is widely used for the assessment of early ischemic changes (EICs) before thrombolysis. However, for symptomatic intracerebral hemorrhage (sICH) following intravenous recombinant tissue plasminogen activator (rt-PA), the prediction abilities of CT-ASPECTS, diffusion-weighted imaging (DWI)-ASPECTS, and DWI-ASPECTS including EICs in deep white matter (DWI-ASPECTS  + W) are unclear. We investigated associations between each score and sICH following intravenous rt-PA. Data from consecutive patients who received intravenous rt-PA for acute ischemic...
Source: Journal of Thrombosis and Thrombolysis - November 18, 2019 Category: Hematology Source Type: research

No Association between Thrombin Generation and Intra-Plaque Haemorrhage in Symptomatic Carotid Atherosclerotic Plaques: The Plaque at RISK (PARISK) Study.
CONCLUSION:  Features of carotid plaque on MRI show no significant association with TG in stroke patients. Systemic TG does not seem to be an important factor in IPH development. PMID: 29972860 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - July 4, 2018 Category: Hematology Authors: Crombag GAJC, Spronk HM, Nelemans P, Schreuder FHBM, Truijman MTB, van Dijk AC, de Rotte AAJ, Liem MI, Daemen MJAP, van der Steen AFW, Mess WH, Nederkoorn PJ, Hendrikse J, van der Lugt A, Wildberger JE, Ten Cate H, van Oostenbrugge RJ, Kooi ME Tags: Thromb Haemost Source Type: research

A Case of Familial Hemophagocytic Lymphohistiocytosis Type 4 With Involvement of the Central Nervous System Complicated With Infarct
Conclusions: Physicians managing patients with HLH must be vigilant about the possibility of central nervous system involvement including stroke.
Source: Journal of Pediatric Hematology Oncology - July 25, 2017 Category: Hematology Tags: Online Articles: Clinical and Laboratory Observations Source Type: research

Thrombophilia risk is not increased in children after perinatal stroke
Perinatal stroke causes cerebral palsy and lifelong disability. Specific diseases are definable, but mechanisms are poorly understood. Evidence suggests possible associations between arterial perinatal stroke and prothrombotic disorders, but population-based, controlled, disease-specific studies are limited. Understanding thrombophilia in perinatal stroke informs pathogenesis models and clinical management. We conducted a population-based, prospective, case-control study to determine the association of specific perinatal stroke diseases with known thrombophilias. Children with idiopathic magnetic resonance imaging–cl...
Source: Blood - May 18, 2017 Category: Hematology Authors: Curtis, C., Mineyko, A., Massicotte, P., Leaker, M., Jiang, X. Y., Floer, A., Kirton, A. Tags: Pediatric Hematology, Free Research Articles, Thrombosis and Hemostasis, Vascular Biology, CME article Source Type: research

Transient ischemic attack as an unusual initial manifestation of acute promyelocytic leukemia.
Abstract Patients with acute promyelocytic leukemia (APL) are prone to both bleeding and thrombosis. Both of these have a significant impact on the morbidity and mortality of patients with this disease. Here we report a case of a 41-year-old male, who presented with transient ischemic attack (TIA) and early neurological deterioration (END) as initial manifestations prior to an ultimate diagnosis of APL. This patient had no cerebrovascular risk factors or familial cerebrovascular disease. The patient experienced an acute ischemic stroke, verified by magnetic resonance imaging (MRI), in less than 24 h after his sec...
Source: International Journal of Hematology - March 16, 2016 Category: Hematology Authors: Liu L, Yuan X Tags: Int J Hematol Source Type: research

Repeated early thrombolysis in cervical spinal cord ischemia
We report the first case of an MRI-verified cervical spinal ischemia treated by thrombolysis and review the literature. A 72-year old woman with right-sided motor hemiparesis and trunk ataxia was treated by intravenous thrombolysis with full recovery. Three days later she developed again a severe right-sided sensorimotor hemiparesis and a second off-label intravenous thrombolysis was repeated. Magnetic resonance imaging revealed a right-sided posterior-lateral cervical spinal ischemia. Spinal ischemia may clinically present with a cerebral-stroke-like picture challenging diagnostic and therapeutic procedure. Systemic throm...
Source: Journal of Thrombosis and Thrombolysis - January 13, 2016 Category: Hematology Source Type: research

MRI, the technology for imaging of thrombi and inflammation.
Abstract Atherosclerosis and its sequelae have a major impact on morbidity and mortality. The rupture of an inflamed atherosclerotic plaque is a crucial event, since it can result in acute thrombotic closure of an arterial vessel, resulting e. g. in myocardial infarction or stroke. Not only detection of early plaque rupture with imminent closure is therefore of clinical interest, but also timely detection of vascular inflammation and atherosclerotic plaque progression. However, plaque inflammation or even plaque rupture without vessel occlusion is not reliably detectable by current imaging techniques. Coronary a...
Source: Hamostaseologie - January 30, 2015 Category: Hematology Authors: von Zur Muhlen C, Bode C Tags: Hamostaseologie Source Type: research

Should oral anticoagulants be restarted after warfarin-associated cerebral haemorrhage in patients with atrial fibrillation?
Abstract Intracranial haemorrhage (ICH), which affects up to 1% of patients on oral anticoagulation per year, is the most feared and devastating complication of this treatment. After such an event, it is unclear whether anticoagulant therapy should be resumed. Such a decision hinges upon the assessment of the competing risks of haematoma growth or recurrent ICH and thromboembolic events. ICH location and the risk for ischaemic cerebrovascular event seem to be the key factors that lead to risk/benefit balance of restarting anticoagulation after ICH. Patients with lobar haemorrhage or cerebral amyloid angiopathy rem...
Source: Thrombosis and Haemostasis - November 21, 2013 Category: Hematology Authors: Paciaroni M, Agnelli G Tags: Thromb Haemost Source Type: research

MRI artifacts in the ferric chloride thrombus animal model: an alternative solution
This article is protected by copyright. All rights reserved.
Source: Journal of Thrombosis and Haemostasis - June 29, 2013 Category: Hematology Authors: Martijn Wolters, Raf H.M. Hoof, A. Wagenaar, Kim Douma, Marc A.M.J. Zandvoort, Tilman H. Hackeng, Mark J. Post, Walter H. Backes, M. Eline Kooi Tags: Letter ‐ to the Editor Source Type: research

Regulatory T cells are strong promoters of acute ischemic stroke in mice by inducing dysfunction of the cerebral microvasculature
We have recently identified T cells as important mediators of ischemic brain damage, but the contribution of the different T-cell subsets is unclear. Forkhead box P3 (FoxP3)–positive regulatory T cells (Tregs) are generally regarded as prototypic anti-inflammatory cells that maintain immune tolerance and counteract tissue damage in a variety of immune-mediated disorders. In the present study, we examined the role of Tregs after experimental brain ischemia/reperfusion injury. Selective depletion of Tregs in the DEREG mouse model dramatically reduced infarct size and improved neurologic function 24 hours after stroke a...
Source: Blood - January 24, 2013 Category: Hematology Authors: Kleinschnitz, C., Kraft, P., Dreykluft, A., Hagedorn, I., Gobel, K., Schuhmann, M. K., Langhauser, F., Helluy, X., Schwarz, T., Bittner, S., Mayer, C. T., Brede, M., Varallyay, C., Pham, M., Bendszus, M., Jakob, P., Magnus, T., Meuth, S. G., Iwakura, Y., Tags: Thrombosis and Hemostasis Source Type: research