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Building Evidence on Safety of Thrombolysis for Patients Receiving Direct Oral Anticoagulants
Nearly 20% of patients with acute ischemic stroke (AIS) are undergoing direct oral anticoagulant (DOAC) treatment at the time of their stroke. Common indications for DOACs among these patients include stroke prevention from atrial fibrillation, treatment of venous and pulmonary thrombosis, and coronary and peripheral atherosclerotic disease. Novel indications for DOAC use are expected to emerge and may increase the proportion of patients with AIS who are undergoing treatment with DOACs. Current US and European acute stroke treatment guidelines recommend withholding intravenous thrombolysis (thrombolysis), a morbidity- and ...
Source: JAMA Neurology - January 3, 2023 Category: Neurology Source Type: research

Single-Center Description of Therapeutic Anticoagulation Practices and Outcomes in Large Hemispheric Infarctions
Discussion Although radiographic HT is common among patients with LHI, it does not always portend symptomatic clinical deterioration. Further research regarding AC timing and safety is necessary.
Source: Neurology Clinical Practice - December 13, 2022 Category: Neurology Authors: Breit, H., Sterenstein, A., Abburi, N., Song, S., John, S., Da Silva, I., Koffman, L. Tags: Research Article Source Type: research

Reversal of Oral Vitamin K Antagonists Using Prothrombin Complex Concentration Prior to IV tPA Administration
Irmak Salt, Işıl Kalyonu Aslan, Çisil İrem Özgenç Biçer, Eren GözkeNeurology India 2022 70(3):1238-1239 Herein, we report two acute ischemic stroke cases that we used prothrombin complex to reverse the effects of warfarin in order to apply intravenous thrombolytic treatment. To the best of our knowledge, there are only limited amount of cases that prothrombin complex concentrates were applied prior to intravenous thrombolytic treatment administration. As one of the biggest acute stroke clinics in our country, we aim to open a d...
Source: Neurology India - July 1, 2022 Category: Neurology Authors: Irmak Salt I & #351; & #305;l Kalyonu Aslan & #199;isil & #304;rem & #214;zgen & #231; Bi & #231;er Eren G & #246;zke Source Type: research

Warfarin Treatment Is Associated to Increased Internal Carotid Artery Calcification
Conclusions: Long-lasting warfarin anticoagulation associated with increased calcification of carotid atherosclerotic plaques, particularly in locations known to be the predilection sites of stroke-causing plaques. The clinical significance of this novel finding warrants further investigations.
Source: Frontiers in Neurology - July 12, 2021 Category: Neurology Source Type: research

Neurologic Manifestations of the Antiphospholipid Syndrome - an Update
Curr Neurol Neurosci Rep. 2021 Jun 14;21(8):41. doi: 10.1007/s11910-021-01124-z.ABSTRACTPURPOSE OF REVIEW: In recent years, the spectrum of neurological manifestations of antiphospholipid syndrome (APS) has been growing. We provide a critical review of the literature with special emphasis on presentation, proposed mechanisms of disease, and treatment of neurological involvement in APS.RECENT FINDINGS: Although stroke is the most common cause of neurological manifestations in patients with APS, other neurological disorders have been increasingly associated with the disease, including cognitive dysfunction, headache, and epi...
Source: Epilepsy Curr - June 14, 2021 Category: Neurology Authors: Miguel Leal Rato Matilde Bandeira Vasco C Rom ão Diana Aguiar de Sousa Source Type: research

Non-Vitamin K Antagonist Oral Anticoagulants for the Treatment of Cerebral Venous Sinus Thrombosis: a Retrospective, Matched Cohort Analysis
ConclusionsThe safety and efficacy results of NOAC use for CVT were similar to those for age-matched and sex-matched controls treated with VKAs, as well as historical published controls. Assessment of NOAC efficacy and safety in CVT in multicenter cohort studies and randomized controlled trials is warranted.
Source: Neurocritical Care - May 27, 2021 Category: Neurology Source Type: research

Prevalence, Mechanisms, and Management of Ischemic Stroke in Heart Failure Patients
Semin Neurol DOI: 10.1055/s-0041-1726329Heart failure (HF) and stroke, two of the major causes of death worldwide, are closely associated. Although atrial fibrillation (AF), which occurs in more than half of patients with HF, is a major risk factor for stroke, there is a great deal of evidence that HF itself increases the risk of stroke independent of AF. The main mechanism of stroke appears to be thromboembolism. However, previous studies have failed to demonstrate the benefit of warfarin in patients with HF without AF, as the benefit of stroke prevention was counteracted by the increased incidence of major bleeding. Rece...
Source: Seminars in Neurology - April 13, 2021 Category: Neurology Authors: Seol, Hyeyoung Kim, Jong S. Tags: Review Article Source Type: research

Rivaroxaban in Recurrent Ischemic Stroke Due to Protein S Deficiency: A Case Report
In this study our patient was treated with rivaroxaban. Protein S deficiency may be a predisposing factor in recurrent ischemic stroke, and rivaroxaban can be a safe and effective treatment option. Further studies are needed to confirm our findings.
Source: Neurology and Therapy - January 30, 2021 Category: Neurology Source Type: research

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