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Update in the Management of Acute Ischemic Stroke
Acute ischemic stroke is the fourth leading cause of death and the leading cause of disability in the United States. Stroke is a medical emergency. The development of stroke systems of care has changed the way practitioners view and treat this devastating disease. Ample evidence has shown that patients presenting early and receiving intravenous thrombolytic therapy have the best chance for significant improvement in functional outcome, particularly if they are transported to specialized stroke centers. Early detection and management of medical and neurologic complications is key at preventing further brain damage in patien...
Source: Critical Care Clinics - August 4, 2014 Category: Intensive Care Authors: Nelson J. Maldonado, Syed O. Kazmi, Jose Ignacio Suarez Source Type: research

Neurocritical care complications of pregnancy and puerperum
Abstract: Neurocritical care complications of pregnancy and puerperum such as preeclampsia/eclampsia, hemolysis, elevated liver enzymes, low platelets syndrome, thrombotic thrombocytopenic purpura, seizures, ischemic and hemorrhagic stroke, postpartum angiopathy, cerebral sinus thrombosis, amniotic fluid emboli, choriocarcinoma, and acute fatty liver of pregnancy are rare but can be devastating. These conditions can present a challenge to physicians because pregnancy is a unique physiologic state, most therapeutic options available in the intensive care unit were not studied in pregnant patients, and in many situations, ph...
Source: Journal of Critical Care - July 14, 2014 Category: Intensive Care Authors: Jennifer A. Frontera, Wamda Ahmed Tags: Clinical Potpourri Source Type: research

In Process Citation.
Abstract Management of ischemic stroke is targeted on four therapeutic objectives: limitation of neurological deficit, prevention of earyl stroke recurrence, protection against complications, and secondary prevention. Intravenous thrombolysis within 4.5h of stroke onset is the only proven therapy to improvefunctional outcome. Although promising, neither endovascular recanalisation nor neuroprotective strategies have demonstrated efficacy so far. Immediate administration of antiplatelet agents like acetylsalicylic acid and clopidogrel - in case of intravenous thrombolysis at the earliest after 24h - is effective to...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - June 1, 2014 Category: Intensive Care Authors: Görtler M, Oldag A, Brejova A Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

CHADS2 and CHA2DS2-VASc scores can predict thromboembolic events after supraventricular arrhythmia in the critically ill patients
Conclusion: CHADS2 and CHA2DS2-VASc scores are predictive of SVA-related thromboembolism in the critically ill patient.
Source: Journal of Critical Care - May 30, 2014 Category: Intensive Care Authors: Sébastien Champion, Yannick Lefort, Bernard-Alex Gaüzère, Didier Drouet, Bruno Julien Bouchet, Guillaume Bossard, Sabina Djouhri, David Vandroux, Kushal Mayaram, Bruno Mégarbane Tags: Clinical Potpourri Source Type: research

Perioperative management and therapy of bleeding complications.
Abstract The new oral anticoagulants directly inhibit either thrombin (Dabigatran, Pradaxa®,) or activated Factor X (rivaroxaban, Xarelto®, and apixaban, Eliquis®) and have been approved for thromboprophylaxis after hip and knee replacement surgery and stroke prevention in non-valvular atrial fibrillation. Moreover, rivaroxaban has been approved for the treatment of deep venous thrombosis, prevention of pulmonary embolism and anticoagulation after acute myocardial infarction. The direct FXa-inhibitor edoxaban (Lixiana®) expects approval for the prevention of stroke in atrial fibrillation in Germany in 2014. Th...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - March 1, 2014 Category: Intensive Care Authors: von Heymann C, Kaufner L, Körber M Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

New direct oral oral anticoagulants (DOACs) - indications of DOACs.
Abstract The direct oral anticoagulants (DOACs) were developed because of the urgent therapeutic need due to the deficits of vitamin K antagonist therapy. The predominant indications in internal medicine are the acute treatment and secondary prevention of deep venous thrombosis (DVT) and pulmonary embolism (PE) as well as stroke prevention in patients with atrial fibrillation. For the acute therapy and secondary prevention of DVT/PE the DOACS were non inferior to low-molecular-weight heparin (LMWH) plus vitamin K antagonists at a significantly reduced rate of severe bleeding complications. Only Rivaroxaban is curr...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - March 1, 2014 Category: Intensive Care Authors: Darius H Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research

Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies
We describe a pregnant lady who presented with sensorineural deafness of the right ear and paralysis of the 9 th , 10 th , and 12 th cranial nerves on the right side. She was diagnosed to have thrombosis of the right transverse sinus and sigmoid sinus with extension to the jugular vein and confluence of sinuses. She improved with anticoagulant treatment.
Source: Indian Journal of Critical Care Medicine - January 25, 2013 Category: Intensive Care Authors: N ByjuJames JoseK SaifudheenV Abdul GafoorP Jithendranath Source Type: research

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