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Source: Neurology
Condition: Hemorrhagic Stroke

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Total 691 results found since Jan 2013.

DCE-MRI blood-brain barrier assessment in acute ischemic stroke
Conclusion: BBB in acute stroke patients can be successfully assessed quantitatively. The decrease of BBB permeability in unaffected regions at follow-up may be an indicator of global BBB leakage even in vessel territories remote from the index infarct.
Source: Neurology - January 29, 2017 Category: Neurology Authors: Villringer, K., Sanz Cuesta, B. E., Ostwaldt, A.-C., Grittner, U., Brunecker, P., Khalil, A. A., Schindler, K., Eisenblätter, O., Audebert, H., Fiebach, J. B. Tags: Diagnostic test assessment, MRI, All Cerebrovascular disease/Stroke ARTICLE Source Type: research

Avoidance of steroids in the reversible cerebral vasoconstriction syndrome
Reversible cerebral vasoconstriction syndrome (RCVS), characterized by multifocal constrictions of cerebral arteries resolving spontaneously within 3 months, most commonly presents with unusual, severe, mostly thunderclap headaches (severe pain peaking in less than 1 minute).1,2 Seizures and focal neurologic deficits related to cortical subarachnoid hemorrhage, intracerebral hemorrhage, ischemic stroke, or posterior reversible encephalopathy syndrome may occur.3–5 Treatment relies on rest; withdrawal of any vasoactive drugs; avoidance of triggering factors; administration of nimodipine, given by analogy to aneurysmal...
Source: Neurology - January 15, 2017 Category: Neurology Authors: Mawet, J. Tags: All Headache, Stroke in young adults, All Imaging, Vasculitis, All Cerebrovascular disease/Stroke EDITORIALS Source Type: research

Large-scale identification of patients with cerebral aneurysms using natural language processing
Conclusions: We harnessed the power of the EMR by applying NLP to obtain a large cohort of patients with intracranial aneurysms and their matched controls. Such algorithms can be generalized to other diseases for epidemiologic and genetic studies.
Source: Neurology - January 8, 2017 Category: Neurology Authors: Castro, V. M., Dligach, D., Finan, S., Yu, S., Can, A., Abd-El-Barr, M., Gainer, V., Shadick, N. A., Murphy, S., Cai, T., Savova, G., Weiss, S. T., Du, R. Tags: All Cerebrovascular disease/Stroke, All epidemiology, Subarachnoid hemorrhage ARTICLE Source Type: research

Blood pressure levels and the risk of intracerebral hemorrhage after ischemic stroke
Conclusions: Among patients with recent noncardioembolic ischemic stroke, the risk of ICH is high. High SBP and DBP are associated with an increased risk of ICH. The association between BP and ICH is not dependent on ischemic stroke subtype.
Source: Neurology - January 8, 2017 Category: Neurology Authors: Hilkens, N. A., Greving, J. P., Algra, A., Klijn, C. J. M. Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Intracerebral hemorrhage ARTICLE Source Type: research

AEDs after ICH: Preventing the prophylaxis
Has the routine use of antiepileptic drugs (AEDs) in intracerebral hemorrhage (ICH) become a habit too difficult to break? Adherents to evidence-based medicine must surely have a conniption in light of this continuing practice. The guidelines have remained clear over the years: Do not use antiseizure medications in ICH unless there has been a seizure. Yet prophylactic AED use after acute ICH remains widespread in the United States. This is brought to our attention in the current issue of Neurology®. Naidech et al.1 report on the patterns of AED use in ICH over 5 years across several academic medical centers in Chicago....
Source: Neurology - December 25, 2016 Category: Neurology Authors: Koch, S., Sung, G. Tags: Critical care, Antiepileptic drugs, Intracerebral hemorrhage EDITORIALS Source Type: research

Teaching NeuroImages: Intracranial vertebral dissection in a 15-year-old boy with sickle cell disease
A 15-year-old boy with sickle cell disease became unresponsive after sudden-onset headache. There was no antecedent trauma. A head CT scan demonstrated subarachnoid hemorrhage at the medulla (figure). Magnetic resonance angiography of the head and neck identified the patient's known bilateral internal carotid artery stenosis (a moyamoya-like arteriopathy associated with stroke in sickle cell disease) and a new right vertebral artery dissection, which was confirmed on conventional angiography (figure). Prior MRI performed as part of routine cerebral monitoring did not reveal any preexisting abnormality of the vertebral artery.
Source: Neurology - December 11, 2016 Category: Neurology Authors: Siegler, J. E., Banwell, B., Ichord, R. N. Tags: Pediatric stroke; see Cerebrovascular Disease/ Childhood stroke RESIDENT AND FELLOW SECTION Source Type: research

Cardioembolism as the unsuspected missing link between migraine and ischemic stroke
First identified in 1975, the relationship between migraine and stroke has received considerable attention.1 Forty years later, solid evidence indicates that those with migraine have a 1.5-fold to 2.5-fold increased risk of stroke.2–4 However, the strength of this relationship varies based on the subtypes of migraine (with vs without aura) and stroke (hemorrhagic vs ischemic). While the majority of data support an increased risk of ischemic stroke in those with migraine, the association between migraine without aura and ischemic stroke seems weaker and more controversial, possibly due to methodologic heterogeneity across studies.2,3
Source: Neurology - December 11, 2016 Category: Neurology Authors: Sposato, L. A., Peterlin, B. L. Tags: Migraine, All Cerebrovascular disease/Stroke, Cardiac, Embolism, Risk factors in epidemiology EDITORIALS Source Type: research

Teaching NeuroImages: Multicompartmental intracranial hemorrhage in a pediatric patient
A previously healthy 9-year-old girl presented with sudden-onset headache followed by confusion. In the emergency department, she was hypertensive, bradycardic, and no longer responsive to any stimuli. An emergent head CT scan demonstrated a left frontal intraparenchymal hematoma with intraventricular and subarachnoid extension as well as subfalcine herniation (figure). She underwent decompressive hemicraniectomy, and digital subtraction angiography confirmed a 7-mm left middle cerebral artery aneurysm (figure).
Source: Neurology - December 4, 2016 Category: Neurology Authors: Siegler, J. E., Ichord, R. N. Tags: Childhood stroke, Intracerebral hemorrhage, Subarachnoid hemorrhage RESIDENT AND FELLOW SECTION Source Type: research

Stable incidence but declining case-fatality rates of subarachnoid hemorrhage in a population
Conclusions: Although the incidence of SAH remained stable in this population-based region, 5-day, 30-day, and 90-day case-fatality rates declined significantly. Advances in surgical and medical management, along with systems-based changes such as the emergence of neurocritical care units, are potential explanations for the reduced case-fatality.
Source: Neurology - November 20, 2016 Category: Neurology Authors: Mackey, J., Khoury, J. C., Alwell, K., Moomaw, C. J., Kissela, B. M., Flaherty, M. L., Adeoye, O., Woo, D., Ferioli, S., De Los Rios La Rosa, F., Martini, S., Khatri, P., Broderick, J. P., Zuccarello, M., Kleindorfer, D. Tags: Outcome research, Subarachnoid hemorrhage ARTICLE Source Type: research

Florbetapir-PET to diagnose cerebral amyloid angiopathy: A prospective study
Conclusions: Florbetapir appears to label vascular amyloid in patients with CAA-related ICH. The approved florbetapir binary visual reading method can have diagnostic value in appropriate clinical settings. Classification of evidence: This study provides Class II evidence that florbetapir-PET provides a sensitivity of 100% (95% confidence interval [CI] 66%–100%) and specificity of 89% (95% CI 51%–99%) for determination of probable CAA among cognitively normal patients.
Source: Neurology - November 6, 2016 Category: Neurology Authors: Gurol, M. E., Becker, J. A., Fotiadis, P., Riley, G., Schwab, K., Johnson, K. A., Greenberg, S. M. Tags: Stroke prevention, MRI, PET, Intracerebral hemorrhage ARTICLE Source Type: research

Teaching NeuroImages: Swirl sign and spot sign in intraparenchymal hematoma
A 10-year-old-girl was admitted with headache and vomiting. Nonenhanced CT showed hyperdense intraparenchymal hematoma with a hypodense area, consistent with swirl sign, a classic sign of active bleeding (figure 1).
Source: Neurology - October 30, 2016 Category: Neurology Authors: Wagemans, B. A. J. M., Klinkenberg, S., Postma, A. A. Tags: CT, Prognosis, Pediatric stroke; see Cerebrovascular Disease/ Childhood stroke, Intracerebral hemorrhage RESIDENT AND FELLOW SECTION Source Type: research

Early start of DOAC after ischemic stroke: Risk of intracranial hemorrhage and recurrent events
Conclusions: Even if DOACs are often started early after an index event, the risk of ICH appears to be low. Among all patients receiving anticoagulation, the rate of recurrent events was 6 times higher than the rate of ICH.
Source: Neurology - October 30, 2016 Category: Neurology Authors: Seiffge, D. J., Traenka, C., Polymeris, A., Hert, L., Peters, N., Lyrer, P., Engelter, S. T., Bonati, L. H., De Marchis, G. M. Tags: Stroke prevention, Clinical trials Observational study (Cohort, Case control) ARTICLE Source Type: research

Cortical superficial siderosis predicts early recurrent lobar hemorrhage
Conclusions: Disseminated cSS on MRI and cSAH on CT are independent imaging markers of increased risk for early recurrent ICH. These markers may provide additional insights into the mechanisms of ICH recurrence in patients with CAA.
Source: Neurology - October 30, 2016 Category: Neurology Authors: Roongpiboonsopit, D., Charidimou, A., William, C. M., Lauer, A., Falcone, G. J., Martinez-Ramirez, S., Biffi, A., Ayres, A., Vashkevich, A., Awosika, O. O., Rosand, J., Gurol, M. E., Silverman, S. B., Greenberg, S. M., Viswanathan, A. Tags: All Cerebrovascular disease/Stroke, Intracerebral hemorrhage, Subarachnoid hemorrhage ARTICLE Source Type: research

Body mass index and stroke in UK women: "Obesity paradox" revisited
Obesity is a major risk factor for stroke. However, several studies have reported a protective effect of obesity on stroke, particularly after a prior cardiovascular event, a phenomenon described as the "obesity paradox" or "reverse epidemiology."1 No convincing biological evidence explains this paradox. The evidence that increased body mass index (BMI) increases risk for ischemic stroke in Western and Asian populations is strong, but the relationship with hemorrhagic stroke remains less established.
Source: Neurology - October 2, 2016 Category: Neurology Authors: Rexrode, K., Rundek, T. Tags: All Cerebrovascular disease/Stroke, Cohort studies, Risk factors in epidemiology, Intracerebral hemorrhage, Subarachnoid hemorrhage EDITORIALS Source Type: research

Adiposity and ischemic and hemorrhagic stroke: Prospective study in women and meta-analysis
Conclusions: In UK women, higher BMI is associated with increased risk of ischemic stroke but decreased risk of hemorrhagic stroke. The totality of the available published evidence suggests that BMI-associated risks are greater for ischemic than for hemorrhagic stroke.
Source: Neurology - October 2, 2016 Category: Neurology Authors: Kroll, M. E., Green, J., Beral, V., Sudlow, C. L. M., Brown, A., Kirichek, O., Price, A., Yang, T. O., Reeves, G. K., For the Million Women Study Collaborators Tags: All Cerebrovascular disease/Stroke, Cohort studies, Risk factors in epidemiology, Intracerebral hemorrhage, Subarachnoid hemorrhage ARTICLE Source Type: research