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Summary of evidence-based guideline: Periprocedural management of antithrombotic medications in patients with ischemic cerebrovascular disease: Report of the Guideline Development Subcommittee of the American Academy of Neurology
Objective: To assess evidence regarding periprocedural management of antithrombotic drugs in patients with ischemic cerebrovascular disease. The complete guideline on which this summary is based is available as an online data supplement to this article. Methods: Systematic literature review with practice recommendations. Results and recommendations: Clinicians managing antithrombotic medications periprocedurally must weigh bleeding risks from drug continuation against thromboembolic risks from discontinuation. Stroke patients undergoing dental procedures should routinely continue aspirin (Level A). Stroke patients underg...
Source: Neurology - May 27, 2013 Category: Neurology Authors: Armstrong, M. J., Gronseth, G., Anderson, D. C., Biller, J., Cucchiara, B., Dafer, R., Goldstein, L. B., Schneck, M., Messe, S. R. Tags: Ultrasound, All Medical/Systemic disease, All Neuro-ophthalmology, All Cerebrovascular disease/Stroke, All Trauma SPECIAL ARTICLE Source Type: research

Is There an Increased Risk of Intracranial Hemorrhage When Treating Patients Who Are Currently on Dual Anti-Platelets with IV tPA? (P01.233)
CONCLUSIONS: In our cohort, there was no additional risk of hemorrhagic complications in patients on dual antiplatelet therapy who received IVtPA, prospective studies are needed to confirm this finding.Disclosure: Dr. Kung has nothing to disclose. Dr. Korsnack has nothing to disclose. Dr. Zaidi has nothing to disclose. Dr. Jumaa has nothing to disclose.
Source: Neurology - February 14, 2013 Category: Neurology Authors: Kung, V., Korsnack, A., Zaidi, S., Jumaa, M. Tags: P01 Cerebrovascular Disease I Source Type: research

Warfarin treatment and thrombolysis: How to persuade procrastinators?
This study, which uses data from the American Heart Association Get With The Guidelines (GWTG)–Stroke Registry, concluded that there was no association between IV thrombolysis and symptomatic intracranial hemorrhage (SICH).1 These findings are in agreement with some2–4 but contrast with other studies (including 2 meta-analyses).5–8 The study by Xian et al. is the largest study to date drawing from hospitals throughout the United States, including 23,437 patients who received IV thrombolysis.1 Nearly 8% of these patients had prior warfarin use and 48.6% of the warfarin-treated patients who met the eligibil...
Source: Neurology - February 4, 2013 Category: Neurology Authors: Seet, R. C. S., Harrer, J. U. Tags: EDITORIALS Source Type: research

tPA and warfarin: Time to move forward
The appropriate use of IV tissue plasminogen activator (tPA) for patients with acute ischemic stroke remains an area of active discussion among health care professionals. Since its approval in the United States by the Food and Drug Administration in 1996, the medical community has continued to review and discuss the risks vs benefits of this important therapy. Two recent publications1,2 and accompanying editorials have refocused attention on the vexing issue of using IV tPA in patients taking warfarin. The Xian et al.1 study found a 1.1% absolute increase in the risk of intracranial hemorrhage (ICH) with warfarin use (5.7%...
Source: Neurology - February 4, 2013 Category: Neurology Authors: Alberts, M. J., Naidech, A. M. Tags: All Cerebrovascular disease/Stroke EDITORIALS Source Type: research

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