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Left ventricular hypertrophy and left atrial size are associated with ischemic strokes among non-vitamin K antagonist oral anticoagulant users
ConclusionsPrior cerebrovascular events, diabetes, left ventricular hypertrophy, and increased left atrial size are risk factors for developing an IS among NOAC users.
Source: Journal of Neurology - August 7, 2023 Category: Neurology Source Type: research

Risk of intracranial hemorrhage with direct oral anticoagulants: a systematic review and meta-analysis of randomized controlled  trials
ConclusionAll DOACs had a lower risk of ICH than VKAs. In terms of the risk of ICH, DOACs were overall as safe as LMWHs, and apixaban and dabigatran were as safe as aspirin, but rivaroxaban was not. For secondary prevention stroke, the risk of ICH with DOACs was overall lower than warfarin and similar to aspirin, but it should be noted that compared with aspirin, rivaroxaban may increase the risk of ICH. This is the first pair-wise meta-analysis that compares the risk of ICH between DOACs and other antithrombotic drugs in detail across all diseases, which may have certain significance for patients with high risk of ICH to ...
Source: Journal of Neurology - February 17, 2021 Category: Neurology Source Type: research

Endovascular stroke treatment in orally anticoagulated patients: an analysis from the German Stroke Registry-Endovascular Treatment
ConclusionsET can be performed safely and successfully in LVO stroke patients treated with OAC.Clinical trial registration-URLhttp://www.clinicaltrials.gov. Unique identifier: NCT03356392.
Source: Journal of Neurology - December 29, 2020 Category: Neurology Source Type: research

Telling friend from foe in emergency vertigo and dizziness: does season and daytime of presentation help in the differential diagnosis?
The objective of the present study was to analyze frequency and distribution patterns of specific vestibular and non-vestibular diagnoses in an interdisciplinary university emergency room (ER), including data on daytime and season of presentation. A retrospective chart analysis of all patients seen in a one-year period was performed. In the ER 4.23% of all patients presented with VD (818 out of 19,345). The most frequent-specific diagnoses were BPPV (19.9%), stroke/transient ischemic attack (12.5%), acute unilateral vestibulopathy/vestibular neuritis (UVH; 8.3%), and functional VD (8.3%). Irrespective of the diagnosis, the...
Source: Journal of Neurology - July 10, 2020 Category: Neurology Source Type: research

Optimization of risk stratification for anticoagulation-associated intracerebral hemorrhage: net risk estimation
ConclusionsIn this anticoagulation-associated ICH cohort, baseline hemorrhagic risk exceeded ischemic risk in approximately 50%, highlighting the importance of careful consideration of risk/benefit ratio prior to anticoagulation decisions. The remaining 50% suffered an ICH despite excess baseline ischemic risk, stressing the need for biomarkers to allow more precise estimation of hemorrhagic complication risk.
Source: Journal of Neurology - December 16, 2019 Category: Neurology Source Type: research

Stroke severity in patients with preceding direct oral anticoagulant therapy as compared to vitamin K antagonists
AbstractBackgroundAlthough direct oral anticoagulants (DOAC) have proven at least equally effective in the prevention of acute ischemic stroke (AIS) in patients with atrial fibrillation as compared to the vitamin K antagonists (VKA), no reliable data on the severity of AIS of DOAC patients as compared to VKA is available.MethodsUsing a prospectively collected cohort of AIS patients, we performed univariate and multivariate (displayed as adjusted Odds Ratios, OR and 95% confidence intervals, 95% CI) analyses regarding the severity of AIS in patients with preceding DOAC (N = 210) versus VKA (N = 173) therapy. Additio...
Source: Journal of Neurology - June 3, 2019 Category: Neurology Source Type: research

In-hospital ischaemic stroke treated with intravenous thrombolysis or mechanical thrombectomy
The objective of this study is to compare outcomes in patients with IHS and community-onset strokes (COS) treated by recanalization therapy. We analysed data prospectively collected in consecutive patients treated by thrombolysis, thrombectomy, or both for cerebral ischemia at the Lille University Hospital. We compared four outcomes measures at 3  months in patients with IHS and COS: (1) modified Rankin scale (mRS) 0–1, (2) mRS 0–2, (3) death, and (4) symptomatic intracranial haemorrhage (ECASS 2 definition). Of 1209 patients, 64 (5.3%) had IHS, with an increasing proportion over time (p = 0.001). Their median onset...
Source: Journal of Neurology - July 15, 2017 Category: Neurology Source Type: research