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Intracerebral hemorrhage under platelet inhibition and oral anticoagulation in patients with cerebral amyloid angiopathy
Nervenarzt. 2021 Oct 15. doi: 10.1007/s00115-021-01206-w. Online ahead of print.ABSTRACTOral anticoagulation in patients with cerebral amyloid angiopathy is a therapeutic challenge. The association of cerebral amyloid angiopathy with intracerebral hemorrhage, a high mortality of intracerebral hemorrhage especially under oral anticoagulation and the high risk of recurrent bleeding require a multidisciplinary approach and a thorough risk-benefit analysis. Vitamin K antagonists increase the risk of intracerebral bleeding and the accompanying mortality by 60% and should be avoided if possible or reserved for special clinical s...
Source: Der Nervenarzt - October 15, 2021 Category: Neurology Authors: R Hau ßmann P Homeyer M Hau ßmann M Brandt M Donix V Puetz J Linn Source Type: research

Pontine infarction responsible for wall-eyed bilateral internuclear ophthalmoplegia syndrome
A 68-year-old man with hypertension, cardiac arrhythmia, and a mechanical heart valve replacement treated with vitamin K antagonists was admitted for the acute onset of diplopia. Neuro-ophthalmologic examination showed a bilateral exotropia in primary gaze position (wall-eyed) with bilateral adduction deficit that did not improve by convergence (figure, video at Neurology.org/cp). In lateral gaze, a horizontal nystagmus of the abducting eyes appeared. Vertical saccades were normal (video). Pupils were symmetric and reactive to light. Brain MRI with diffusion-weighted images showed an acute pontine ischemic lesion (figure)....
Source: Nature Clinical Practice - December 8, 2014 Category: Neurology Authors: Mathis, T., Ducray, F., Tilikete, C., Vighetto, A., Biotti, D. Tags: Clinical neurology examination, All Neuro-ophthalmology, Ocular motility, Diplopia (double vision), All Cerebrovascular disease/Stroke Cases Source Type: research