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Extreme preterm neonate with fetal warfarin syndrome
A 25+3 week gestation male infant weighing 493 g was delivered via caesarean section for intrauterine growth restriction and abnormal Dopplers. The mother was on long-term thromboprophylactic warfarin 5 mg/day due to her prosthetic mechanical heart valve following childhood rheumatic fever. Once pregnancy was diagnosed, at 4+0 weeks’ gestation, warfarin was discontinued and low-molecular-weight heparin was started. Warfarin was recommenced at 12+1 weeks’ gestation after a small maternal stroke. Neonatal dysmorphic facial features were noted, most obviously nasal hypoplasia (figure 1). The hypoplastic upper airw...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - April 19, 2023 Category: Perinatology & Neonatology Authors: Birbal, R., Olaniyi, O., Clarke, P. Tags: Images in neonatal medicine Source Type: research

Clinical and radiographic outcomes following traumatic Grade 3 and 4 carotid artery injuries: a 10-year retrospective analysis from a Level 1 trauma center. The Parkland Carotid and Vertebral Artery Injury Survey.
CONCLUSIONS Although the posttraumatic cerebral infarction rate may be overestimated, the results of this study suggest that the Grade 3 and 4 BCAIs carry the highest stroke risk of the blunt cerebrovascular injuries, and those infarctions were identified on or shortly after hospital admission. Despite a 40% recanalization rate in the Grade 4 BCAI group and an 89% rate of persistent pseudoaneurysm in the Grade 3 BCAI group, follow-up imaging showed progressive worsening without radiographic improvement in only a small number of patients, and these findings alone did not correlate with adverse clinical outcome. Follow-up pr...
Source: Journal of Neurosurgery - December 19, 2014 Category: Neurosurgery Authors: Scott WW, Sharp S, Figueroa SA, Eastman AL, Hatchette CV, Madden CJ, Rickert KL Tags: J Neurosurg Source Type: research

Efficacy and Safety of Novel Oral Anticoagulants in Patients with Cervical Artery Dissections
We report on the use, safety, and efficacy of NOACs in the treatment of CAD. Methods: We retrospectively identified patients diagnosed with CAD at a single academic center between January 2010 and August 2013. Patients were categorized by their antithrombotic treatment at hospital discharge with a NOAC (dabigatran, rivaroxaban, or apixaban), traditional anticoagulant (AC: warfarin or treatment dose low-molecular weight heparin), or antiplatelet agent (AP: aspirin, clopidogrel, or aspirin/extended-release dypyridamole). Using appropriate tests, we compared the baseline medical history, presenting clinical symptoms and initi...
Source: Cerebrovascular Diseases - November 12, 2014 Category: Neurology Source Type: research

Simultaneous onset of myocardial infarction and ischemic stroke in a patient with atrial fibrillation: Multiple territory injury revealed on angiography and magnetic resonance
An 84-year-old man with a history of hypertension and paroxysmal atrial fibrillation (AF) who received no anticoagulant drugs experienced acute chest pain and transient loss of consciousness. He was transferred to our emergency room. His initial electrocardiogram showed sinus rhythm with ST-segment elevation in the I, aVL, and V1–V6 leads. His blood pressure was 158/92mmHg and his pulse was regular at 70beats per minute. A chest radiograph showed increased heart size and pulmonary vascular congestion. His troponin T level was elevated (more than 0.1ng/mL). He was diagnosed with ST-elevation myocardial infarction (MI) and...
Source: International Journal of Cardiology - February 4, 2014 Category: Cardiology Authors: Osamu Hashimoto, Kozo Sato, Yohei Numasawa, Joji Hosokawa, Masahiro Endo Tags: Online Letters to the Editor 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