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Potential new uses of non-vitamin K antagonist oral anticoagulants to treat and prevent stroke
Conclusion: There may be a role for NOACs in stroke prevention and treatment beyond atrial fibrillation. Randomized controlled trials are needed to compare NOACs to current stroke prevention and treatment strategies in certain subgroups of patients with cerebrovascular disease.
Source: Neurology - September 21, 2015 Category: Neurology Authors: Yaghi, S., Kamel, H., Elkind, M. S. V. Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Infarction, Cerebral venous thrombosis VIEWS & amp;amp; REVIEWS Source Type: research

Propensity Score-Matched Analysis of Lesion Patterns in Stroke Patients With Patent Foramen Ovale and Patients With Spontaneous Intracranial Artery Dissection
Conclusion: The present study suggests that lesion patterns observed from DWI of patients with PFO and SIAD might provide clues to the etiology of infarcts. Single lesions (cortical or subcortical) might be a typical feature of PFO associated strokes, while multiple lesions in one vascular territory might be a specific feature of SIAD associated strokes. Introduction Both patent foramen ovale (PFO) and spontaneous intracranial artery dissection (SIAD) are important stroke risk factors, especially in young and middle-aged adults (1–3). About 25% of patients with ischemic stroke are cryptogenic (4), and PFO is ...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

When a Single Antiplatelet Agent for Stroke Prevention Is Not Enough: Current Evidence and Future Applications of Dual Antiplatelet Therapy.
Abstract OPINION STATEMENT: For secondary stroke prevention, long-term dual antiplatelet therapy is not recommended due to increased bleeding risks. There is no specific evidence for using dual antiplatelet therapy for cervical artery dissection or for adding a second antiplatelet agent after a stroke while taking aspirin monotherapy. For patients with atrial fibrillation and stroke/TIA unable to tolerate warfarin, aspirin monotherapy is reasonable. Dual antiplatelet therapy carries a similar risk of major bleeding as warfarin that offsets reductions in stroke risk. Dual antiplatelet therapy is recommended for end...
Source: Atherosclerosis - February 27, 2016 Category: Cardiology Authors: Yuan K, Kim AS Tags: Curr Treat Options Cardiovasc Med Source Type: research

Etiology of first‐ever ischaemic stroke in European young adults: the 15 cities young stroke study
ConclusionsThe etiology of IS in young adults has clear gender‐specific patterns that change with age. A notable portion of these patients remains without an evident stroke mechanism according to TOAST criteria.
Source: European Journal of Neurology - July 10, 2013 Category: Neurology Authors: N. Yesilot Barlas, J. Putaala, U. Waje‐Andreassen, S. Vassilopoulou, K. Nardi, C. Odier, G. Hofgart, S. Engelter, A. Burow, L. Mihalka, M. Kloss, J. Ferrari, R. Lemmens, O. Coban, E. Haapaniemi, N. Maaijwee, L. Rutten‐Jacobs, A. Bersano, C. Cereda, P. Tags: Original Article Source Type: research

When a Single Antiplatelet Agent for Stroke Prevention Is Not Enough: Current Evidence and Future Applications of Dual Antiplatelet Therapy
Opinion statement For secondary stroke prevention, long-term dual antiplatelet therapy is not recommended due to increased bleeding risks. There is no specific evidence for using dual antiplatelet therapy for cervical artery dissection or for adding a second antiplatelet agent after a stroke while taking aspirin monotherapy. For patients with atrial fibrillation and stroke/TIA unable to tolerate warfarin, aspirin monotherapy is reasonable. Dual antiplatelet therapy carries a similar risk of major b...
Source: Current Treatment Options in Cardiovascular Medicine - February 24, 2016 Category: Cardiology Source Type: research

E-092 Use of balloon-guide catheters for concomitant mechanical thrombectomy and carotid revascularization with flow-arrest results in significantly lower sICH and better 90-day outcomes in tandem stroke patients
ConclusionUse of balloon-guide catheters for concomitant mechanical thrombectomy and carotid revascularization with flow-arrest results in significantly lower sICH and better 90-day outcomes in tandem stroke patients.Disclosures A. Baig: None. J. Neumaier: None. M. Waqas: None. A. Monteiro: None. J. Cappuzzo: None. W. Khawar: None. B. Donnelly: None. E. Levy: 2; C; : Claret Medical, GLG Consulting, Guidepoint Global, Imperial Care, Medtronic, Rebound, StimMed, Misionix, Mosiac, Clarion, IRRAS. 4; C; NeXtGen Biologics, RAPID Medical, Claret Medical, Cognition Medical, Imperative Care, Rebound Therapeutics, StimMed, Three Ri...
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Baig, A., Neumaier, J., Waqas, M., Monteiro, A., Cappuzzo, J., Khawar, W., Donnelly, B., Levy, E., Siddiqui, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

Severity and outcomes according to stroke etiology in patients under 50 years of age with ischemic stroke
Abstract To analyze the association of stroke etiological subtypes with severity and outcomes at 3 and 12 months in patients ≤50 years. Observational study of patients admitted to a stroke unit (2007–2013). Variables: demographic data, vascular risk factors, comorbidities, severity on admission (NIHSS), and good functional outcome (mRS ≤ 1) at 3 and 12 months. We used multivariate analyses to evaluate the influence of stroke etiology on severity and outcomes. We included 214 patients, 58.3 % men, mean age 41.4 years. General linear models showed all etiologies were more severe than lacunar strokes (P�...
Source: Journal of Thrombosis and Thrombolysis - February 5, 2016 Category: Hematology Source Type: research

Etiologies of internal carotid artery pseudo-occlusions in acute stroke patients: what neurointerventionalists can expect.
Abstract In cases of acute stroke, differentiation between an occluded and a patent internal carotid artery (ICA) is crucial for diagnosis and management. Although computed tomography angiography (CTA) can be highly accurate in defining high-grade stenosis and ICA occlusions, misleading ICA occlusion patterns are not rare in acute stroke patients. We investigated the underlying causes of ICA pseudo-occlusions with CTA with respect to digital subtraction angiography (DSA). 11 out of 72 patients had pseudo-occlusion on CTA. Of these, there were three cases of tandem occlusions accompanying high-grade ICA stenosis, f...
Source: The British Journal of Radiology - December 19, 2016 Category: Radiology Authors: Akpınar S, Gelener P, Yilmaz G Tags: Br J Radiol Source Type: research

Angiographical Identification of Intracranial, Atherosclerosis-Related, Large Vessel Occlusion in Endovascular Treatment
Conclusions Among only a few identification methods, the ICAS-LVO can be feasibly identified by angiographical findings. The identification of ICAS-LVO based on based on occlusion type, is a reliable and practical identification method for ICAS-LVO. Procedural details by occlusion type and its predictability to endovascular results were reported. Furthermore, occlusion type can be determined before or in the early stages of the procedure, which may be most helpful in setting up an optimal endovascular treatment strategy. Author Contributions J-HB established the study idea, designed the manuscript structure, acquired an...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Greater Risk for Decompressive Craniectomy in Large-artery Strokes Due to Cervical Artery (P1.013)
CONCLUSIONS: Among young and middle-aged stroke patients, CeAD may be a higher risk for decompressive craniectomy compared to other large-artery stroke types. This association may be mediated by stroke severity, but further analysis is ongoing.Disclosure: Dr. Surakiatchanukul has nothing to disclose. Dr. Koskey has nothing to disclose. Dr. McMurry has nothing to disclose. Dr. Grider has nothing to disclose. Dr. Currie has nothing to disclose. Dr. Turner has nothing to disclose. Dr. Worrall has received personal compensation in an editorial capacity for Neurology. Dr. Worrall has received royalty payments from Merritt's Neu...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Surakiatchanukul, T., Koskey, G., McMurry, T., Grider, R., Currie, L., Turner, H., Worrall, B., Southerland, A. Tags: Cerebrovascular Disease and Interventional Neurology I ePosters 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

Rivaroxaban in cervical and “cervico-cerebral” artery dissections: a new therapeutic option?
We describe four cases of CADs and, firstly in literature, cervico-cerebral (CCADs) in young patients (average age of 42  years) treated with rivaroxaban 20 mg daily. Three of these four dissections had affected the vertebral artery (condition with an unfavorable prognosis and more often complicated by subarachnoid hemorrhages), and the other one was a carotid dissection at the extra-intracranial passage. All patien ts were followed clinically and with serial neurosonological examinations at 1, 3, and 6 months and with magnetic resonance angiography (MRA) at 6 months. All patients presented a good outcome with vascular...
Source: Neurological Sciences - April 11, 2019 Category: Neurology Source Type: research

Perioperative complications in patients treated with posterior cervical fusion and bilateral cages
Conclusions: The results of our study show that PCF with cages can be considered a safe alternative for patients undergoing cervical spine surgery. The procedure has a favorable overall complication profile, short length of stay, and negligible blood loss.
Source: Journal of Craniovertebral Junction and Spine - December 19, 2017 Category: Orthopaedics Authors: Krzysztof B Siemionow Pawel Glowka Robert J Blok Mark C Gillespy Mukund I Gundanna William D Smith Zeshan Hyder Bruce M McCormack Source Type: research

A rare case of thyrotoxicosis and bilateral internal carotid artery dissections
Cervical artery dissection is a rare but important diagnosis to consider in young patients presenting with stroke. Multiple etiologies of cervical artery dissections have been previously reported, but the association with thyrotoxicosis is extremely rare. A previously healthy 43-year-old female presented to the emergency department with new symptoms related to thyrotoxicosis and bilateral internal carotid artery dissections. Her atrial fibrillation and hypertension resolved by treating the underlying hyperthyroidism with methimazole and propranolol.
Source: The American Journal of Emergency Medicine - June 25, 2020 Category: Emergency Medicine Authors: Thomas Winter, Eyal Kraut, Kristjan Thompson Source Type: research

Thyrotoxicosis and bilateral internal carotid artery dissections
Cervical artery dissection is a rare but important diagnosis to consider in young patients presenting with stroke. Multiple etiologies of cervical artery dissections have been previously reported, but the association with thyrotoxicosis is extremely rare. A previously healthy 43-year-old female presented to the emergency department with new symptoms related to thyrotoxicosis and bilateral internal carotid artery dissections. Her atrial fibrillation and hypertension resolved by treating the underlying hyperthyroidism with methimazole and propranolol.
Source: The American Journal of Emergency Medicine - June 26, 2020 Category: Emergency Medicine Authors: Thomas Winter, Eyal Kraut, Kristjan Thompson Tags: Case Report Source Type: research