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Total 442 results found since Jan 2013.

Reversal strategies and outcomes in patients with atrial fibrillation and warfarin-associated intracranial hemorrhage
While anticoagulants are highly effective in preventing thromboembolism in atrial fibrillation (AF), they raise the risk of hemorrhage, which can be life-threatening especially in cases of intracranial hemorrhage (ICH). Warfarin-associated intraparenchymal hemorrhage (IPH) leads to death within 30 days in as many as 60% of cases while the other major category of ICH on warfarin, subdural hemorrhage (SDH), leads to death in approximately a quarter of cases.1 Managing these potentially devastating bleeds is an important consideration in treating patients on oral anticoagulant therapy.
Source: Journal of Stroke and Cerebrovascular Diseases - July 15, 2020 Category: Neurology Authors: Daniel E. Singer, Leila H. Borowsky, Susan Regan, Jong Woo Lee, Kristina Zint, Lionel Riou Franca, Joshua N. Goldstein Source Type: research

Medical Management for Secondary Stroke Prevention
This article reviews the evidence base and recommendations for medical management for secondary stroke prevention. RECENT FINDINGS Recent developments for secondary stroke prevention include evidence to support the use of short-term dual antiplatelet therapy after minor stroke and transient ischemic attack, direct oral anticoagulants for nonvalvular atrial fibrillation, reversal agents for direct oral anticoagulant–associated hemorrhage, and aspirin rather than presumptive anticoagulation with a direct oral anticoagulant for embolic stroke of undetermined source. SUMMARY Most strokes are preventable. The mainstays ...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

A Case of Ischemic Stroke With Congenital Protein C Deficiency and Carotid Web Successfully Treated by Anticoagulant and Carotid Stenting
Conclusion: To our knowledge, this is the first report in which an immediate thrombus formation on the carotid web was observed in a patient with congenital protein C deficiency. In a case of acute ischemic stroke with carotid web, especially when congenital coagulopathy such as protein C deficiency is suspected, careful follow-up with ultrasound imaging should be performed.
Source: Frontiers in Neurology - February 17, 2020 Category: Neurology Source Type: research

Relationship of White Matter Lesions with Intracerebral Hemorrhage Expansion and Functional Outcome: MISTIE II and CLEAR III
ConclusionsConcomitant WML does not increase the odds for HE in patients with ICH but increases the odds for poor functional outcome.Clinical Trial Registrationhttp://www.clinicaltrials.gov trial-identifiers: NCT00224770 and NCT00784134.
Source: Neurocritical Care - February 4, 2020 Category: Neurology Source Type: research

Critical Issues and Recent Advances in Anticoagulant Therapy: A Review
Angelika Batta, Bhupinder S Kalra, Raj KhirasariaNeurology India 2019 67(5):1200-1212 As the population is aging, clinicians are coming across more patients with atrial fibrillation and venous thromboembolism requiring anticoagulation to prevent stroke and systemic embolisms. Due to a high prevalence and unfavorable consequences, managing thromboembolic diseases have become areas of clinical concern. Traditional anticoagulants like heparin, low molecular weight heparin and warfarin have been used for the prevention and treatment of venous and arterial thromboses. But, issues of bleeding, parenteral route of administration...
Source: Neurology India - November 18, 2019 Category: Neurology Authors: Angelika Batta Bhupinder S Kalra Raj Khirasaria Source Type: research

Multicenter prospective analysis of stroke patients taking oral anticoagulants: The PASTA registry - Study design and characteristics
The management of atrial fibrillation and deep venous thrombosis has evolved with the development of direct oral anticoagulants (DOAC), and oral anticoagulant (OAC) might influence the development or clinical course in both ischemic and hemorrhagic stroke. However, detailed data on the differences between the effects of the prior prescription of warfarin and DOAC on the clinical characteristics, neuroradiologic findings, and outcome of stroke are limited.
Source: Journal of Stroke and Cerebrovascular Diseases - October 28, 2019 Category: Neurology Authors: Satoshi Suda, Yasuyuki Iguchi, Shigeru Fujimoto, Yoshiki Yagita, Yu Kono, Masayuki Ueda, Kenichi Todo, Tomoyuki Kono, Takayuki Mizunari, Mineo Yamazaki, Takao Kanzawa, Seiji Okubo, Kimito Kondo, Nobuhito Nakajima, Takeshi Inoue, Takeshi Iwanaga, Makoto Na Source Type: research

Use of anticoagulant therapy and cerebral microbleeds: a systematic review and meta-analysis
ConclusionAnticoagulant use is associated with higher prevalence and incidence of CMBs. This association appears to depend on location of CMBs and type of anticoagulants. More longitudinal investigations with adjustment for confounders are required to establish the causality.
Source: Journal of Neurology - October 14, 2019 Category: Neurology Source Type: research

Practice Variations in the Use of Novel Oral Anticoagulants for Nonvalvular Atrial Fibrillation-Related Stroke among Stroke Neurologists in Saudi Arabia.
In conclusion, the practice of stroke neurologists is consistent with and supports the available evidence from observational studies on the time of initiation of NOACs. Our findings provide a guide for clinicians who manage nvAF-related stroke until more robust evidence from randomized controlled trials is available. PMID: 31531241 [PubMed]
Source: Neurology Research International - September 20, 2019 Category: Neurology Tags: Neurol Res Int Source Type: research

Protocol for AREST: Apixaban for Early Prevention of Recurrent Embolic Stroke and Hemorrhagic Transformation —A Randomized Controlled Trial of Early Anticoagulation After Acute Ischemic Stroke in Atrial Fibrillation
Discussion: AREST will offer randomized controlled trial data about timeliness and safety of anticoagulation in AIS patients with AF.Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT02283294.
Source: Frontiers in Neurology - September 19, 2019 Category: Neurology Source Type: research

Safety and Efficacy of Dabigatran vs Warfarin After CVT
This randomized clinical trial conducted in 9 countries compares the use of dabigatran with warfarin in stroke prevention among patients who just experienced cerebral venous thrombosis.
Source: JAMA Neurology - September 3, 2019 Category: Neurology Source Type: research

Intracardiac Thrombus Following Rivaroxaban Treatment in a Patient with Atrial Fibrillation Associated with Rheumatic Heart Disease
We report a case of atrial fibrillation with rheumatic heart disease (RHD) who had intracardiac thrombus and cardiogenic cerebral embolism with rivaroxaban therapy. Intracardiac thrombus disappeared after switching from rivaroxaban to warfarin. Patients of RHD have the possibility of gradual progression of valvular disease even if they are old, so we need to distinguish nonvalvular atrial fibrillation from RHD before starting direct oral anticoagulants.
Source: Journal of Stroke and Cerebrovascular Diseases - August 15, 2019 Category: Neurology Authors: Hiroaki Ohara, Shiro Yamamoto, Keiko Nagano, Kazuo Hashikawa Tags: Case Report Source Type: research

Stroke and transient ischemic attacks related to antiplatelet or warfarin interruption
Conclusion Antiplatelet or vitamin K antagonist suspension has a temporal relationship with the occurrence of stroke and TIA. Since these events are preventable, it is crucial that healthcare professionals convince their patients that drug withdrawal can cause serious consequences.RESUMO Pacientes em terapia anticoagulante ou antiagregante plaquet ária frequentemente são solicitados a descontinuar essas medicações antes e durante procedimentos cirúrgicos ou invasivos. Se o paciente interromper tratamento sem supervisão médica, poderá aumentar de risco de acidente vascular cerebral (AVC). Objetivo Identificar preval...
Source: Arquivos de Neuro-Psiquiatria - July 29, 2019 Category: Neurology Source Type: research

Clinical Effectiveness of Direct Oral Anticoagulants vs Warfarin in Older Patients With Atrial Fibrillation and Ischemic Stroke
This cohort assesses the clinical effectiveness of direct oral anticoagulants vs warfarin for stroke prevention in patients with atrial fibrillation.
Source: JAMA Neurology - July 22, 2019 Category: Neurology Source Type: research

A Therapeutic International Normalized Ratio Results in Smaller Infarcts and Better Outcomes for Patients with Ischemic Stroke
Background: Prior studies have shown that warfarin is effective for both primary and secondary stroke prevention in individuals with atrial fibrillation. It is also known that those on warfarin with atrial fibrillation often have poorer long-term poststroke outcomes, possibly because cardioembolic strokes tend to be larger and more severe. Less is known regarding the direct effect of the international normalized ratio (INR) value at the time of stroke on severity or long-term functional status. Methods: We prospectively followed a consecutive series of 112 patients presenting to our institution with acute ischemic stroke b...
Source: Journal of Stroke and Cerebrovascular Diseases - July 16, 2019 Category: Neurology Authors: Dawn Merbach, Erin Lawrence, Dania Mallick, Elisabeth B. Marsh Source Type: research

Effectiveness of Nonvitamin K Antagonist Oral Anticoagulants and Warfarin for Preventing Further Cerebral Microbleeds in Acute Ischemic Stroke Patients with Nonvalvular Atrial Fibrillation and At Least One Microbleed: CMB-NOW Multisite Pilot Trial
Nonvitamin K antagonist oral anticoagulants (NOACs) are considered superior, or at least noninferior, to warfarin in preventing stroke or systemic embolism in patients with nonvalvular atrial fibrillation. Here, we recruited acute ischemic stroke patients with nonvalvular atrial fibrillation and at least one cerebral microbleed (CMB), and evaluated the proportion of patients who had an increased number of CMBs (%) after receiving anticoagulant therapy with NOACs or with warfarin for 12 months.
Source: Journal of Stroke and Cerebrovascular Diseases - April 17, 2019 Category: Neurology Authors: Mutsumi Yokoyama, Atsushi Mizuma, Tohru Terao, Fumiaki Tanaka, Kazutoshi Nishiyama, Yasuhiro Hasegawa, Eiichiro Nagata, Shigeru Nogawa, Hiroyuki Kobayashi, Noriharu Yanagimachi, Takashi Okazaki, Kazuo Kitagawa, Shunya Takizawa, for the CMB-NOW Study Inves Source Type: research