79,843 results match your criteria Intracranial Hemorrhage


Haematological management of major bleeding associated with direct oral anticoagulants - UK experience.

Br J Haematol 2019 Feb 19. Epub 2019 Feb 19.

Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

The lack of antidotes for activated factor X-inhibitor direct oral anticoagulants (DOACs) means that management of bleeding consists largely of existing supportive therapies. This study aimed to: (i) examine the relative frequency of DOAC-related major bleeding in relation to DOAC prescriptions over the study period; (ii) describe the presentation and haematological management of DOAC-related major bleeding; and (iii) evaluate the association between the use of prothrombin-complex-concentrate (PCC) and in-hospital mortality. Over a 3-year period, 32 UK hospitals submitted data on haematological management of DOAC-related bleeding. Read More

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http://dx.doi.org/10.1111/bjh.15808DOI Listing
February 2019

Evaluation of the yield of post-clipping angiography and nationwide current practice.

Acta Neurochir (Wien) 2019 Feb 19. Epub 2019 Feb 19.

Department of Neurosurgery, University Medical Center Utrecht, Internal Postage: G03.124, PO-box 85500, 3584 CX, Utrecht, The Netherlands.

Background: Surgical treatment of intracranial saccular aneurysms aims to prevent (re)hemorrhage by complete occlusion of the aneurysmal lumen. It is unclear whether routine postoperative imaging, to assess aneurysmal occlusion, is necessary since intraoperative assessment by the neurosurgeon may be sufficient. We assessed routine clinical protocols for post-clipping imaging in the Netherlands and determined whether intraoperative assessment of aneurysm clippings sufficiently predicts aneurysm residuals. Read More

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http://dx.doi.org/10.1007/s00701-019-03834-3DOI Listing
February 2019

Low-dose versus standard-dose intravenous alteplase for octogenerian acute ischemic stroke patients: A multicenter prospective cohort study.

J Neurol Sci 2019 Jan 29;399:76-81. Epub 2019 Jan 29.

School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Department of Public Health, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address:

Background And Purpose: The optimal dose of alteplase for acute ischemic stroke among geriatric patients is unclear. We aimed to assess the efficacy and safety of a low-dose (0.6 mg/kg) and standard-dose (0. Read More

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http://dx.doi.org/10.1016/j.jns.2019.01.047DOI Listing
January 2019

Risk factors of intracranial hemorrhage after mechanical thrombectomy of anterior circulation ischemic stroke.

Neuroradiology 2019 Feb 18. Epub 2019 Feb 18.

Department of Neuroradiology, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.

Purpose: Intracranial hemorrhage (ICH) is a potentially severe complication after mechanical thrombectomy (MT). Here, we investigated risk factors for the occurrence of any and symptomatic ICH after MT due to large-vessel occlusion of the anterior circulation.

Methods: Consecutive patients with acute ischemic anterior circulation stroke with large-vessel occlusion undergoing MT were analyzed. Read More

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http://dx.doi.org/10.1007/s00234-019-02180-6DOI Listing
February 2019

[Pathological changes in extra- and intracranial vessel in young adults in the aspect of sudden death].

Zh Nevrol Psikhiatr Im S S Korsakova 2019 ;119(1):64-68

Sechenov's First Moscow State Medical University, Moscow, Russia.

Aim: To determine the main causes and pathomorphological characteristic of extra- and intracranial vessel pathological changes in young adults in the aspect of sudden death (SD).

Material And Methods: The authors investigated 10485 SD cases in young adults in the period from 2012 to 2016 (5 years) according to Moscow coroner bureau autopsy data. Morphological, chemical, histological, histochemical methods (staining with hematoxylin and eosin, van Gieson's stain, Masson's trichrome stain) were used. Read More

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http://dx.doi.org/10.17116/jnevro201911901164DOI Listing
January 2019

Relationship of clinical presentation and angiographic findings in patients with indirect cavernous carotid fistulae.

J Neurointerv Surg 2019 Feb 18. Epub 2019 Feb 18.

Radiology and Neurological Surgery, Columbia University, New York, USA.

Introduction: Indirect cavernous carotid fistulae (ICCFs) can present with insidious, non-specific symptoms and prove difficult to diagnose. This study evaluates associations among ICCF symptoms and angiographic findings.

Methods: A retrospective analysis was performed of prospectively maintained records at four medical centers to identify patients with ICCFs evaluated with angiography. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014421DOI Listing
February 2019

Impact of single phase CT angiography collateral status on functional outcome over time: results from the MR CLEAN Registry.

J Neurointerv Surg 2019 Feb 18. Epub 2019 Feb 18.

Radiology & Nuclear Medicine, Amsterdam University Medical Center (AMC), Amsterdam, The Netherlands.

Background: Collateral status modified the effect of endovascular treatment (EVT) for stroke in several randomized trials. We assessed the association between collaterals and functional outcome in EVT treated patients and investigated if this association is time dependent.

Methods: We included consecutive patients from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands (MR CLEAN) Registry (March 2014-June 2016) with an anterior circulation large vessel occlusion undergoing EVT. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014619DOI Listing
February 2019

Fatal inhalation of volcanic gases in three tourists of a geothermal area.

Forensic Sci Int 2019 Feb 7. Epub 2019 Feb 7.

Department of Experimental Medicine, Forensic Toxicology Unit, University of Campania "L. Vanvitelli", Via L. Armanni, 5, 80138, Naples, Italy.

The study reports the environmental, toxicological and histopathological forensic investigations applied on three victims of accidental death (father, mother and son), due to the fall in a volcanic pothole, during the touristic visit of the "Solfatara park", near Naples (Italy). At autopsy greenish skin discolouration was observed and all bodies showed the classical signs of asphyxial deaths, such as cyanosis and hemorrhagic pulmonary edema. Focal micro-hemorrhages were found in the brain at intracranial and subpial levels. Read More

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http://dx.doi.org/10.1016/j.forsciint.2019.01.044DOI Listing
February 2019

Prediction of Outcomes for Ruptured Aneurysm Surgery.

Stroke 2019 Feb 19:STROKEAHA118023771. Epub 2019 Feb 19.

From the Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas. (V.S.B., T.Y.E.A., S.G.A., A.R.P., K.A.L., C.E., J.B., C.M.M., B.G.W., D.S., H.H.B., J.W.).

Background and Purpose- Predicting long-term functional outcomes after intracranial aneurysmal rupture can be challenging. We developed and validated a scoring system-the Southwestern Aneurysm Severity Index-that would predict functional outcomes at 1 year after clipping of ruptured aneurysms. Methods- Ruptured aneurysms treated microsurgically between 2000 and 2014 were included. Read More

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https://www.ahajournals.org/doi/10.1161/STROKEAHA.118.023771
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http://dx.doi.org/10.1161/STROKEAHA.118.023771DOI Listing
February 2019
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Early management of poor-grade aneurysmal subarachnoid hemorrhage: A prognostic analysis of 104 patients.

Clin Neurol Neurosurg 2019 Feb 5;179:4-8. Epub 2019 Feb 5.

Department of Neurosurgery, The Second Hospital of Shandong University, Jinan 250033, Shandong, China. Electronic address:

Objective: This study aimed to investigate the efficacy of early management for poor-grade aneurysmal subarachnoid hemorrhage (aSAH; WFNS grade IV and V), and analyze the prognostic factors.

Patients And Methods: A total of 104 consecutive patients with poor-grade aSAH from the Department of Neurosurgery, the Second Hospital of Shandong University were enrolled between January 2010 and December 2017. All these patients underwent early microsurgical clipping or endovascular coiling within three days after onset. Read More

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http://dx.doi.org/10.1016/j.clineuro.2019.02.003DOI Listing
February 2019

Intra-arterial dantrolene for refractory cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage.

World Neurosurg 2019 Feb 15. Epub 2019 Feb 15.

Department of Neurology, University of Missouri Hospital and Clinics, Columbia, Missouri, USA.

Background: Dantrolene has a safe side-effect profile and a mechanism of action that makes it attractive as an option for treatment of cerebral vasospasm. The authors report two cases of refractory cerebral vasospasm secondary to aneurysmal subarachnoid hemorrhage that were successfully treated with intra-arterial dantrolene.

Case Descriptions: Two patients, a 63-year-old woman and 36-year-old woman, developed severe vasospasm refractory to intra-arterial vasodilators after rupture of anterior communicating artery aneurysms. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.01.239DOI Listing
February 2019

A case of metastatic brain tumor mimicking an expanding thalamic hematoma.

Surg Neurol Int 2019 15;10. Epub 2019 Jan 15.

Department of Pathology, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan.

Background: Brain tumor are a major etiology of secondary intracranial hemorrhage (ICH) because ICH in patients with cancer often occurs from an intratumoral hemorrhage. However, it is sometimes difficult to detect a tumor when it is tiny and buried, especially during initial examination.

Case Description: A 65-year-old woman who was diagnosed with pulmonary small cell carcinoma 6 months previously developed sudden-onset consciousness disturbance and left hemiparesis. Read More

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http://dx.doi.org/10.4103/sni.sni_318_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357533PMC
January 2019

Meta-analysis of real-world evidence comparing non-vitamin K antagonist oral anticoagulants with vitamin K antagonists for the treatment of patients with non-valvular atrial fibrillation.

J Mark Access Health Policy 2019 4;7(1):1574541. Epub 2019 Feb 4.

HEHTA, University of Glasgow, Glasgow, UK.

: Numerous real-world studies have compared non-vitamin K antagonist oral anticoagulants (NOACs) with vitamin K antagonists (VKAs) in patients with non-valvular atrial fibrillation (NVAF). A meta-analysis was performed to synthesize the available evidence. : Systematic searches were performed through 12/2016 to identify non-randomized NVAF studies comparing NOACs with VKAs, and reporting effectiveness, safety, or persistence. Read More

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http://dx.doi.org/10.1080/20016689.2019.1574541DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366429PMC
February 2019

Feasibility and efficacy of enhanced recovery after surgery protocol in Chinese elderly patients with intracranial aneurysm.

Clin Interv Aging 2019 23;14:203-207. Epub 2019 Jan 23.

Department of Neurosurgery, Inner Mongolia Xing'an Meng People's Hospital, Ulanhot 137400, China,

Objective: Intracranial aneurysm is a kind of severe intracranial disease mainly responsible for subarachnoid hemorrhage, and the rupture of intracranial aneurysm results in a mortality rate of 30%-40%. For the first time in the world, this study aimed to assess the feasibility and efficacy of enhanced recovery after surgery (ERAS) protocol in Chinese elderly patients with intracranial aneurysm.

Methods: In this study, 300 elderly patients with intracranial aneurysm were recruited and divided into two groups as follows: ERAS group (n=150, ERAS protocol) and control group (n=150, conventional management). Read More

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https://www.dovepress.com/feasibility-and-efficacy-of-enhanc
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http://dx.doi.org/10.2147/CIA.S187967DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350647PMC
January 2019
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An enemy hides in the ceiling; pediatric traumatic brain injury caused by metallic ceiling fan: Case series and literature review.

Br J Neurosurg 2019 Feb 18:1-5. Epub 2019 Feb 18.

d Department of Neurosurgery , Tokyo Women's Medical University Medical Center East , Tokyo , Japan.

Purpose: We report a series of 29 pediatric patients who sustained head injuries due to metallic ceiling fans. They all were admitted to the Emergency Department of Neurosurgery Teaching Hospital in Baghdad, Iraq, during January 2015 to January 2017.

Results: Pediatric ceiling fan head injuries are characterized by four traits which distinguish them from other types of head injuries; 1- Most of them were because of climbing on or jumping from furniture between the ages of two and five. Read More

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http://dx.doi.org/10.1080/02688697.2019.1573312DOI Listing
February 2019

Basilar occlusion and rupture secondary to rare fungal sinusitis: A case report.

World Neurosurg 2019 Feb 14. Epub 2019 Feb 14.

Lyerly Neurosurgery / Baptist Health, Baptist Neurological Institute, Jacksonville, FL.

Background: Intracranial vascular infections of fungal etiology are extremely rare. The vast majority of cases occur in immunocompromised patients with invasive fungal disease, most commonly originating in the paranasal sinuses or the lungs. An extremely rare type in this part of the world, called Granulomatous Invasive Rhinosinusitis, has been reported to affect immunocompetent patients in most cases, and its causative strain has potential to invade the intracranial arteries. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.01.179DOI Listing
February 2019
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Heparin during endovascular stroke treatment seems safe Heparin during endovascular stroke treatment does not ameliorate clinical outcome and is associated with lower chance of reperfusion.

J Neuroradiol 2019 Feb 14. Epub 2019 Feb 14.

Comprehensive Stroke Center, Department of Systems Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. Electronic address:

Background And Purpose: the effect of intravenous heparin during mechanical thrombectomy for acute ischemic stroke is not clear. We aimed to study efficacy and safety of heparin use during endovascular stroke treatment in a real-world setting.

Materials And Methods: patients with anterior circulation stroke were divided, based on the use of intraprocedural heparin, in those treated and those untreated. Read More

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http://dx.doi.org/10.1016/j.neurad.2019.01.095DOI Listing
February 2019
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Efficacy of Direct Revascularization Surgery for Hemorrhagic Moyamoya Syndrome As a Late Complication of Cranial Irradiation for Childhood Craniopharyngioma.

J Stroke Cerebrovasc Dis 2019 Feb 13. Epub 2019 Feb 13.

Department of Neurosurgery, Tohoku University, Sendai, Japan.

Moyamoya syndrome (MMS) is an uncommon late complication after cranial irradiation. Its hemorrhagic presentation from the associated pseudo-aneurysm is extremely rare, and the optimal management strategy is undetermined. We herein report a 36-year-old man who developed intraventricular hemorrhage from a pseudo-aneurysm at the extended left anterior choroidal artery as an abnormal collateral of MMS 30 years after surgical removal and cranial irradiation for childhood craniopharyngioma. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.01.033DOI Listing
February 2019
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Long-term mortality after DOAC-associated intracranial haemorrhage.

Thromb Res 2019 Feb 11;176:30-32. Epub 2019 Feb 11.

Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.

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http://dx.doi.org/10.1016/j.thromres.2019.02.007DOI Listing
February 2019
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Mechanical thrombectomy of M2 occlusions with distal access catheters using ADAPT.

J Neuroradiol 2019 Feb 13. Epub 2019 Feb 13.

Department of Diagnostic and Interventional Neuroradiology, Medical School Hannover, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany; Department of Interventional Neuroradiology, Johanna-Etienne-Hospital, Am Hasenberg 46, D-41462 Neuss, Germany.

Background And Purpose: The direct aspiration first pass technique (ADAPT) using distal access catheters (DAC) has proven to be an effective and safe endovascular treatment strategy of acute ischemic stroke with large vessel occlusions (LVO). However, data about direct aspiration using DAC in M2 segment occlusions is limited. We assess the safety and efficacy of DACs in acute M2 occlusions using ADAPT with large bore (5 French /6 French) aspiration catheters as the primary method for endovascular recanalization. Read More

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http://dx.doi.org/10.1016/j.neurad.2019.01.096DOI Listing
February 2019
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Stomaching Acute Brain Injury.

Neurocrit Care 2019 Feb 15. Epub 2019 Feb 15.

Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.

Gastrointestinal complications, including hemorrhage, can occur with intracranial lesions and after craniotomy. As early as the 19th century, surgeons were aware that brain tumors could cause gastric ulcers and acute perforations. Investigators used animal experiments both to reproduce these clinical observations and to seek ways to block the effects. Read More

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http://dx.doi.org/10.1007/s12028-019-00685-9DOI Listing
February 2019
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The Origin of Intracranial Pressure Causing Brainstem Hemorrhages.

Neurocrit Care 2019 Feb 15. Epub 2019 Feb 15.

Division of Neurocritical Care and Hospital Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.

The origin of secondary brainstem hemorrhages following an acute expansive hemispheric lesion has been attributed to Henri Duret, who proposed that hemorrhaging was caused by a shock wave through the cerebral spinal fluid. However, other experiments have shown important findings correlating brainstem hemorrhages to arterial hemorrhages. Animal studies found that the rapidity of expansion of a lesion would be crucial in producing these lesions, but there was no consistent correlation with paratentorial grooving so commonly seen with increased intracranial pressure. Read More

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http://dx.doi.org/10.1007/s12028-019-00688-6DOI Listing
February 2019
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Non-vitamin K antagonist oral anticoagulants with amiodarone, P-glycoprotein inhibitors, or polypharmacy in patients with atrial fibrillation: Systematic review and meta-analysis.

J Cardiol 2019 Feb 12. Epub 2019 Feb 12.

Yonsei University Health System, Seoul, Republic of Korea. Electronic address:

Background: Amiodarone, which inhibits CYP2C9 and P-glycoprotein, is commonly prescribed with non-vitamin K antagonist oral anticoagulants (NOACs) and polypharmacy in high-risk atrial fibrillation (AF) patients. We studied efficacy and safety of NOACs in AF patients receiving amiodarone, P-glycoprotein inhibitor, or polypharmacy.

Methods: After a systematic database search (Medline, EMBASE, CENTRAL, SCOPUS, and Web of Science), four phase-III randomized trials comparing NOACs and warfarin in "with/without amiodarone," "with/without P-glycoprotein inhibitors," or "with/without multiple (≥5, polypharmacy) concomitant drugs" subgroups were included. Read More

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http://dx.doi.org/10.1016/j.jjcc.2018.12.018DOI Listing
February 2019
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Perioperative Treatment of Brain Arteriovenous Malformations Between 2006 and 2014: The Helsinki Protocol.

Neurocrit Care 2019 Feb 14. Epub 2019 Feb 14.

Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Objective: We reviewed retrospectively the perioperative treatment of microsurgically resected brain arteriovenous malformations (bAVMs) at the neurosurgical department of Helsinki University Hospital between the years 2006 and 2014. We examined the performance of the treatment protocol and the incidence of delayed postoperative hemorrhage (DPH).

Methods: The Helsinki protocol for postoperative treatment of bAVMs was used for the whole patient cohort of 121. Read More

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http://dx.doi.org/10.1007/s12028-019-00674-yDOI Listing
February 2019
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The Ottawa subarachnoid hemorrhage clinical decision rule for classifying emergency department headache patients.

Am J Emerg Med 2019 Feb 7. Epub 2019 Feb 7.

Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong Township, Kaohsiung County 833, Taiwan. Electronic address:

Background: Subarachnoid hemorrhage (SAH) is a serious cause of headaches. The Ottawa subarachnoid hemorrhage (OSAH) rule helps identify SAH in patients with acute nontraumatic headache with high sensitivity, but provides limited information for identifying other intracranial pathology (ICP).

Objectives: To assess the performance of the OSAH rule in emergency department (ED) headache patients and evaluate its impact on the diagnosis of intracranial hemorrhage (ICH) and other ICP. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.02.003DOI Listing
February 2019
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Sequential Monitoring of the Comparative Effectiveness and Safety of Dabigatran in Routine Care.

Circ Cardiovasc Qual Outcomes 2019 Feb;12(2):e005173

Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (S.S., C.G., J.M.F., M.K., K.F.H.).

Background The increasing availability of electronic healthcare data enables ongoing monitoring of the effectiveness and safety of newly marketed medications. We sought to demonstrate a 5-year prospective monitoring system of dabigatran for stroke prevention that may expedite discovery and allow ongoing evidence development. Methods and Results Between 2011 and 2015, we conducted 9 sequential analyses of dabigatran versus warfarin users in a sequential cohort design in 2 US claims databases. Read More

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http://dx.doi.org/10.1161/CIRCOUTCOMES.118.005173DOI Listing
February 2019
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Reversal and Resumption of Antithrombotic Therapy in LVAD- Associated Intracranial Hemorrhage.

Ann Thorac Surg 2019 Feb 11. Epub 2019 Feb 11.

Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio; Department of Neurology, NYU School of Medicine, New York, NY. Electronic address:

Background: Little data exists regarding reversal and resumption of antithrombotics following left ventricular assist device (LVAD)-associated intracranial hemorrhage (ICH).

Methods: Prospectively collected data of LVAD patients with ICH was reviewed. Coagulopathy reversal agents, antithrombotic regimens and thrombotic (venous thromboembolism, ischemic stroke, myocardial infarction) and hemorrhagic (recurrent ICH, gastrointestinal bleed, anemia requiring transfusion) complications were recorded. Read More

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http://dx.doi.org/10.1016/j.athoracsur.2019.01.016DOI Listing
February 2019
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Rapid Alteplase Administration Improves Functional Outcomes in Patients With Stroke due to Large Vessel Occlusions.

Stroke 2019 Feb 14:STROKEAHA118021840. Epub 2019 Feb 14.

Calgary Stroke Program, Department of Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, Health Science Centre, University of Calgary, Alberta, Canada (M.D.H.).

Background and Purpose- We report the relation of onset-to-treatment time and door-to-needle time with functional outcomes and mortality among patients with ischemic stroke with imaging-proven large vessel occlusion treated with intravenous alteplase. Methods- Individual patient-level data from the HERMES (Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke Trials) collaboration were pooled from 7 trials that randomized patients to mechanical thrombectomy added to best medical therapy versus best medical therapy alone. Analysis was restricted to patients who received alteplase directly at the endovascular hospital. Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.021840DOI Listing
February 2019
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Tortuosity of the Internal Carotid Artery and Its Clinical Significance in the Development of Aneurysms.

J Clin Med 2019 Feb 12;8(2). Epub 2019 Feb 12.

TENSOR-Team of NeuroSurgery-Oriented Reaserch, Jagiellonian University Medical College, 31-008 Kraków, Poland.

Tortuosity of blood vessels is a common angiographic finding that may indicate systemic disease and can be correlated with vascular pathologies. In this work, we determined whether patients with and without internal carotid artery (ICA) aneurysm presented with differences in its tortuosity descriptors. We retrospectively analysed data of 298 patients hospitalized between January 2014 and June 2018. Read More

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http://dx.doi.org/10.3390/jcm8020237DOI Listing
February 2019
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Safety of Thrombolysis in a Patient with an Intracranial Dural Arteriovenous Fistula.

Eur J Case Rep Intern Med 2019 14;6(1):001019. Epub 2019 Jan 14.

Medical Oncology Department, Hospital São Francisco Xavier, Lisbon, Portugal.

Intracranial dural arteriovenous fistula is an abnormal connection between an artery and a vein that has an increased risk of bleeding. This case report presents a 53-year-old man diagnosed with a dural arteriovenous malformation fistula in occipital topography, lacking therapeutic indication because of an extension. He was admitted to an intensive care unit due to a high-risk pulmonary thromboembolism with indication for thrombolysis. Read More

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http://dx.doi.org/10.12890/2019_001019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372050PMC
January 2019
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Intracranial Hemorrhage with Cerebral Venous Sinus Thrombosis.

J Emerg Med 2019 Feb 9. Epub 2019 Feb 9.

Department of Emergency Medicine, Desert Regional Medical Center, Palm Springs, California.

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http://dx.doi.org/10.1016/j.jemermed.2018.12.037DOI Listing
February 2019
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Intracranial haemorrhage in children and adults with haemophilia A and B: a literature review of the last 20 years.

Blood Transfus 2019 Feb 4:1-7. Epub 2019 Feb 4.

Haemophilia Centre, University Hospital of Padua, Padua, Italy.

Intracranial haemorrhage (ICH) is the most serious event in haemophiliacs, resulting in high rates of mortality and disability. Although the use of a prophylaxis regimen has improved outcomes, the mortality caused by ICH is still around 20%. ICH is more frequent at two different ages: in childhood (mostly in children aged ≤2 years) and in adulthood (with known risk factors such as hypertension and age ≥60 years). Read More

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http://dx.doi.org/10.2450/2019.0253-18DOI Listing
February 2019
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Utility of Repeat Head CT in Patients on Preinjury Antithrombotic Medications.

Am Surg 2018 Oct;84(10):1626-1629

Division of Trauma/Acute Care Surgery/Surgical Critical Care, Department of Surgery, Harbor-UCLA Medical Center, Torrance, California, USA.

Presently, there are no standardized guidelines regarding the necessity or timing of repeat head imaging in patients on antithrombotics (antiplatelet agents, warfarin, or novel oral anticoagulants) with suspected traumatic brain injury. This is a two-year single institutional retrospective analysis of patients with suspected traumatic brain injury on antithrombotic medications. Patients with a stable or negative repeat head CT were compared with patients who developed a new bleed or demonstrated progression of intracranial hemorrhage (ICH). Read More

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October 2018
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Current status of endovascular treatment for dural arteriovenous fistulae in the anterior cranial fossa: A systematic literature review.

Int J Med Sci 2019 1;16(2):203-211. Epub 2019 Jan 1.

Department of Neurosurgery, The First Hospital of Jilin University, Changchun, 130021, China.

Anterior cranial fossa (ACF) dural arteriovenous fistulae (DAVFs) are rare, and a systematic review of the literature is lacking. Such a review is necessary, however, so a systematic PubMed search of related studies was performed. Twenty-four studies were identified, reporting on 48 patients, of whom 39 had definite age and sex information and 33 (84. Read More

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http://dx.doi.org/10.7150/ijms.29637DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367520PMC
January 2019
1 Read

Spontaneous Intracranial and Lumbar Subdural Hematoma Presenting as Vaginal Pain.

J Emerg Med 2019 Feb 8. Epub 2019 Feb 8.

Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland.

Background: Spontaneous spinal and intracranial subdural hematomas are rarely reported, especially occurring simultaneously. Anticoagulation use has been associated with spontaneous hemorrhages. Prompt diagnosis is required to prevent permanent neurological sequelae. Read More

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http://dx.doi.org/10.1016/j.jemermed.2018.12.032DOI Listing
February 2019
2 Reads

Safety of Peripheral Line Administration of 3% Hypertonic Saline and Mannitol in the Emergency Department.

J Emerg Med 2019 Feb 8. Epub 2019 Feb 8.

Department of Pharmacy Practice, Marshall B. Ketchum University College of Pharmacy, Fullerton, California.

Background: Hypertonic saline (HTS) and mannitol are frequently utilized in the emergency department (ED) to manage elevations in intracranial pressure (ICP).

Objective: The objective of this study was to compare the incidence of extravasation injury when HTS or mannitol was administered via peripheral i.v. Read More

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http://dx.doi.org/10.1016/j.jemermed.2018.12.046DOI Listing
February 2019
1 Read

Cost Comparison of Surgical Clipping and Endovascular Coiling of Unruptured Intracranial Aneurysms - A Systematic Review.

World Neurosurg 2019 Feb 8. Epub 2019 Feb 8.

University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany, Department of Health Economics and Health Services Research.

Objective: Rupture of unruptured intracranial aneurysms (UIA) is the main cause for subarachnoid hemorrhage (SAH). UIA are widespread among the population. Advanced technology enables us to diagnose UIAs with increasing reliability and subsequently treat them. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.01.195DOI Listing
February 2019
1 Read

Ultrasound identification of patients at increased risk of intracranial hemorrhage after successful endovascular recanalization for acute ischemic stroke.

World Neurosurg 2019 Feb 8. Epub 2019 Feb 8.

Neuroradiology Unit, University of Padua School of Medicine, Padua, Italy.

Background: Intracranial hemorrhage (ICH) is the most feared complication of endovascular treatment (EVT) for acute ischemic stroke due to anterior circulation large vessel occlusion (LVO). The purpose of this study was to identify cerebral hemodynamic predictors of ICH and poor outcome in patients with successful recanalization.

Materials And Methods: Serial transcranial color-coded sonography (TCCS) examinations assessed vessel status and cerebral hemodynamics of 226 [mean-age 69. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.01.198DOI Listing
February 2019
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Medical Malpractice of Vestibular Schwannoma: A 40-Year Review of the United States Legal Databases.

Otol Neurotol 2019 Mar;40(3):391-397

Department of Otolaryngology-Head and Neck Surgery.

Objectives: To analyze medical malpractice lawsuit trends pertaining to cases of vestibular schwannomas (VS).

Methods: Two major computerized legal databases (LexisNexis and WestLaw) were queried and reviewed for evaluation of all the US state and federal court records from civil trials alleging malpractice between 1976 and 2016.

Results: A total of 32 VS cases were identified. Read More

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http://dx.doi.org/10.1097/MAO.0000000000002133DOI Listing
March 2019
2 Reads

Clinical Effects of Early Edaravone Use in Acute Ischemic Stroke Patients Treated by Endovascular Reperfusion Therapy.

Stroke 2019 Feb 11:STROKEAHA118023815. Epub 2019 Feb 11.

Department of Acute Critical Care and Disaster Medicine (M.E., Y.O.), Tokyo Medical and Dental University Graduate School of Medicine, Japan.

Background and Purpose- Although several clinical studies suggested the beneficial effects of edaravone in acute ischemic stroke, most were performed under settings that differ from those in the current treatment strategy, which has dramatically changed with progress in reperfusion therapies. This study aimed to evaluate the efficacy of edaravone in patients with acute ischemic stroke treated by emergent endovascular reperfusion therapy. Methods- We conducted a retrospective observational study using a national administrative database. Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.023815DOI Listing
February 2019
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Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international, randomised, open-label, blinded-endpoint, phase 3 trial.

Lancet 2019 Feb 6. Epub 2019 Feb 6.

Department of Cardiovascular Sciences, University of Leicester, Leicester, UK; NIHR Leicester Biomedical Research Centre, The Glenfield Hospital, Leicester, UK.

Background: Systolic blood pressure of more than 185 mm Hg is a contraindication to thrombolytic treatment with intravenous alteplase in patients with acute ischaemic stroke, but the target systolic blood pressure for optimal outcome is uncertain. We assessed intensive blood pressure lowering compared with guideline-recommended blood pressure lowering in patients treated with alteplase for acute ischaemic stroke.

Methods: We did an international, partial-factorial, open-label, blinded-endpoint trial of thrombolysis-eligible patients (age ≥18 years) with acute ischaemic stroke and systolic blood pressure 150 mm Hg or more, who were screened at 110 sites in 15 countries. Read More

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http://dx.doi.org/10.1016/S0140-6736(19)30038-8DOI Listing
February 2019
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Neurological Complications of Cardiological Interventions.

Curr Neurol Neurosci Rep 2019 Feb 9;19(2). Epub 2019 Feb 9.

Department of Neurology, Carver College of Medicine, University of Iowa, 200 Hawkins drive, Iowa City, IA, 52242, USA.

Purpose Of Review: Neurological complications are common during cardiac procedures. The type of procedure influences the profile of neurological complications and their management. In this article, we review the different neurological complications encountered following cardiac procedures, and treatment strategies for managing those complications. Read More

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http://link.springer.com/10.1007/s11910-019-0923-1
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http://dx.doi.org/10.1007/s11910-019-0923-1DOI Listing
February 2019
8 Reads

Effect of choroidal collateral vessels on de novo hemorrhage in moyamoya disease: analysis of nonhemorrhagic hemispheres in the Japan Adult Moyamoya Trial.

J Neurosurg 2019 Feb 8:1-7. Epub 2019 Feb 8.

1Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto.

OBJECTIVEFollowing hemorrhagic stroke in moyamoya disease, de novo intracranial hemorrhage can occur in the previously unaffected nonhemorrhagic hemisphere. In the present analysis the authors intended to determine whether the presence in the nonhemorrhagic hemisphere of choroidal collateral vessels, which have been the focus of attention as a source of bleeding, affects the risk of de novo hemorrhage.METHODSThe subject of focus of the present cohort study was the nonhemorrhagic hemispheres of adult patients with hemorrhagic moyamoya disease enrolled in the Japan Adult Moyamoya Trial and allocated to the nonsurgical arm. Read More

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http://dx.doi.org/10.3171/2018.10.JNS181139DOI Listing
February 2019
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Two Diverse Hemodynamic Forces, a Mechanical Stretch and a High Wall Shear Stress, Determine Intracranial Aneurysm Formation.

Transl Stroke Res 2019 Feb 8. Epub 2019 Feb 8.

Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan.

Intracranial aneurysm (IA) usually induced at a bifurcation site of intracranial arteries causes a lethal subarachnoid hemorrhage. Currently, IA is considered as a macrophage-mediated inflammatory disease triggered by a high wall shear stress (WSS) on endothelial cells. However, considered the fact that a high WSS can be observed at every bifurcation site, some other factors are required to develop IAs. Read More

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http://dx.doi.org/10.1007/s12975-019-0690-yDOI Listing
February 2019
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Progressive Cerebral Ischemia and Intracerebral Hemorrhage after Indirect Revascularization for a Patient with Cerebral Proliferative Angiopathy.

J Stroke Cerebrovasc Dis 2019 Feb 6. Epub 2019 Feb 6.

Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan.

We previously reported a patient with cerebral proliferative angiopathy (CPA) who showed cerebral ischemia in resting and acetazolamide-stressed N-isopropyl-p-[I] iodoamphetamine single-photon emission computed tomography (I-IMP-SPECT). At onset, the patient was treated conservatively. However, during the 2 years following initial onset, his hemiparesis and aphasia had gradually aggravated and his IQ scores were markedly decreased. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2018.11.021DOI Listing
February 2019
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Safety, accuracy, and cost effectiveness of bedside bolt external ventricular drains (EVDs) in comparison to tunnelled EVDs inserted in theatres.

World Neurosurg 2019 Feb 5. Epub 2019 Feb 5.

Wessex Neurological Centre, University Hospital Southampton, Southampton, UK; Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's, University of London and St George's University Hospital NHS Trust, London, UK. Electronic address:

Objective: External ventricular drain (EVD) placement is frequently required in neurosurgical patients to divert CSF and monitor intracranial pressure. The usual practise is the tunnelled EVD technique performed in operating theatres. EVD insertion through a bolt in intensive care is also described. Read More

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http://dx.doi.org/10.1016/j.wneu.2019.01.106DOI Listing
February 2019
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Antiplatelet Medication and Operative Subdural Hematomas: A Retrospective Cohort Study Evaluating Reoperation Rates.

World Neurosurg 2019 Feb 5. Epub 2019 Feb 5.

Department of Neurosurgery, Geisinger, Danville, PA; Research Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.

Background: Antiplatelet therapy is common and complicates the operative management of subdural hematomas (SDH). The risk of reoperation inferred by antiplatelet medication and the ability of platelet transfusion to reduce hemorrhagic complications in patients presenting with antiplatelet associated SDHs is poorly defined.

Methods: We performed a retrospective review of consecutive patients treated with craniotomy or craniectomy for evacuation of an acute or mixed density SDH between 2012-2017 at two academic institutions. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18788750193025
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http://dx.doi.org/10.1016/j.wneu.2019.01.151DOI Listing
February 2019
4 Reads

Home-Time as a Surrogate Marker for Functional Outcome After Aneurysmal Subarachnoid Hemorrhage.

Stroke 2018 Dec;49(12):3081-3084

From the Department of Neurosurgery, University Hospital Zurich and Clinical Neuroscience Center, University of Zurich, Switzerland (M.N.S., E.K., O.B., L.R.)

Background and Purpose—Commonly used tools to determine functional outcome after aneurysmal subarachnoid hemorrhage (aSAH) have limitations. Time spent at the patient’s home has previously been proposed as a robust outcome measure after ischemic stroke. Here, we set out to validate home-time as an outcome measure after aSAH. Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.022808DOI Listing
December 2018
1 Read
5.723 Impact Factor

Acute Blood Pressure Management in Neurocritically Ill Patients.

Pharmacotherapy 2019 Feb 7. Epub 2019 Feb 7.

University Hospitals Cleveland Medical Center, Cleveland, OH.

Optimal blood pressure management is controversial in neurocritically ill patients due to conflicting concerns of worsening ischemia with decreased blood pressure versus cerebral edema and increased intracranial pressure with elevated blood pressure. In addition, there is a lack of high-quality evidence regarding optimal blood pressure goals in patients with most of these conditions. This review summarizes guideline recommendations and examines the literature for blood pressure management in patients with ischemic stroke, intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage, traumatic brain injury, and spinal cord injury. Read More

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http://dx.doi.org/10.1002/phar.2233DOI Listing
February 2019
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Risk Factors of Procedural Complications Related to Woven EndoBridge (WEB) Embolization of Intracranial Aneurysms.

Clin Neuroradiol 2019 Feb 7. Epub 2019 Feb 7.

Department of Neuroradiology, University Hospital of Cologne, Kerpener Straße 67, 50937, Cologne, Germany.

Purpose: The Woven EndoBridge (WEB) device has been proven to be a safe and efficient endovascular treatment option for wide-necked bifurcation aneurysms. The study aimed to evaluate the incidence and risk factors of procedural complications related to WEB embolization of ruptured and unruptured intracranial aneurysms.

Methods: This was a multicenter, observational study of consecutive patients with ruptured and unruptured aneurysms who were treated with the WEB at three German tertiary care centers between May 2011 and February 2018. Read More

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http://dx.doi.org/10.1007/s00062-019-00762-8DOI Listing
February 2019
1 Read