Cerebrovascular diseases extra
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Cerebrovasc Dis Extra · Dec 2020
High Prevalence of Deep Venous Thrombosis in Non-Severe COVID-19 Patients Hospitalized for a Neurovascular Disease.
Severe SARS-CoV-2 infection induces COVID-19 along with venous thromboembolic occurrences particularly in intensive care units. For non-severe COVID-19 patients affected by neurovascular diseases, the prevalence of deep venous thrombosis (DVT) is unknown. The aim of our study was to report data obtained after systematic Doppler ultrasound scanning (DUS) of lower limbs in such patients. ⋯ Despite thromboprophylaxis, systematic bedside DUS showed a high prevalence (38.5%) of asymptomatic DVT in non-severe COVID-19 patients suffering from a neurovascular disease. In the absence of a reliable marker of DVT, we suggest that this non-invasive investigation could be an interesting tool to monitor peripheral venous thrombotic complications in such patients.
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Cerebrovasc Dis Extra · Jan 2020
Occurrence of Cerebrovascular Diseases Decreased after the Great East Japan Earthquake and Tsunami of 2011.
A temporary increase in the occurrence of cerebrovascular diseases (CVDs) after the Great East Japan Earthquake and Tsunami of 2011 was reported; however, no studies have been conducted to investigate long-term effects. We assessed the long-term impact of the disaster on the incidence of CVDs. ⋯ The occurrence of CVDs in the flooded coastal areas did not increase in the year of the Great East Japan Earthquake and Tsunami; furthermore, it decreased for men according to the severity of flood damage in the subsequent years; this can be attributed to supportive activities for the tsunami victims and the migration of the population.
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Cerebrovasc Dis Extra · Jan 2019
Observational StudyAcute Stroke Treatment in Patients with Basilar Artery Occlusion: A Single-Center Observational Study.
Acute ischemic stroke (AIS) due to basilar artery occlusion (BAO) represents 1-4% of all ischemic strokes. BAO results in strokes associated with a high risk of a poor functional outcome and, in 86-95% of the untreated cases, it results in death because of the vital cerebral structures involved. Diagnosis can be delayed because of the variability in presenting symptoms, and acute treatment is often attempted even beyond 6 h from symptoms onset because of the high risk of a fatal prognosis. ⋯ In our study, we found that younger age, low NIHSS score at admission, and high pc-ASPECTS, but not onset to treatment time, are associated with a favorable clinical outcome. Transferred patients did not have a significantly poorer outcome. These findings confirm that acute stroke treatment improves clinical outcome in BAO patients, in spite of a delayed diagnosis and an extended therapeutic window, considering lesion volume and localization in DWI MRI.
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Cerebrovasc Dis Extra · Jan 2018
Multicenter StudyPredictors of Cardioembolic Stroke in Japanese Patients with Atrial Fibrillation in the Fushimi AF Registry.
Large-scale clinical trials have analyzed risk factors for any ischemic stroke in patients with atrial fibrillation (AF). However, the risk factors for cardioembolic stroke (CES), specifically, have not been reported. To clarify the risk factors for CES and clinically significant cardioembolic infarction, we examined the incidence of CES and larger infarct volume (IV) (> 30 mL) CES, employing the Fushimi AF Registry, a community-based prospective cohort of AF patients in the Fushimi ward, Kyoto, Japan. ⋯ In this population-based cohort of Japanese patients with AF, in addition to previous stroke/TIA and older age, sustained AF and low body weight emerged as risk factors for CES, as opposed to any stroke, which may have a different risk profile. Patients with CKD or previous stroke/TIA who developed cardioembolic infarction exhibited more advanced severity. There is a need for direct oral anticoagulants that can be used safely in patients with comorbid AF and CKD.
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Cerebrovasc Dis Extra · Jan 2017
Multicenter Study Comparative StudyVolume and Characteristics of Intracerebral Hemorrhage with Direct Oral Anticoagulants in Comparison with Warfarin .
Patients undergoing anticoagulation therapy often experience intracerebral hemorrhages (ICHs), and warfarin in particular is known to increase hematoma expansion in ICHs, which results in a poor outcome. Recent studies reported that, in comparison with warfarin, direct oral anticoagulants (DOACs) cause fewer ICHs with better functional outcome. However, since it is still unknown whether DOACs are associated with a smaller hematoma volume of ICHs, we aimed to compare the volume, hematoma expansion, and outcomes associated with ICHs treated with DOACs and warfarin. ⋯ Based on the results of the present study, in terms of the risks associated with ICHs, the use of DOACs appears to be safer than warfarin for anticoagulation therapy. Further studies are required to validate these findings. .