Abstract:
OBJECTIVES:To assess the impact of anticoagulants and antiplatelet agents on the severity and outcome of spontaneous non-traumatic intra-cerebral hemorrhage (ICH). To evaluate associations between reversal of anticoagulation and mortality/morbidity in these patients. METHODS:Data was collected on a consecutive cohort of adults presenting with ICH to an academic Emergency Department over a 3-year period starting January 2006. RESULTS:The final cohort of 245 patients consisted of 125 females (51.1%). The median age of the cohort was 73 years [inter-quartile (IQR) range of 59-82 years]. Antiplatelet (AP) use was seen in 32.6%, 18.4% were using anticoagulant (AC) and 8.9% patients were on both drugs (AC+AP). Patients on AC had significantly higher INR (median 2.3) and aPTT (median 31 s) when compared to patients not on AP/AC (median INR 1.0, median aPTT 24s; p<0.001). Similarly patients on AC+AP also had higher INR (median 1.9) and aPTT (median 30s) when compared to those not on AC/AP (p<0.001). Hemorrhage volumes were significantly higher for patients on AC alone (median 64.7 cm(3)) when compared to those not on either AC/AP (median 27.2 cm(3); p=0.05). The same was not found for patients using AP (median volume 20.5 cm(3); p=0.813), or both AC+AP (median volume 27.7 cm(3); p=0.619). Patients on AC were 1.43 times higher at risk to have intra-ventricular extension of hemorrhage (IVE) as compared to patients not on AC/AP (95% CI 1.04-1.98; p=0.035). There was no relationship between the use of AC/AP/AC+AP and functional outcome of patients. Patients on AC were 1.74 times more likely to die within 7 days (95% CI 1.0-3.03; p=0.05). No relationship was found between use of AP or AC+AP use and mortality. Of the 82 patients with INR>1.0, 52 patients were given reversal (minimum INR 1.4, median 2.3). Therapy was heterogeneous, with fresh frozen plasma (FFP) being the most commonly used agent (86.5% patients, median dose 4U). Vitamin K, activated factor VIIa and platelets were the other agents used. Post reversal, INR normalized within 24h (median 1.2, IQR 1.1-1.3). There was no association between reversal and volume of hemorrhage, IVE, early mortality (death<7 days) or functional outcome. CONCLUSIONS:Anticoagulated patients were at 1.7 times higher risk of early mortality after ICH. Reversal of INR to normal did not influence mortality or functional outcome.
journal_name
Clin Neurol Neurosurgjournal_title
Clinical neurology and neurosurgeryauthors
Stead LG,Jain A,Bellolio MF,Odufuye AO,Dhillon RK,Manivannan V,Gilmore RM,Rabinstein AA,Chandra R,Serrano LA,Yerragondu N,Palamari B,Decker WWdoi
10.1016/j.clineuro.2009.12.002subject
Has Abstractpub_date
2010-05-01 00:00:00pages
275-81issue
4eissn
0303-8467issn
1872-6968pii
S0303-8467(09)00319-9journal_volume
112pub_type
杂志文章abstract::The possible toxical effect of heavy metals in the pathogenesis of brachial and lumbar plexopathies during heroin addiction has been previously hypothesized by some authors, but never detected. A 24-year-old man, addicted to heroin showed the clinical picture of a symmetrical brachial neuropathy, without other neurolo...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(89)80040-x
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVES:Parkinson disease (PD), a neurodegenerative disease, has also some immunologic basis in which several regulatory factors, like Helios and Neuropilin-1 (NRP-1) may show some roles in its pathogenesis. We aimed to evaluate the circulatory frequency of T regulatory cells (Tregs) expressing Helios and NRP-1 in P...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.105833
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVES:The aim of the present study was to evaluate whether patients with paroxysmal atrial fibrillation (AF) without symptoms of cerebral ischemia or significant carotid stenosis have reduced blood flow through the middle cerebral arteries (MCAs), as well as to assess differences between blood flow through the MCA...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2007.06.001
更新日期:2007-11-01 00:00:00
abstract::Recent studies have reported that microRNA-155 (miR-155) is linked to the clinical outcomes of many tumors. However, its role in prognosis of gliomas remains unclear. This meta-analysis aims to evaluate the prognostic value of miR-155 in the survival of patients with gliomas. Hazard ratios (HRs) with 95% confidence in...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.clineuro.2018.12.005
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:The objective of this study is to investigate the application of transcranial magnetic stimulation combined with neuronavigation for preoperative mapping of the language area in neurosurgical interventions on the opercular area of the dominant hemisphere. METHODS:Five patients were operated upon gliomas in t...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2010.05.005
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Aneurysmal subarachnoid hemorrhage (aSAH) is an often devastating form of stroke. Aside from the initial hemorrhage, cardiac complications can occur resulting in neurogenic stress cardiomyopathy (NCM), leading to impaired cardiac function. We investigated whether aSAH patients with NCM had poorer long term f...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2012.09.006
更新日期:2013-07-01 00:00:00
abstract::Involvement of those cranial nerves subserving taste is common in the Guillain-Barré syndrome, yet seldom reported are disturbances of taste. This may reflect relative sparing of taste fibers, which are small thinly myelinated fibers. However, the true incidence of taste disturbances in GBS is probably underestimated ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/0303-8467(90)90012-t
更新日期:1990-01-01 00:00:00
abstract::Three cases of spinal cord compression due to solitary osteochondroma of the spine are reported. The rarity and benign nature of the tumour is stressed. Other reported cases are reviewed. ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(85)90113-1
更新日期:1985-01-01 00:00:00
abstract::A 33-year-old woman, with a 7-year clinical history of invasive thymoma treated at ages 26 and 30 years by thymectomy and radiation, presented with a generalized convulsion and loss of consciousness. Following the seizure there was no neurological deficit and normal tendon reflexes. Magnetic resonance imaging (MRI) of...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2006.09.007
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:In this study, we aimed to evaluate sexual dysfunction (SD) between two different regions of Turkey in patients with Parkinson's Disease (PD). PATIENTS AND METHODS:Forty-three PD patients in Ordu and 71 patients in Istanbul were included. The Unified PD Rating Scale and Hoehn and Yahr Stage (HYS) scale were ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2017.08.014
更新日期:2017-10-01 00:00:00
abstract:INTRODUCTION:Early after having been diagnosed with relapsing remitting multiple sclerosis (RRMS), young patients coping with the new situation require good social support and interactions. Successful social interaction is critically dependent upon the ability to understand the minds of others and their feelings. Socia...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2012.10.027
更新日期:2013-07-01 00:00:00
abstract::A case, in which rhinorrhoea was caused by a pituitary adenoma, is presented. Leakage of CSF or metrizamide could be observed on CT. ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(84)90278-6
更新日期:1984-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the usefulness of serum and CSF adenosine deaminase (ADA) activity for the diagnosis of tuberculous meningitis (TBM) from other meningitis. METHODS:We studied CSF and serum ADA activity for 83 cases of TBM, 148 of bacterial meningitis (BM), and 262 of viral or aseptic meningitis. RESULTS:The mea...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2013.05.017
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVES:Updated multi-institutional database studies assessing perioperative risk factors on 30-day morbidity and mortality after skull base surgeries are limited. We aim to identify perioperative risk factors and report the incidence of 30-day morbidity and mortality in adult patients after skull base surgery. PAT...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2018.06.015
更新日期:2018-08-01 00:00:00
abstract::An unusual case of cholesterol granuloma of the temporal bone is described presenting as a cerebellopontine tumor. This lesion seemed to arise from an inflammatory process obstructing pneumatized cells. It consists of extradural granulation tissue and must be distinguished from intradural epidermoid cyst, which is, in...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(92)90102-9
更新日期:1992-01-01 00:00:00
abstract::Hypothalamic hamartomas (HH) are rare, non-neoplastic heterotopic tissues which contains normal neurons and glia including oligodendrocytes and fibrillary astrocytes but in an abnormal distribution. They arise from the floor of the third ventricle, tuber cinereum, or mammillary bodies. Estimated incidence ranges from ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2020.106077
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:Digital subtraction angiography is the gold standard for diagnosis of vascular pathology. The value of angiography of non-target vessels following mechanical thrombectomy for the treatment of acute ischemic stroke (AIS) is unknown. PATIENTS AND METHODS:Consecutive patients treated with mechanical thrombectom...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.105842
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Meige's syndrome is a rare form of segmental dystonia characterized by blepharospasm and oromandibular dystonia. Medical treatment including botulinum toxin injections usually present disappointing results. The experience on Deep Brain Stimulation (DBS) in the treatment of Meige's syndrome and other segmenta...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2009.12.005
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:In a previous polysomnographic cross-sectional study we found a significant relationship between sleep disorders and multiple sclerosis (MS) related fatigue. The purpose of this open follow-up observation was to compare the impact of treatment of sleep disorders on MS related fatigue measured with the Modifie...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2013.05.018
更新日期:2013-09-01 00:00:00
abstract::SPECT with Tc-99m HM-PAO as a radiopharmaceutical was performed in 17 patients meeting research criteria for Alzheimer's disease (AD), in 10 patients with a clinical diagnosis of multi-infarct-dementia (MID) and in 12 healthy volunteers. Regional tracer uptake was measured in frontal, parietal, and temporoparietal reg...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(91)90007-c
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:As a result of continuously increasing life expectancy, the number of requests for surgery to treat degenerative diseases of the spine in the elderly population will increase. Since older age is associated with the occurrence of medical comorbidities, the demand for less extensive surgical approaches is growi...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2019.04.025
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVES:The diagnosis and the surgical removal of a brain tumor can have serious impact on the quality of life of a patient. The question rises, whether having more or just less memories of the procedure is better for coping with such an event. Furthermore, for preoperative information of future patients it is impor...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2018.05.013
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:Cerebral microbleeds (CMB) on gradient-echo T2*-weighted magnetic resonance image (MRI) are frequently seen in patients with cerebral diseases. In this observational study we assessed whether CMB are a predictive factor for first-ever cerebrovascular events. PATIENTS AND METHODS:This study consisted of 698 s...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2009.08.011
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVE:Perfusion studies are increasingly used to triage acute stroke patients for endovascular recanalization therapies. We compare the safety and efficacy of CT perfusion (CTP)-guided to time-guided mechanical recanalization in acute ischemic stroke (AIS) patients. METHODS:A review was conducted on 132 patients, ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2013.09.036
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Ventriculostomy is one of the most common neurosurgical procedures and an important tool in the treatment and monitoring of elevated intracranial pressure. Low accuracy has frequently been reported in the literature with risk of drain misplacement over 20% and with a need for reinsertion in up to 40%. As an ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2013.05.026
更新日期:2013-10-01 00:00:00
abstract::We explored the feasibility of using subcutaneous low-molecular-weight-heparin (LMWH) injections in place unfractionated heparin (UFH) while anticoagulating patients with cerebral ischemia. In this open-labeled, prospective study, patients admitted to our hospital with transient ischemic attacks or stroke requiring an...
journal_title:Clinical neurology and neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0303-8467(98)00039-0
更新日期:1998-09-01 00:00:00
abstract::A 7-year-old girl presented with focal seizures without symptoms of raised intracranial tension. Routine histological, immunocytochemical and ultrastructural methods revealed a desmoplastic low grade cerebral astrocytoma. Follow up for 2 years after biopsy did not show recruitment of neurological symptoms or signs. Bi...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/0303-8467(94)00051-7
更新日期:1995-02-01 00:00:00
abstract::A 27-year-old male had experienced an episode of severe headache and nausea, sometimes accompanied by an inability to name objects. Magnetic resonance imaging showed a huge cyst within the left temporal lobe and a high degree of brain shift by it. A small round mass, which appeared to be a mural nodule, was located in...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(99)00059-1
更新日期:1999-12-01 00:00:00
abstract::Dialysis disequilibrium syndrome is a disorder of the central nervous system in patients on dialysis. The underlying etiology is thought to be primarily due to cerebral edema; however, neuroradiologic findings have not been described previously. We describe a patient who presented with new onset headaches and status e...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(03)00039-8
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:We performed a retrospective study to identify factors associated with preoperative and late postoperative seizures in primary supratentorial meningiomas. PATIENTS AND METHODS:Between July 2003 and December 2014, we extracted 303 consecutive patients who underwent primary resection for supratentorial meningi...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2019.03.007
更新日期:2019-05-01 00:00:00