Abstract:
OBJECTIVE:Rapid reversal of the anticoagulatory effect of vitamin K antagonists represents the primary emergency treatment for oral anticoagulant-related intracerebral hemorrhage (OAC-ICH). Predicting the amount of prothrombin complex concentrate (PCC) needed to reverse OAC in individual patients is difficult, and repeated international normalized ratio (INR) measurements in central laboratories (CLs) are time-consuming. Accuracy and effectiveness of point-of-care INR coagulometers (POCs) for INR reversal in OAC-ICH have not been evaluated. METHODS:In phase 1, the agreement of emergency POC and CL INR measurements was determined. In phase 2, stepwise OAC reversal was performed with PCC using a predetermined dosing schedule. Concordance of POC and CL INR measurements during reversal and time gain due to POC were determined. RESULTS:In phase 1 (n = 165), Bland-Altman analysis showed close agreement between POCs and CLs (mean INR deviation 0.04). In phase 2 (n = 26), POCs caused a median initial net time gain of 24 minutes for the start of treatment with PCC. Median time for POC-documented complete OAC reversal was 28 minutes, compared with 120 minutes for CLs. Bland-Altman analysis between POCs and CLs revealed a mean INR deviation of 0.13 during stepwise PCC administration. POCs tended to slightly overestimate the INR, especially at higher INR levels. Remarkably, POC-guided reversal led to a median reduction of 30.5% of PCC dose compared with the a priori dose calculation. Hematomas enlarged in 20% of patients. INTERPRETATION:POC INR monitoring is a fast, effective, and economic means of PCC dose-titration in OAC-ICH. Larger studies examining the clinical efficacy of this procedure are warranted.
journal_name
Ann Neuroljournal_title
Annals of neurologyauthors
Rizos T,Jenetzky E,Herweh C,Hug A,Hacke W,Steiner T,Veltkamp Rdoi
10.1002/ana.21965subject
Has Abstractpub_date
2010-06-01 00:00:00pages
788-93issue
6eissn
0364-5134issn
1531-8249journal_volume
67pub_type
临床试验,杂志文章abstract::Human T-lymphotropic virus type I (HTLV-I) has been associated with adult T-cell leukemia/lymphoma (ATL), a malignancy of mature CD4-positive lymphocytes, and with tropical spastic paraparesis (TSP), a demyelinating neurological syndrome. This article describes the clinical and pathological features of ATL and reviews...
journal_title:Annals of neurology
pub_type: 杂志文章,评审
doi:10.1002/ana.410230739
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:Oral anticoagulation treatment (OAT) resumption is a therapeutic dilemma in intracerebral hemorrhage (ICH) care, particularly for lobar hemorrhages related to amyloid angiopathy. We sought to determine whether OAT resumption after ICH is associated with long-term outcome, accounting for ICH location (ie, loba...
journal_title:Annals of neurology
pub_type: 杂志文章,meta分析,多中心研究
doi:10.1002/ana.25079
更新日期:2017-11-01 00:00:00
abstract::We measured neurotransmitter markers in autopsied brain of infants with glycine encephalopathy (GE). Because patients with GE develop intractable seizures, special attention was devoted to those neurotransmitter systems implicated in human epilepsy. Mean levels of glycine in the frontal cortex of GE patients were thre...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410240319
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVE:Migraine aura is sparsely studied due to the highly challenging task of capturing patients during aura. Cortical spreading depression (CSD) is likely the underlying phenomenon of aura. The possible correlation between the multifaceted phenomenology of aura symptoms and the effects of CSD on the brain has not ...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.25096
更新日期:2017-12-01 00:00:00
abstract::We have developed a radioimmunoassay to measure a specific neurological component, the basic protein of myelin, and have used this test for assessing this component in spinal fluid. The levels of basic protein in spinal fluid correlate closely with the clinical activity of multiple sclerosis; therefore the test can be...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410080104
更新日期:1980-07-01 00:00:00
abstract::A young woman with Kearns-Sayre syndrome and progressive central nervous system deterioration over 15 years had decreased plasma and cerebrospinal fluid folate levels while receiving phenytoin for a seizure disorder. A muscle biopsy showed a "ragged red fiber" myopathy with reduced muscle carnitine and mitochondrial e...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410130620
更新日期:1983-06-01 00:00:00
abstract::The nosological status of multifocal motor neuropathy remains controversial. The clinical and electrodiagnostic hallmarks suggest selective motor fiber involvement. In this study, we asked to what extent sensory nerves might be involved pathologically in multifocal motor neuropathy. Examination of sensory nerve biopsy...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410390308
更新日期:1996-03-01 00:00:00
abstract::The post-poliomyelitis syndrome (PPS) refers to symptoms of new weakness, fatigue, and pain years after recovery from acute poliomyelitis. Oligoclonal IgG bands have been reported in the cerebrospinal fluid (CSF) from PPS patients, suggesting that the syndrome is immune mediated or caused by persistent viral infection...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410260604
更新日期:1989-12-01 00:00:00
abstract::Nineteen patients with radiologically confirmed stroke, and varying degrees of hemiparesis, were studied using somatosensory evoked potentials and the recently developed technique of transcutaneous motor cortex stimulation. The functional deficit caused by stroke was assessed at the time of evoked potential testing an...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410250111
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to evaluate whether the visual analysis of muscle magnetic resonance imaging scans can identify specific patterns of muscle involvement. METHODS:We assessed scans from 83 patients with muscle disorders characterized by rigidity of the spine secondary to mutations in 4 different genes...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.21846
更新日期:2010-02-01 00:00:00
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journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.10098
更新日期:2002-01-01 00:00:00
abstract::Patients with atrial fibrillation are at risk for cerebral embolism; however, the roles of chronic anticoagulation or antiplatelet therapy for stroke prevention in patients with nonvalvular atrial fibrillation have been controversial. Recently, the results of three large prospective randomized trials that examined the...
journal_title:Annals of neurology
pub_type: 杂志文章,评审
doi:10.1002/ana.410300402
更新日期:1991-10-01 00:00:00
abstract::Mutations in AbetaPP cause deposition of Abeta amyloid fibrils in brain parenchyma and cerebral vessels, resulting in Alzheimer's disease (AD) and/or cerebral amyloid angiopathy (CAA). We report a novel mutation (L705V) within the Abeta sequence of AbetaPP in a family with autosomal dominant, recurrent intracerebral h...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.20571
更新日期:2005-10-01 00:00:00
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journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.22102
更新日期:2010-11-01 00:00:00
abstract::Few studies evaluate neuropathological correlates of behavioral changes in Alzheimer disease (AD). We identified 31 autopsy patients with a diagnosis of definite AD. Behavioral changes were assessed with the Neuropsychiatric Inventory. Brain sections were collected from bilateral orbitofrontal and left anterior cingul...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to assess the distribution, frequency, and specific location of mutant huntingtin protein (mHTT) aggregates-the pathological hallmark of Huntington disease (HD)-within the various compartments of the spinal cord and their potential impact on the local vasculature and blood-spinal cord...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.25107
更新日期:2017-12-01 00:00:00
abstract::A 40-year-old man with relapsing-remitting multiple sclerosis (MS) developed primary central nervous system lymphoma (PCNSL) after having received 21 doses of natalizumab monotherapy. PCNSL is a disease of the elderly, with the majority of patients being diagnosed in the 7th to 8th decade of life. Immunodeficiency, ia...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.21782
更新日期:2009-09-01 00:00:00
abstract::Clinical evidence is presented to support the contention that the sternocleidomastoid muscle is innervated primarily by undecussated fibers from the ipsilateral hemisphere. Stroke patients often show contralateral hemiparesis accompanied by weakness in head turning to the side of the paresis. ...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410070116
更新日期:1980-01-01 00:00:00
abstract::Autopsy examination confirmed the diagnosis of subacute necrotizing encephalomyelopathy (SNE) in a 7-month-old male infant who underwent several metabolic studies before death. Intermittent lactic acidemia and fumaric aciduria, an extreme hyperglycemic response to an intravenous bolus of alanine, and an elevated total...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410060605
更新日期:1979-12-01 00:00:00
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journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410050112
更新日期:1979-01-01 00:00:00
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journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410440508
更新日期:1998-11-01 00:00:00
abstract::The cause of the selective degeneration of motor neurons in amyotrophic lateral sclerosis (ALS) remains unexplained. One potential pathogenetic mechanism is chronic toxicity due to disturbances of the glutamatergic neurotransmitter system, mediated via alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA)-s...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410420211
更新日期:1997-08-01 00:00:00
abstract::The need for novel, efficacious, antiseizure therapies is widely acknowledged. This study investigates in humans the feasibility, safety, and efficacy of high-frequency electrical stimulation (HFES; 100-500 Hz) triggered by automated seizure detections. Eight patients were enrolled in this study, which consisted of a ...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.20377
更新日期:2005-02-01 00:00:00
abstract::We report a neurological disease among Cree Indian children in a northern Quebec village. The disease manifests as severe mental retardation, cerebral atrophy with white matter changes and calcifications, and systemic immunological abnormalities. Eleven cases are known in five families. The familial incidence of cases...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410240402
更新日期:1988-10-01 00:00:00
abstract:OBJECTIVE:Human immunodeficiency virus (HIV) infection of the central nervous system (CNS) is frequently associated with intrathecal immunoglobulin synthesis and cerebrospinal fluid (CSF) pleocytosis, but little is known about the B-cell response in the CSF of these patients. In this study, we investigated the relation...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.21195
更新日期:2007-11-01 00:00:00
abstract::Intellectual disability is common and is associated with significant morbidity. Until the latter half of the 20th century, there were no efficacious treatments. Following initial breakthroughs associated with newborn screening and metabolic corrections, little progress was made until recently. With improved understand...
journal_title:Annals of neurology
pub_type: 杂志文章,评审
doi:10.1002/ana.24002
更新日期:2013-09-01 00:00:00
abstract::Brains from male cases with dyslexia show symmetry of the planum temporale and predominantly left-sided cerebrocortical microdysgenesis. We now report on three women with dyslexia. In all brains, the planum temporale was again symmetrical. Also, in two of the brains, multiple foci of cerebrocortical glial scarring wer...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410280602
更新日期:1990-12-01 00:00:00
abstract::Dopamine transporter messenger RNA (mRNA) expression was assessed by in situ hybridization over individual pigmented neurons from the substantia nigra pars compacta in midbrain sections from 7 parkinsonian and 7 age-matched, neurologically normal patients. In the normal control brains, high levels of expression of dop...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410350421
更新日期:1994-04-01 00:00:00
abstract::The blood-brain barrier is a natural diffusion barrier, which expresses active carriers extruding drugs on their way to the brain back into the blood against concentration gradients. Whereas these so-called adenosine triphosphate-binding cassette (ABC) transporters prevent the brain entry of toxic compounds under phys...
journal_title:Annals of neurology
pub_type: 杂志文章,评审
doi:10.1002/ana.21012
更新日期:2006-11-01 00:00:00
abstract::This report reviews the fundamental principles and the changing concepts of nerve stimulation techniques, and discusses the proper application of these techniques in the differential diagnosis of peripheral nerve disorders. Nerve conduction studies help delineate the extent and distribution of the neural lesion and di...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410160402
更新日期:1984-10-01 00:00:00