Investigators performed a pre-planned secondary analysis of the open-label, randomized Antihypertensive Treatment of Acute Cerebral Hemorrhage 2 study, specifically on the magnetic resonance images obtained during the intensive blood pressure lowering portion of the trial.
Outcomes in intracerebral hemorrhage are less severe in patients with prior NOAC use.
The results confirm that ischemic, hemorrhagic, and subarachnoid stroke have very different etiologies.
Researchers have observed an upward trend in the incidence of pregnancy-related spontaneous subarachnoid hemorrhage.
Results from a secondary analysis of the ENCHANTED trial add to a pile of weak data that likely will not affect clinical practice.
Surprisingly, no evidence was found to suggest that patients with these markers benefit from intensive blood pressure reduction.
Although spot sign predicted ICH expansion, it proved to be a less robust diagnostic marker than demonstrated by previous single-center cohort studies.
Patients with cirrhosis had a 2.17% per year incidence of stroke compared with 1.11% per year incidence of stroke in patients without cirrhosis.
Compared with other sources of ICH, those associated with arteriovenous malformations had lower odds of death.
Intensive antiplatelet therapy appears to reduce risk of recurrence immediately after stroke, but may pose risks further out.
Resumption of oral anticoagulants after intracerebral hemorrhage was found to improve outcomes at 1 year.
Restarting anticoagulation after both nonlobar and lobar ICH was associated with decreased mortality.
As more patients survive ICH, emphasis is slowly shifting from survival to improving ICH-related morbidity and optimization of functional recovery.
Optimal antiplatelet treatment has yet to be determined for stroke survivors with prior intracerebral hemorrhage.
Neither lying flat nor sitting up appears to alter outcomes in patients presenting with acute stroke.
Among ICH survivors, 63% developed both depression and dementia during a 5-year follow-up study.
Patients receiving treatment with vitamin K antagonists (VKA) or antiplatelet agents face a significantly increased risk of mortality within 24 hours of intracranial hemorrhage.
Despite being more common than thought, many cases of neonatal hemorrhagic stroke remain idiopathic.
Concomitant use of oral anticoagulants contributed to a significantly higher increased risk for ICH.
Being overweight may slightly lower chances for hemorrhagic stroke, the study found.
Lower serum calcium levels correlate with risk of hematoma expansion in intracerebral hemorrhage.
Associations with increased mortality were found for both low and high hemoglobin levels, suggesting a U-shaped relationship.
Still, regional variations exist, indicating that more personalized prevention programs may be needed.
As ICH volume is known to increase within the first 3 hours following intracerebral hemorrhage, timely reversal is vital for patients on anticoagulation.
Sleep duration has previously been linked to hypertension and stroke risk.
Women with pregnancy at an advanced age had significantly higher rates of ischemic stroke, hemorrhagic stroke, myocardial infarction, and cardiovascular death.
Surprisingly, multiple types of stroke were associated with a greater risk of seizure than TBI.
The authors speculate that women may have pre-stroke functional deficits, and minorities may have poorer access to care.
Patients with symptoms of TIA should undergo brain imaging to rule out ICH prior to antithrombotic therapy.
The study did not establish whether early intervention improves outcomes.
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