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Hypercoagulable AND Stroke

Yu Shimizu, Katsuhiro Tsuchiya, Hironori Fujisawa
BACKGROUND: Cerebral venous thrombosis is rare and an uncommon cause of stroke and has diverse etiologies and varied clinical presentations. Here, we report 2 cases of deep cerebral venous thrombosis. CASE DESCRIPTION: A 64-year-old woman presented with cerebral venous thrombosis due to a hypercoagulable state associated with ovarian tumor. On initial fluid-attenuated inversion recovery and diffusion-weighted imaging, there was a diffuse high-intensity lesion in the bilateral thalamus...
February 13, 2019: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Michał Ząbczyk, Rafal Meus, Krzysztof Piotr Malinowski, Joanna Natorska, Anetta Undas
Left ventricular thrombus (LVT) is associated with a hypercoagulable state and occurs most frequently after myocardial infarction (MI). Blood prothrombotic alterations might predispose to LVT formation, its recurrence, and subsequent cerebrovascular events. We investigated 58 patients with a history of LVT unrelated to recent MI or LV ejection fraction <25% and 58 well-matched control subjects. We determined plasma clot permeability, fibrinolytic efficiency, thrombin generation, and endothelial markers after 3 to 6 months of anticoagulant treatment...
January 24, 2019: American Journal of Cardiology
Peter Khalil, Ghazal Kabbach
PURPOSE OF REVIEW: As the management of acute coronary syndrome (ACS) continues to evolve, many old practices proved to be of a little benefit and other approaches established the new pillars of modern medicine. Treating ACS patients with dual antiplatelet therapy (DAPT) for a year by combining aspirin and a P2Y12 inhibitor (clopidogrel, ticagrelor, or prasugrel) has resulted in better outcomes and is currently the standard of therapy. However, owing to the persistent activation of the coagulation cascade, patients may continue to experience recurrent ischemia and high mortality rates despite compliance with the dual antiplatelet therapy...
January 28, 2019: Current Cardiology Reports
M D Sfredel, E Burada, B Cătălin, V Dinescu, G Târtea, M Iancău, E Osiac
OBJECTIVE: Hemostasis is a complex physiological process that stops bleeding at the site of a vascular injury. Although the majority of vascular accidents are ischemic, the role of hypercoagulable state and stroke needs further investigation. MATERIALS AND METHODS: Fresh whole blood was taken from 61 acute ischemic stroke patients and compared to 18 healthy subjects and investigated with optical coherence tomography imaging after initiating coagulation. We used an OCT1300SS system (Thorlabs) and did 3D scans...
April 2018: Current Health Sciences Journal
Efthimios Dardiotis, Athina-Maria Aloizou, Sofia Markoula, Vasileios Siokas, Konstantinos Tsarouhas, Georgios Tzanakakis, Massimo Libra, Athanassios P Kyritsis, Alexandros G Brotis, Michael Aschner, Illana Gozes, Dimitrios P Bogdanos, Demetrios A Spandidos, Panayiotis D Mitsias, Aristidis Tsatsakis
Numerous types of cancer have been shown to be associated with either ischemic or hemorrhagic stroke. In this review, the epidemiology and pathophysiology of stroke in cancer patients is discussed, while providing vital information on the diagnosis and management of patients with cancer and stroke. Cancer may mediate stroke pathophysiology either directly or via coagulation disorders that establish a state of hypercoagulation, as well as via infections. Cancer treatment options, such as chemotherapy, radiotherapy and surgery have all been shown to aggravate the risk of stroke as well...
January 2, 2019: International Journal of Oncology
Sarkis Morales Vidal, Geeta Verma, Carolyn Goldschmidt, José Biller
Stroke in young women is commonly cryptogenic or associated with an underlying hypercoagulable state (e.g., hormonal contraception). Paradoxical embolization has been postulated as a potential risk factor for stroke in young adults. Many sources of venous thrombosis leading to paradoxical embolization have been described. There have been few reported cases of uterine enlargement leading to iliac vein compression and paradoxical embolization. We present the case of a young adult woman who had a left middle cerebral artery infarction related to patent foramen ovale and right common iliac vein compression from an enlarged fibroid uterus...
September 2018: Case Reports in Neurology
Diamantis I Tsilimigras, Demetrios Moris, Georgios Karaolanis, Stavros K Kakkos, Konstantinos Filis, Fragiska Sigala
Peripheral artery disease (PAD) is the third most common manifestation of atherosclerosis after coronary artery (CAD) and cerebrovascular disease (CVD).1 The progressive build-up of the plaque inside the arterial wall results in the impairment of blood flow that subsequently causes critical limb ischemia with resting pain, ulceration or gangrene. In most cases, people with PAD have plaque findings in other vascular territories as well and, thus, are at increased risk of major adverse cardiovascular or cerebrovascular events (MACCE), including myocardial infarction, and stroke...
December 31, 2018: Current Pharmaceutical Design
Theocharis Koufakis, Vasiliki Antonopoulou, Maria Grammatiki, Spyridon N Karras, Ramzi Ajjan, Pantelis Zebekakis, Kalliopi Kotsa
We have described three uncommon cases of patients who presented with clinical thrombotic events (stroke, pulmonary embolism and deep venous thrombosis) during the course of a hypercalcemia-induced hypercoagulable state. After thorough investigation, the diagnosis of primary hyperparathyroidism - due to a parathyroid adenoma - was established in all cases. The association between hypercalcemia and venous or arterial thrombosis has been previously described; however, relevant data are still insufficient. The existing evidence in the field was reviewed and the interesting underlying pathophysiologic mechanisms were also discussed...
July 1, 2018: International Journal of Hematology-oncology and Stem Cell Research
Anca Moţăţăianu, Smaranda Maier, Anita Gothard, Zoltán Bajkó, Rodica Bălaşa
Introduction: Nonbacterial thrombotic endocarditis (NBTE), also known as marantic endocarditis, is a rare, underdiagnosed complication of cancer, in the context of a hypercoagulable state. NBTE represents a serious complication due to the high risk of embolisation from the sterile cardiac vegetations. If these are not properly diagnosed and treated, infarctions in multiple arterial territories may occur. Case presentation: The case of a 47-year-old male is described...
April 2018: Journal of Critical Care Medicine
Naoto Kuroda, Hisaya Hiramatsu, Masanori Mori, Tokutaro Tanaka
Trousseau syndrome was first described by Armand Trousseau in 1865 and is characterized by hypercoagulation resulting from malignant tumors. This complication can markedly impact quality of life (QOL). This is the first report of a terminally ill patient who developed large-vessel occlusion stroke from Trousseau syndrome and underwent mechanical thrombectomy. A 75-year-old woman presented with stage IV ovarian cancer. Goals of care were transitioned to palliative care. The patient was hospitalized with vertebral compression fracture, and suddenly developed right hemiparesis and total aphasia during admission...
December 18, 2018: Journal of Pain and Symptom Management
Xinzhen Yin, Jimin Wu, Shuijiang Song, Baorong Zhang, Yanxing Chen
BACKGROUND: Adenomyosis is a benign disease with elevated CA125 level. CASE PRESENTATION: We report 3 cases with adenomyosis who developed ischemic stroke during menstruation. The levels of CA125, CA19-9, and D-dimer were elevated, which dropped markedly after the menstrual phase. The development of nonbacterial thrombotic endocarditis (NBTE) and stenosis of the cerebral arteries associated with hypercoagulable state and the hyperviscosity nature of the mucinous protein may be the underlying mechanisms...
December 19, 2018: BMC Neurology
Jason Arthur, Petra Duran-Gehring, Christopher Kumetz, Steven Chadwick, Mark McIntosh
BACKGROUND: Cerebral venous thrombosis (CVT) is a rare, difficult-to-diagnose form of venous thromboembolic disease and is considered a type of stroke. Its presentation is highly variable and may be easily confused for more common and less debilitating or life-threatening diagnoses such as migraine, seizure, or idiopathic intracranial hypertension. CASE REPORT: A 25-year-old woman presented with a complaint of bifrontal throbbing headache and blurry vision. A bedside ultrasound of the orbit suggested increased intracranial pressure...
December 8, 2018: Journal of Emergency Medicine
Matías Otto-Yáñez, Rodrigo Torres-Castro, Joaquín Nieto-Pino, Mercedes Mayos
Stroke, one of the main causes of disability and death worldwide, is frequently associated to the obstructive sleep apnea-hypopnea syndrome. This sleep disorder has been demonstrated to be an independent risk factor for stroke, and therefore its investigation and treatment has been recommended for patients with stroke. Mechanisms relating these two clinical disorders include: oxidative stress, cerebral blood flow alterations, autonomic dysfunction, and hypercoagulability, as well as patent foramen ovale, blood pressure, and heart rhythm disorders...
2018: Medicina
Qi-Xiong Qin, Xue-Min Cheng, Li-Zhi Lu, Yun-Fei Wei, Da-Cheng Wang, Hai-Hua Li, Guo-Hui Li, Hong-Bin Liang, Sheng-Yu Li, Li Chen, Zhi-Jian Liang
AIM: To investigate the specific biomarkers and potential pathogenesis of colorectal cancer-related ischemic stroke (CRCIS). METHODS: A retrospective study was conducted on CRCIS patients (colorectal cancer patients with ischemic stroke without conventional stroke risk factors) registered at seven centers between January 2007 and December 2017. Clinical data and laboratory and imaging findings were compared with age- and sex- matched patients with colorectal cancer (CRC) without ischemic stroke that were admitted to the same hospital during the same period...
November 21, 2018: World Journal of Gastroenterology: WJG
Erica C Camargo, Steven K Feske, Aneesh B Singhal
Pregnancy confers a substantially increased risk of stroke in women. The period of highest risk of stroke is the peripartum/postpartum phase, coinciding with the highest risk for hypertensive disorders of pregnancy and peak gestational hypercoagulability. Hemorrhagic stroke is the most common type of obstetric stroke. Hypertensive disorders of pregnancy are important contributors to obstetric stroke and predispose women to premature cardiovascular disease. The rate of stroke associated with hypertensive disorders of pregnancy has increased in the United States...
February 2019: Neurologic Clinics
Tuğçe Aksu Uzunhan, Nur Aydinli, Mine Çalişkan, Burak Tatli, Meral Özmen
BACKGROUND: Our aim is to retrospectively assess short-term neurological outcomes in pediatric stroke with patient features. METHODS: Children aged 28 days-18 years with arterial ischemic stroke (AIS), cerebral sinovenous thrombosis (CSVT), and hemorrhagic stroke (HS) between 2007 and 2013 were evaluated. Neurological findings within the first three months were accepted as short-term prognosis and modified Rankin scale was used. RESULTS: In the study, 33 patients (62%) with AIS, 12 (23%) with HS, and 8 (15%) with CSVT were included...
November 18, 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
Eiko Higuchi, Sono Toi, Yuka Shirai, Satoko Mizuno, Hiromi Onizuka, Yoji Nagashima, Kazunori Hashimoto, Kazuo Kitagawa
The hypercoagulable state in patients with cancer has been shown to be closely associated with ischemic stroke. However, it is unlikely that benign tumors are related to stroke. The development of benign uterine tumors is common in middle-aged women. Previous studies have shown cases of ischemic stroke with benign uterine tumor, but the causal relationship between these 2 remain unknown. We report a case of recurrent ischemic stroke in a middle-aged woman who had a benign uterine tumor. After excision, there was no recurrence for 2 years...
October 23, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Susanna C Larsson, Matthew Traylor, Hugh S Markus
Vitamin K plays a crucial role in blood coagulation, and hypercoagulability has been linked to atherosclerosis-related vascular disease. We used the Mendelian randomization study design to examine whether circulating vitamin K₁ (phylloquinone) levels are associated with ischemic stroke. Four single-nucleotide polymorphisms associated with vitamin K₁ levels were used as instrumental variables. Summary-level data for large artery atherosclerotic stroke ( n = 4373 cases), small vessel stroke ( n = 5386 cases), cardioembolic stroke ( n = 7193 cases), and any ischemic stroke ( n = 34,217 cases and 404,630 non-cases) were available from the MEGASTROKE consortium...
October 25, 2018: Nutrients
Edmund Kenneth Kerut, William F Campbell, Michael E Hall, Michael R McMullan
A patent foramen ovale (PFO) is implicated in several pathologic processes, including that of cryptogenic stroke (cCVA). Recent trials identify "high-risk" PFOs in patients with cCVA as likely to benefit from percutaneous closure. The younger the patient (<60 years old) the more likely a PFO may be attributable to the cCVA. The RoPE Score index helps determine the likelihood that an existing PFO is related to a cCVA. This may help guide the clinician and patient when contemplating percutaneous PFO closure...
November 2018: Echocardiography
Koki Okazaki, Fumiaki Oka, Hideyuki Ishihara, Michiyasu Suzuki
BACKGROUND: Cerebral infarction associated with a malignant tumor is widely recognized as Trousseau syndrome. In contrast, few cases of cerebral infarction associated with benign tumors have been reported. We present two cases of embolic stroke that seemed to be caused by mucin-producing adenomyosis. CASE PRESENTATION: The patients were women aged 42 and 50 years old. Both patients developed right hemiparesis and aphasia, and cerebral infarctions were detected in the left cerebral hemisphere...
October 4, 2018: BMC Neurology
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