Effect of direct oral anticoagulant for acute major cerebral artery occlusion in cardioembolic stroke/transient ischemic attack patients with non-valvular atrial fibrillation.

Background: Direct oral anticoagulants (DOACs) can reduce the frequency of cardioembolic stroke with non-valvular atrial fibrillation as well as or better compared to vitamin K antagonists (VKAs). However, whether taking DOACs prior to stroke can prevent acute major cerebral artery occlusion (MCAO) has not been fully elucidated.

Methods: We enrolled patients who underwent cardioembolic stroke or transient ischemic attack with non-valvular atrial fibrillation who were admitted to our hospital between April 2011 and February 2017.

Cerebral infarction associated with accessory middle cerebral arteries: two case reports.

We herein present two cases of cerebral infarction in the middle cerebral artery (MCA) territory associated with an accessory middle cerebral artery (AMCA), which is a rare anomalous vessel arising from the anterior cerebral artery that coexists with the main trunk of the MCA. Cerebral infarction occurred in both patients: due to occlusion of the MCA main trunk in one patient and occlusion of the AMCA in the other patient. These cases suggest the importance of recognizing an AMCA when interpreting neuroradiological findings in patients with MCA ischemic stroke, especially in the hyperacute phase.

Hospital cost of ischemic stroke and intracerebral hemorrhage in Japanese stroke centers.

Background: In Japan, the healthcare expenditure has increased to 8.0% of the gross domestic products in 2001. Stroke care is costly.

Hyponatremia upon resumption of paroxetine therapy.

We present a 79-year-old woman with severe hyponatremia secondary to resumption of treatment with paroxetine, a selective serotonin-reuptake inhibitor antidepressant. Confusion and fatigue followed re-initiation of paroxetine after a 3-month hiatus. Hyponatremia, serum hypoosmolality, and urine hyperosmolality strongly suggested the syndrome of inappropriate secretion of antidiuretic hormone.

Role of thrombin in CNS damage associated with intracerebral haemorrhage: opportunity for pharmacological intervention?

Intracerebral haemorrhage (ICH) results in high mortality and morbidity. The most important causes of neurological deterioration after ICH are progression of oedema and injury to nerve cells and axons surrounding the haematoma, as well as haematoma enlargement. Recent studies have indicated that thrombin, formed upon clotting of the haematoma, plays an important role in these processes.