The authors of this trial investigated the benefits and risks of early anticoagulation following acute ischemic stroke, and compared the effects of direct oral anticoagulants vs. vitamin K antagonists. Overall, treatment with direct oral anticoagulants resulted in a reduced risk of poor clinical outcomes, primarily due to reduced risk of intracerebral hemorrhage.
Transcranial Doppler delivery of sonothrombolysis was feasible and safe, but showed no clinical benefit at 90 days. However, this treatment deserves further investigation and evaluation for potential benefit.
This article will explore the subtle and enigmatic presentations of stroke. These patients often will present with nonspecific symptoms, such as vision problems, headache, a subtle language deficit, dizziness, or amnesia.
The following reviews of studies presented at the 2019 International Stroke Conference were written after my personal attendance at the presentations, followed by review of the simultaneous publications in The New England Journal of Medicine and The Lancet. All comments and opinions are solely those of this editor. — Matthew E. Fink, MD
Recent research on transient ischemic attacks (TIA) has changed how emergency medicine providers evaluate and manage this sometimes difficult diagnosis. This article provides readers with current information and relevant studies pertaining to TIAs.
In this meta-analysis of multiple observational studies, clinical outcomes after oral anticoagulant-associated intracerebral hematoma were similar for those associated with vitamin K antagonists or the new class of direct oral anticoagulants.
Intracerebral hemorrhage is the most dangerous and feared complication of oral anticoagulation and leads to a high mortality. Debate continues about the relative risk of hemorrhage with two classes of oral anticoagulants.