Essential Topics About the Imaging Diagnosis and Treatment of Hemorrhagic Stroke: A Comprehensive Review of the 2022 AHA Guidelines

Gil-Garcia, Cesar-Alejandro; Alvarez, Eduardo-Flores; Garcia, Ricardo-Cebrian; Mendoza-Lopez, Abril-Carolina; González-Hermosillo, Leslie-Marisol; Garcia-Blanco, Maria-del-Carmen; Roldan-Valadez, Ernesto

doi:10.1016/j.cpcardiol.2022.101328

Cited by 29 publications

(13 citation statements)

References 97 publications

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“…Therefore, it is difficult to improve neurological function in patients with intracranial haemorrhage. However, the presence or absence of hematoma growth is also associated with blood pressure control, cerebral amyloid angiopathy, chronic kidney disease and lifestyle (smoking, alcohol consumption), which may confuse the reported association [48][49][50]. Additionally, the antifibrinolytic effect of tranexamic acid can promote the stability of thrombosis, and the effective benefits may be offset by the increase in ischemic events of IS or TIA [13].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of tranexamic acid in intracranial haemorrhage: A meta-analysis

et al. 2023

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Background Although some studies have shown that tranexamic acid is beneficial to patients with intracranial haemorrhage, the efficacy and safety of tranexamic acid for intracranial haemorrhage remain controversial. Method The PubMed, EMBASE, and Cochrane Library databases were systematically searched. The review followed PRISMA guidelines. Data were analyzed using the random-effects model. Results Twenty-five randomized controlled trials were included. Tranexamic acid significantly inhibited hematoma growth in intracranial hemorrhage (ICH) and traumatic brain injury (TBI) patients. (ICH: mean difference -1.76, 95%CI -2.78 to -0.79, I2 = 0%, P < .001; TBI: MD -4.82, 95%CI -8.06 to -1.58, I2 = 0%, P = .004). For subarachnoid hemorrhage (SAH) patients, it significantly decreased the risk of hydrocephalus (OR 1.23, 95%CI 1.01 to 1.50, I2 = 0%, P = .04) and rebleeding (OR, 0.52, 95%CI 0.35 to 0.79, I2 = 56% P = .002). There was no significance in modified Rankin Scale, Glasgow Outcome Scale 3–5, mortality, deep vein thrombosis, pulmonary embolism, or ischemic stroke/transient ischemic. Conclusion Tranexamic acid can significantly reduce the risk of intracranial haemorrhage growth in patients with ICH and TBI. Tranexamic acid can reduce the incidence of complications (hydrocephalus, rebleeding) in patients with SAH, which can indirectly improve the quality of life of patients with intracranial haemorrhage.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of tranexamic acid in intracranial haemorrhage: A meta-analysis

et al. 2023

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“…Plasma from these individuals was analyzed by untargeted metabolomics to identify candidate biomarkers with high predictive power for CVT. In the validation stage, we collected a validation cohort of 61 eligible healthy controls (HC), 65 eligible cerebral artery infarction (CI) controls according to the Guidelines for the Early Management of Patients with Acute Ischemic Stroke, 12 66 eligible cerebral hemorrhage (non-traumatic intracerebral hemorrhage, CH) controls according to the 2022 AHA Guidelines, 13 and 67 patients with acute CVT to verify the proposed biomarkers. The flow chart of the study design is shown in Figure 1.…”

Section: Methodsmentioning

confidence: 99%

Potential role of plasma branched-chain amino acids in the differential diagnosis of acute cerebral venous thrombosis

Jiang

Zhou

Wei

et al. 2023

J Cereb Blood Flow Metab

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Cerebral venous thrombosis (CVT) is a special and easily misdiagnosed or undiagnosed subtype of stroke. To identify specific biomarkers with a high predictive ability for the diagnosis of acute CVT, we performed metabolomic analysis in plasma samples from acute CVT patients and healthy controls and confirmed the results in validation cohorts. In the discovery stage, there were 343 differential metabolites, and the caffeine metabolism pathway and the biosynthesis pathway for the branched chain amino acids (BCAAs) valine, leucine, and isoleucine were two significant pathways between the CVT and healthy cohorts. The area under the curve (AUC) for metabolites associated with valine, leucine, and isoleucine biosynthesis was 0.934. In the validation stage, the BCAA concentrations demonstrated an AUC of 0.935 to differentiate patients with acute CVT from the control cohort. In addition, BCAAs combined with D-dimer levels were used to establish a diagnostic model for CVT, and the AUC was 0.951, showing good diagnostic efficacy of separating CVT patients from the control cohort. BCAAs as plasma biomarkers deserve to be further studied and even developed in clinical CVT management.

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“…Certain arrhythmias, especially AF can lead to the formation of blood clots in the atria. If these clots dislodge, they can form emboli, travel to the brain, and cause a stroke [ 21 ]. Arrhythmias may predispose patients to transient disruptions in blood flow to the brain resulting in brief episodes of neurological dysfunction producing transient ischemic attack [ 22 ].…”

Section: Reviewmentioning

confidence: 99%

Neurological Consequences of Cardiac Arrhythmias: Relationship Between Stroke, Cognitive Decline, and Heart Rhythm Disorders

Srinivas,

Vignesh RK,

Ayinapudi

et al. 2024

Cureus

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Cardiac arrhythmias are one of the most common disorders with high morbidity and mortality. The effect of cardiac arrhythmias on the brain is very pronounced due to the high sensitivity of the brain to oxygen and blood supply. This mortality is preventable by early diagnosis and treatment which improves the patient’s quality of life. Intervening at the right time, post arrhythmia is significant in preventing deaths and improving patient outcomes. Multiple pathophysiological mechanisms are studied for the brain-axis implications, that have the potential to be targeted by novel therapies. In this review, we describe the pathophysiological mechanisms and recent advances in detail to understand the functional aspects of the brain-heart axis and neurological implications post-stroke, caused by cardiac disorders. This paper aims to discuss the current literature on the neurological consequences of cardiac arrhythmias and delve into a deeper understanding of the brain-heart axis, imbalances, and decline, with the aim of summarizing everything and all about the neurological consequences of cardiac arrhythmias.

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Essential Topics About the Imaging Diagnosis and Treatment of Hemorrhagic Stroke: A Comprehensive Review of the 2022 AHA Guidelines

Cited by 29 publications

References 97 publications

Efficacy and safety of tranexamic acid in intracranial haemorrhage: A meta-analysis

Efficacy and safety of tranexamic acid in intracranial haemorrhage: A meta-analysis

Potential role of plasma branched-chain amino acids in the differential diagnosis of acute cerebral venous thrombosis

Neurological Consequences of Cardiac Arrhythmias: Relationship Between Stroke, Cognitive Decline, and Heart Rhythm Disorders

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