T he main complication of anticoagulation therapy is bleeding. We have conducted a literature review to determine: (a) the rate of bleeding during long-term anticoagulant therapy in various clinical disorders, and (b) the clinical and laboratory risk factors that predispose patients to bleeding. For the purposes of this review, we defined long-term therapy as lasting greater than 4 weeks. Hemor...

Migraine is a common episodic neurovascular brain disorder associated with increased risk of cardio- and cerebrovascular ischemia. Migraine headache is likely caused by activation of the trigeminovascular system and release of calcitonin gene-related peptide (CGRP). Monoclonal antibodies against CGRP or its receptor are currently being evaluated for the prevention of migraine attacks. Prelimina...

Background: Different aspects of acute stroke management and strategies for stroke prevention derive from two viewpoints: specific traditional and historical backgrounds and evidence-based medicine from modern randomized controlled trials (RCTs), meta-analysis and authorized clinical practice guidelines (GLs). Regarding stroke, GLs have been published by national and international organizations...

The sticky platelet syndrome (SPS) is a congenital disorder characterized by platelet hyperaggregability to epinephrine and/or adenosine diphosphate; this predisposes affected individuals to acute myocardial infarction, ischemic optic neuropathy, recurrent venous thromboembolism, and transient ischemic cerebral attacks and strokes. Here, we describe an unusual case with recurrent cerebrovascula...

The lupus anticoagulant, an acquired circulating serum y-globulin, prolongs all phospholipid-dependent coagulation tests. Recent associations of the lupus anticoagulant and focal cerebral and/or ocular ischemia have been made. We present 5 cases of lupus anticoagulant-associated cerebrovascular ischemia and review all reported cases for the first time. Clinical spectra, cerebral angiographic fi...

A group of 12 otherwise normal elderly volunteers (mean age = 69.8 years), were detected to have mild hypertension. Cerebral blood flow (CBF) values were measured using 133Xe inhalation method prior to initiating medical treatment and repeated at 6, 12, 24 and 36 months after BP was adequately controlled and restored to normal (below 150/90). Results indicate that CBF values increased markedly ...

A50-year-old woman was admitted for a mild left hemispheric stroke with right-sided hemiparesis and motor aphasia. In the previous 3 months, she had suffered from several transient ischemic attacks in all cerebrovascular territories, as revealed by MRI, which was suggestive of recurrent cardiac embolization. Transesophageal echocardiography revealed an atrial septum aneurysm; spiral computed to...

Sclerotherapy is an increasingly popular treatment modality for patients with chronic venous insufficiency and varicose veins. Potential complications of foam sclerotherapy include cerebrovascular accidents and transient ischemic attacks (TIAs). We report the case of a 55-year-old woman who had a TIA shortly after undergoing foam sclerotherapy. She had presented for treatment with no confirmed ...

The incidence of carotid artery disease and cerebrovascular symptoms were determined in 102 consecutive patients with peripheral arterial disease. Symptoms were correlated with risk factors of age, hypertension, smoking and diabetes and with the extent of disease at the carotid bifurcation. The incidence of stroke with permanent neurological deficit was twice as high in diabetics as in non-diab...

STROKES caused by thromboembolic occlusive events may involve the platelet in several ways: (1) production of platelet-fibrin thrombi, (2) containment of bleeding into the area of ischemia, and (3) participation in atheroma formation. One accepted pathogenesis for small recurrent strokes (transient ischemic attacks or TIAs) is recurrent embolization of platelet-fibrin thrombi or atheromatous ma...