English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

P34 Background : Several factors are suspected in the  occurrence of hemorrhages after rtPA thrombolysis in cerebral infarcts,  but little is known about coagulation in these patients. Methods  and results : One hundred consecutive patients had rtPA at the  dose of 0.8 mg/kg infused for 90 minutes.We studied the values of  fibrinogen, FDP, aPTT, INR and thrombocyte count before thrombolysis  and at 2 and 24 hours.Results: Cerebral bleeding at 24  hours included 16 hemorrhagic infarcts (HI) and 7 parenchymal hematomas  (PH). 1. Cerebral bleeding in general. Univariate analysis comparing  patientswith HI+PH vs patients without bleeding detected 2 significant  factors : severity at entry (p=0.03) and and increased values of FDP at  2 hours (p=0.05). Each early CT symptom and pooled early CT symptoms  did not appear as factors of bleeding. Multivariate analysis showed  that values of FDP&gt;150mg/L multiplicate the odds of bleeding by 6.9,  being then a more powerful factor than severity at entry. 2. Factors of  seriousness of bleeding. FDP values&gt;150 mg/L multiplicate the odds of  parenchymal hematoma by 17. Comparison of patients with PH and HI only  showed one potential factor, the lack of hypercholesterolemia (p=0.06).  Interestingly, age, delay, severity at entry, early CT signs of  ischemia were not factors of parenchymal invasion. Heparin in the fist  24 hours was a potential factor, but not reaching statistical  significance. In a logistic regression model, the lack of  hypercholesterolemia multiplicates the risk of PH by 10.  Conclusion : The ”making“ of a parenchymal hematoma  involves at least 2 phases : (1) an early ”acquired coagulopathy“  characterized by increased FDP values at 2 hours (ie a particularly  intense thrombolysis); and (2) an increased vulnerability of the  arteriolar wall, possibly related to the lipid content of the vessels.  The observation of the ”coagulopathy“ should contraindicate any  antithrombotic drug during the first 24 hours and imply a surveyance of  haemostasis and cerebral bleeding with T2* gradient-Echo MRI during the  following days.

stroke

THE ”MAKING“ OF A PARENCHYMAL HEMATOMA. An early coagulopathy and specific risk factors contribute to grave intracerebral bleeding after intravenous rtPA thrombolysis.