warfarin and Brain-Diseases

All patients with neurologic diseases should receive perioperative VTE prophylaxis. The choice of mechanical, pharmacologic, or combined modalities of prophylaxis depends on both the underlying risk factors and surgical VTE risks. Prophylaxis and treatment options must be individualized to the patient. Prevention of VTE will help minimize the need for therapeutic treatment. Options for treatment include both inpatient and outpatient regimens using UFH or LMWH. In patients with an absolute or relative contraindication to anticoagulation, an IVC filter is an appropriate management strategy. Perioperative bridging therapy should be considered in patients with high or moderate risks for recurrent VTE.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Anticoagulants; Aspirin; Brain Diseases; Chondroitin Sulfates; Dermatan Sulfate; Dose-Response Relationship, Drug; Drug Combinations; Fibrinolytic Agents; Heparin; Heparitin Sulfate; Humans; Postoperative Complications; Venous Thrombosis; Warfarin

Topics: Animals; Anti-Bacterial Agents; Anticoagulants; Ants; Bartonella Infections; Brain Diseases; Diagnosis, Differential; Doxycycline; Heart Arrest; Humans; Insect Bites and Stings; Male; Middle Aged; Pulmonary Embolism; Tomography, X-Ray Computed; Vancomycin; Warfarin

Topics: Anticoagulants; Brain Diseases; Hemosiderosis; Humans; Male; Middle Aged; Warfarin

A pro-thrombotic condition was described in 1983 which was characterised by the presence of circulating antiphospholipid antibodies, as well as peripheral thrombosis (e.g. DVT), a tendency to internal organ involvement, repeated miscarriage, and, occasionally, thrombocytopenia (aPL) (Hughes, Br Med J 287:1088-1089, 1983). Previously, there had been a number of observations, mainly in patients with lupus having "false positive" tests for syphilis, miscarriage and circulating lupus anticoagulants. The description in 1983 had three notable features (a) a detailed comprehensive clinical picture of the syndrome; (b) this description differed from other coagulopathies in showing a propensity for arterial thrombosis (e.g. stroke and heart attack); and (c) this was a syndrome quite independent from lupus. There are indications that the primary antiphospholipid syndrome will turn out to be more common than lupus, though this could still be a reflection of referral practice.

Topics: Abortion, Spontaneous; Antibodies, Antiphospholipid; Antiphospholipid Syndrome; Arterial Occlusive Diseases; Aspirin; Brain Diseases; Cardiovascular Diseases; Constriction, Pathologic; Female; Heparin, Low-Molecular-Weight; Humans; Immunoglobulins, Intravenous; Immunosuppressive Agents; Infarction; Pregnancy; Thrombosis; Warfarin

Topics: Adult; Aged; Anticoagulants; Brain; Brain Diseases; Carotid Artery, Internal, Dissection; Cerebral Angiography; Humans; Hypoglossal Nerve Diseases; Knee; Magnetic Resonance Imaging; Male; Neurilemma; Peroneal Nerve; Stroke; Warfarin

Topics: Aged; Amphotericin B; Anticoagulants; Brain Diseases; Debridement; Diabetes Mellitus, Type 2; Humans; Male; Mucormycosis; Paranasal Sinus Diseases; Warfarin

The authors report the findings of two patients that confirm the location of the horizontal meridian in the human visual cortex. The first patient had an inferior quadrant defect with a band of horizontal meridian sparing. Magnetic resonance imaging showed a lesion concentrated along the medial striate cortex. The second patient had a homonymous horizontal defect that resulted from removal of an arteriovenous malformation located in the lateral striate cortex. The findings of these two patients demonstrate that the horizontal meridian is represented at the calcarine fissure base in the primary visual cortex.

Topics: Adult; Anticoagulants; Arteriovenous Malformations; Brain Diseases; Cerebral Angiography; Cerebral Arteries; Cerebral Veins; Female; Hemianopsia; Humans; Magnetic Resonance Imaging; Middle Aged; Visual Cortex; Visual Fields; Warfarin

The overall incidence of pulmonary embolism (PE) among neurosurgical in-patients, whose ages ranged from 23 to 80, was 0.7%. Our report here is based on five cases of patients with PE. Four of these five patients were over 50 years of age. They had been admitted because of such reasons as brain tumor, spinal cord injury, intracerebral hematoma, and venous sinus thrombosis. Deep vein thrombosis (DVT) was seen in four but none were diagnosed before they had developed PE. Decreased level of consciousness and prolonged bed rest appeared to be common risk factors for PE. Mean duration between admission and onset of PE was 31 days. Although non-specific, tachycardia, tachypnea and hypoxemia were the most common signs and symptoms. As a definitive diagnostic procedure, pulmonary angiography was performed in most of cases. One patient required surgical embolectomy and others were treated with anticoagulation or fibrinolytic agents. In order to prevent recurrent thromboembolic phenomena, ligation of the inferior vena cava was a useful mode of treatment when anticoagulation was not indicated. And this approach seemed to be valid in most neurosurgical patients. We conclude that PE and DVT were not uncommon complications among Japanese neurosurgical patients and they can be treated successfully in collaboration with a cardiovascular surgeon if the diagnosis can be made correctly.

Topics: Adult; Aged; Brain Diseases; Female; Humans; Male; Middle Aged; Postoperative Complications; Pulmonary Embolism; Spinal Cord Diseases; Thrombolytic Therapy; Urokinase-Type Plasminogen Activator; Vena Cava, Inferior; Warfarin

The authors report two cases of delayed radiation necrosis of the brain. In these cases a dramatic clinical and computerized tomographic improvement was noted after the institution of anticoagulant therapy. Based on a review of the literature, a possible causal mechanism is suggested. It was believed from both the clinical observation and the literature review that the anticoagulant agents had a direct effect upon the improvement in these patients. Laboratory data are needed to determine the role of anticoagulant therapy in the treatment of delayed radiation necrosis of the brain.

Topics: Adult; Brain Diseases; Brain Neoplasms; Carcinoma; Female; Glioma; Heparin; Humans; Male; Necrosis; Radiation Injuries; Thyroid Neoplasms; Tomography, X-Ray Computed; Warfarin

From March 1971 through April 1975, one hundred twenty patients underwent mitral valve replacement with a Hancock "stabilized glutaraldehyde process" porcine aortic xenograft. A simultaneous canine experimental series was also carried out. In the clinical series, the early mortality was 8.3%. Actuarial analyses of all patients predicts survival at two years of 81.0% and at four years of 70.0%. The predicted survival for patients without coronary disease or prior prosthetic valve replacement is 87.5% at two years and 77.5% at four years. There were four thromboembolic episodes, a rate of 2.4% per patient-year. None were fatal. No valve failure were noted. Histologic examination and shrink temperature analysis of recovered valves show excellent tissue preservation at 40 months. The data indicate that the Hancock valve is durable, enjoys a low incidence of thromboembolism, and may be the valve of choice for mitral valve replacement.

Topics: Adult; Aged; Aldehydes; Animals; Aortic Valve; Brain Diseases; Cardiac Surgical Procedures; Coronary Disease; Dogs; Endocarditis, Bacterial; Evaluation Studies as Topic; Female; Gastrointestinal Hemorrhage; Glutaral; Hematoma; Humans; Male; Methods; Middle Aged; Mitral Valve; Mitral Valve Insufficiency; Mitral Valve Stenosis; Postoperative Complications; Swine; Thromboembolism; Thrombophlebitis; Transplantation, Heterologous; Warfarin

Size-frequency distribution curves of erythrocytes were generated with the Coulter Counter in 73 normal subjects and patients. Mean corpuscular volume (MCV) determined by routine calculation and MCV determined by size-frequency distribution were similar in all normal subjects and in patients with a single population of erythrocytes. Some patients with iron-deficiency anemia, folate deficiency, and vitamin B12 deficiency had two discrete erythrocyte populations. Some patients with microcytic anemia were shown to have a population of normocytes in addition to the predominant microcytic population. Reticulocytes and normocytes were identified in two patients recovering from macrocytic anemia. Transfused blood was identified as a separate population in a patient with microcytic anemia. In cases with two erythrocyte populations, the MCV of the principal population, as determined from size-distribution curves, differed from the MCV of the entire erythrocyte pool, as was determined by routine methods. Analysis of sequential erythrocyte size distributions in patients under treatment demonstrated the dynamics of erythrocyte subpopulations. Anisocytosis was quantified and shown to be associated frequently with hospitalized patients.

Topics: Adenocarcinoma; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Pernicious; Brain Diseases; Electronics, Medical; Erythrocyte Count; Erythrocytes; Female; Folic Acid Deficiency; Heart Failure; Hematocrit; Hemorrhage; Humans; Male; Methotrexate; Middle Aged; Reticulocytes; Thrombophlebitis; Vitamin B 12 Deficiency; Warfarin

Topics: Autopsy; Brain Diseases; Child, Preschool; Female; Humans; Israel; Male; Reye Syndrome; Warfarin

Topics: Arteriosclerosis; Biomedical Research; Blood Chemical Analysis; Brain Diseases; Cerebrovascular Disorders; Coronary Disease; Enzyme Inhibitors; Fats; Hydrocortisone; Hypertension; Myocardial Infarction; Pharmacology; Physiology; Rabbits; Research; Thrombin; Warfarin