Article
Clinical Neurology
Lauren Previch, Giuseppe Lanzino, Robert D. Brown, Kelly D. Flemming
Summary: This study investigated the effects of select medications on the risk of hemorrhage in patients with CM. The results showed that antithrombotic agents, vitamin D supplementation, fish oil, and SSRIs were associated with a lower risk of hemorrhage. The use of these medications did not increase the risk of CM hemorrhage.
WORLD NEUROSURGERY
(2022)
Review
Cardiac & Cardiovascular Systems
Davide Capodanno, Jean-Philippe Collet, George Dangas, Gilles Montalescot, Jurrien M. ten Berg, Stephan Windecker, Dominick J. Angiolillo
Summary: TAVR presents challenges in terms of antithrombotic therapy, especially for elderly patients with multiple comorbidities. Careful selection of anticoagulant therapy strategies is crucial, and the net benefit of combining antiplatelet and OAC therapy remains uncertain.
JACC-CARDIOVASCULAR INTERVENTIONS
(2021)
Article
Clinical Neurology
Burak Karaaslan, Beste Gulsuna, Gokberk Erol, Ozlem Dagli, Hakan Emmez, Gokhan Kurt, Emrah Celtikci, Alp Ozgun Borcek
Summary: The study suggests that SRS is a safe and effective treatment for reducing the risk of hemorrhage in CM patients. It should be considered as an alternative treatment for patients with high surgical risks and a history of hemorrhage, instead of a wait-and-see approach.
JOURNAL OF NEUROSURGERY
(2022)
Article
Clinical Neurology
Nycole K. Joseph, Shivram Kumar, Robert D. Brown, Giuseppe Lanzino, Kelly D. Flemming
Summary: Prospective data from a group of women with known CMs show that pregnancy does not increase the risk of hemorrhage, and vaginal delivery is safe in appropriate candidates.
Article
Hematology
Sirui Ma, Rushad Patell, Eric Miller, Siyang Ren, Josue Marquez-Garcia, Samuel Panoff, Ria Sharma, Amanda Pinson, Pavania Elavalakanar, Grif fin Weber, Erik Uhlmann, Donna Neuberg, Salil Soman, Jeffrey I. Zwicker
Summary: This study found no increased risk of intracranial hemorrhage in patients with primary brain tumors exposed to antiplatelet medications, based on a matched retrospective cohort study.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Cardiac & Cardiovascular Systems
Shantel Weinsheimer, Jeffrey Nelson, Adib A. Abla, Nerissa U. Ko, Cynthia Tsang, Obiora Okoye, Joseph M. Zabramski, Amy Akers, Atif Zafar, Marc C. Mabray, Blaine L. Hart, Leslie Morrison, Charles E. McCulloch, Helen Kim
Summary: Familial cerebral cavernous malformations (CCM) is an autosomal dominant disease caused by specific gene mutations. This study reported the rates of intracranial hemorrhage (ICH) in familial CCM and assessed the association between CCM lesion burden and risk of symptomatic ICH during follow-up. The results showed that the overall symptomatic ICH rate for familial CCM cases was 2.8 per 100 patient-years, and those with a history of ICH before enrollment had a higher risk of subsequent ICH. Total lesion count was also found to be associated with increased risk of ICH during follow-up. These findings have important implications for patient outcome and risk stratification.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2023)
Article
Clinical Neurology
Yang Yang, Julia Velz, Marian C. Neidert, Martin N. Stienen, Luca Regli, Oliver Bozinov
Summary: The study found that there is a wide variation in hemorrhage rates of conservatively managed brainstem cavernous malformations, with both retrospective and prospective rates consistent with the literature. The long-term hemorrhage rate falls between the prospective and retrospective rates.
WORLD NEUROSURGERY
(2022)
Review
Clinical Neurology
Michael Paddock, Sarah Lanham, Kanwar Gill, Saurabh Sinha, Daniel J. A. Connolly
Summary: Cerebral cavernous malformations, the second most common vascular malformations in the central nervous system, can present with a variety of symptoms in children and can be diagnosed through imaging. The diagnosis, follow-up, and management of the condition are crucial for affected children and their families.
PEDIATRIC NEUROLOGY
(2021)
Article
Clinical Neurology
Tong Liu, Kai Li, Yongli Wang, Zilong Zhao, Xin Chen, Fanjian Li, Lu Zhao, Zhijun Peng, Tao Zhu, Jianning Zhang
Summary: Factors such as subarachnoid hemorrhage, lesion size, morphology, extent of hemosiderin involvement, and motor dysfunction were identified as independent risk factors affecting the neurological function prognosis in patients with spinal cavernous malformation. Clinically, these factors may be used to identify high-risk patients for worse outcomes and guide treatment decisions based on individual risk factors and symptoms.
JOURNAL OF NEUROSURGERY-SPINE
(2021)
Review
Biochemistry & Molecular Biology
Teodora Larisa Timis, Ioan Alexandru Florian, Sergiu Susman, Ioan Stefan Florian
Summary: Aneurysms and vascular malformations in the brain are significant sources of intracranial hemorrhage and mortality. Microglia, the resident immune cells of the central nervous system, play crucial roles in these pathologies, with proinflammatory microglia potentially exacerbating brain injury and anti-inflammatory microglia aiding in its resolution. Further research is needed to fully understand the roles of microglia in these conditions.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Article
Neurosciences
Cormac G. Gavin, Matthias W. R. Radatz
Summary: The optimal management of cavernous malformations (CMs) is controversial, but stereotactic radiosurgery (SRS) has gained acceptance in managing CMs, especially in high-risk cases. However, the long-term benefits of SRS and the reduced rehemorrhage rate may just reflect natural history. Adverse radiation effects (AREs) have been a concern but have been reduced with lower dose treatment protocols. Recent studies suggest higher hemorrhage rates and neurological sequelae in untreated brainstem and thalamic CMs, supporting the use of early proactive SRS in symptomatic deep-seated CMs.
Article
Cardiac & Cardiovascular Systems
Domenico G. Della Rocca, Michele Magnocavallo, Luigi Di Biase, Sanghamitra Mohanty, Chintan Trivedi, Nicola Tarantino, Carola Gianni, Carlo Lavalle, Christoffel Johannes Van Niekerk, Jorge Romero, David F. Briceno, Mohamed Bassiouny, Amin Al-Ahmad, J. David Burkhardt, Veronica N. Natale, G. Joseph Gallinghouse, Armando Del Prete, Giovanni B. Forleo, Javier Sanchez, Dhanunjaya Lakkireddy, Rodney P. Horton, Douglas N. Gibson, Andrea Natale
Summary: This study shows that long-term half-dose DOAC significantly reduces the risk of DRT and TE as well as major bleeding events after successful Watchman implantation, compared to standard antiplatelet therapy.
JACC-CARDIOVASCULAR INTERVENTIONS
(2021)
Article
Neurosciences
Yingkun He, Yanyan He, Weixing Bai, Dehua Guo, Taoyuan Lu, Lin Duan, Zhen Li, Lingfei Kong, Juha A. Hernesniemi, Tianxiao Li
Summary: This study analyzed the vascular stability of brain arteriovenous malformation (bAVM) in patients after partial embolization. The results showed that the biomarkers for bAVM vascular stability were most abnormal between 1 and 28 days after partial embolization.
CNS NEUROSCIENCE & THERAPEUTICS
(2023)
Article
Gastroenterology & Hepatology
Yoshimasa Horie, Yusuke Horiuchi, Akiyoshi Ishiyama, Tomohiro Tsuchida, Shoichi Yoshimizu, Toshiaki Hirasawa, Junko Fujisaki, Iruru Maetani, Toshiyuki Yoshio
Summary: This study found that discontinuing aspirin is not necessary for esophageal endoscopic resection, but caution must be exercised regarding the use of direct oral anticoagulants (DOAC).
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
(2022)
Article
Clinical Neurology
Bixia Chen, Dino Saban, Steffen Rauscher, Annika Herten, Laurel Rauschenbach, Alejandro Santos, Yan Li, Boerge Schmidt, Yuan Zhu, Ramazan Jabbarli, Karsten H. Wrede, Christoph Kleinschnitz, Ulrich Sure, Philipp Dammann
Summary: The study suggests that obesity may be a risk factor for CCM hemorrhage, significantly associated with ICH as mode of presentation. Other risk factors did not show such effects and none of the factors were independent predictors of cumulative 5-year risk of (re)bleeding.
Article
Neuroimaging
John Charles Benson, Shannon Chiu, Kelly Flemming, Deena M. Nasr, Giuseppe Lanzino, Waleed Brinjikji
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2020)
Review
Clinical Neurology
Lorenzo Rinaldo, Giuseppe Lanzino, Kelly D. Flemming, Timo Krings, Waleed Brinjikji
ACTA NEUROCHIRURGICA
(2020)
Article
Clinical Neurology
Kelly D. Flemming, Shivram Kumar, Robert D. Brown, Giuseppe Lanzino
WORLD NEUROSURGERY
(2020)
Review
Clinical Neurology
Anthony S. Larson, Kelly D. Flemming, Giuseppe Lanzino, Waleed Brinjikji
ACTA NEUROCHIRURGICA
(2020)
Editorial Material
Clinical Neurology
Alejandro A. Rabinstein, Kelly D. Flemming
Article
Clinical Neurology
Waleed Brinjikji, Harry J. Cloft, Kelly Flemming, Giuseppe Lanzino
WORLD NEUROSURGERY
(2020)
Article
Clinical Neurology
Romuald Girard, Yan Li, Agnieszka Stadnik, Robert Shenkar, Nicholas Hobson, Sharbel Romanos, Abhinav Srinath, Thomas Moore, Rhonda Lightle, Abdallah Shkoukani, Amy Akers, Timothy Carroll, Gregory A. Christoforidis, James Koenig, Cornelia Lee, Kristina Piedad, Steven M. Greenberg, Helen Kim, Kelly D. Flemming, Yuan Ji, Issam A. Awad
Summary: The study aims to optimize biomarkers for accurate diagnosis of cerebral cavernous angioma with symptomatic hemorrhage (CASH), predict the risk of future hemorrhage, and monitor cases after bleeding and in response to therapy.
Article
Clinical Neurology
Nycole K. Joseph, Shivram Kumar, Robert D. Brown, Giuseppe Lanzino, Kelly D. Flemming
Summary: Prospective data from a group of women with known CMs show that pregnancy does not increase the risk of hemorrhage, and vaginal delivery is safe in appropriate candidates.
Editorial Material
Clinical Neurology
Ryan M. Naylor, Britney Topinka, Lorenzo Rinaldo, Jaclyn Jacobi, Bryan Neth, Kelly D. Flemming, Luis E. Savastano
Summary: Supplemental digital content is available within the text.
Article
Clinical Neurology
Helen Kim, Kelly D. Flemming, Jeffrey A. Nelson, Avery Lui, Jennifer J. Majersik, Michael Dela Cruz, Joseph Zabramski, Odilette Trevizo, Giuseppe Lanzino, Atif Zafar, Michel Torbey, Marc C. Mabray, Myranda Robinson, Jared Narvid, Janine Lupo, Richard E. Thompson, Daniel F. Hanley, Nichol McBee, Kevin Treine, Noeleen Ostapkovich, Agnieszka Stadnik, Kristina Piedad, Nicholas Hobson, Timothy Carroll, Abdallah Shkoukani, Julian Carrion-Penagos, Carolina Mendoza-Puccini, James Koenig, Issam Awad
Summary: This study summarized baseline features of 110 cases of CASH, indicating that most patients had independent functional outcomes but their quality of life was affected to some extent. The EuroQol-5D scores of patients showed health problems, while the Patient-Reported Outcomes Measurement Information System-29 showed poorer anxiety scores for patients.
Article
Clinical Neurology
Soliman Oushy, Kelly D. Flemming, Harry Cloft, Luis E. Savastano
Summary: Carotid web (CaW) is a rare and commonly overlooked lesion along the posterior wall of the carotid bulb that can cause stroke in otherwise healthy patients. Intravascular imaging modalities such as intravascular ultrasound and optical coherence tomography (OCT) have been proposed as adjuncts to digital subtraction angiography for evaluating CaW, but the use of OCT in CaW has not been described. This report investigated the utility of OCT as an adjunct imaging modality in evaluating CaW morphology in a young patient with recurrent ischemic strokes.
INTERVENTIONAL NEURORADIOLOGY
(2023)
Article
Clinical Neurology
Lauren Previch, Giuseppe Lanzino, Robert D. Brown, Kelly D. Flemming
Summary: This study investigated the effects of select medications on the risk of hemorrhage in patients with CM. The results showed that antithrombotic agents, vitamin D supplementation, fish oil, and SSRIs were associated with a lower risk of hemorrhage. The use of these medications did not increase the risk of CM hemorrhage.
WORLD NEUROSURGERY
(2022)
Meeting Abstract
Clinical Neurology
Hirofumi Nakatomi, Satoshi Kiyofuji, Hideaki Ono, Minoru Tanaka, Hiroyasu Kamiyama, Katsumi Takizawa, Hideaki Imai, Nobuhito Saito, Yoshiaki Shiokawa, Akio Morita, Kelly D. Flemming, Michael J. Link
Article
Clinical Neurology
Lorenzo Rinaldo, Deena M. Nasr, Kelly D. Flemming, Giuseppe Lanzino, Waleed Brinjikji
Summary: Symptomatic nonsaccular vertebrobasilar aneurysms (NSVBAs) are associated with high rates of aneurysm-related death. Anecdotal evidence suggests that brainstem infarction may be a harbinger of aneurysm rupture. Perforator infarction is independently associated with the risk of aneurysm rupture in NSVBA patients.
JOURNAL OF NEUROSURGERY
(2021)
Article
Clinical Neurology
Kelly D. Flemming, Shivram Kumar, Robert D. Brown, Ravinder J. Singh, Kevin Whitehead, Lauren McCreath, Giuseppe Lanzino
CEREBROVASCULAR DISEASES
(2020)