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Recent News and Articles on the Keywords: intracerebral hemorrhage + lower dose + tpa  Related to the article below (Last Update: 7/1/2008)

Coffee, tea may curb stroke risk in male smokers
Reuters - Jun 25, 2008
During 13.6 years of follow-up, there were 2702 cerebral infarctions, 383 intracerebral hemorrhages, 196 subarachnoid hemorrhages, and 84 unspecified ...
Coffee and Tea May Protect Against Stroke
Medscape (subscription) - Jun 24, 2008
Coffee consumption did not affect the risks for intracerebral hemorrhage and subarachnoid hemorrhage. Coffee consumption was effective in reducing the risk ...
Women, Mexican-Americans At Higher Risk Of Ruptured Brain Aneurysm
Science Daily (press release) - Jun 12, 2008
An SAH is different from the other type of "bleeding stroke," intracerebral hemorrhage or ICH, which can also result from a ruptured aneurysm or a misformed ...

HealthNews
Leukemia Medication May Be Beneficial to Stroke Patients
HealthNews, CA - Jun 29, 2008
And, because the drug causes bleeding, it can't be used for other types of strokes such as an intracerebral hemorrhage, which occurs when a blood vessel in ...
Leukemia pill may improve stroke treatment: study
Reuters UK, UK - Jun 22, 2008
And because the drug causes bleeding, it can not be used in a more rare type of stroke known an intracerebral hemorrhage, which is caused when a blood ...
FDA Approves VELCADE(R) (Bortezomib) for Injection for Patients ...
FOXBusiness - Jun 20, 2008
There have been reports of gastrointestinal and intracerebral hemorrhage in association with VELCADE. Transfusions may be considered. ...TYO:4502 - OTC:CMTX
Cardium's InnerCool Therapies Unit Announces Italian ...
FOXBusiness - Jun 19, 2008
... and in recovery / intensive care, and as an adjunctive treatment for fever control in patients with cerebral infarction and intracerebral hemorrhage. ...CXM
Source: Google News

Antithrombotic and Thrombolytic Therapy for Ischemic Stroke -
GW Albers, P Amarenco, JD Easton, RL Sacco, P Teal - Chest, 2001 - Am Coll Chest Phys
... eligible for IV recombinant tPA therapy, a ... 22 patients with spontaneous intracerebral
hemorrhage were treated ... subjects, early (day 2) low-dose heparin therapy ...

Factors related to intracranial hematoma formation in patients receiving tissue-type plasminogen … -
DE Levy, TG Brott, EC Haley, JR Marler, GL … - Stroke, 1994 - Am Heart Assoc
... of 22 patients given a TPA dose of at ... Increases the Therapeutic Window for Low-Dose
Tissue Plasminogen ... SS Group Intracerebral Hemorrhage After Intravenous t-PA ...

Acute Tissue Damage After Injections of Thrombin and Plasmin into Rat Striatum -
M Xue, MR Del Bigio - Stroke, 2001 - Am Heart Assoc
... Intracerebral hemorrhage causes brain damage through multiple mechanisms ... toxic in
the first day after hemorrhage. ... would not be achievable at a much lower dose. ...

Aggressive Mechanical Clot Disruption and Low-dose Intra-arterial Third-generation Thrombolytic … -
AI Qureshi, AM Siddiqui, MFK Suri, SH Kim, Z Ali, … - Neurosurgery, 2002 - neurosurgery-online.com
... was performed after an initial dose of 2 ... without vascular complications, the low
hemorrhage rate (none ... without increasing the risk of intracerebral hemorrhage. ...

Lower-dose heparin with fibrinolysis is associated with lower rates of intracranial hemorrhage. -
RP Giugliano, CH McCabe, EM Antman, CP Cannon, FV … - American Heart Journal, 2001 - pt.wkhealth.com
... risk factors for intracerebral hemorrhage after thrombolysis. ... associated with major
hemorrhage during reperfusion ... receptor blockade and low-dose heparin during ...

… -Mediated Thrombolysis in Brain Ischemia Increased Risk of Hemorrhage With Combined Ultrasound and … -
M Daffertshofer, A Gass, P Ringleb, M Sitzer, U … - Stroke, 2005 - Am Heart Assoc
... one because of an atypical intracerebral hemorrhage 6 days ... treated with tPA plus
low-frequency ultrasound. ... that ultrasound increased the risk of hemorrhage. ...

… reduced hemorrhagic incidence in focal cerebral ischemia of rat by low dose combination therapy of … -
Y Yang, Q Li, A Shuaib - Neuropharmacology, 2000 - Elsevier
... group developed non-fatal intracerebral hemorrhage (as the ... diapedetic capillary and
vascular hemorrhage ( Fisher and ... group but none in low dose urokinase group ...

Combined Intravenous and Intra-Arterial r-TPA Versus Intra-Arterial Therapy of Acute Ischemic Stroke … -
CA Lewandowski, M Frankel, TA Tomsick, J Broderick … - Stroke, 1999 - Am Heart Assoc
... placebo/IA patients and correlated to the total dose of r ... of thrombolytics used compared
with IV therapy, and lower rates of intracerebral hemorrhage (ICH ...

Intravenous Tissue-Type Plasminogen Activator for Treatment of Acute Stroke The Standard Treatment … -
GW Albers, VE Bates, WM Clark, R Bell, P Verro, SA … - JAMA, 2000 - Am Med Assoc
... contraindication (known bleeding diathesis, intracerebral neoplasm, arteriovenous ...
low rate of symptomatic hemorrhage is unlikely ... may result in a lower rate of ...

Intravenous Tissue-Type Plasminogen Activator Therapy for Ischemic Stroke Houston Experience 1996 to … -
JC Grotta, WS Burgin, A El-Mitwalli, M Long, M … - Archives of Neurology, 2001 - Am Med Assoc
... Table 2. Symptomatic Intracerebral Hemorrhage (ICH) Rates in All ... trend toward a decline
in hemorrhage rates from ... patients beyond 3 hours with lower dose IV tPA ...

Source: Google Scholar
 
 

Intracerebral hemorrhage: lower doses of tPA safer

A Johns Hopkins study has shown that patients treated for intracerebral hemorrhage, survived more often if given 1 milligram instead of the previously studied 3 milligram dose of the clot-busting drug tissue plasminogen activator ( tPA; Alteplase ).
 
In the study, Daniel Hanley, at The Johns Hopkins University School of Medicine, demonstrated that rates of continued bleeding and subsequent death can be reduced if the tPA dosage is lowered to 1 mg.

" We have good evidence that lower doses of tPA not only worked as well as the higher dose, but also markedly reduced side effects in regard to bleeding," Hanley said. " Ten years ago, the mortality rate for this type of stroke was at 80 percent. One year ago, it was 50 percent. In this study it was 13 percent."

An intracerebral hemorrhage is the only type of stroke without a clearly defined treatment. It occurs in more than 100,000 Americans each year. Up to half of patients die, and those who survive suffer significant disabilities. During such a stroke, blood often extends into the ventricles, increasing the chances of damage.

In a previous study by Hanley and his group of 26 patients, a 3 milligram dose of tPA could be used safely to treat this type of stroke, reducing the mortality rate to 19 percent. However, continued bleeding was observed in 23 percent of the patients.

This new study was designed to find ways to reduce bleeding and further improve patient outcomes.

Researchers studied 16 patients who received either 0.3 milligram or 1 milligram of tPA every 12 hours through a catheter for up to four days or until the ventricles opened.
The patient groups were balanced with respect to age, gender, initial stroke severity and demographic characteristics.

Results from daily CT scans from this study and the previous study showed that blood clots broke up over the first three days at similar rates for all three doses.
Similarly, compared with a placebo, all doses substantially accelerated clot removal. But unlike the patients who received 3 milligram doses, none of the patients who received either 1 or 0.3 milligram doses experienced continued bleeding as a clinically significant side effect. Also, there were fewer deaths in each of the lower-dose groups, suggesting that the lower doses are safer.

Researchers also found that, although both lower-dose levels were equally effective at dissolving clots and reducing mortality rates, a sampling of the cerebral spinal fluid revealed that the 1 milligram dose stayed at therapeutic levels for longer periods of time than the 0.3 milligram dose. They also found that because the 1 milligram dose appears to clear the clot more rapidly from the third and fourth ventricles, the catheter can be removed sooner, greatly reducing risk of complications.

Source: Johns Hopkins Medical Institutions, 2006
 
 
 
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