Lack of association between cerebral microbleeds and low serum cholesterol in patients with acute intracerebral hemorrhage.

BACKGROUND: The association of cerebral microbleeds (CMBs) with intracerebral hemorrhage (ICH) is well known and its relationship with low serum cholesterol in ICH patients might be of interest. METHODS: A total of 105 patients with ICH were evaluated. In all subjects cholesterol levels were measured after 12h of fasting and gradient-echo magnetic resonance imaging (GE-MRI) was performed for detecting CMBs. RESULTS: CMBs were more common among patients with hypertension and leukoaraiosis (p=0.008 and p=0.001). Patients with and without CMBs did not differ according to total cholesterol, LDL cholesterol, triglycerides and HDL cholesterol levels. CONCLUSION: In this study, 61% of Turkish ICH patients had CMBs, which was not associated with lipid profiles. Leukoaraiosis was independently associated with CMBs.

Prevention of deep venous thrombosis and pulmonary embolism in patients with acute intracerebral hemorrhage.

OBJECTIVES: Although patients with intracerebral hemorrhage (ICH) are at risk for deep venous thrombosis (DVT), the data about preventive options for DVT prophylaxis in this population is insufficient. We investigated the safety of low dose low molecular weight heparin (LMWH) for DVT prophylaxis in patients with ICH and the effect of heparin on the enlargement of hemorrhage. METHODS: We prospectively randomized 75 primary ICH patients to subcutaneous LMWH (Enoxaparin sodium 40mg/d) or long compression stockings (CS) after the first 48 hours. All patients had cranial computed tomography (CT) scan at admittance, 24th and 72nd hours, seventh and 21st days, CT pulmonary angiography and bilateral lower extremity venous Doppler at 7th day. Hematoma volumes were calculated on the initial and follow-up CTs with ABC/2 method. RESULTS: Mean +/- SD age of the patients was 68.1 +/- 11.98 and 66.08 +/- 9.55 in LMWH and CS groups, respectively. Twenty-two of LMVH group and 8 of CS group were female. After randomization to LMWH or CS, we did not observe any hematoma enlargement at 72nd hours, 7 and 21st days in both groups. In addition, there was not any other systemic bleeding complication in LMWH group. We detected 4 asymptomatic DVT in our patients (3 in LMWH and 1 in CS group). Although asymptomatic DVT was more common in LMWH group, it was not statistically significant (P = 1). CONCLUSIONS: Low dose heparin treatment after 48 hours of stroke in ICH patients is not associated with an increased hematoma growth and should be used for DVT and PE prophylaxis.

Triphasic EEG pattern in bilateral paramedian thalamic infarction.

Two cases of bilateral paramedian thalamic infarction (BPTI) showing triphasic waves (TWs) on the electroencephalogram (EEG) at acute stage are presented in this study. BPTI is a rare syndrome with decreased level of consciousness, gaze abnormalities and cognitive deterioration. TWs are nonspecific EEG findings occurring in both metabolic and nonmetabolic conditions. The TWs in BPTI might be related to level of consciousness and does not always predict a poor prognosis in BPTI.