Cerebral vascular accident

INTRODUCTION: Various clinical and radiologic variables impact the neurologic prognosis of patients with ischemic cerebrovascular accidents. About 30% of ischemic cerebrovascular accidents are caused by proximal obstruction of the anterior circulation; in these cases, systemic thrombolysis is of limited usefulness. CT angiography is indicated in candidates for endovascular treatment. Various radiologic factors, including the grade of leptomeningeal collateral circulation, as well as the length, density, and extension of the thrombus, have been identified as predictors of neurologic prognosis after anterior ischemic cerebrovascular accidents due to proximal vascular obstruction...

Encephalopathy is a rare side effect associated with carbapenem antibiotics, typically presenting within one week of initiating treatment. It is almost exclusively seen in patients with poor renal function. We present a case of a middle-aged male with a history of cerebral vascular accident and normal renal function admitted for agitation, delirium, and insomnia more than two weeks after starting ertapenem to treat osteomyelitis. He was empirically treated for meningitis on admission, and ertapenem was discontinued...

To analyze the long-term results of transposition of the internal carotid artery (ICA) into the lateral wall of the external carotid artery (ECA) in the presence of hemodynamically significant stenosis of the ICA. During the period from 3.10.2017 to 28.12.2020, 784 patients with isolated hemodynamically significant ICA orifice stenosis were included in the present retrospective multicentric open comparative study "Russian Birch." Depending on the implemented surgical technique, groups were formed: group 1 (n = 517) - eversion carotid endarterectomy (eCEA); group 2 (n = 193) classic CEA with implantation of a xenopericardium patch treated with di-epoxy compounds; group 3 (n = 74) - transposition of the ICA into the lateral wall of the ECA...

OBJECTIVE: To analyze the work of the Center for the Treatment of Cerebrovascular Pathology in Children and Adolescents, operating on the basis of the Morozov Children's City Clinical Hospital of the Moscow Health Department for the period 2018-2021 and to assess the peculiarities of organizing the provision of specialized care to children and adolescents with acute cerebrovascular accident (ACA). MATERIAL AND METHODS: Annual reports of the Center for the period 2018-2021; included children and adolescents aged 1 month to 17 years 11 months 29 days, with new onset ischemic stroke (IS) and hemorrhagic stroke (HS), cerebral venous thrombosis (sinus thrombosis), confirmed clinically and radiologically...

Hepatopulmonary syndrome (HPS) is a condition characterized by chronic liver disease, intrapulmonary arteriovenous shunting, and increased alveolar-arterial oxygen gradient. This case report presents a 54-year-old male patient with a history of stroke, liver cirrhosis, portal vein thrombosis, hypertension, diabetes, and bladder cancer, who presented with worsening headaches and confusion over the course of five years. Digital subtraction angiogram (DSA) revealed multiple bilateral arteriovenous shunts, suggesting a shunting mechanism similar to that observed in HPS...

PURPOSE: Retinal artery occlusion (RAO) is an ophthalmic emergency that can lead to poor visual outcomes and is associated with an increased risk of stroke and cardiovascular events. Wide-field swept-source OCT-A (WF SS-OCTA) can provide quick and non-invasive angiographic information with a wide field of view. Here, we looked for associations between OCT-A vascular imaging metrics and vision in RAO patients. METHODS: Patients with diagnoses of central (CRAO) or branched retinal artery occlusion (BRAO) were included...

Regular blood transfusion is the mainstay of treatment in transfusion-dependent β-thalassemia (TDT); however, transfusions culminate in an array of serious complications. Therefore, a single-arm, non-randomized clinical trial was conducted in hydroxyurea refractory TDT patients to explore the long-term safety and efficacy of thalidomide. The primary outcomes for efficacy were rise in hemoglobin (Hb) level and changes in transfusion frequency. Whereas, several clinical and laboratory parameters were assessed for safety of thalidomide...

BACKGROUND: Traumatic pseudoaneurysms are rare but have a high mortality rate; therefore, immediate diagnosis is vital. Most pseudoaneurysms are in the internal carotid artery or peripheral arteries, while proximal middle cerebral artery pseudoaneurysms have rarely been reported. We present a case of ruptured traumatic pseudoaneurysm located at the M1-M2 bifurcation. CASE DESCRIPTION: A 42-year-old man was injured in a motorcycle accident and his Glasgow coma scale score on admission was 7 (Eye opening1, Verbal response2, Motor response4 [E1V2M4])...

Acute myeloid leukemia (AML) patients encounter complications mainly due to their underlying disease or chemotherapy. Although they are at high risk for both hemorrhagic and thrombotic complications, thrombotic vascular complication as an initial manifestation is less common and rarely reported, especially in non-acute promyelocytic leukemia (non-APML). A 58-year-old female with no co-morbidity presented with fever, decreased appetite, headache, and weakness in her left upper and lower limbs. Laboratory findings showed hyperleukocytosis with 90% blast cells and thrombocytopenia (50,000/dl)...

(1) Background: Stroke patients are exposed to various psychosocial factors, such as depression, anxiety, and stress, which can cause problems with respect to their quality of sleep and social participation. (2) Objectives: We analyzed the causal relationships between the factors affecting sleep quality and social participation in hospitalized and community-based stroke patients using a path analysis model. (3) Methods: A questionnaire survey was administered to stroke patients from June to November 2020 using the Pittsburgh Sleep Quality Index to assess sleep quality; the Beck Depression Inventory to assess depression; the Beck Anxiety Inventory to assess anxiety; the Stress Scale to assess stress; and the Reintegration to Normal Living Index to assess participation...

We report the pathological and molecular findings in an adult male Himalayan red panda (Ailurus fulgens fulgens) whose death was attributed to parenchymal brain haemorrhage (PBH) of the thalamus. Post-mortem examination revealed severe, acute PBH and intraventricular haemorrhage with major involvement of the thalamus, as well as scattered chronic microinfarctions. Vascular disease in the brain and other organs was suggestive of systemic hypertension. Histological lesions included arteriolar hyalinosis and varying degrees of arteriosclerosis, arterial tunica media hypertrophy and hyperplasia and infiltration of arterial walls by lipid-laden macrophages...

Upper limb stroke rehabilitation has been understudied in usual occupational therapy. The study's purpose was to describe the timing and amount of usual occupational therapy in the stroke population for hospital-based outpatient upper limb rehabilitation. A multi-site study of timing and amount of occupational therapy was calculated for mild and moderate upper limb stroke impairments using the Fugl-Meyer Assessment-Upper Extremity (FMA-UE). Mild stroke participants ( n = 58) had a mean of 164.25 days, and the moderate stroke participants ( n = 64) had a mean of 106...

Myocardial bridge (MB) is a congenital abnormality where part of a coronary epicardial artery runs under the myocardium fibers and is compressed in systole; this becomes more pronounced when nitroglycerin (NTG) is administered. In this report, we describe the case of a 40-year-old African American man who presented with chest pain that did not respond to NTG or isosorbide mononitrate and was only partially relieved by narcotics. His past medical history was significant for coronary artery disease (CAD) with a stent into the left anterior descending artery (LAD) several months prior, hypertension, hyperlipidemia, paroxysmal atrial fibrillation, sick sinus syndrome, permanent pacemaker, pulmonary embolism, and cerebral vascular accident...

Post-traumatic cerebral venous sinus thrombosis is one of the several causes of cerebral venous thrombosis, but its early diagnosis and management are still difficult in this traumatic context. Our objective is to describe clinical and radiological presentations and to report specific management and outcomes of this rare post-traumatic complication. We reported in this manuscript a case series of 10 patients hospitalized in the intensive care department with post-traumatic cerebral venous thrombosis. Demographic, clinical, and radiological data and their medical management are reported...

Infective endocarditis (IE) carries high morbidity and mortality. Although minimal in incidence, fungal causes (mostly Candida species) carry the highest mortality among all cases of infective endocarditis. We describe a rare case of a 47-year-old male with a past medical history of cerebral vascular accident (CVA), heart failure with reduced ejection fraction status post (SP) automated implantable cardioverter defibrillator (AICD) placement, paroxysmal atrial fibrillation, coronary artery disease (CAD), infective endocarditis with mitral valve replacement and tricuspid valve replacement, and pulmonary hypertension who presented to the emergency department (ED) with complaints of shortness of breath and weakness for four days...

BACKGROUND: Epilepsy is one of the most prevalent neurological conditions among the elderly. Age-related epileptogenic disorders as well as the ageing itself pose a risk for seizures in the elderly. The lack of witnesses, non-specific symptoms, and transient symptoms make the diagnosis challenging in the elderly. AIM: This study aimed to assess the various presentation and aetiology for the seizure disorder in the elderly population. MATERIALS AND METHODS: A total of 125 elderly patients ≥60 years with new onset seizure were included in the study...

Atherosclerotic lesions in the common carotid artery are one of the most frequent causes of ischemic stroke. They are usually diagnosed by cardiologists and are managed following complementary examinations. In dental practice, panoramic radiograph is a basic examination frequently performed in first line. On this radiography, possible unilateral or bilateral opacities projecting to the latero-cervical regions can be visualized, raising suspicion of carotid calcifications. The aim of this study was to present, through three cases and a review of the literature, the benefit of PR in the diagnosis of carotid calcifications and the approaches to be followed in case of such suspicious images...

BACKGROUND: COVID-19 has led to significant hospitalization and intensive care unit admission rates. The demographic parameters of COVID-19 patients, such as age, underlying illnesses, and clinical symptoms, substantially influence the incidence and mortality of these individuals. The current study examined the clinical and demographic characteristics of COVID-19 intensive care unit (ICU) patients in Yazd, Iran. METHODS: The descriptive-analytical cross-sectional study was conducted on ICU patients with a positive RT-PCR test for coronavirus, admitted to the ICU in Yazd province, Iran, over 18 months...

Background: Private sector literature demonstrates an association between perioperative transfusions and poor clinical outcomes. Hemostatic agents, surgeon training, and patient blood management programs (PBMPs) may mitigate perioperative bleeding. This study attempts to identify preoperative risk factors associated with perioperative transfusions in Veterans. Study Design and Methods: This study is a retrospective review of the prospectively maintained Veterans Affairs Surgical Quality Improvement Project database...

OBJECTIVE: To assess the relationship of vascular complications with cerebrovascular reactivity (CVR) and endothelial dysfunction in patients with obstructive sleep apnea (OSA). MATERIAL AND METHODS: One hundred and twelve patients were examined. The patients were stratified into the main group with moderate and severe OSA and the control group without apnea. All patients underwent anthropometry, polysomnography, transcranial dopplerography and duplex scanning of the brachial artery...