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https://www.readbyqxmd.com/read/30341546/early-mri-negative-posterior-circulation-stroke-presenting-as-acute-dizziness
#1
Jae-Hwan Choi, Eun Hye Oh, Min-Gyu Park, Seung Kug Baik, Han-Jin Cho, Seo Young Choi, Tae-Hong Lee, Ji Soo Kim, Kwang-Dong Choi
The aim of this study was to determine the frequency, clinical and radiological features, and efficacy of clinical evaluation and perfusion-weighted imaging (PWI) for the prediction of final stroke in patients with DWI/MRI-negative posterior circulation stroke (PCS) presenting acute dizziness/vertigo. From our comprehensive prospective stroke registry of acute ischemic stroke during a 7-year period, we identified 1846 consecutive patients with PCS, 850 of whom presented with acute dizziness/vertigo. Of these 850 patients, initial DWI-MRI was negative in 35 (4...
October 19, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/30337422/bet-2-ability-of-a-normal-gait-examination-to-rule-out-cerebellar-stroke-in-acute-vertigo
#2
Alisha Greer, Mark Hewitt
A short-cut review was carried out to establish whether a normal gait examination can rule out cerebellar stroke in patients with acute vertigo. 16 studies were relevant to the question. The author, year and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that a normal gait examination cannot rule out a cerebellar stroke but the presence of an abnormal gait can be associated.
November 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/30313095/acute-vertigo-and-sensorineural-hearing-loss-from-infarction-of-the-vestibulocochlear-nerve-a-case-report
#3
Seonghwan Byun, Ji Ye Lee, Bo Gyung Kim, Hyun Sook Hong
RATIONALE: Acute unilateral audiovestibulopathy is a common neurotological syndrome. Differential diagnoses of acute unilateral audiovestibulopathy include viral infection, vascular insults, and tumors. Regarding vascular causes, ischemic stroke in the anterior inferior cerebellar artery (AICA) territory is known to be the leading cause of acute audiovestibular loss. Previous reports of AICA infarction with audiovestibulopathy failed to demonstrate magnetic resonance imaging (MRI)-positive vestibulocochlear infarctions...
October 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/30308594/recurrent-vertigo-is-a-predictor-of-stroke-in-a-large-cohort-of-hypertensive-patients
#4
Pierre-Yves Courand, Michael Serraille, Adrien Grandjean, Caroline Tilikete, Hugues Milon, Brahim Harbaoui, Pierre Lantelme
OBJECTIVE: Dizziness is associated with hypertension but there are numerous other causes. The aims of the present study were to describe the characteristics and the clinical correlates of dizziness in a large cohort of hypertensive patients, and to test its prognostic value for all-cause, cardiovascular, and stroke mortality. METHODS: A total of 1716 individuals from the OLD-HTA Lyon's cohort of hypertensive patients recruited in the 1970s were categorized according to the absence or the presence of dizziness...
October 10, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/30285930/-lateral-medullary-stroke-with-extracranial-course-of-the-postero-inferior-cerebellar-artery
#5
Matías J Alet, Virginia Pujol Lereis, Sebastián F Ameriso, Luis Lemme-Plaghos
We present two cases of lateral medullary stroke in subjects with extracranial trajectory of the postero-inferior cerebellar artery. Case 1: a 21-year-old male who presented ataxia and right dysmetria after cervical trauma in a rugby match. Case 2: 56-year-old woman, who started with vertigo and left hemiparesis after intense physical effort. In both cases, the angiographic studies showed an extracranial trajectory of the posterior inferior cerebellar artery. This vessel rarely originates below the foramen magnum, in close relationship with the first three cervical vertebrae and the atlanto-axial joint...
2018: Medicina
https://www.readbyqxmd.com/read/30187161/vascular-vertigo-updates
#6
REVIEW
Kwang-Dong Choi, Ji-Soo Kim
Discriminating strokes in patients with acute dizziness/vertigo is challenging especially when other symptoms and signs of central nervous involvements are not evident. Despite the developments in imaging technology over the decades, a significant proportion of acute strokes may escape detection on imaging especially during the acute phase or when the lesions are small. Thus, small strokes causing isolated dizziness/vertigo would have a higher chance of misdiagnosis in the emergency department. Even though several diagnostic algorithms have been advanced for acute vascular vertigo, we still await more comprehensive and sophisticated ones that can also be applied to transient vestibular symptoms due to vascular compromise...
September 5, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/30122930/evaluation-of-bppv-with-vertebral-artery-values
#7
Alper Yazıcı, Yusuf İnanç
Objectives: The aim of this study was to investigate the association between benign paroxysmal positional vertigo (BPPV) and vertebral artery (VA) flow rates and diameters by using Doppler ultrasonography in patients with BPPV. Additionally, we aimed to investigate the abnormalities of VA values obtained by extracranial color-coded duplex sonography in BPPV, which could be accepted as a precursor lesion for posterior cerebral ischemic stroke. Materials and methods: Between September 2017 to February 2018, 50 patients diagnosed with BPPV were enrolled in this study...
2018: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/30092562/factors-associated-with-stroke-misdiagnosis-in-the-emergency-department-a-retrospective-case-control-study
#8
Abhay Venkat, Cecilia Cappelen-Smith, Shabeel Askar, Peter R Thomas, Sonu Bhaskar, Amanda Tam, Alan J McDougall, Suzanne J Hodgkinson, Dennis J Cordato
BACKGROUND: Failure to recognise acute stroke may result in worse outcomes due to missed opportunity for acute stroke therapies. Our study examines factors associated with stroke misdiagnosis in patients admitted to a large comprehensive stroke centre. METHODS: Retrospective review comparing 156 consecutive stroke patients misdiagnosed in emergency department (ED) with 156 randomly selected stroke controls matched for age, gender, language spoken and stroke subtype for the period 2014-2016...
August 9, 2018: Neuroepidemiology
https://www.readbyqxmd.com/read/30019629/safety-and-predictors-of-stroke-mimics-in-the-norwegian-tenecteplase-stroke-trial-nor-test
#9
Christopher Elnan Kvistad, Vojtech Novotny, Halvor Næss, Guri Hagberg, Hege Ihle-Hansen, Ulrike Waje-Andreassen, Lars Thomassen, Nicola Logallo
Background Stroke mimics are frequently treated with thrombolysis in clinical practice and thrombolytic trials. Although alteplase in stroke mimics has proven to be safe, safety of tenecteplase in stroke mimics has not been assessed in an ischemic stroke study setting. We aimed to assess clinical characteristics and safety of stroke mimics treated with thrombolysis in the Norwegian Tenecteplase Stroke Trial. We also aimed to identify possible predictors of stroke mimics as compared to patients with acute cerebral ischemia...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29859863/a-case-of-posterior-circulation-ischemic-stroke-caused-by-heparin-induced-thrombocytopenia-after-detaining-hepatic-arterial-infusion-catheter
#10
Koji Hirashita, Atsushi Matsumoto, Satoru Yabuno, Takahiro Kanda, Masatoshi Yunoki, Kimihiro Yoshino
In Japan, hepatic arterial infusion chemotherapy (HAIC) using reservoir system is recommended for patients with hepatocellular carcinoma (HCC) whose hepatic spare ability is favorable. Arterial infusion catheter is commonly detained in hepatic artery via femoral or brachial artery. In our hospital, catheter is often inserted by puncturing the left subclavian or brachial artery considering the patient's activities of daily living (ADL) during long-term detaining. However, it rarely causes posterior circulation ischemic stroke because of the left vertebral artery branches on the path of catheter...
September 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29807531/a-case-report-of-multiple-cervical-artery-dissection-after-peripheral-type-facial-palsy-and-use-of-steroids
#11
Sung Eun Chung, Tae Hwan Yoon, Kyung Mi Lee, Hyug-Gi Kim, Bum Joon Kim
BACKGROUND: Cervical artery dissection is one of the most important causes of ischemic stroke in young age patients. However, multiple cervical artery dissection simultaneously involving the anterior and posterior circulation is uncommon. Here, we would like to report a case of a patient with bilateral vertebral artery (VA) and internal carotid artery dissection (ICA) after a use of systemic steroid due to peripheral facial palsy. CASE PRESENTATION: A 44-year-old man with hypertension visited emergency department due to recurrent vertigo...
May 28, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29803531/vertigo-and-dizziness-understanding-and-managing-fall-risk
#12
REVIEW
Jennifer C Alyono
Vertigo and dizziness are common conditions among older adults. They are closely associated with fall risk and portend major implications for geriatric injury and disability. Management can be particularly challenging, because symptoms are often nonspecific and may reflect multiple etiologies. Chronic dizziness can reflect dysfunction in the vestibular, somatosensory, or visual systems or in their central integration. Systemic processes, such as postural hypotension, arrhythmias, heart failure, medication use, and lower extremity weakness or frailty, also contribute...
August 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29734824/assessment-of-the-effect-of-mesoglycan-in-the-treatment-of-audiovestibular-disorders-of-vascular-origin
#13
MULTICENTER STUDY
Giampiero Neri, Vincenzo Marcelli, Luigi Califano
It is a well-known fact that inner ear diseases are often caused by microcirculatory disorders, and the recent literature is oriented towards investigations into the relationship between the cardiovascular system and cochleovestibular illness with related classical symptoms: tinnitus, hearing loss, and vertigo or instability. These symptoms, and particularly the vertigo, may be the alarm signal of microcirculatory disorders of the labyrinth or vertebrobasilar circulation so as to represent a possible symptom of posterior circulation stroke...
January 2018: International Journal of Immunopathology and Pharmacology
https://www.readbyqxmd.com/read/29722738/analysis-of-risk-factors-in-patients-with-peripheral-vertigo-or-central-vertigo
#14
Yunlin Wang, Jing Liu, Zhijie Cui, Lili Yan, Jianping Si
INTRODUCTION: This study was aimed to determine risk factors for central vertigo (CV) in patients with isolated vertigo accompanied by hearing loss or not. PATIENTS AND METHODS: Patients with CV or peripheral vertigo (PV) who were admitted to our hospital between January 2014 and July 2016 were retrospectively reviewed. All patients underwent thorough physical examination with detailed medical histories recorded, including smoking, hypertension, diabetes, cardiovascular disease, and stroke history...
May 2018: Neurologist
https://www.readbyqxmd.com/read/29721613/identification-of-dizzy-patients-who-will-develop-an-acute-cerebrovascular-syndrome-a-descriptive-study-among-emergency-department-patients
#15
I Mármol-Szombathy, E Domínguez-Durán, L Calero-Ramos, S Sánchez-Gómez
PURPOSE: To calculate the incidence of subsequent acute cerebrovascular syndrome in emergency department patients with vertigo or dizziness symptoms and to determine predictors of subsequent acute cerebrovascular syndrome in these patients. METHODS: Descriptive and retrospective hospital based-population study among emergency department patients with vertigo or dizziness symptoms in 1 year. One year follow-up since the medical visit was performed. Chi-square and Fisher tests were used for qualitative variables; Mann-Whitney U test for quantitative variables...
July 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29720346/tako-tsubo-cardiomyopathy-with-transient-global-amnesia-and-cerebellar-embolic-stroke-triggered-by-existential-fear
#16
Claudia Stöllberger, Nicolas DeCillia, Josef Finsterer
BACKGROUND: Embolic stroke is a complication of Tako-Tsubo-cardiomyopathy (TTC), transient left ventricular dysfunction mimicking myocardial infarction without coronary culprit lesion explaining the whole left ventricular dysfunction. Transient global amnesia (TGA) is characterized by sudden onset of anterograde amnesia without compromise of other neurologic functions. CASE REPORT: A 57 years old female was admitted because of sudden confusion and loss of her memory after emotional stress...
May 2018: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/29713938/the-urgent-neurological-consultation-in-the-population-of-the-province-of-ferrara-italy
#17
Vittorio Govoni, Elena Della Coletta, Elisa Fallica, Edward Cesnik
In the province of Ferrara, Italy, the urgent neurological consultation (UNC) cases in the population correspond to the resident outpatients who undergo a UNC in the ER of the university hospital of Ferrara (UHFe). Thanks to this health organization a retrospective survey identified 612 UNC cases (range of age 7-102 years, median 67,5 years) in the study period giving a period prevalence rate of 173 per 100,000 (95% CI 159.3-187.3) which increased with age (χ2 for trend = 178.4 p < 0.001). The daily UNC cases (range 0-14, mean = 7...
July 2018: Neurological Sciences
https://www.readbyqxmd.com/read/29704209/neurologic-manifestations-of-elderly-patients-with-cancer
#18
Bernardo Cacho-Díaz, Nydia A Lorenzana-Mendoza, Gervith Reyes-Soto, José A Ávila-Funes, Ana P Navarrete-Reyes
BACKGROUND: The incidence of cancer is an age-related phenomenon; therefore, the interest on clinical manifestations, diagnostic approach and treatment strategies for older patients diagnosed with cancer has increased lately. Neurologic symptoms are one of the main reasons for consultation and a common cause of decreased quality of life among cancer patients. AIMS: To identify the neurologic manifestations of patients ≥ 65 years of age diagnosed with cancer and compare them to those presented by a younger population...
April 27, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29667152/falls-in-mexican-older-adults-aged-60-years-and-older
#19
Luis M Valderrama-Hinds, Soham Al Snih, Nai-Wei Chen, Martin A Rodriguez, Rebeca Wong
BACKGROUND: Falls are a major cause of disability, morbidity, institutionalization, and mortality in older adults. OBJECTIVES: The purpose of the study was to examine the risk factors for falls among Mexican older adults aged 60 years and older. METHODS: This study included 6247 participants and their spouse or partner aged 60 years and older from the Mexican Health and Aging Study, an ongoing longitudinal study (2001-2012) conducted in Mexico...
April 17, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29623865/-stroke-mimicking-acute-peripheral-vertigo-how-to-avoid-misdiagnosis-importance-of-alarm-symptoms-and-assessment-of-eye-movements
#20
R B van Leeuwen, E van Wensen, B R Schudel
Identifying the occurrence of stroke in patients with isolated vertigo is difficult for general practitioners (GPs) as well as for physicians working in the Emergency Department. Three patients with acute vestibular syndrome are presented in this clinical lesson. The importance of an adequate neuro-otological examination is emphasised. However, many GPs lack knowledge of the nystagmus and the head impulse test. Alternative strategies for GPs are discussed.
2018: Nederlands Tijdschrift Voor Geneeskunde
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