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Vertigo, stroke

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https://www.readbyqxmd.com/read/30092562/factors-associated-with-stroke-misdiagnosis-in-the-emergency-department-a-retrospective-case-control-study
#1
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
#2
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
#3
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...
May 30, 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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/29562793/wolff-parkinson-white-syndrome-and-noncompaction-in-leber-s-hereditary-optic-neuropathy-due-to-the-variant-m-3460g-a
#14
Josef Finsterer, Claudia Stollberger, Edmund Gatterer
This report describes a 66-year-old Caucasian male who acutely developed severe, bilateral impairment of visual acuity at 24 years of age. Leber's hereditary optic neuropathy (LHON) was suspected but the diagnosis was not genetically confirmed until the age of 49 years when the primary LHON mutation m.3460G>A was detected. Since onset, visual acuity had slightly improved. The family history was positive for LHON (brother, two sisters of mother, female cousin) and genetically confirmed in his brother and one aunt...
May 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29558752/lateral-medullary-infarction-with-or-without-extra-lateral-medullary-lesions-what-is-the-difference
#15
Hyun Goo Kang, Bum Joon Kim, Sang Hun Lee, Dong-Wha Kang, Sun U Kwon, Jong S Kim
BACKGROUND: Lateral medullary infarction (LMI) is not an uncommon disease. Although lesions are usually restricted to the lateral medullary area, some patients have additional infarcts in other parts of the brain. The clinical features and prognosis of isolated LMI (pure LMI, LMIpr) have been investigated. However, it remains unclear whether clinical characteristics, prognosis and factors associated with prognosis differ between patients with LMIpr and those with additional lesions (LMI plus, LMIpl)...
2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29549469/why-acute-unilateral-vestibular-midbrain-lesions-rarely-manifest-with-rotational-vertigo-a-clinical-and-modelling-approach-to-head-direction-cell-function
#16
Marianne Dieterich, Stefan Glasauer, Thomas Brandt
A retrospective clinical study focused on the frequency of rotational vertigo in 63 patients with acute unilateral midbrain strokes involving the vestibular and ocular motor systems. In contrast to unilateral pontomedullary brainstem lesions, rotational vertigo in midbrain lesions occurred with a low frequency (14%) and transient (< 1 day) course. Swaying vertigo or unspecific dizziness (22%) and postural imbalance (31%) were more frequent. Midbrain strokes with transient rotational vertigo manifested with lesions chiefly in the caudal midbrain tegmentum, while manifestations with swaying, unspecific, or no vertigo chiefly occurred in rostral mesencephalic or meso-diencephalic lesions...
May 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29530223/diagnosis-and-management-of-transient-ischemic-attacks-in-primary-care-a-systematic-review
#17
Priyanka Bose, Andrew Wilson, Amit Mistri
INTRODUCTION Many patients who suffer a transient ischaemic attack (TIA) present to their general practitioner (GP). Early identification and treatment reduces the risk of subsequent stroke, disability and mortality. AIM To review the accuracy of TIA diagnosis in primary care, immediate management and interventions to assist GPs with the condition. METHODS This study included the search of Medline, Embase, Web of Science and Scopus databases (1995-2015). Relevant titles and abstracts were obtained using structured criteria (diagnosis, immediate management or intervention of TIAs in primary care), with full review and data extraction for eligible publications...
June 2017: Journal of Primary Health Care
https://www.readbyqxmd.com/read/29468623/isolated-basilar-artery-dissection-with-ischemic-stroke-report-of-4-cases
#18
Szu-Ju Chen, Li-Kai Tsai, Sung-Chun Tang, Jiann-Shing Jeng
PURPOSE: Isolated basilar artery dissection (BAD) is a rare cause of ischemic stroke. Since the clinical presentations and imaging findings could be non-specific and subtle, the diagnosis may be difficult. Here, we presented four cases of isolated BAD with acute ischemic stroke. CASE REPORT: Four patients (age, 22 to 57 years) experienced acute onset of hemiparesis and/or vertigo with half of them having initial headache. Acute infarct was noted at pons or thalamus...
September 15, 2017: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/29459396/diagnosing-stroke-in-acute-dizziness-and-vertigo-pitfalls-and-pearls
#19
REVIEW
Ali S Saber Tehrani, Jorge C Kattah, Kevin A Kerber, Daniel R Gold, David S Zee, Victor C Urrutia, David E Newman-Toker
No abstract text is available yet for this article.
March 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29440137/basilar-artery-fenestration-an-unusual-possible-cause-of-ischaemic-stroke
#20
Xuan Wu, Aiyu Lin, Jiting Zhu, Bin Cai
Basilar artery fenestration is an uncommon congenital dysplasia and may be associated with ischaemic stroke. We present a case of a previously healthy 36-year-old man who presented with vertigo and vomiting. MRI showed posterior circulation territory infarction. High-resolution magnetic resonance angiography revealed a slit-like fenestration in the basilar artery. This patient had no traditional vascular risk factors or aetiology of cryptogenic stroke. The patient recovered from his neurological deficit after antiplatelet therapy and was given prophylactic aspirin therapy...
February 12, 2018: BMJ Case Reports
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