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Dissection and vasculitis

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https://www.readbyqxmd.com/read/28835326/juvenile-stroke
#1
Florian Schöberl, Peter Arthur Ringleb, Reza Wakili, Sven Poli, Frank Arne Wollenweber, Lars Kellert
BACKGROUND: So-called juvenile stroke, i.e., stroke in a person aged 18 to 55, affects approximately 30 000 persons per year in Germany and is thus an important cause of mortality and permanent morbidity. The spectrum of causes of stroke is broader in this age group than in older patients and is also differently distributed. METHODS: This review is based on pertinent publications retrieved by a selective search in PubMed and on current guideline recommendations...
August 7, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28816948/medial-medullary-infarction-caused-by-antineutrophil-cytoplasmic-antibody-related-vasculitis-case-report-and-review-of-the-literature
#2
Kumi Yanagiha, Kazuhiro Ishii, Tomoyuki Ueno, Aiki Marushima, Akira Tamaoka
RATIONALE: Medial medullary infarction accounts for less than 1% of brain infarctions, and medial medullary infarctions is very rarely caused by antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. PATIENT CONCERNS: We report the case of a 76-year-old man at low risk of arteriosclerosis who presented with disorders on the left side including gaze-evoked nystagmus, paralysis of the extremities, pyramidal signs, sensory disturbance, and dysesthesia. Brain magnetic resonance imaging also showed right medial medullary infarction...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28761455/unusual-presentation-of-extensive-spontaneous-coronary-dissection-case-report-and-literature-review
#3
Júlio César Queiroz França, Márcio Antonio Santos, Moacir Fernandes Godoy
BACKGROUND: The etiology of spontaneous dissection of coronary artery (SDCA) is not well understood yet. Different studies have linked this entity to pregnancy, physical stress, collagen diseases and vasculitis. In general, patients do not exhibit the classic risk factors for coronary artery disease, which mandates the suspicion of this condition, especially in young adults with acute coronary syndrome. CASE REPORT: In this article, we report the case of a 63-year old male patient, asymptomatic, who came for periodic evaluation and after evaluation by exercise and myocardial scintigraphy had high suspicion for severe coronary artery disease and underwent coronary angiography, which showed spontaneous dissection of the left and right branches of the coronary arteries...
January 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/28743241/complete-ophthalmoplegia-complete-ptosis-and-dilated-pupil-due-to-internal-carotid-artery-dissection-as-the-first-manifestation-of-takayasu-arteritis
#4
H M M T B Herath, S P Pahalagamage, D Withana, Sunethra Senanayake
BACKGROUND: Takayasu arteritis is a rare, chronic large vessel vasculitis involving the aorta and its primary branches. As the disease progresses, the active inflammation of large vessels leads to dilation, narrowing and occlusion of the arteries. Arterial dissection is due to separation of the layers of the arterial wall resulting in a false lumen, where blood seeps into the vessel wall. Neurological sequelae of intracranial arterial dissection results from cerebral ischemia due to thromboembolism and hypo perfusion...
July 25, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28739362/stroke-in-ehlers-danlos-syndrome-kyphoscoliotic-type-dissection-or-vasculitis
#5
Annegret Quade, Martin Wiesmann, Joachim Weis, Ingo Kurth, Houman Jalaie, Marianne Rohrbach, Martin Häusler
BACKGROUND: Patients with the kyphoscoliotic type of Ehlers-Danlos syndrome have an increased risk of vascular complications such as aortic dissection and perforation. Cerebral ischemia has only rarely been documented. PATIENT DESCRIPTION: This 13-year-old girl with the kyphoscoliotic type of Ehlers-Danlos syndrome experienced a large right middle cerebral artery distribution infarction. Full intravenous heparinization was started in response to presumed arterial dissection...
September 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28722365/-segmental-arterial-mediolysis-a-differential-diagnosis-of-vasculitis
#6
Yassaman Alipour Tehrany, Sylvain Terraz, Jörg D Seebach
Segmental arterial mediolysis (SAM) is a rare non-atherosclerotic, non-inflammatory disease of unknown aetiology mostly affecting medium-sized arteries of the splanchnic circulation. Histologically, SAM is characterized by vacuolization and lysis of the arterial media leading to dissection, stenosis/occlusion or aneurysms. Symptoms vary from unspecific abdominal pain to hemorrhagic shock due to vessel rupture. The clinical and radiological presentation can mimic vasculitis, fibromuscular dysplasia or collagen vascular diseases...
April 5, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28712642/a-rare-case-of-febrile-abdominal-pain-revealing-horton-s-disease
#7
Arnaud Chaudet, Jean-Michel Goujon, Aiham Daniel Ghazali
BACKGROUND: Horton's disease is a systemic inflammatory vasculitis, usually found in persons over 50years old. It affects medium and large-sized arteries stemming from the external carotid, especially the superficial temporal arteries. It can affect extracranial large vessels but only rarely the aorta. Diagnosis of aortitis is difficult and its incidence is probably underestimated. CASE PRESENTATION: A 68-year-old Caucasian woman consulted in an emergency department for febrile abdominal pain with inflammatory syndrome...
July 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28656474/dissecting-kawasaki-disease-a-state-of-the-art-review
#8
REVIEW
S M Dietz, D van Stijn, D Burgner, M Levin, I M Kuipers, B A Hutten, T W Kuijpers
Kawasaki disease (KD) is a pediatric vasculitis with coronary artery aneurysms (CAA) as its main complication. The diagnosis is based on the presence of persistent fever and clinical features including exanthema, lymphadenopathy, conjunctival injection, and changes to the mucosae and extremities. Although the etiology remains unknown, the current consensus is that it is likely caused by an (infectious) trigger initiating an abnormal immune response in genetically predisposed children. Treatment consists of high dose intravenous immunoglobulin (IVIG) and is directed at preventing the development of CAA...
August 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28587578/extra-vascular-findings-in-patients-undergoing-magnetic-resonance-angiography-of-the-abdomen-pelvis-and-lower-extremities-a-retrospective-study-of-352-patients
#9
Jan M Sohns, Jan Menke, Leonard Bergau, Bernhard G Weiss, Sebastian Schmuck, Desiree Weiberg, Wieland Staab, Thorsten Derlin, Marc Dorenkamp, Christian Sohns
Background The aim of this study was to assess the prevalence and clinical significance of extra-vascular findings in patients undergoing magnetic resonance angiography of the abdomen, pelvis and lower extremities. Materials and methods Three hundred fifty-two patients underwent abdominal, pelvic and lower extremity 1.5 T magnetic resonance angiography. Clinically relevant vascular and extra-vascular findings were identified. Relevant vascular findings were classified as stenosis, occlusion, aneurysm, sclerosis, dissection or vasculitis...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28500877/clinically-isolated-aortitis-pitfalls-progress-and-possibilities
#10
REVIEW
Ilkay Cinar, He Wang, James R Stone
Non-infectious aortitis may be caused by several distinct systemic rheumatologic diseases. In some patients, aortitis is identified either pathologically or radiologically in the absence of clinical evidence of a systemic vasculitis. By consensus nomenclature, such cases are referred to as clinically isolated aortitis (CIA). Some systemic disorders may initially present as CIA including giant cell arteritis (GCA), IgG4-related disease, infectious aortitis, and granulomatosis with polyangiitis. CIA most commonly occurs in women of European descent over the age of 50 and, thus, mirrors the gender, age, and geographic distribution of GCA...
April 23, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28500366/comparison-of-3d-magnetic-resonance-imaging-and-digital-subtraction-angiography-for-intracranial-artery-stenosis
#11
Ji Eun Park, Seung Chai Jung, Sang Hun Lee, Ji Young Jeon, Ji Ye Lee, Ho Sung Kim, Choong-Gon Choi, Sang Joon Kim, Deok Hee Lee, Seon-Ok Kim, Sun U Kwon, Dong-Wha Kang, Jong S Kim
OBJECTIVES: To compare three-dimensional high-resolution magnetic resonance imaging (3D HR-MRI) and digital subtraction angiography (DSA) for diagnosing and evaluating stenosis in the entire circle of Willis. METHODS: The study included 516 intracranial arteries from 43 patients with intracranial artery stenosis (ICAS) who underwent both 3D HR-MRI and DSA within 1 month. Two readers independently diagnosed atherosclerosis, dissection, moyamoya disease and vasculitis, rated their diagnostic confidence for each vessel and measured the luminal diameters...
May 12, 2017: European Radiology
https://www.readbyqxmd.com/read/28495942/tipic-syndrome-beyond-the-myth-of-carotidynia-a-new-distinct-unclassified-entity
#12
A Lecler, M Obadia, J Savatovsky, H Picard, F Charbonneau, N Menjot de Champfleur, O Naggara, B Carsin, M Amor-Sahli, J P Cottier, J Bensoussan, E Auffray-Calvier, A Varoquaux, S De Gaalon, C Calazel, N Nasr, G Volle, D C Jianu, O Gout, F Bonneville, J C Sadik
BACKGROUND AND PURPOSE: The differential diagnosis of acute cervical pain includes nonvascular and vascular causes such as carotid dissection, carotid occlusion, or vasculitis. However, some patients present with unclassified vascular and perivascular changes on imaging previously reported as carotidynia. The aim of our study was to improve the description of this as yet unclassified clinico-radiologic entity. MATERIALS AND METHODS: From January 2009 through April 2016, 47 patients from 10 centers presenting with acute neck pain or tenderness and at least 1 cervical image showing unclassified carotid abnormalities were included...
May 11, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28491267/update-on-the-management-of-giant-cell-arteritis
#13
REVIEW
Janet Roberts, Alison Clifford
Giant cell arteritis (GCA) is a large vessel vasculitis that may be associated with significant complications such as blindness, stroke, or aortic aneurysm and dissection in a subset of patients. Given the serious side effects associated with prolonged courses of glucocorticoids and frequent relapses experienced when doses are tapered, increased efforts are being dedicated to the discovery of safer and more effective therapies to control this disease. The purpose of this review is to critically evaluate the role of glucocorticoid-sparing agents in the medical management of GCA with a special focus on the most recent evidence regarding the role of biologic agents, including tocilizumab (TCZ), abatacept and ustekinumab, and other novel therapies...
April 2017: Therapeutic Advances in Chronic Disease
https://www.readbyqxmd.com/read/28490787/the-changing-face-of-polyarteritis-nodosa-and-necrotizing-vasculitis
#14
REVIEW
Seza Ozen
Polyarteritis nodosa (PAN) is a vasculitic disease characterized primarily by necrotizing vasculitis - inflammatory lesions in blood vessels that lead to vessel wall necrosis. Our understanding of PAN and necrotizing vasculitis has evolved over time. In addition to PAN, necrotizing vasculitis is now a recognized feature of a broad range of diseases with different aetiopathogenesis. For example, necrotizing vasculitis associated with hepatitis B virus infection has a different aetiopathogeneis to PAN and is now classified as a separate disease...
June 2017: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/28479185/neuroimaging-of-takayasu-arteritis-in-a-patient-with-ulcerative-rectocolitis
#15
Lucia Monti, Rosamaria Servillo, Irene Grazzini, Leila Khader, Maurizio Acampa, Alfonso Cerase
BACKGROUND: Takayasu arteritis (TA), also known as aortoarteritis and pulseless disease, is an autoimmune, idiopathic, large-vessel vasculitis that primarily affects the aorta and its major branches, the coronary arteries, and the pulmonary arteries. METHODS: This is a peculiar clinical and radiological pattern of TA in a young female Caucasian. Her medical history included diagnosis of ulcerative rectocolitis at the age of 14. Because of the occurrence of anemia and exacerbation of rectocolitis, she had started infliximab associated with low doses of cortisone and mesalazine...
May 4, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28448235/intracranial-artery-steno-occlusion-diagnosis-by-using-two-dimensional-spatially-selective-radiofrequency-excitation-pulse-mr-imaging
#16
Mi Sun Chung, Seung Chai Jung, Seon-Ok Kim, Ho Sung Kim, Choong Gon Choi, Sang Joon Kim, Sun U Kwon, Dong-Wha Kang, Jong S Kim
Purpose To determine whether magnetic resonance (MR) imaging by using two-dimensional spatially selective radiofrequency (RF) excitation pulses (zoomed MR imaging) is a reliable method for the diagnosis of intracranial artery steno-occlusion compared with full-field-of-view (FOV) MR imaging. Materials and Methods The institutional review board approved this retrospective study and informed consent was waived. From December 2014 to August 2015, 88 patients who underwent both full-FOV MR imaging and zoomed MR imaging for further evaluation of intracranial artery steno-occlusion at prior luminal evaluation were included...
September 2017: Radiology
https://www.readbyqxmd.com/read/28367219/alpha-1-antitrypsin-deficiency-presenting-with-mpo-anca-associated-vasculitis-and-aortic-dissection
#17
Bram M Voorzaat, Jan van Schaik, Stijn L P Crobach, Catharina S P van Rijswijk, Joris I Rotmans
The combination of alpha-1 antitrypsin (AAT) deficiency, ANCA-vasculitis, and aortic aneurysm has been rarely described in literature. We report an eventually fatal case in a 70-year-old patient who initially presented with giant cell arteritis and ANCA associated glomerulonephritis. Several years later, he presented with aortic dissection due to large vessel vasculitis, raising the suspicion of AAT deficiency, as two first-line relatives had chronic obstructive pulmonary disease, while they never smoked. This diagnosis was confirmed by AAT electrophoresis and immunohistochemistry on a temporal artery biopsy...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28361331/anca-associated-vasculitis-pathogenesis-a-commentary
#18
REVIEW
Eric J Gapud, Philip Seo, Brendan Antiochos
PURPOSE OF REVIEW: The ANCA-associated vasculitides are a group of small vessel vasculitides characterized by autoantibodies recognizing the neutrophil cytoplasmic antigens PR3 and MPO. We examine the current clinical and molecular immunology understanding of ANCA-associated vasculitides and discuss the current needs in our understanding of the pathogenic mechanisms of these rare diseases. RECENT FINDINGS: The majority of efforts to understand the pathogenesis of these diseases have focused on dissecting neutrophil biology because the neutrophil is the primary expressor of ANCA autoantigens...
April 2017: Current Rheumatology Reports
https://www.readbyqxmd.com/read/28330435/idiopathic-carotidynia
#19
Aleksandra Policha, David Williams, Mark Adelman, Frank Veith, Neal S Cayne
Idiopathic carotidynia is a syndrome characterized by pain and tenderness over the carotid artery without an associated structural luminal abnormality. Controversy exists over whether this is a distinct disease entity or merely a symptom attributable to other causes of neck pain, such as carotid dissection or vasculitis. A 50-year-old woman presented with sudden-onset right neck pain. Imaging studies demonstrated transmural inflammation of the proximal internal carotid artery, without evidence of intraluminal pathology...
April 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28317622/aortic-dissection-in-takayasu-arteritis
#20
Kun-Qi Yang, Yan-Kun Yang, Xu Meng, Ying Zhang, Hui-Min Zhang, Hai-Ying Wu, Ya-Xin Liu, Xiong-Jing Jiang, Jun Cai, Xian-Liang Zhou, Ru-Tai Hui, De-Yu Zheng, Li-Sheng Liu
BACKGROUND: Aortic dissection (AD) is a rare complication of Takayasu arteritis (TA). The clinical presentation and long-term management outcomes of AD in patients with TA have not been well described. MATERIALS AND METHODS: We conducted a retrospective study of patients with TA along with AD admitted to Fuwai Hospital between January 1985 and March 2016. Clinical data and follow-up data were collected and analyzed. RESULTS: Of the 1,154 patients with TA, we identified 10 patients (0...
April 2017: American Journal of the Medical Sciences
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