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https://www.readbyqxmd.com/read/28799861/absence-of-cortical-vein-opacification-is-associated-with-lack-of-intra-arterial-therapy-benefit-in-stroke
#1
Ivo G H Jansen, Annemieke B van Vuuren, Wim H van Zwam, Ido R van den Wijngaard, Olvert A Berkhemer, Hester F Lingsma, Cornelis H Slump, Robert J van Oostenbrugge, Kilian M Treurniet, Diederik W J Dippel, Marianne A A van Walderveen, Aad van der Lugt, Yvo B W E M Roos, Henk A Marquering, Charles B L M Majoie, René van den Berg
Purpose To assess the degree of cortical vein opacification in patients with internal carotid artery or middle cerebral artery (MCA) stroke and to evaluate the relationship with treatment benefit from intra-arterial therapy (IAT). Materials and Methods Written informed consent was obtained from all patients in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands. From the trial's database, all patients (recruited from December 2010 until March 2014) with baseline computed tomographic (CT) angiograms were retrospectively included...
August 11, 2017: Radiology
https://www.readbyqxmd.com/read/28794091/a-rare-cause-of-early-neonatal-cyanosis-absent-right-pulmonary-artery
#2
Avadhesh Joshi, Manish Kumar, Sumitha Arun, Mane Manisha Sheshrao
Unilateral absent right pulmonary artery is a rare developmental anomaly that usually presents in late childhood and adolescence as recurrent respiratory tract infections, dyspnoea and haemoptysis. We report a case of a 2-day-old baby with respiratory distress and differential cyanosis. Echocardiogram showed pulmonary hypertension with absent right pulmonary artery. The findings were confirmed by CT angiogram. The baby improved with pulmonary vasodilators and antifailure medications.
August 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28780709/stent-therapy-for-aortic-coarctation-in-children-30%C3%A2-kg-use-of-the-low-profile-valeo-stent
#3
Sok-Leng Kang, Andrew Tometzki, Demetris Taliotis, Robin Martin
To report our experience of coarctation stent therapy in small children weighing less than 30 kg, with the low profile dilatable Valeo stent and review the literature on coarctation stent therapy in this patient population. Coarctation stent implantation was undertaken in 14 consecutive children using the Bard Valeo Stent. Demographic, angiographic, echocardiographic and clinical data were reviewed retrospectively. The median age at the time of procedure was 5.1 (2.6-7.5) years and median weight was 20.8 (14...
August 5, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28764242/page-kidney-in-wunderlich-syndrome-causing-acute-renal-failure-and-urosepsis-successful-timely-minimally-invasive-management-of-a-devastating-clinical-entity
#4
Sundaramoorthy Vijayganapathy, Vilvapathy Senguttuvan Karthikeyan, Ashwin Mallya, Jayaram Sreenivas
Wunderlich Syndrome (WS) is an uncommon condition where acute onset of spontaneous bleeding occurs into the subcapsular and perirenal spaces. It can prove fatal if not recognized and treated aggressively at the appropriate time. A 32-year-old male diagnosed elsewhere as acute renal failure presented with tender left loin mass, fever and hypovolemic shock with serum creatinine 8.4 mg/dl. He was started on higher antibiotics and initiated on haemodialysis. Ultrasonogram (USG), Non-Contrast Computed Tomography (NCCT) and Magnetic Resonance Imaging (MRI) showed bilateral perirenal subcapsular haematomas - right 3...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28741720/alteplase-for-acute-ischemic-stroke-after-heparin-reversal-with-protamine-a-case-report-and-review
#5
Gabriel V Fontaine, Shawn M Smith
BACKGROUND: Few patients presenting with acute ischemic stroke (AIS) are eligible for alteplase, especially those receiving ongoing anticoagulation. We describe the first reported case of a patient receiving full-dose intravenous (IV) alteplase for AIS after heparin reversal with protamine. CASE: A 73-year-old male presented with AIS. He was treated with IV heparin, tirofiban, loading-dose prasugrel, and aspirin prior to percutaneous coronary intervention (PCI) for placement of a right coronary artery stent...
July 25, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28736349/completion-of-the-circle-of-willis-varies-by-gender-age-and-indication-for-cta
#6
Orel A Zaninovich, Wyatt L Ramey, Christina M Walter, Travis M Dumont
OBJECTIVE: The Circle of Willis (CoW) is the foremost anastomosis and blood distribution center of the brain. Its effectiveness depends on its completion and the size and patency of its vessels. Gender- and age-related anatomical variations in the CoW may play an important role in the pathogenesis of cerebrovascular diseases. In this study, we analyzed CT angiograms to assess for differences in CoW completion related to gender, age, and indication for CTA. METHODS: 834 CTAs were retrospectively analyzed for all CoW vessels to compare the incidence of complete CoW and variation frequency based on gender, age, and indication...
July 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28720746/-a-rare-case-of-ruptured-internal-carotid-posterior-communicating-artery-aneurysm-associated-with-contralateral-delayed-oculomotor-nerve-palsy
#7
Chika Somagawa, Yutaka Fukuda, Shota Yoshimura, Kei Satoh, Takeshi Hiu, Tomonori Ono, Ryujirou Ushijima, Keisuke Toda, Keisuke Tsutsumi
A 55-year-old man presented with difficulty breathing, chest pain, and disturbance of consciousness, and was transferred to our hospital. Initial whole body CT revealed a diffuse subarachnoid hemorrhage(SAH)with severe pulmonary edema that was considered neurogenic in origin. He received controlled ventilation under sedation and conservative care for the SAH. One day after the onset of the SAH, his left pupil suddenly became dilated to 6mm, with no reaction to light. Head CT showed no new bleeding. Subsequent CT angiogram revealed a right internal carotid-posterior communicating artery aneurysm(IC-PC AN)with a posterior-lateral projection; however, no vessel abnormality was observed in the left anterior or posterior circulations...
July 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28720694/myocardial-infarction-masquerading-as-myocarditis-in-a-patient-with-factor-v-leiden-unmasked-with-mr
#8
Jason Leo Walsh, Benjamin Howell Lole Harris, Walid Gharzuddine, Hussain Isma'eel
We present a case of a 21-year-old man presenting with sharp left-sided chest pain. A CT pulmonary angiogram was negative, ECG was unremarkable and a mild troponin rise was observed. Myocarditis was suspected as the most likely diagnosis, particularly in view of the patient's previous diagnosis of myocarditis 3 years prior. A cardiac MRI was indicative of an acute mid-anterior myocardial infarction (MI) and an old inferior MI with an associated aneurysm. A subsequent angiogram revealed a subtotal occlusion in the second diagonal artery, likely precipitated by homozygous factor V Leiden...
July 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28720601/a-case-of-progressive-orthopnoea-and-shoulder-pain-secondary-to-bilateral-diaphragmatic-paralysis
#9
Anna Herbert, Waseem Asrar Khan, Salem Madi
A 45-year-old man with a raised body mass index presented with an acute history of right lower chest pain and increasing breathlessness. C reactive protein, D dimer and cardiac echocardiography were negative, with mild bibasal atelectasis the only positive reported finding from erect chest X-ray and CT pulmonary angiogram. He was discharged with antibiotics for a chest infection. He remained severely breathless and was referred to the sleep-related breathing disorders clinic. He described shoulder pain, daytime tiredness and sleeping upright due to a ââ'¬Ëœsuffocatingââ'¬â"¢ sensation...
July 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28710237/focal-neurological-presentation-in-hashimoto-s-encephalopathy-mimicking-a-vascular-occlusion-of-the-middle-cerebral-artery
#10
Ahmad Alazzeh, Sarah Jaroudi, Matthew Gooch, Alan N Peiris
Hashimoto's encephalopathy is a rare form of autoimmune encephalopathy. It is likely an underdiagnosed entity especially in the setting of focal neurological defects. We report a case of a 49-year-old man who presented with "strange behavior"of a day's duration. Examination was significant only for lethargy, poor attention span and agitation. Routine labs revealed leucocytosis. Head CT scan was unremarkable. Lumbar puncture showed high white blood cells with lymphocytosis and elevated protein level. The patient was empirically treated for meningitis without improvement...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28698088/microsurgical-repair-of-ruptured-aneurysms-associated-with-moyamoya-pattern-collateral-vessels-of-the-middle-cerebral-artery-a-report-of-two-cases
#11
Min Lang, Nina Z Moore, Alex M Witek, Varun R Kshettry, Mark Bain
BACKGROUND: Patients with Moyamoya or other intracranial steno-occlusive disease are at risk for developing aneurysms associated with flow through collateral vessels. Because these lesions are rare, the optimal management remains unclear. Here, we describe two cases of microsurgical repair of ruptured collateral vessel aneurysms associated with middle cerebral artery (MCA) occlusion. CASE DESCRIPTION: The first patient was a 61-year-old male who presented with right frontal and intraventricular hemorrhage...
July 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28694612/cerebral-and-coronary-vasculature-in-disease-associations-and-dissociations-in-the-south-indian-population
#12
Krishnan Srinivasan, Srinivasan Ravikumar, Sadanandavalli Retnaswami Chandra, Selva Ganapathy, G S Ravi
INTRODUCTION: Cerebrovascular accidents constitute the most common cause of disability all over the world. In India prevalence rate is 545 per 100000 and mortality rate is around 7.5 per thousand. Therefore the authors undertook a study on patients who underwent coronary artery bypass surgery (CABG). They were investigated for clinical and/or radiological evidence of cerebrovascular disease (CVD) with the aim to decide on early neurological intervention. PATIENTS AND METHODS: 210 patients who had undergone CABG were evaluated with neck vessel Doppler using high resolution duplex scanner system and computed tomography (CT) scan as well as MR angiogram (MRA) in addition to assessment of co morbid risk factors...
July 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28688878/retrospective-review-of-billowing-phenomenon-a-mimic-of-endoleak-following-placement-of-endologix-covered-stent-for-the-treatment-of-abdominal-aortic-aneurysm
#13
Naseem Helo, Arthur C Chang, Christine Hyun, Christian Bianchi, Theodore H Teruya, Alex C Yi, Kenneth S Chon
BACKGROUND: Billowing is a unique CT finding of the Endologix stent graft where a rim of contrast is observed outside the stent's endoskeleton but still contained within the graft cover. The purpose of this study is to evaluate the incidence and clinical outcome of billowing following an Endologix stent graft placement. METHODS: All patients who underwent Abdominal Aortic Aneurysm (AAA) repair with endovascular placement of an Endologix stent graft from January 2002-September 2013 that were followed with imaging were included in the study...
July 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28676304/imaging-trends-in-acute-venous-thromboembolic-disease-2000-to-2015
#14
Isaac Wang, Matthew S Davenport, Ella A Kazerooni
PURPOSE: To measure diffusion of new knowledge and correlate imaging utilization for suspected acute venous thromboembolism (VTE) with d-dimer utilization, landmark publications, and institutional guidelines. MATERIALS: Between 2000 and 2015, the number of CT pulmonary angiograms (CTPAs), CTPA combined with indirect CT venography (CTV), ventilation-perfusion (VQ) scans, and lower extremity venous Doppler ultrasound (US) examinations were obtained for inpatients and emergency department (ED) patients and correlated with d-dimer utilization, landmark publications regarding radiation and VTE imaging, and an institutional inpatient best-practice alert requiring VTE prophylaxis assessment (2008)...
July 1, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28659455/calcified-embolus-mimics-patent-middle-cerebral-artery-on-ct-angiogram
#15
EDITORIAL
Vignan Yogendrakumar, Satya Patro, Dar Dowlatshahi, Grant Stotts, Daniela Iancu
No abstract text is available yet for this article.
August 2017: Practical Neurology
https://www.readbyqxmd.com/read/28652286/point-of-care-ultrasound-versus-ct-pulmonary-angiogram-in-suspected-pulmonary-embolus
#16
Joseph Bacani Bacani, Kerstin De Wit
A short cut review was carried out to establish whether non-invasive, multi-organ point of care ultrasound could reduce the need for CTPA in adult patients presenting with clinical suspicion of pulmonary embolus. 3 papers presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that multi-organ POCUS shows promise but that more data is needed to make a definitive statement regarding validity in clinical practice...
July 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28649478/cerebral-air-embolism-as-possible-cause-of-stroke-during-therapeutic-endobronchial-application-of-argon-plasma-coagulation
#17
Venkatkiran Kanchustambham, Manasa Reddy, Swetha Saladi, Setu Patolia
A 68-year-old male was admitted for evaluation of an endobronchial mass obstructing the right middle lobe (RML) and right lower lobe (RLL) of the lung. Flexible bronchoscopy revealed a notable endobronchial lesion in the bronchus intermedius that completely obstructed the RML and the RLL. Argon plasma coagulation (APC) at 30 watts and gas flow at 0.8 liters/minute to 1 liter/minute were applied to the tumor. In the recovery room, the patient was discovered to have a left-sided facial droop and left-sided weakness...
May 17, 2017: Curēus
https://www.readbyqxmd.com/read/28647656/delayed-retroclival-and-cervical-spinal-subdural-hematoma-complicated-by-pre-existing-chiari-malformation-in-an-adult-trauma-patient
#18
Ha Nguyen, Hoon Choi, Shekar Kurpad, Hesham Soliman
INTRODUCTION: Traumatic spinal subdural hematoma involving the retroclival region and upper cervical spine is a rare pathology. To our knowledge, there have only been two prior cases in an adult trauma patient. We describe a patient with pre-existing Chiari 1 malformation, who recently sustained a unilateral Type 1 OCF (occipital condyle fracture) with associated disruption of the tectorial membrane and transverse ligament, that returned with a retroclival subdural hematoma extending down to C7, causing spinal cord compression and symptomatic obstructive hydrocephalus...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28645902/the-cause-of-the-stroke-a-diagnostic-uncertainty
#19
Abhishek Dattani, Ava Jackson
A 39-year-old man with a history of sickle cell disease (SCD) presented with left leg weakness. He had a normal CT head and CT angiogram, but MRI head showed multiple acute bilateral cortical infarcts including in the right precentral gyrus. The MRI findings were more in keeping with an embolic source rather than stroke related to SCD, although it could not be ruled out. He also had an echocardiogram which revealed a patent foramen ovale. He was treated with antiplatelet therapy and also had red blood cell exchange transfusion...
June 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28616222/a-case-report-of-an-unusual-cause-of-postoperative-leg-pain-after-posterior-lumbar-fusion
#20
R Daureeawoo, S Baliga, W Mohahmed, E B Ahmed
We report the case of a 36-year old man who underwent elective posterior lumbar spinal fusion after presenting with bilateral leg pain with associated back pain. He had undergone a L5/S1 discectomy in 2001, which provided good symptomatic relief. On this admission, he underwent elective L4-S1 posterolateral fusion and bilateral L4/5 and L5/S1 decompression. Intra-operatively a pedicle screw had to be re-inserted after fluoroscopy confirmed a lateral breech. The patient had no major postoperative complications until the sixth day when the patient re-presented with acute leg pain and weakness...
July 2017: Annals of Medicine and Surgery
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