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Rare causes of stroke

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https://www.readbyqxmd.com/read/28936439/a-case-of-pulmonary-arteriovenous-malformation-role-of-interventional-radiology-in-diagnosis-and-treatment
#1
Pranav Sharma, Puneet Kochar, Salil Sharma, Nishant Gupta, Shuo Li, Kusum Hooda, Yogesh Kumar
Pulmonary arterio-venous malformations (PAVMs) are abnormal pulmonary arteries and pulmonary veins communicating directly without interposition of a capillary bed and about 80-90% of patients with PAVMs eventually may present with hereditary hemorrhagic telangiectasia (HHT), remaining ones are sporadic cases. On the other hand, about 15-35% of HHT patients may present with PAVMs. The PAVMs have a tendency to grow and increase in size over time and various factors like puberty, pregnancy and pulmonary arterial hypertension (PAH) affect growth...
September 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28918510/acquired-hepatocerebral-degeneration-ahd-a-peculiar-neurological-impairment-in-advanced-chronic-liver-disease
#2
A Pigoni, F Iuculano, C Saetti, L Airaghi, L Burdick, S Spreafico, M Curioni, R Lombardi, L Valenti, A L Fracanzani, S Fargion
We discuss the case of a rare and often unrecognized neurologic syndrome, called Acquired Hepatocerebral Degeneration (AHD), observed in patients with advanced liver disease and portosystemic shunts. The clinical manifestations can be very heterogeneous and in our case included a combination of cerebellar and extrapyramidal signs, arisen in a period of few days. Brain Magnetic Resonance Imaging (MRI) showed, in T1-weighted images, diffuse bilateral hyper intensities in basal ganglia and biemispheric brain and cerebellar cortices, resembling paramagnetic deposits...
September 16, 2017: Metabolic Brain Disease
https://www.readbyqxmd.com/read/28916665/integrin-%C3%AE-4-overexpression-on-rat-mesenchymal-stem-cells-enhances-transmigration-and-reduces-cerebral-embolism-after-intracarotid-injection
#3
Li-Li Cui, Franziska Nitzsche, Evgeny Pryazhnikov, Marina Tibeykina, Laura Tolppanen, Jussi Rytkönen, Tuulia Huhtala, Jing-Wei Mu, Leonard Khiroug, Johannes Boltze, Jukka Jolkkonen
BACKGROUND AND PURPOSE: Very late antigen-4 (integrin α4β1)/vascular cell adhesion molecule-1 mediates leukocyte trafficking and transendothelial migration after stroke. Mesenchymal stem cells (MSCs) typically express integrin β1 but insufficient ITGA4 (integrin α4), which limits their homing after intravascular transplantation. We tested whether ITGA4 overexpression on MSCs increases cerebral homing after intracarotid transplantation and reduces MSC-borne cerebral embolism. METHODS: Rat MSCs were lentivirally transduced to overexpress ITGA4...
September 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28915130/dolichoectasia-of-vertebrobasilar-arteries-as-a-cause-of-hydrocephalus-and-ischemic-cerebral-stroke
#4
Miodrag Zdravković, Milos Kostov, Sladjana Petrovic, Jovana Zdravkovic
INTRODUCTION: Dolichoectasia of vertebrobasilar artery is a rare vasculopathy, which is characterized by ectasia, elongation, and tortuosity of the basilar artery. CASE DESCRIPTION: A 85-year-old man was referred to the Clinic of Neurology with sudden-onset coma. A brain computed tomography scan showed remarkable fusiform dilatation with elongation of basilar artery, with compressive effect on brain stem. Autopsy confirmed existence of vertebrobasilar dolichoectasia, with organized old thrombus and partially with recent occlusive thrombosis...
September 14, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28912818/a-successfully-treated-case-of-gastrointestinal-stromal-tumor-causing-severe-anemia-and-localized-peritonitis-showing-angina-pectoris-resulting-in-watershed-cerebral-infarction
#5
Yoshihide Sehara, Yuka Hayashi, Kenichi Ohya, Naoki Kaneko, Mikio Sawada
Ischemic stroke following acute myocardial infarction is a rare but a serious complication. Because the pathophysiology of stroke is dynamic, it is often hard to identify the cause of stroke. Here, we present the case of a 75-year-old man with ischemic stroke following angina pectoris caused by severe anemia and localized peritonitis due to gastrointestinal stromal tumor of small intestine. On admission, he showed consciousness disturbance, fever, and left hemiplegia. The electrocardiogram on admission showed ST-segment depression in V2 to V6 which was normalized 4 hours later...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28912365/d-dimer-in-african-americans-whole-genome-sequence-analysis-and-relationship-to-cardiovascular-disease-risk-in-the-jackson-heart-study
#6
Laura M Raffield, Neil A Zakai, Qing Duan, Cecelia Laurie, Joshua D Smith, Marguerite R Irvin, Margaret F Doyle, Rakhi P Naik, Ci Song, Ani W Manichaikul, Yongmei Liu, Peter Durda, Jerome I Rotter, Nancy S Jenny, Stephen S Rich, James G Wilson, Andrew D Johnson, Adolfo Correa, Yun Li, Deborah A Nickerson, Kenneth Rice, Ethan M Lange, Mary Cushman, Leslie A Lange, Alex P Reiner
OBJECTIVE: Plasma levels of the fibrinogen degradation product D-dimer are higher among African Americans (AAs) compared with those of European ancestry and higher among women compared with men. Among AAs, little is known of the genetic architecture of D-dimer or the relationship of D-dimer to incident cardiovascular disease. APPROACH AND RESULTS: We measured baseline D-dimer in 4163 AAs aged 21 to 93 years from the prospective JHS (Jackson Heart Study) cohort and assessed association with incident cardiovascular disease events...
September 14, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28904820/successful-cerebral-thrombectomy-for-a-nonagenarian-with-stroke-in-the-subacute-phase-after-transcatheter-aortic-valve-implantation
#7
Kazuya Matsuo, Atsushi Fujita, Jun Tanaka, Tomoaki Nakai, Masaaki Kohta, Kohkichi Hosoda, Toshiro Shinke, Ken-Ichi Hirata, Eiji Kohmura
BACKGROUND: Thromboembolic events are infrequent but serious complications of transcatheter aortic valve implantation (TAVI), occurring in 2.3-10% of the patients. However, the cause of post-TAVI stroke is unclear. CASE DESCRIPTION: A 90-year-old female underwent transfemoral-TAVI for severe aortic stenosis. Ten days later, she presented with an ischemic stroke of the left middle cerebral artery territory due to new-onset atrial fibrillation (NOAF). She underwent emergent endovascular thrombectomy with good reperfusion approximately 6 hours after onset of symptoms...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28904807/the-return-of-a-former-foe-syphilis-with-antiphospholipid-syndrome-as-a-cause-of-acute-stroke
#8
Daniela Noakes, Katherine Evans, Rohan Pathansali
This article highlights a rare complication of syphilis infection and the importance of including syphilis and antiphospholipid antibody testing in the acute stroke screen..
September 2017: JRSM Open
https://www.readbyqxmd.com/read/28904575/facial-palsy-in-cerebral-venous-thrombosis-an-atypical-case-in-a-young-girl
#9
Ayşe Kartal
Cerebral venous thrombosis (CVT) is a rare and potentially life-threating cause of stroke. A number of etiologies and risk factors for CVT have been identified so far. These include head trauma, local and systemic infectious diseases, malignancies, autoimmune diseases, and oral contraceptive use. The most common clinical symptoms are headache and changes in consciousness. Cranial nerve palsy in CVT is uncommon, and there are very few reports of facial nerve palsy. This case report highlights an atypical manifestation in a CVT patient, who presented with peripheral facial palsy...
April 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28894947/thalamic-transitory-ischemic-attacks-presenting-as-jacksonian-sensory-march
#10
Victoria Schubert, Stephan Lauxmann, Benjamin Bender, Holger Lerche
Spreading somatosensory symptoms appearing as Jacksonian sensory march are usually considered to be due to an epileptic seizure. We report on three cases in which these symptoms were caused by thalamic ischemia. Two patients presented with stereotypically recurring hemiparesthesias lasting 2-5 min that gradually spread from the face to the arm and leg on one side. A first cerebral magnetic resonance imaging including DWI was negative in both cases, whereas new thalamic infarctions appeared on repeated imaging when clinical symptoms remained...
September 11, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28893698/clinical-manifestations-of-isolated-chronic-middle-cerebral-artery-occlusion-in-relation-to-angiographic-features
#11
Hee Sup Shin, Chang-Woo Ryu, Hak Cheol Ko, Soonchan Park, Sang-Beom Kim
BACKGROUND AND PURPOSE: Isolated chronic middle cerebral artery occlusion (ChMCAO) is not a rare condition, and it is known to cause hemodynamic stroke. The purpose of this study was to evaluate differences in the clinical manifestations and prognosis of isolated ChMCAO in relation to angiographic features. METHODS: Fifty-six patients with isolated ChMCAO were enrolled in this retrospectively study. In accordance with the degree of antegrade collateral flow (AF) on angiography, patients were categorized into poor and good AF groups...
September 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28885973/hemorrhagic-stroke-in-a-young-healthy-male-following-use-of-pre-workout-supplement-animal-rage-xl
#12
Brandon F Harris, Coty Winn, Thomas B Ableman
So-called "pre-workout" supplements are substances marketed as natural dietary supplements with claims of helping athletes achieve more focused and intense workouts. The use of such products remains popular among American youth as a whole, but is especially high among active duty service members. Supplements are minimally regulated by the Food and Drug Administration (FDA), and unlike pharmaceuticals, supplements are often brought to market without any testing to show neither efficacy nor safety. Several case reports have documented serious adverse events and raise the question of whether supplement use was a causative factor...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28883716/spontaneous-cervical-artery-dissection-in-patients-aged-over-70-years-two-cases-and-systematic-literature-review
#13
Nolwenn Riou-Comte, Gioia Mione, Lisa Humbertjean, Marie-Alexia Ottenin, Jean-Christophe Lacour, Sébastien Richard
OBJECTIVE: Spontaneous cervical artery dissection (CAD) is a cerebrovascular disease typically considered to affect the young population. Literature reports cases in the elderly only as incidental findings, making the diagnosis unlikely in older patients. Incidence and pathogeny in this specific population remain to be assessed. METHODS: We reviewed patients aged over 70 years admitted for spontaneous CAD in the Stroke Unit of the University Hospital of Nancy (northeastern France) over a period of 12 years as well as all reported cases in literature...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28879705/guillain-barre-syndrome-induced-by-heat-stroke-a-case-report-and-literature-review
#14
Huijun Wen
BACKGROUND: Heat stroke is a potentially fatal condition that is caused by elevated core temperature. GuillainBarre syndrome (GBS) induced by heat stroke is extremely rare, and its manifestation with damage to multiple cranial nerves has not been described. METHODS: We describe a rare case of GBS induced by heat stroke with damage to multiple cranial and peripheral nerves. The clinical, radiological, and electrophysiological profiles were presented and analyzed...
September 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28868103/ischemic-stroke-in-a-patient-with-quadricuspid-aortic-valve-and-patent-foramen-ovale
#15
Michael Spartalis, Eleni Tzatzaki, Eleftherios Spartalis, Christos Damaskos, Demetrios Moris, Dimitrios Tsiapras, Vassilis Voudris
Quadricuspid aortic valve (QAV) is a rare congenital aortic valve abnormality. It is less common as compared to bicuspid or unicuspid aortic valve abnormality. QAV causes aortic regurgitation usually in the fifth to sixth decade of life. We present a rare case of a female patient with cryptogenic stroke due to a QAV and a patent foramen ovale (PFO). The patient underwent transcatheter closure of PFO, as there was no clear indication for surgery for her valve. Surgical removal remains the method of choice for the treatment of the QAV before left ventricular decompensation occurs...
August 2017: Cardiology Research
https://www.readbyqxmd.com/read/28858408/clinical-characteristics-of-stroke-occurring-in-the-toilet-are-older-adults-more-vulnerable
#16
Joji Inamasu, Kazuhiro Tomiyasu, Satoru Miyatake, Keita Mayanagi, Masami Yoshii, Masashi Nakatsukasa
AIM: While autonomic imbalance during defecation/micturition can cause hemodynamic instability, stroke occurring in the toilet has rarely been investigated. The objective of the present study was to clarify the frequency and clinical characteristics of toilet-related stroke. METHODS: Clinical data prospectively acquired between January 2011 and December 2015 on 1939 patients with acute stroke (1224 cerebral infarctions [CI], 505 intracerebral hemorrhages [ICH] and 210 subarachnoid hemorrhages [SAH]) were reviewed to identify patients with a toilet-related stroke...
August 31, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28835326/juvenile-stroke
#17
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/28820556/unusual-locations-for-cardiac-papillary-fibroelastomas
#18
Davide Carino, Francesco Nicolini, Alberto Molardi, Clara Indira Dadamo, Tiziano Gherli
Papillary fibroelastomas (PFEs) are rare and benign cardiac tumors which usually are localized on the valves (mostly on the aortic valve), though they may originate also from the ventricles or atrial walls. Whilst, in the large majority of cases, these lesions are asymptomatic they may cause serious complications such as thromboembolic events, or more rarely valvular dysfunctions. Surgical excision is necessary for a symptomatic lesion. The management of asymptomatic lesions is not defined. Herein are reported the details of a miniseries of six cases operated on at the authors' institution between 2005 and 2015...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28814273/add-on-neurological-benefits-of-antiviral-therapy-in-hcv-patients-with-chronic-kidney-disease-a-nationwide-cohort-study
#19
Ming-Shyan Lin, Tien-Hsing Chen, Wey-Yil Lin, Chi-Hung Liu, Yung-Yu Hsieh, Wen-Nan Chiu, Chih-Hsiang Chang, Mei-Yen Chen, Chang-Min Chung, Yu-Sheng Lin
BACKGROUND: Hepatitis C virus (HCV)-infected patients with chronic kidney disease (CKD) have rarely been studied because they rarely accept interferon-based therapy (IBT) and have been difficult to follow up. We investigated long-term outcomes of IBT on the population. METHODS: This population-based cohort study used the Taiwan National Health Insurance Research Database as its data source. HCV patients diagnosed with CKD between Jan. 1, 2003, and Dec. 31, 2013, were selected...
August 16, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28810087/multiple-pulmonary-arteriovenous-malformations-an-unusual-cause-of-shortness-of-breath-and-recurrent-strokes
#20
Kalyan C Potu, Shenjing Li, Shawn C Kelly, Julia A Prescott-Focht, Scott Pham
OBJECTIVE: To discuss an uncommon case of a patient with multiple pulmonary arteriovenous malformations (PAVMs) presenting with dyspnea on exertion and recurrent strokes. BACKGROUND: A 79-year-old woman with recent onset recurrent cerebrovascular accidents (CVAs) was referred to cardiology for evaluation of dyspnea on exertion. Clinical examination was unrevealing. METHODS: A transthoracic echocardiogram (TTE) with agitated saline was suggestive of an extra-cardiac shunt...
February 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
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