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Rare causes of stroke

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https://www.readbyqxmd.com/read/27914158/causes-of-death-in-an-acute-psychiatric-inpatient-unit-of-a-portuguese-general-hospital
#1
Sofia Barbosa, Márcia Sequeira, Sara Castro, Rita Manso, Catarina Klut Câmara, Bruno Trancas, Nuno Borja-Santos, Teresa Maia
INTRODUCTION: Psychiatric patients are at increased risk of death from a number of natural and unnatural causes. This study examines the mortality causes of all psychiatric inpatients of an acute psychiatric unit at a general hospital in Portugal for sixteen years (1998 to 2013). MATERIAL AND METHODS: Twenty-one inpatients died at the inpatient unit between 1998 and 2013 (average 1.3 per year). A retrospective study through case-file review was carried to collect demographic characteristics, medical and psychiatry diagnosis...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27897305/-cervical-ischaemic-neuronopathy-and-cardioembolism-another-cause-of-man-in-the-barrel-syndrome
#2
H Gonzalez-Usigli, A Gandarilla, J J Garcia, J Serrato, N Estrada
INTRODUCTION: Spinal infarction accounts for 1% of all strokes. Cardioembolism is a rare cause. Common areas of ischemic spinal damage are watershed in the dorsal or lumbar regions; however cervical spinal cord infarction has been reported previously. CASE REPORT: We present a new case of a man-in-the-barrel syndrome produced by cardiac embolization associated with atrial fibrillation during an acute myocardial infarction, which caused cervical ischemic neuronopathy (infarction of the anterior horn)...
December 16, 2016: Revista de Neurologia
https://www.readbyqxmd.com/read/27895449/cadasil-presenting-with-spontaneous-intracerebral-hemorrhage-report-of-a-case-and-description-of-the-first-family-in-northern-greece
#3
I Koutroulou, T Karapanayiotides, N Grigoriadis, D Karacostas
INTRODUCTION: CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy), the most common inherited cause of stroke and dementia in adults, has been described in six Greek families. Common presenting manifestations include migraine with aura, brain ischemia, mood disorders and cognitive decline. Spontaneous intracerebral hemorrhage (SICH) rarely occurs in CADASIL and only exceptionally as the first clinical manifestation. CASE DESCRIPTION: We have previously reported the sixth Greek family with CADASIL and in particular, two brothers in whom the genetic testing documented a classic mutation of the NOTCH3 gene (Arg169Cys)...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27890763/positional-occlusion-of-vertebral-artery-due-to-cervical-spondylosis-as-rare-cause-of-wake-up-stroke-report-of-2-cases
#4
Hirofumi Nishikawa, Fumitaka Miya, Yotaro Kitano, Genshin Mori, Shigetoshi Shimizu, Hidenori Suzuki
BACKGROUND: Positional compression of the vertebral artery (VA) due to cervical spondylosis is an uncommon cause of stroke. We report two cases of cervical spondylosis causing wake-up stroke, which is extremely rare. CASE DESCRIPTION: The first case was a 78-year-old woman who presented with vertigo and vomiting lasting from waking up. Magnetic resonance (MR) images and angiography documented right cerebellar infarction, and stenosis of the right cervical VA. Dynamic angiography revealed that the right VA was occluded when her neck was extended or rotated to the right...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27881097/ischaemic-stroke-and-clostridium-septicum-sepsis-and-meningitis-in-a-patient-with-occult-colon-carcinoma-a-case-report-and-review-of-the-literature
#5
Kosmas Macha, Antje Giede-Jeppe, Hannes Lücking, Roland Coras, Hagen B Huttner, Jürgen Held
BACKGROUND: Clostridium septicum is a rare cause of meningitis and brain abscess in children and adults. Gas production by the pathogen can lead to pneumocephalus and the overall mortality rate of Clostridium septicum CNS infection is as high as 74%. The most common entry site of the pathogen is the gastrointestinal tract. CASE PRESENTATION: We describe a 74-year-old man who presented with a left-sided cerebral infarction in the middle cerebral artery territory...
November 24, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27879470/incidence-and-management-of-thrombotic-and-thromboembolic-complications-following-the-norwood-procedure-a-systematic-review
#6
Arnav Agarwal, Mohammed Firdouse, Nishaan Brar, Andy Yang, Panos Lambiris, Anthony K Chan, Tapas K Mondal
BACKGROUND: The stage 1 Norwood procedure and its variants represent the first step of palliation for hypoplastic left heart syndrome. Although appropriate postoperative thromboprophylaxis is integral, significant variance remains across institutional practices. The purpose of this systematic review is to estimate the incidence of thrombosis and thromboembolism following the Norwood or modified Blalock-Taussig shunt procedure and examine current thromboprophylaxis regimens. METHODS: Ovid MEDLINE and Embase were searched from January 2000 to June 2016 for primary studies explicitly reporting incidence of thrombosis, thromboembolism (strokes and pulmonary embolisms), or shunt occlusion in neonates, infants, and children undergoing the Norwood procedure or any variant...
November 21, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27879304/aortic-valve-fibroelastoma-a-rare-cause-of-stroke
#7
Vivek Kumar, Parita Soni, Arsalan Hashmi, Manfred Moskovits
The prevalence of primary cardiac tumours varies from 0.02% to 0.45%. Cardiac papillary fibroelastoma (CPF) is a rare tumour diagnosed incidentally on imaging. The clinical manifestations result from thromboembolisation and include transient ischaemic attack, stroke and sudden cardiac death. We present a patient aged 57 years with CPF arising from the aortic valve. The patient presented with right hemiparesis due to acute stroke. He received tissue plasminogen activator with complete resolution of neurological symptoms...
November 22, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27854159/sheehan-s-syndrome-and-sickle-cell-disease-the-story-of-natasha
#8
Barbara A Wilson, Anita Rose, Gerhard Florschutz
Sheehan's syndrome (SS) is one of the pituitary disorders caused by severe blood loss during childbirth leading to necrosis of the pituitary gland. Diagnosis is made following severe haemorrhage, failure to produce milk and failure to menstruate. Rare in countries with good obstetric care, SS is still frequent in those countries with poor healthcare services. The majority of papers published on SS do not mention psychological or neuropsychological sequelae. Of those that do, mood disorders are sometimes reported and occasionally cognitive problems are noted, typically attention, memory or executive deficits...
November 17, 2016: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/27853491/dissection-of-extracranial-internal-carotid-artery-due-to-balloon-guiding-catheter-resulting-in-asymptomatic-internal-carotid-artery-occlusion
#9
Suha Akpinar, Guliz Yilmaz
Dissection of the internal carotid artery (ICA) is a rare condition that accounts for a significant proportion of ischemic strokes in young adults. Iatrogenic dissection as a complication of neurointerventional procedures is a traumatic dissection which has been reported relatively rare in the literature. In this report, a case of dissection of the ICA is reported that was caused by repetitive movement of the balloon guiding catheter during stent-assisted thrombectomy (SAT), resulting in occlusion of the ICA...
July 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
https://www.readbyqxmd.com/read/27853085/bilateral-vertebral-artery-aneurysms-at-the-atlantoaxial-joint-level-causing-recurrent-stroke
#10
Kenichi Komatsu, Akihiko Ozaki, Koichi Iwasaki, Sadayuki Matsumoto
Vertebral arteries (VAs) are vulnerable to mechanical stress between the atlas and axis, and subsequent VA dissection can cause posterior circulation infarction. We herein present a rare but informative case of bilateral VA aneurysms that caused recurrent stroke. The localization of the aneurysms and dynamic angiography with neck movement suggested a pathogenesis related to chronic mechanical injury of the VAs, though no skeletal abnormality was detected. The recurrences stopped and both aneurysms shrank after neck collar fixation and after the combination use of antithrombotics...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27847773/evaluation-and-treatment-of-the-acute-cerebral-infarction-with-convexal-subarachnoid-hemorrhage
#11
Min Hyung Lee, Sang Uk Kim, Dong Hoon Lee, Young Il Kim, Chul Bum Cho, Seung Ho Yang, Il Sup Kim, Jae Taek Hong, Jae Hoon Sung, Sang Won Lee
Non-traumatic convexal subarachnoid hemorrhage (CSAH) is a comparatively infrequent with various vascular and nonvascular causes, it rarely occurs concomitant to acute ischemic stroke. We report a case of a 59-year-old woman, visited emergency room with right side subjective weakness spontaneously. Magnetic resonance diffusion-weighted images revealed an acute infarction of anterior cerebral arterial territory. Computed tomographic angiography showed a left frontal CSAH without any vascular lesions. And other laboratory studies were non-specific...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27832926/update-on-specificities-of-stroke-in-women
#12
Hanne Christensen, Line Bentsen, Louisa Christensen
The majority of strokes occur in women who in crude numbers have poorer outcome including higher mortality from stroke than men. This may, however, to a large degree be explained by the preponderance of women in the older age groups. Nevertheless, incidence of stroke is higher in men than in women. Overall rates of stroke decline, but more in men than in women; consequently the excess number of strokes in women will be on the rise in the years to come. Risk factors differ between men and women: e.g. rates of atrial fibrillation and hypertension are higher in women with stroke, while rates of e...
November 7, 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27827296/spontaneous-thrombosis-of-an-unruptured-saccular-aneurysm-causing-mca-infarction
#13
Anton Fomenko, Anthony M Kaufmann
Spontaneous complete thrombosis of an unruptured intracranial aneurysm leading to ischemic stroke is rare. We present a case of a 56-year-old man who suffered an acute left middle cerebral artery (MCA) infarction, attributable to complete thrombosis of an unruptured saccular MCA bifurcation aneurysm with occlusion of the parent artery. The presenting hemiparesis and aphasia partially improved over a long hospital rehabilitation stay. Follow-up imaging demonstrated no recanalization of the aneurysm or parent vessels...
November 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/27824310/-diagnosis-and-treatment-of-stroke-during-pregnancy
#14
Melinda Vanya, Ivan Devosa, Delia Szok, Gyorgy Bartfai
Stroke, the sudden onset of brain dysfunction from a vascular cause, is one of the most common causes of long-term disability. Although rare during childbearing years, stroke is even more devastating when it occurs in a young woman trying to start a family. Pregnancy and the postpartum period are associated with an increased risk of ischemic stroke and intracerebral hemorrhage, although the incidence estimates have varied. There are several causes of stroke that are in fact unique to pregnancy and the postpartum period, such as preeklampszia and eklampszia, amniotic fluid embolus, postpartum angiopathy and postpartum cardiomyopathy...
September 2016: Neuropsychopharmacologia Hungarica
https://www.readbyqxmd.com/read/27819760/reversible-cerebral-vasoconstriction-syndrome-in-association-with-fingolimod-use
#15
Scott Belliston, Jayshree Sundararajan, Kathy Newell, Sharon Lynch
BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS), also known as Call-Fleming syndrome, is characterized by thunderclap headaches, non-aneurysmal segmental cerebral vasoconstriction seen on arteriogram, and spontaneously resolves within twelve weeks. Fingolimod has been reported to cause posterior reversible encephalopathy syndrome (PRES) and one case of RCVS. OBJECTIVE: We report a case of RCVS possibly related to fingolimod use, and compare to cases of adverse outcomes in fingolimod use...
November 7, 2016: International Journal of Neuroscience
https://www.readbyqxmd.com/read/27819416/neurological-manifestations-of-acute-posterior-multifocal-placoid-pigment-epitheliopathy
#16
Hussein Algahtani, Ashjan Alkhotani, Bader Shirah
BACKGROUND AND PURPOSE: Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is an immune-mediated chorioretinal disease that causes acute visual symptoms with characteristic ophthalmoscopic findings. Neurological complications are rarely reported in the literature. Here we report two new cases of APMPPE that presented with neurological manifestations, one of which was associated with peripheral neuropathy, which has not been described before. METHODS: A retrospective database review of all patients with a diagnosis of APMPPE was performed...
October 2016: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/27815629/pulmonary-artery-perforation-and-coronary-air-embolism-two-fatal-outcomes-in-percutaneous-left-atrial-appendage-occlusion
#17
J Zwirner, R Bayer, C Hädrich, A Bollmann, N Klein, J Dreßler, B Ondruschka
Percutaneous left atrial appendage (LAA) closure is a routinely performed method to reduce the risk of stroke in patients suffering from atrial fibrillation, when an oral anticoagulation is no longer indicated due to relevant bleeding complications. Currently, the Amplatzer Amulet and the Watchman system are two equally used systems. While there is an acute success rate of more than 95 per cent for this intervention, several minor and major complications such as pericardial effusions, air embolism, vascular lesions in proximity to the heart or even death can occur...
November 4, 2016: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/27815594/wnk-signalling-pathways-in-blood-pressure-regulation
#18
REVIEW
Meena Murthy, Thimo Kurz, Kevin M O'Shaughnessy
Hypertension (high blood pressure) is a major public health problem affecting more than a billion people worldwide with complications, including stroke, heart failure and kidney failure. The regulation of blood pressure is multifactorial reflecting genetic susceptibility, in utero environment and external factors such as obesity and salt intake. In keeping with Arthur Guyton's hypothesis, the kidney plays a key role in blood pressure control and data from clinical studies; physiology and genetics have shown that hypertension is driven a failure of the kidney to excrete excess salt at normal levels of blood pressure...
November 4, 2016: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/27799374/where-did-the-clot-go-an-unusual-complication-of-mechanical-thrombectomy-caused-by-malignancy-related-subclavian-steal-phenomenon-in-a-patient-with-acute-basilar-artery-occlusion
#19
Nikkie Randhawa, Jonathan P Squires, Manraj Kanwal Singh Heran, Sharanpal K Mann
Subclavian steal is a relatively common vascular phenomenon usually caused by atherosclerotic disease. While symptoms are rare, arm claudication of the ipsilateral limb is most common, with paroxysmal symptoms of vertebrobasilar insufficiency (often exercise induced) being relatively uncommon. Here we present a case of brachial artery embolism during mechanical thrombectomy for basilar artery thrombosis, secondary to subclavian steal phenomenon. This atypical and potentially irreversible complication should be considered in patients with acute ischemic stroke undergoing neurointerventional management when subclavian steal is discovered angiographically...
October 31, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27798932/clinical-presentation-magnetic-resonance-angiography-ultrasound-findings-and-stroke-patterns-in-patients-with-vertebral-artery-dissection
#20
Albrecht Günther, Otto W Witte, Martin Freesmeyer, Robert Drescher
BACKGROUND/AIMS: Vertebral artery dissection (VAD) is an important cause of ischemic stroke. In this observational study, clinical data, magnetic resonance (MR) and ultrasound (US) imaging findings and ischemic patterns were analyzed. METHODS: Forty-seven patients with a diagnosis of VAD underwent clinical examination, US, MR of the brain and neck and MR angiography (MRA) of the cervical arteries. Vascular abnormalities and ischemic brain lesions were noted. Data were evaluated separately and compared for spontaneous and traumatic VAD subgroups...
2016: European Neurology
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