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Rare causes of stroke

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https://www.readbyqxmd.com/read/28739362/stroke-in-ehlers-danlos-syndrome-kyphoscoliotic-type-dissection-or-vasculitis
#1
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 had a large right middle cerebral artery distribution infarction. Full intravenous heparinization was started in response to presumed arterial dissection...
May 29, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28733467/acromegaly-at-diagnosis-in-3173-patients-from-the-li%C3%A3-ge-acromegaly-survey-las-database
#2
Patrick Petrossians, Adrian F Daly, Emil Natchev, Luigi Maione, Karin Blijdorp, Mouna Sahnoun Fathallah, Renata Auriemma, Alpha M Diallo, Anna-Lena Hulting, Diego Ferone, Vaclav Hana, Silvia Filipponi, Caroline Sievers, Claudia Nogueira, Carmen Fajardo Montañana, Davide M C Carvalho, Vaclav Hana, Günter K Stalla, Marie-Lise Jaffrain-Réa, Brigitte Delemer, Annamaria A L Colao, Thierry Brue, Sebastian J C M M Neggers, Sabina Zacharieva, Philippe Chanson, Albert Beckers
Acromegaly is a rare disorder caused by chronic growth hormone (GH) hypersecretion. While diagnostic and therapeutic methods have advanced, little information exists on trends in acromegaly characteristics over time. The Liège Acromegaly Survey (LAS) database, a relational database, is designed to assess the profile of acromegaly patients at diagnosis and during long-term follow-up at multiple treatment centers. The study population consisted of 3173 acromegaly patients from ten countries; 54.5% were female...
July 21, 2017: Endocrine-related Cancer
https://www.readbyqxmd.com/read/28733124/left-upper-lung-lobectomy-is-an-embolic-risk-factor-for-cerebral-infarction
#3
Yuya Kobayashi, Hiroyuki Yahikozawa, Ryota Takamatsu, Rie Watanabe, Kenichi Hoshi, Wataru Ishii, Shunichi Sato
Cerebral embolism is typically caused by a cardiogenic thrombus. The patent foramen ovale is a well-known cause of paradoxical embolism. However, some idiopathic cases of stroke have been reported. Such strokes are designated as embolic stroke of undetermined sources. Among them, lung lobectomy may be a new embolic risk factor for cerebral embolism. The risk of thrombus formation is high at the pulmonary vein stump after lung lobectomy, especially in the left upper lobe. Interestingly, the risk remains several years after surgery...
July 19, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28724035/spontaneous-carotid-dissection
#4
Carolina Dutra Queiroz Flumignan, Ronald Luiz Gomes Flumignan, Luis Carlos Uta Nakano, Jorge Eduardo de Amorim
Carotid dissection is a rare occurrence but it is the main cause of stroke in individuals aged less than 45 years, and can be the etiology in up to 25% of strokes in young adults. We report a case with classic image of ying yang on vascular ultrasound, which was treated according to the best available medical evidence, yielding a favorable outcome.
May 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28720658/ticagrelor-versus-aspirin-in-acute-embolic-stroke-of-undetermined-source
#5
Pierre Amarenco, Gregory W Albers, Hans Denison, J Donald Easton, Scott R Evans, Peter Held, Michael D Hill, Jenny Jonasson, Scott E Kasner, Per Ladenvall, Kazuo Minematsu, Carlos A Molina, Yongjun Wang, K S Lawrence Wong, S Claiborne Johnston
BACKGROUND AND PURPOSE: Ticagrelor is an effective antiplatelet therapy among patients with atherosclerotic disease and, therefore, could be more effective than aspirin in preventing recurrent stroke and cardiovascular events among patients with embolic stroke of unknown source (ESUS), which includes patients with ipsilateral stenosis <50% and aortic arch atherosclerosis. METHODS: We randomized 13 199 patients with a noncardioembolic, nonsevere ischemic stroke or high-risk transient ischemic attack to ticagrelor (180 mg loading dose on day 1 followed by 90 mg twice daily for days 2-90) or aspirin (300 mg on day 1 followed by 100 mg daily for days 2-90) within 24 hours of symptom onset...
July 18, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28715882/influences-of-body-mass-index-and-physical-activity-on-hypertension-and-stroke-in-korean-adult-males-10-year-longitudinal-study
#6
Yonghwan Kim, Haemi Jee
PURPOSE: Hypertension and stroke have been major causes of increased mortality and social and economic burden in Korea. Although physical activity is one of the critical factors for managing adult diseases, studies on the long-term effects are rarely discussed. Therefore, the aim of this study was to elucidate the role of physical activity in hypertension and stroke via a 10-year longitudinal study. METHODS: Routinely performed health examination data of 5,624,503 Korean men between ages 20 to 70 obtained from the Korean National Health and Nutrition Examination Survey (KNHNES: 2001-2011) were assessed for this study...
June 30, 2017: Journal of Exercise Nutrition & Biochemistry
https://www.readbyqxmd.com/read/28713430/incidental-thrombus-in-transit-causing-embolic-stroke
#7
Brian Malm, Paul Hermany, Alan Morrison
Thrombus in transit leading to paradoxical systemic arterial embolism is a rare echocardiographic finding in patients presenting with embolic stroke. We present a case of a patient who had an atrial thrombus in transit discovered incidentally and later suffered a fatal stroke. Etiologies of cardioembolic stroke and the use of echocardiography in diagnosis and management are briefly discussed.
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28697940/characterization-of-perioperative-contralateral-stroke-after-carotid-endarterectomy
#8
W Darrin Clouse, Emel A Ergul, Virendra I Patel, R Todd Lancaster, Glenn M LaMuraglia, Richard P Cambria, Mark F Conrad
OBJECTIVE: Contralateral stroke is an infrequent cause of perioperative stroke after carotid endarterectomy (CEA). Whereas the risks of ipsilateral stroke complicating CEA have been discriminated, factors that lead to contralateral stroke are poorly defined. The purpose of this study was to identify the risk of perioperative (30-day) contralateral stroke after CEA as well as predisposing preoperative and operative factors. Its specific effect on long-term survival was interrogated. METHODS: The Vascular Study Group of New England (VSGNE) was queried from April 1, 2003, to February 29, 2016, for all CEAs...
July 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28684051/patent-foramen-ovale-closure-to-prevent-secondary-neurologic-events
#9
REVIEW
Rosie Jasper, James C Blankenship
In October of 2016 the United States Food and Drug Administration approved the Amplatzer Patent Foramen Ovale (PFO) occluder device for use in patients with cryptogenic stroke, to reduce the risk of recurrent stroke. This event followed 15years of off-label use of atrial septal occluder devices, 3 randomized trials, and enormous controversy over the efficacy of this procedure. While none of the trials reached the primary endpoint needed to prove the efficacy of PFO closure in preventing recurrent stroke, meta-analyses and 5-year follow-up of 1 trial suggest that PFO closure decreases the risk of recurrent stroke, especially in sub-groups with large shunts and atrial septal aneurysms, and especially when the Amplatzer device (rather than other devices) is used...
July 3, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28682888/spontaneous-recanalization-of-atherosclerotic-middle-cerebral-artery-occlusion-case-report
#10
Ying Mao, Yujing Huang, Li Zhang, Guangxian Nan
RATIONALE: Intracranial vascular atherosclerotic occlusion is one of the most common causes of ischemic stroke world wide. The involvement of large intracranial vessels, in particular, the middle cerebral artery, is usually associated with unfavorable outcomes in patients. Spontaneous recanalization of atherosclerotic occlusion is relatively rare. PATIENT CONCERNS: The first patient was a 43-year-old male with slurred speech and left-sided weakness for a duration of 24 hours...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28680766/cerebrovascular-fibromuscular-dysplasia-the-mgh-cohort-and-literature-review
#11
Andrea M Harriott, Eli Zimmerman, Aneesh B Singhal, Michael R Jaff, Mark E Lindsay, Guy A Rordorf
BACKGROUND: Fibromuscular dysplasia (FMD) is a rare noninflammatory, nonatherosclerotic arteriopathy of medium-sized arteries affecting up to 7% of the population. The disease can affect any artery but commonly affects renal, extracranial carotid, and vertebral arteries. The epidemiology and natural course of cerebrovascular FMD is unknown and requires further investigation. METHODS: We present demographic and outcomes data on a case series of 81 patients with cerebrovascular FMD from Massachusetts General Hospital presenting between 2011 and 2015 followed by a review of the peer-reviewed literature...
June 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/28679849/mendelian-genes-and-risk-of-intracerebral-hemorrhage-and-small-vessel-ischemic-stroke-in-sporadic-cases
#12
Michael Chong, Martin O'Donnell, Vincent Thijs, Antonio Dans, Patricio López-Jaramillo, Diego Gómez-Arbeláez, Charles Mondo, Anna Czlonkowska, Marta Skowronska, Shahram Oveisgharan, Salim Yusuf, Guillaume Paré
BACKGROUND AND PURPOSE: Mendelian strokes are rare genetic disorders characterized by early-onset small-vessel stroke. Although extensively studied among families with syndromic features, whether these genes affect risk among sporadic cases is unknown. METHODS: We sequenced 8 genes responsible for Mendelian stroke in a case-control study of sporadic stroke cases (≤70 years). Participants included 1251 primary stroke cases of small-vessel pathology (637 intracerebral hemorrhage and 614 small-vessel ischemic stroke cases) and 1716 controls from the INTERSTROKE study (Study of the Importance of Conventional and Emerging Risk Factors of Stroke in Different Regions and Ethnic Groups of the World)...
July 5, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28673423/chagas-disease
#13
REVIEW
José A Pérez-Molina, Israel Molina
Chagas disease is an anthropozoonosis from the American continent that has spread from its original boundaries through migration. It is caused by the protozoan Trypanosoma cruzi, which was identified in the first decade of the 20th century. Once acute infection resolves, patients can develop chronic disease, which in up to 30-40% of cases is characterised by cardiomyopathy, arrhythmias, megaviscera, and, more rarely, polyneuropathy and stroke. Even after more than a century, many challenges remain unresolved, since epidemiological control and diagnostic, therapeutic, and prognostic methods must be improved...
June 30, 2017: Lancet
https://www.readbyqxmd.com/read/28672907/good-recovery-of-subarachnoid-hemorrhage-concomitant-with-ischemia-due-to-anterior-cerebral-artery-dissection-by-conservative-treatment-a-case-report
#14
Yiqi Wang, Yu Geng, Zongjie Shi, Tianming Shi, Jinhua Zhang
The present report describes the case of a 57-year-old woman presenting with subarachnoid hemorrhage (SAH) and acute ischemic stroke (AIS) due to anterior cerebral artery (ACA) dissection, which exhibited severe stenosis at the origin with distal dilatation of the A2 segment and occlusion of the A3 segment. In this case, computed tomography (CT) revealed SAH in right superior frontal sulcus and the interhemispheric fissure. Magnetic resonance imaging demonstrated acute infarct in the territory of the right ACA...
July 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28670986/-periprosthetic-joint-infection-caused-by-rhodococcus-equi-case-report
#15
Imre Sallai, Nóra Péterfy, Mohammad Sanatkhani, Zoltán Bejek, Imre Antal, Gyula Prinz, Katalin Kristóf, Gábor Skaliczki
Rhodococcus equi is a rare pathogen in humans causing infections mostly in immunocompromised hosts. We present the first case of periprosthetic joint infection caused by Rhodococcus equi. An 88-year-old male patient was referred to our clinic with a history of fever and right hip pain. The patient had multiple hip surgeries including total joint arthroplasty and revision for aseptic loosening on the right side. He was immunocompetent, but his additional medical history was remarkable for diabetes mellitus, diabetic nephropathy and stroke with hemiplegia resulting in immobilization...
July 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28667815/pulmonary-thromboembolism-in-an-emergency-hospital-are-our-patients-different
#16
Ana Maria Balahura, Andrada Guţă, Vlad Mihalcea, Emma Weiss, Maria Dorobanţu, Daniela Bartoş, Elisabeta Bădilă, Gheorghe Andrei Dan
INTRODUCTION: Pulmonary embolism (PTE) represents a medical emergency and is the third most common cause of mortality after myocardial infarction and stroke. The purpose of this study was to describe the characteristics and management of patients with PTE admitted in a referral emergency hospital in Romania. MATERIAL AND METHODS: We retrospectively reviewed all cases of PTE diagnosed in one of the largest emergency hospitals in Bucharest during a 2-year period (January 2014 - December 2016)...
June 27, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28662876/herpes-zoster-involving-the-second-division-of%C3%A2-the-trigeminal-nerve-case-report-and-literature%C3%A2-review
#17
Rebecca Paquin, Lisiane F Susin, Garrett Welch, Jonathan B Barnes, Mark R Stevens, Franklin R Tay
Herpes zoster along the maxillary division of the trigeminal nerve is a rare condition that is caused by reactivation of the varicella zoster virus that resides within the trigeminal ganglion after the primary infection of chickenpox. The disease may be manifested as a toothache during its prodromal stage. The active stage of the disease is characterized by the appearance of a vesicular rash. Postherpetic neuralgia is a common complication of herpes zoster after resolution of the facial and intraoral symptoms...
June 26, 2017: Journal of Endodontics
https://www.readbyqxmd.com/read/28658884/post-stroke-psychosis-following-lesions-in-basal-ganglion
#18
Shruti Srivastava, Mukul P Agarwal, Ankur Gautam
Stroke is the second most common cause of death and fourth leading cause of disability worldwide. Post stroke behavioural manifestations are often not recognized, undiagnosed and hence remain untreated. They may even suffer from misdiagnosis of functional disorders before coming at conclusion of organic pathology. Early diagnosis and prompt treatment helps in lowering the overall morbidity related to stroke and improves quality of life of these patients with rare manifestations. Here, we report two cases of elderly female patients presenting with delusions and hallucinations subsequent to stroke, with lesions in basal ganglia detected on neuro-imaging...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28648416/primary-percutaneous-coronary-intervention-for-acute-st-elevation-myocardial-infarction-outcomes-and-determinants-of-outcomes-a-tertiary-care-center-study-from-north-india
#19
Gajendra Dubey, Sunil Kumar Verma, Vinay Kumar Bahl
BACKGROUND: Primary percutaneous coronary intervention (PCI) is the current standard of care for acute ST elevation myocardial infarction (STEMI). Most of the data on primary PCI in acute STEMI is from western countries. We studied the outcomes of primary PCI for acute STEMI at a tertiary care center in North India. METHODS: Consecutive patients undergoing primary PCI for STEMI were prospectively studied during the period from February 2103 to May 2015. The outcomes assessed were all cause in hospital mortality, factors associated with mortality, major adverse cardiac and cerebrovascular event rate (composite of all cause in hospital mortality, non-fatal re infarction and stroke) and procedural complications...
May 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28647711/down-syndrome-and-moyamoya-disease-unusual-cause-of-stroke
#20
Carlos Tavares Bello, Catarina Barreiros, Inês Gil, Carlos Vasconcelos
Down syndrome is a frequent clinical entity, being considered one of the most frequent chromosomal aberrations. It is characterised by a typical clinical phenotype and is associated with a heterogeneous group of organ and system-specific abnormalities. The cardiovascular system is commonly affected and if so, it may be associated with an increased morbidity and mortality. Cerebrovascular events in patients with Down syndrome are multifactorial, being possibly related to congenital heart disease, vascular malformations and traditional cardiovascular risk factors...
June 24, 2017: BMJ Case Reports
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