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Rare causes of stroke

Vera Spatenkova, Pavlina Krejzarova, Jaroslav Jedlicka
Introduction: Dysphagia is a risk factor for aspiration pneumonia and acute respiratory failure in acute stroke patients. Dysphagia lusoria is caused by compression on the esophagus from artery lusoria, when the aberrant right subclavian artery arises from the descending aortic arch. We present a rare case report of pre-stroke undiagnosed dysphagia lusoria as a cause of aspiration pneumonia with acute respiratory failure in a 67-year-old female patient admitted with a minor left intracerebral hemorrhage in the left basal ganglia...
2018: SAGE Open Medical Case Reports
Turgut Tatlisumak, Brett Cucchiara, Satoshi Kuroda, Scott E Kasner, Jukka Putaala
Nontraumatic intracerebral haemorrhage (ICH) is a common subtype of stroke with a poor prognosis, high mortality and long-term morbidity. The incidence of ICH increases with age. ICH has not been widely investigated in young adults (herein defined as aged ∼18-50 years) despite an annual incidence of ∼5 per 100,000 individuals. Furthermore, ICH characteristics differ between young and elderly patients. Risk factors for ICH are surprisingly common in young adults, in whom ICH is often caused by structural lesions or hypertension, and only rarely by anticoagulation therapy and cerebral amyloid angiopathy (which are common predisposing factors in elderly patients)...
March 9, 2018: Nature Reviews. Neurology
Fernando Peixoto Ferraz de Campos, Marcia Yoshie Kanegae, Vera Demarchi Aiello, Pedro José Dos Santos, Tatiane Carneiro Gratão, Erasmo Simão Silva
Central nervous system (CNS) ischemic events, besides being a common and devastating disease, are accompanied by severe disability and other morbidities. The cause of such events is not always that simple to diagnose, and among the young, a broad spectrum of possibilities should be considered. We present the case of a young man who presented two episodes of CNS ischemia with a 1 year gap between them, which occurred in the same situation while he was walking and carrying a heavy backpack. The second event first presented as a transient ischemic attack followed by a stroke the day after...
January 2018: Autopsy & Case Reports
Yutaka Igarashi, Takahiro Kanaya, Shoji Yokobori, Takeshi Tsukamoto, Hiroyuki Yokota
PURPOSE: Cerebrovascular ischaemia is a rare but serious complication of damage to the carotid or vertebral arteries in the neck caused by blunt injury to the neck. Screening for blunt cerebrovascular injury should be performed in patients with certain signs or symptoms and risk factors. We described a case of traumatic bilateral vertebral artery injury (VAI) including unilateral vertebral arterial occlusion that resolved 3 months post-injury with antiplatelet and direct oral anticoagulant therapy...
March 1, 2018: European Spine Journal
Meng Luen Lee, Ming Yuh Chang, Tung Ming Chang, Rei Cheng Yang, Ming Che Chang, Albert D Yang
Concurrent involvement of bilateral renal and cerebral arteries, usually incurred as stenosis, is rare in childhood-onset Takayasu arteritis (c-TA). We report the case of a 14-year-old girl, with c-TA, presenting with transient ischemic attack after endovascular revascularization for renal artery stenosis and cerebrovascular stroke after surgical revascularization for cerebral artery stenosis associated with childhood-onset moyamoya syndrome. We deem that decrease of blood pressure by endovascular revascularization and improvement of cerebral perfusion by surgical revascularization may have jeopardized the cerebral deep watershed zone to cerebral ischemia followed by cerebral hyperperfusion syndrome and caused transient ischemic attack and cerebrovascular stroke in our patient...
March 5, 2018: Journal of Korean Medical Science
Raja K Kutty, Jacob Paul Alapatt, Aparna Govindan
Yawning, a physiologic reflex exhibited by vertebrates, is seldom noticed as a symptom of a disease. Not too often is a patient aware of it as a symptom, unless it is of such a distressing nature to seek attention. In this situation, to distinguish between normal and abnormal behavior would pose a diagnostic dilemma for the attending physician. Intractable yawning has been a presenting symptom of many pathologic states such as stroke, epilepsy, and migraine. Literature is sparse regarding intractable yawning caused by tumors of the brain...
January 2018: Asian Journal of Neurosurgery
Tsuneo Nakajima, Toshihiro Sakai, Hitoshi Hara
We report a forty-six-year-old man with a past history of brain abscess managed by surgical drainage and recurrent ischemic strokes. After treatment of brain abscess, he had been on medication for symptomatic epilepsy, but had ceased medication by his judgment. He was taken to a hospital in an ambulance for an epileptic seizure. In the hospital he suffered from drug-induced renal dysfunction caused by the intravenous anti-epileptic drug, and right hemiparesis due to ischemic stroke occurred on the third hospitalization day...
February 28, 2018: Rinshō Shinkeigaku, Clinical Neurology
Magda R Hamczyk, Ricardo Villa-Bellosta, Pilar Gonzalo, María J Andrés-Manzano, Paula Nogales, Jacob F Bentzon, Carlos López-Otín, Vicente Andrés
Background -Progerin, an aberrant protein that accumulates with age, causes the rare genetic disease Hutchinson-Gilford progeria syndrome (HGPS). HGPS patients with ubiquitous progerin expression exhibit accelerated aging and atherosclerosis, and die in their early teens mainly from myocardial infarction or stroke. The mechanisms underlying progerin-induced atherosclerosis remain unexplored, in part due to the lack of appropriate animal models. Methods -We generated an atherosclerosis-prone model of HGPS by crossing apolipoprotein E-deficient ( Apoe-/- ) mice with LmnaG609G/G609G mice ubiquitously expressing progerin...
February 28, 2018: Circulation
Nilesh H Pawar, Oliver J Nickalls, Keng Leong Tan, Vui K Ho, Shin Yi Ng, Jiashen Loh
Streptococcus pneumoniae (S. pneumoniae) is a significant human bacterial pathogen and the major cause of pneumonia. In the post-antibiotic era, S. pneumoniae endocarditis is rare but carries a high risk of central nervous system (CNS) involvement. We present a case of invasive S. pneumoniae infection, which led to a cardioembolic stroke in a young man from septic emboli. Diagnosing a disseminated S. pneumoniae infection at an early stage is crucial and may improve patient outcomes.
December 18, 2017: Curēus
Tianxi Zhang, Yan Wang, Peng Ye, Jiaji Liu, Yun Cheng, Shuhong Wang, Jan Rohozinski, Yuanyuan Zhang, Anyong Yu
Despite common injury caused by snakebite, snakebite-induced ischemic stroke is rare. We reported on a patient who incurred a large cerebral infarction after being bitten by a Deinagkistrodon acutus, one of the most poisonous snakes in the southwestern of China. Applying 3D computed tomography (CT) of head combined with cerebral angiography examinations showed a large cerebral infarction, hernia in the right brain, developmental abnormalities of the right middle cerebral artery and cerebral artery of right brain...
2018: Journal of X-ray Science and Technology
Yoshinori Maki, Ryota Ishibashi, Hitoshi Fukuda, Miyako Kobayashi, Masaki Chin, Sen Yamagata
Vertebral arteriovenous fistula (VAVF), which can cause subarachnoid hemorrhage (SAH) when having a perimedurally drainage, has been reported as a rare vascular abnormality in patients with neurofibromatosis type 1 (NF-1). In addition, extracranial vertebral aneurysm (EVAn) coexisting with VAVF and NF-1 is considered rare, and further complication with SAH is extremely rare in patients. There is only one reported case of NF-1 complicated with SAH from VAVF with an EVAn. Here, we present a case of a middle-aged patient with NF-1...
February 23, 2018: Neurologia Medico-chirurgica
Szu-Ju Chen, Li-Kai Tsai, Sung-Chun Tang, Jiann-Shing Jeng
PURPOSE: Isolated basilar artery dissection (BAD) is a rare cause of ischemic stroke. Since the clinical presentations and imaging findings could be non-specific and subtle, the diagnosis may be difficult. Here, we presented four cases of isolated BAD with acute ischemic stroke. CASE REPORT: Four patients (age, 22 to 57 years) experienced acute onset of hemiparesis and/or vertigo with half of them having initial headache. Acute infarct was noted at pons or thalamus...
September 15, 2017: Acta Neurologica Taiwanica
Qi Liu, Xianwei Wang, Yilong Wang, Chunxue Wang, Xingquan Zhao, Liping Liu, Zixiao Li, Xia Meng, Li Guo, Yongjun Wang
BACKGROUNDS: The previous studies on the association between marital status and stroke outcomes were rare. Furthermore, the existing studies mostly focused on the protective effect of marriage on survival. We conducted the study to evaluate the association between marital status and adverse stroke outcomes in patients with AIS based on China national stroke registry. METHODS: This was a multicenter, prospective cohort study of patients with AIS. Patients were classified into two groups based on marital status at admission: married and unmarried...
February 20, 2018: Journal of Neurology
Philipp Erhart, Tobias Brandt, Beate K Straub, Ingrid Hausser, Sabine Hentze, Dittmar Böckler, Caspar Grond-Ginsbach
BACKGROUND AND PURPOSE: A recurrent duplication of chromosome 16p13.1 was associated with aortic dissection as well as with cervical artery dissection. We explore the segregation of this duplication in a family with familial aortic disease. METHODS: Whole exome sequencing (WES) analysis was performed in a patient with a family history of aortic diseases and ischemic stroke due to an aortic dissection extending into both carotid arteries. RESULTS: The index patient, his affected father, and an affected sister of his father carried a large duplication of region 16p13...
February 14, 2018: Molecular Genetics & Genomic Medicine
Federico Pacei, Luca Quilici, Stephen Mullin, Alessandro Innocenti, Luca Valvassori, Raffaele Nardone, Luciano Bet
Ischemic stroke has rarely been reported in association with a web of the carotid artery. We describe here an additional case of ischemic stroke caused by a carotid web in a young healthy woman. Detection of this vascular abnormality required the use of CT angiography and cerebral digital subtraction angiography. Although there is little evidence regarding the optimal management of this condition, under medical treatment with dual antiplatelet therapy our patient remained free of recurrent stroke events. This case report study illustrates that the web of the carotid artery is an uncommon cause of stroke which should always be considered and ruled out, especially in young patients with otherwise cryptogenic stroke...
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Yan Wang, Yoon Choi, Joshuae Gallardo, Ifeoma Nwaneri, James R Brorson
OBJECTIVE: We aimed to evaluate the yield of extensive etiologic workup in lacunar stroke patients. BACKGROUND: As lacunar strokes are infrequently caused by thromboembolism, the clinical relevance of extensive workup for thromboembolic sources is questioned. METHODS: Among consecutive stroke admissions to a single center over 3 years, the 100 cases initially classified as lacunar stroke and a sample of 100 cases classified as non-lacunar ischemic strokes were studied...
February 6, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Sandra Sousa, Nuno Vasco Costa, Cátia Carmona, Élia Coimbra, Fernando Pita
Introduction: Cryptogenic stroke is present in about 40% of ischemic stroke patients. Extracardiac shunt related to pulmonary arteriovenous fistula (PAVF) could be a rare potential risk factor for embolic stroke. Most PAVFs are multiple, congenital, and associated with hereditary conditions. On the other hand, isolated PAVFs are rare conditions and an uncommon cause of cryptogenic stoke. Case Report: We describe a case of a young woman without history of respiratory diseases or vascular risk factors, who presented with acute onset of transitory aphasia and right hemiplegia...
September 2017: Case Reports in Neurology
Sunil Kumar Garg, Pragya Garg, Mehmet Urumdas
Pheochromocytoma is a rare cause of hypertension, but it could have severe consequences if not recognized and treated appropriately. Pheochromocytoma classically presents with paroxysms of hypertension and adrenergic symptoms including classic triad of episodic headache, sweating, and tachycardia. The clinical presentation of pheochromocytoma can mimic a number of other medical conditions including migraine, cardiac arrhythmias, myocardial infarction, and stroke, thus making the diagnosis of pheochromocytoma difficult, and treatment is directed toward presenting issue rather than underlying problem in such patients...
January 2018: Indian Journal of Critical Care Medicine
Dean Walton, Michael Bonello, Malcolm Steiger
A 78-year-old woman presented with involuntary movements of her abdomen, which started after a right hemispheric stroke. She had irregular, variable, hyperkinetic predominantly right-sided abdominal wall movements. MR scan of brain confirmed a recent infarct in the right occipitotemporal lobe and the right cerebellum. Diaphragmatic fluoroscopy confirmed high-frequency flutter as the cause of her abdominal movements and confirmed the diagnosis of van Leeuwenhoek's disease. Anthonie van Leeuwenhoek first described this condition in 1723 and had the condition himself...
February 1, 2018: Practical Neurology
Josef Finsterer, Sinda Zarrouk-Mahjoub
Headache is a prominent feature in mitochondrial disorders (MIDs) but no comprehensive overview is currently available. This review aims at summarising and discussing findings concerning type, frequency, pathogenesis, and treatment of headache in MIDs. The most frequent headache types in MIDs are migraine and migraine-like headache (MLH). MLH is classified as secondary headache. More rarely, tension-type headache, trigemino-autonomic headache, or different secondary headaches can be found. Migraine or MLH may manifest with or without aura...
January 26, 2018: Clinical Neurology and Neurosurgery
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