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https://www.readbyqxmd.com/read/29147130/mobile-mass-in-the-aortic-arch-a-case-report
#1
Fatemeh Ghani-Dehkordi, Rostam Esfandiyari-Bakhtiyari, Firoozeh Alirezaee-Shahraki
BACKGROUND: The finding of a floating mass in the aortic arch is rare and the management remains controversial. CASE REPORT: We describe a 42-year-old woman with an embolic infarction in whom transesophageal echocardiography revealed a mobile mass in the aortic arch that was characterized as atherothrombi with an evidence of embolic infarction in the territory of the middle cerebral artery. Treatment with antiplatelet and anticoagulants failed to resolve the mass and is surgically resected...
July 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/29111002/free-fatty-acid-as-a-determinant-of-ischemic-lesion-volume-in-nonarterial-origin-embolic-stroke
#2
Jong-Won Chung, Woo-Keun Seo, Gyeong-Moon Kim, Chin-Sang Chung, Kwang Ho Lee, Oh Young Bang
GOALS: This study aimed to determine whether the plasma levels of free fatty acid (FFA) are associated with ischemic lesion characteristics in nonarterial-origin embolic stroke. MATERIALS AND METHODS: We prospectively recruited 254 patients with acute cerebral infarction caused by cardioembolic stroke (CES, n=121) or with embolic stroke of undetermined source (ESUS, n=133). Plasma levels of FFA were measured during the acute stage (median of 2days after stroke onset)...
November 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29108806/cerebral-infarcts-by-nonbacterial-thrombotic-endocarditis-associated-with-adenomyosis-a-case-report
#3
Byungseok Kim, Seong-Hoon Kim, Taewon Kim
We report a case of multiple embolic cerebral infarcts associated with nonbacterial thrombotic endocarditis (NBTE) in a patient with adenomyosis. The patient presented with dysarthria, left perioral sensory change, and left-hand weakness. Magnetic resonance imaging revealed multiple vascular territory infarctions involving the bilateral cerebellum and the right precentral gyrus. Magnetic resonance angiography was normal. d-Dimer, carbohydrate antigen (CA) 19-9, and CA125 levels were elevated. Abdominal and pelvic computed tomography with iodine contrast enhancement revealed a huge adenomyosis with left ovarian cyst...
November 3, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29104201/-cardiac-perforation-after-pacemaker-implantation-report-of-a-case
#4
Yuko Ohashi, Kazuhiro Ohkura, Ayano Yamada
A 71-year-old woman was diagnosed with sick sinus syndrome (SSS) upon her cardiogenic cerebral embolism and underwent pacemaker implantation. Active fixation leads were positioned at the right atrial appendage and ventricular septum. Twenty-one days later at her routine checkup, she was asymptomatic and there were no signs of cardiac tamponade or pacing failure. But echocardiography and computed tomography revealed a large amount of pericardial effusion due to the lead perforation. We performed open drainage because her anticoagulant could not be stopped for her history of cerebral infarction...
November 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29049819/treatment-of-a-degenerated-sutureless-sorin-perceval%C3%A2-valve-using-an-edwards-sapien-3
#5
Norman Mangner, David Holzhey, Martin Misfeld, Axel Linke
Valve-in-valve implantation is an alternative to reoperation for patients with degenerated bioprostheses. This case report presents a 75-year-old woman presenting with worsening dyspnoea according New York Heart Association (NYHA) Class III after she had received a Sorin Perceval® S sutureless valve due to severe aortic valve stenosis 5 years ago. Echocardiography revealed a degenerated Perceval valve with severe valvular aortic regurgitation and stenosis. After exclusion of acute infective endocarditis, an Edwards SAPIEN 3 was implanted leading to an immediate haemodynamic improvement...
October 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29031497/patent-foramen-ovale-and-the-risk-of-cerebral-infarcts-in-acute-pulmonary-embolism-a-prospective-observational-study
#6
David Vindiš, Martin Hutyra, Daniel Šaňák, Michal Král, Eva Čecháková, Simona Littnerová, Tomáš Adam, Jan Přeček, Štěpán Hudec, Markéta Ječmenová, Miloš Táborský
BACKGROUND: Pulmonary embolism (PE) is associated with a risk of consecutive paradoxical embolism with brain infarction through a patent foramen ovale (PFO). The aims of this study were to assess the rate of new ischemic brain lesions (IBLs) using magnetic resonance imaging (MRI) during a 12-month follow-up period with anticoagulation and to evaluate the potential relationship with the presence of PFO on transesophageal echocardiography (TEE). SUBJECTS AND METHODS: Seventy-eight patients with acute PE underwent baseline contrast TEE with brain MRI...
October 11, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28993037/reversible-stress-cardiomyopathy-secondary-to-aneurysmal-subarachnoid-hemorrhage-a-case-report
#7
Konstantinos Lampropoulos, Evangelos Giannoulis, Bazoukis George, Gary Tse, Epameinondas Triantafyllou, Athanasios Triantafyllou
BACKGROUND: Acute cerebral incidents have been correlated with cardiac manifestations. Specifically, subarachnoid hemorrhage has been correlated with a syndrome described as neurogenic stress cardiomyopathy and mimics acute coronary syndrome. CASE REPORT: A 55-year-old woman presented at the Emergency Department of our hospital complaining of vomiting and headache of sudden onset. Computed tomography angiography revealed a ruptured aneurysm at the tip of the basilar artery and the patient underwent a successful complete embolism of the sac of the aneurysm...
October 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28966589/recurrent-patent-foramen-ovale-related-cerebral-infarcts-alternately-causing-bilateral-hand-paresis
#8
Seung-Jae Lee
Isolated hand paresis is a rare presentation of stroke, which mostly results from a lesion in the cortical hand motor area, a knob-like area within the precentral gyrus. I report the case of a patient who experienced recurrent ischemic stroke alternately involving bilateral hand knob areas, causing isolated hand paresis. There was no abnormal finding on brain and neck magnetic resonance angiography, transthoracic echocardiography, and 48-h Holter monitoring, and there were no abnormal immunologic and coagulation laboratory findings...
May 2017: Case Reports in Neurology
https://www.readbyqxmd.com/read/28954974/a-case-of-cerebral-embolism-with-a-large-thrombus-in-the-left-atrium-and-a-recurrence-of-thrombus-in-the-left-atrium-after-the-maze-procedure
#9
Masafumi Arakawa, Takashi Shimoyama, Noriko Matsumoto, Satoshi Suda, Jiro Kurita, Kazumi Kimura
A 67-year-old woman developed weakness of the entire left side of the body and disturbance of consciousness, and was admitted to our hospital. She had atrial fibrillation (AF) on arrival at the hospital. Diffusion weighted magnetic resonance imaging showed high intensity area in the right basal ganglia, and magnetic resonance angiography showed occlusion of the right internal carotid artery (ICA). Thrombolytic therapy with intravenous tissue plasminogen activator (IV tPA) was administered 225 minutes after onset, and endovascular procedure also performed...
October 27, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28885101/association-between-the-maximal-distance-of-atrial-septal-protrusion-and-cryptogenic-stroke
#10
Keisuke Tokunaga, Masahiro Yasaka, Takahiro Kuwashiro, Seiji Gotoh, Asako Nakamura, Go Takaguchi, Tetsuro Ago, Masahiro Kamouchi, Takanari Kitazono, Yasushi Okada
Background and purpose Previous studies have suggested that atrial septal aneurysm is a potential risk factor for cerebral embolism. However, the association between the level of atrial septal protrusion and cerebral embolism is still unclear. The purpose of the present study was to assess the association between the maximal distance of atrial septal protrusion and cryptogenic stroke. Methods A total of 588 consecutive acute ischemic stroke patients (70 ± 11 (mean ± SD) years, 401 men) who underwent transesophageal echocardiography were enrolled...
December 20, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28872450/the-association-between-aortic-regurgitation-and-undetermined-embolic-infarction-with-aortic-complex-plaque
#11
Dae-Won Kim, Jung Sun Cho, Jae Yeong Cho, Kye Hun Kim, Byung Joo Sun, Jae-Hyeong Park
Background Retrograde embolism from the descending thoracic aorta is one possible cause of undetermined ischemic stroke. Significant aortic regurgitation can increase the amount of reversed flow in the thoracic aorta and thus is associated with an increased incidence of stroke. Aims This study aimed to examine the association between significant aortic regurgitation and undetermined embolic infarction with aortic complex plaques. Methods This study included 380 patients with undetermined embolic stroke who did not have abnormal flow such as atrial septal defect, patent foramen ovale determined by agitated saline bubble test, intracardiac thrombi on transesophageal echocardiography, atrial fibrillation, or small vessel stroke, cerebral artery, and carotid stenosis on the brain magnetic resonance imaging...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28813763/simultaneous-onset-of-deep-vein-thrombosis-pulmonary-embolism-cerebral-infarction-and-myocardial-infarction-in-a-patient-with-patent-foramen-ovale
#12
Jimmy Yee, Vishesh Kumar, Alex Pham, Kashif Shaikh, Muhammad Omar, Adam Stys, Marian Petrasko
Paradoxical embolism is a known complication with intra-cardiac shunts. It should be considered in the differential as the pathophysiologic mechanism of simultaneous thromboembolism in the venous and systemic vasculature. We present a case of simultaneous deep venous thrombosis, pulmonary embolism and myocardial infarction in the presence of a confirmed patent foramen ovale on echocardiography. Thrombolytic therapy was administered. Subsequent concerns of intracranial hemorrhage on imaging of the brain complicated the management and added to the challenge of co-managing the clot burden in our patient...
June 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28707135/secondary-stroke-prevention-in-cryptogenic-stroke-and-embolic-stroke-of-undetermined-source-esus
#13
REVIEW
Hans-Christoph Diener, Richard Bernstein, Robert Hart
PURPOSE OF THE REVIEW: The purpose of the study was to review the literature on cryptogenic stroke and embolic stroke of undetermined stroke (ESUS). Cryptogenic stroke according to TOAST criteria is a stroke which is not due to cardiogenic embolism, small vessel disease with lacunes or large vessel disease of brain supplying arteries. In the context of secondary stroke prevention studies, cryptogenic stroke is not operationally defined. RECENT FINDINGS: The new concept of "embolic stroke of undetermined source" (ESUS) provides an operational definition...
September 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28630395/cerebral-infarction-by-paradoxical-gas-embolism-during-laparoscopic-liver-resection-with-injury-of-the-hepatic-vessels-in-a-patient-without-a-right-to-left-systemic-shunt
#14
Toshiyasu Kawahara, Masahiro Hagiwara, Hiroyuki Takahashi, Mariko Tanaka, Koji Imai, Jun Sawada, Takayuki Kunisawa, Hiroyuki Furukawa
BACKGROUND Carbon dioxide (CO2) is believed to be the safest gas for laparoscopic surgery, which is a standard procedure. We experienced severe cerebral infarction caused by paradoxical CO2 embolism during laparoscopic liver resection with injury of the hepatic vessels despite the absence of a right-to-left systemic shunt. CASE REPORT A 60-year-old man was diagnosed with hepatocellular carcinoma in the right hepatic lobe secondary to alcoholic liver disease. We planned the laparoscopy-assisted liver resection...
June 20, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28547872/cerebral-white-matter-lesion-burden-is-associated-with-the-degree-of-aortic-valve-calcification-and-predicts-peri-procedural-cerebrovascular-events-in-patients-undergoing-transcatheter-aortic-valve-implantation-tavi
#15
Jonas Doerner, Patrick A Kupczyk, Marius Wilsing, Julian A Luetkens, Klaus Storm, Rolf Fimmers, Tilman Hickethier, Lars Eichhorn, Claas P Naehle, Hans H Schild, Nikos Werner, Georg Nickenig, Alexander Ghanem
OBJECTIVES: To investigate the impact of aortic valve calcification and brain morphology on acute peri-procedural cerebrovascular events (CVEs) in patients undergoing transcatheter aortic valve implantation (TAVI). BACKGROUND: Aortic valve calcification and stenosis can be assessed with echocardiography. Cerebral magnetic resonance imaging (MRI) depicts and quantifies morphological signs of hypoperfusion and vascular embolism, which is of special interest in patients with severe aortic stenosis...
May 26, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28526040/catching-a-floating-thrombus-a-case-report-on-the-treatment-of-a-large-thrombus-in-the-ascending-aorta
#16
Gijs Eduard de Maat, Giorgio Vigano, Massimo Alessandro Mariani, Ehsan Natour
BACKGROUND: The ascending aorta is an uncommon site for non-infective thrombus. In non-aneurysmal and non-atherosclerotic vessels this condition becomes extremely rare, while it represents a source of potential cerebral and peripheral embolic events. Currently, there is no consensus in the guidelines on how to treat a free floating thrombus in ascending aorta, therefore we present our decision making process and therapeutic strategy. CASE PRESENTATION: A healthy 48-year-old man was hospital admitted with acute abdominal pain...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28486992/small-smooth-nonmobile-cardiac-myxoma-detected-by-transesophageal-echocardiography-following-recurrent-cerebral-infarction-a-case-report
#17
Yuki Saito, Yoshihiro Aizawa, Koyuru Monno, Koichi Nagashima, Sayaka Kurokawa, Shunji Osaka, Takayoshi Akimoto, Satoshi Kamei, Masashi Tanaka, Atsushi Hirayama
BACKGROUND: Cardiac myxoma is known to cause repeated events of cerebral embolism. Soft and irregularly shaped myxomas with high mobility are associated with a higher occurrence of cerebral embolism. In contrast, nonmobile cardiac myxomas with a round regular shape are rarely considered to be a cause of cerebral embolism. In this case, we present a patient with recurrent cerebral embolism associated with a small and nonmobile cardiac myxoma of round regular shape. CASE PRESENTATION: A 76-year-old Japanese man presented to our hospital with weakness in his right upper extremity...
May 10, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28482355/visualization-of-atrial-septal-aneurysm-and-patent-foramen-ovale-by-three-dimensional-transesophageal-echocardiography
#18
Mohammad Q Najib, Jhansi L Ganji, Hari P Chaliki
: Transesophageal echocardiography is frequently performed for further evaluation of sources of embolism and better evaluation of atrial septum in patients with cerebral ishemic events. Although two-dimensional transesophageal echocardiography can depict atrial septal aneurysm and patent foramen ovale, the full extent of the patent foramen ovale cannot be easily discerned in some cases. We describe a patient with transient cerebral ischemia where three-dimensional echocardiography provided incremental value when compared to two-dimensional transesophageal echocardiography in the assessment of atrial septal aneurysm and patent foramen ovale...
December 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28458927/papillary-fibroelastoma-as-a-cause-of-cardiogenic-embolic-stroke-in-a-%C3%AE-thalassemia-patient-case-report-and-literature-review
#19
Re-I Chin, John J Monda, Maulik Sheth, William Ogle, Gloria Merenda, Debapriya De
We describe a case of a young male without stroke risk factors who presented with a sudden onset of left-sided weakness, left hand numbness, and left eye blurriness. CT scan of the head without contrast and diffusion-weighted MRI of the brain with contrast revealed an ischemic stroke in the right middle cerebral artery distribution. Transesophageal echocardiography (TEE) revealed a mobile pedunculated mass on the posterior surface of the mitral valve. This mass was resected and pathology showed a cardiac papillary fibroelastoma (CPFE), which was determined to be the cause of the patient's cardioembolic stroke...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28443583/retrograde-cerebral-air-embolism-in-a-patient-with-intestinal-necrosis-a-case-report
#20
Onur Taydaş, Mehmet Ruhi Onur, Erhan Akpınar
BACKGROUND: Cerebral venous air embolism is a severe clinical condition related to an unfavourable outcome in patients with neurological impairment. Cerebral venous air embolism may occur secondarily to arterial or venous interventions. A rare mechanism of cerebral venous air embolism is retrograde embolism, which is characterized by gas flow in a direction that is opposite to that of the normal blood flow. CASE REPORT: A 69-year-old female was admitted to our hospital with shortness of breath and abdominal pain...
August 4, 2017: Balkan Medical Journal
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