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https://www.readbyqxmd.com/read/28220368/embolization-of-ruptured-arteriovenous-malformations-in-the-cerebellopontine-angle-cistern
#1
Hidenori Endo, Shin-Ichiro Osawa, Yasushi Matsumoto, Toshiki Endo, Kenichi Sato, Kuniyasu Niizuma, Miki Fujimura, Teiji Tominaga
Among brainstem arteriovenous malformations (AVMs), there exist small AVMs predominantly located in the cerebellopontine angle cistern (CPAC) with minimal extension into the pial surface of the brainstem. However, previous studies of CPAC AVMs did not particularly discuss the role of embolization in the treatment of these lesions. This study was conducted to clarify the effectiveness and validity of embolization in the treatment of CPAC AVMs. We retrospectively reviewed five patients with CPAC AVMs who underwent endovascular treatment...
February 20, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28163514/pilocytic-midbrain-astrocytoma-presenting-with-fresh-bleed-after-twenty-one-years-survival-following-first-surgery-a-unique-case-of-longest-brainstem-glioma-survival
#2
Guru Dutta Satyarthee, M D Sudhan, V S Mehta
Brainstem glioma usually carries a poor prognosis and prolonged survival is very infrequent. In a detailed Pubmed, Medline search for prolonged survival, authors could got a longest survival only up to seventeen years, reported by Umehara et al, who was subjected to gamma knife therapy and got symptomatic, MRI brain reveled large tumor growth during pregnancy necessitating emergency surgery and histopathological diagnosis was pilocytic astrocytoma. Authors report an interesting case of midbrain glioma diagnosed 21 years back, who underwent gross resection in the year 1993, histopathology was pilocytic astrocytoma, WHO grade I, and received gamma knife surgery for residual subsequently and he presented with sudden onset left sided hemiplegia on the current admission...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28143728/isolated-internuclear-ophthalmoplegia-after-massive-supratentorial-epidural-hematoma-a-case-report-and-review-of-the-literature
#3
Ko-Ting Chen, Tzu-Kang Lin, Tsung-Che Hsieh
BACKGROUND: Isolated internuclear ophthalmoplegia (INO) after traumatic brain injury (TBI) is rare, with most reported patients having minor head injuries. We report a patient with INO after a massive supratentorial epidural hematoma. We review the literature published since 1966, to summarize the mechanisms of injury and clinical outcomes of INO after TBI. CASE DESCRIPTION AND LITERATURE REVIEW: A 54-year-old woman had isolated INO 10 hours after emergent evacuation of a massive supratentorial epidural hematoma...
January 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28137897/blood-brain-and-binocular-vision
#4
Egle Rostron, Mary Polly Dickerson, Gregory Heath
A man aged 51 years presented with sudden onset, horizontal, binocular, double vision and right facial weakness. Ocular motility examination demonstrated a right horizontal gaze palsy pattern in keeping with a one-and-a-half syndrome. Since this was associated with a concomitant, ipsilateral, lower motor neuron (LMN) facial (VIIth) cranial nerve palsy, he had acquired an eight-and-a-half syndrome. Diffusion-weighted MRI confirmed a small infarcted area in the pons of the brainstem which correlated with anatomical location of the horizontal gaze centre and VIIth cranial nerve fasciculus...
January 30, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28127514/interhemispheric-characterization-of-small-vessel-disease-imaging-markers-after-subcortical-infarct
#5
Maria Del C Valdés Hernández, Xinyi Qiu, Xin Wang, Stewart Wiseman, Eleni Sakka, Lucy C Maconick, Fergus Doubal, Cathie L M Sudlow, Joanna M Wardlaw
BACKGROUND: In structural Magnetic Resonance Imaging (MRI) of patients with a recent small subcortical infarct (RSSI) and small vessel disease (SVD) imaging markers coexist. However, their spatial distribution and prevalence with respect to the hemisphere of the RSSI remain unknown. MATERIALS AND METHODS: From brain MRI in 187 patients with an acute lacunar ischemic stroke clinical syndrome and a relevant diffusion weighted imaging (DWI)-positive lesion, we semiautomatically extracted the RSSI, microbleeds, lacunes, old cortical infarcts, and white matter hyperintensities (WMH) using optimized thresholding in the relevant sequences, and rated the load of perivascular spaces...
January 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28089423/crossed-cheiro-oral-syndrome-a-warning-sign-for-medullary-involvement-and-neurological-deterioration
#6
Wei-Hsi Chen, Tsung-Pei Yang, Hsin-Ling Yin
Crossed cheiro-oral syndrome (CCOS) is characterized by crossed sensory disturbance confined to the unilateral perioral area and contralateral hand/finger(s). Although a few classical crossed sensory syndromes accurately predict brainstem or spinal involvement, the clinical significance of CCOS remains unclear. In this study, we analyzed the etiology, localization and outcome of CCOS patients. The results showed that ischemic stroke is the exclusive cause of CCOS. The location of responsible stroke is pertinent to the middle or upper level of the lateral medulla oblongata medial to the lateral sulcus...
January 12, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27960181/stroke-mechanisms
#7
Ka Sing Wong, Louis R Caplan, Jong S Kim
Recent advances in neuroimaging technologies, such as diffusion weighted magnetic resonance imaging (MRI), perfusion weighted computed tomography (CT)/MRI, MR/CT angiography and Doppler ultrasonography allow us to determine the mechanisms of stroke and transient ischemic attack. In addition, high-resolution vessel wall MRI is nowadays increasingly used to understand the stroke mechanism in patients with intracranial atherosclerosis. Artery to artery embolism, hypoperfusion and the combination of the two are the important stroke mechanisms in patients with extracranial atherosclerosis...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27888078/basilar-artery-herniation-into-the-sphenoid-sinus-secondary-to-traumatic-skull-base-fractures-case-report-and-review-of-the-literature
#8
Arthur Wang, John Wainwright, Jared Cooper, Michael S Tenner, Adesh Tandon
BACKGROUND: Traumatic clival fractures occur with less than 0.6% frequency and can be associated with significant neurovascular injuries. The most serious of these injuries is to the basilar artery in which the artery is dissected or is fully occluded, resulting in infarction of the brainstem and cerebellum. Among early reports of these injuries, postmortem autopsy showed entrapment, or incarceration, of the basilar artery at the clival fracture site. A literature search revealed 11 cases of entrapment of the basilar artery within a clival fracture...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27854093/posterior-reversible-encephalopathy-syndrome-mimicking-brainstem-infarction-a-dilemma
#9
Tsung-Han Ho, Chia-Lin Tsai, Yaw-Don Hsu, Jiunn-Tay Lee, Fu-Chi Yang, Chia-Ching Hsu, Chun-Chieh Lin
PURPOSE: We had recently reported one case at American Journal of Emergency Medicine about centralvariant posterior reversible encephalopathy syndrome (PRES) in an 84-year-old woman with an initial misdiagnosis as central pontine myelinolysis (CPM). Here, we introduce another case of centralvariant PRES in a 49-year-old man mimicking as acute brainstem infarction in the cranial computed tomography (CT) findings. CASE REPORT: A 49-year-old man was admitted to the emergency department with a 5-day history of vertigo, cognitive decline, and difficulty in walking...
June 15, 2016: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/27824897/functional-plasticity-after-unilateral-vestibular-midbrain-infarction-in-human-positron-emission-tomography
#10
Sandra Becker-Bense, Hans-Georg Buchholz, Bernhard Baier, Mathias Schreckenberger, Peter Bartenstein, Andreas Zwergal, Thomas Brandt, Marianne Dieterich
The aim of the study was to uncover mechanisms of central compensation of vestibular function at brainstem, cerebellar, and cortical levels in patients with acute unilateral midbrain infarctions presenting with an acute vestibular tone imbalance. Eight out of 17 patients with unilateral midbrain infarctions were selected on the basis of signs of a vestibular tone imbalance, e.g., graviceptive (tilts of perceived verticality) and oculomotor dysfunction (skew deviation, ocular torsion) in F18-fluordeoxyglucose (FDG)-PET at two time points: A) in the acute stage, and B) after recovery 6 months later...
2016: PloS One
https://www.readbyqxmd.com/read/27781047/functional-independence-following-endovascular-treatment-for-basilar-artery-occlusion-despite-extensive-bilateral-pontine-infarcts-on-diffusion-weighted-imaging-refuting-a-self-fulfilling-prophecy
#11
Diogo C Haussen, Renato A C Oliveira, Vikas Patel, Raul G Nogueira
BACKGROUND AND PURPOSE: Extensive brainstem diffusion-weighted imaging (DWI) hyperintensity has been associated with poor outcomes. We aim at documenting a series of patients with extensive DWI pontine lesions who achieved independence following endovascular therapy and aggressive medical therapy in the setting of posterior circulation basilar artery occlusion (BAO). METHODS: This is a retrospective endovascular database review of a single-operator experience over a 9-year period for patients with (1) complete BAO, (2) extensive bilateral pontine DWI changes and (3) 90-day modified Rankin scale 0-2...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27772756/hypertrophic-olivary-degeneration-case-series-and-review-of-literature
#12
REVIEW
Shyam Sabat, Neil Mannering, Amit Agarwal
Hypertrophic Olivary Degeneration (HOD) is a rare neurological condition caused by trans-synaptic degeneration in the brainstem and cerebellum, resulting in varied clinical symptoms, classical being palatal tremors, along with characteristic imaging presentation. Large number of pathologic lesions can cause this condition, ranging from ischemic stroke to neoplasm. The most common conditions include hemorrhage, vascular malformations and infarct. Magnetic resonance scan (MRI) is the imaging modality of choice which shows signal changes with hypertrophy of the inferior olivary nucleus, as well as the primary underlying pathology...
November 15, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27704247/childhood-acute-basilar-artery-thrombosis-successfully-treated-with-mechanical-thrombectomy-using-stent-retrievers-case-report-and-review-of-the-literature
#13
Giancarlo Nicosia, Domenico Cicala, Giuseppe Mirone, Pietro Spennato, Vincenzo Trischitta, Claudio Ruggiero, Gianluigi Guarneri, Mario Muto, Giuseppe Cinalli
INTRODUCTION: Acute basilar artery occlusion (ABAO) is an infrequent but potentially fatal cause of strokes in both adults and children, and it is usually due to vertebral artery dissection (VAD). VAD has been found to be usually a consequence of traumatic vertebral artery injury. ABAO usually presents with symptoms of acute ischemic stroke (AIS) of the posterior circulation or transient ischemic attack (TIA). It may lead to death or long-term disability if not promptly recanalized. Basilar artery recanalization in children can be achieved safely and with excellent clinical outcome using endovascular thrombectomy with the new generation self-expanding and retrievable stents...
October 4, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27680211/critical-neural-targets-for-the-level-of-human-consciousness-arousal-arrest-and-unconsciousness-after-sumatriptan-administration
#14
Jaakko W Långsjö, Kai Lehtimäki, Jyrki Ruohonen, Anne Sajanti, Satu Sandell, Hannu T Heikkilä, Antti Brander, Kari Saarinen, Lauri Herrala
BACKGROUND: Insufficient understanding of the mechanisms of consciousness can make unconsciousness a diagnostic challenge, directly effecting the treatment and the outcome of the patient. Consciousness is a product of brainstem arousal (wakefulness, the level of consciousness) and cortical information integration (awareness, the contents of consciousness). The thalamus serves as a critical hub in the arousal pathway. The nuclei within the internal medullary lamina, together with the associated thalamocortical connections, have been implicated as being especially important for human consciousness...
2016: Brain Injury: [BI]
https://www.readbyqxmd.com/read/27663557/traumatic-basilar-artery-entrapment-with-patency-of-pontine-perforators-and-absence-of-significant-brainstem-infarction-report-of-an-unusual-case
#15
Stefan Kliesch, Christian Bauknecht, Georg Bohner, Thomas Liebig, Eberhard Siebert
We report a rare case of entrapment of the basilar artery into the sphenoid bone caused by a longitudinal fracture of the clivus. Using high resolution three-dimensional flat panel angiography, we show preservation of the basilar artery perforators in spite of severe stenosis of the entrapped segment of the basilar artery. There were no obvious signs and symptoms of posterior fossa stroke clinically or radiographically as far as could be assessed under given clinical circumstances.
September 23, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27660039/recurrent-hemorrhagic-venous-infarctions-caused-by-thrombosis-of-a-pontine-developmental-venous-anomaly-and-protein-s-mutation
#16
Yuri Nakamura, Kei-Ichiro Takase, Takuya Matsushita, Satoshi Yoshimura, Ryo Yamasaki, Hiroyuki Murai, Kazufumi Kikuchi, Jun-Ichi Kira
A 34-year-old man presented with an acute onset of upbeat nystagmus, slurred speech, and limb and truncal ataxias. The patient had a history of limb ataxia and gait disturbance previously treated as brainstem encephalitis with corticosteroids 3 years previously. Brain magnetic resonance imaging showed pontine developmental venous anomaly (DVA) and hemorrhagic infarction within the drainage territory of the DVA. Three months later, the patient exhibited recurrent limb ataxia, double vision, and numbness of the left side of the body...
November 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27651328/diagnostic-accuracy-of-whole-brain-ct-perfusion-in-the-detection-of-acute-infratentorial-infarctions
#17
Christine Bollwein, Annika Plate, Wieland H Sommer, Kolja M Thierfelder, Hendrik Janssen, Maximilian F Reiser, Andreas Straube, Louisa von Baumgarten
INTRODUCTION: Although the diagnostic performance of whole-brain computed tomographic perfusion (WB-CTP) in the detection of supratentorial infarctions is well established, its value in the detection of infratentorial strokes remains less well defined. We examined its diagnostic accuracy in the detection of infratentorial infarctions and compared it to nonenhanced computed tomography (NECT), aiming to identify factors influencing its detection rate. METHODS: Out of a cohort of 1380 patients who underwent WB-CTP due to suspected stroke, we retrospectively included all patients with MRI-confirmed infratentorial strokes and compared it to control patients without infratentorial strokes...
November 2016: Neuroradiology
https://www.readbyqxmd.com/read/27647028/primary-hemorrhagic-neurovascular-diseases-phnvds-in-tibetans-a-retrospective-observational-study
#18
Anqi Xiao, Ruiqi Chen, Hao Li, Lu Ma, Sen Lin, Xin Hu, Chao You
BACKGROUND: Although there have been many studies on primary hemorrhagic neurovascular diseases (PHNVDs) in different populations, a study focusing on PHNVDs in Tibetan people was still lacking. This study aimed to explore the notable characteristics of Tibetan PHNVDs by comparing the most three common PHNVDs (aneurysmal subarachnoid hemorrhage, spontaneous intracerebral hemorrhage and arteriovenous malformation) in our institution between Tibetan and Han patients. METHODS: In this retrospective observational study, the hospital information system (HIS) was utilized to access the records of patients with PHNVDs...
September 16, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27646318/traumatic-basilar-artery-entrapment-with-patency-of-pontine-perforators-and-absence-of-significant-brainstem-infarction-report-of-an-unusual-case
#19
Stefan Kliesch, Christian Bauknecht, Georg Bohner, Thomas Liebig, Eberhard Siebert
We report a rare case of entrapment of the basilar artery into the sphenoid bone caused by a longitudinal fracture of the clivus. Using high resolution three-dimensional flat panel angiography, we show preservation of the basilar artery perforators in spite of severe stenosis of the entrapped segment of the basilar artery. There were no obvious signs and symptoms of posterior fossa stroke clinically or radiographically as far as could be assessed under given clinical circumstances.
September 19, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27638081/ischemic-syndromes-causing-dizziness-and-vertigo
#20
REVIEW
K-D Choi, H Lee, J-S Kim
Dizziness/vertigo and imbalance are the most common symptoms of vertebrobasilar ischemia. Even though dizziness/vertigo usually accompanies other neurologic symptoms and signs in cerebrovascular disorders, a diagnosis of isolated vascular vertigo is increasing markedly by virtue of recent developments in clinical neurotology and neuroimaging. It is important to differentiate isolated vertigo of a vascular cause from more benign disorders involving the inner ear, since therapeutic strategies and prognosis differ between these two conditions...
2016: Handbook of Clinical Neurology
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