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https://www.readbyqxmd.com/read/29775168/dysphagia-in-supratentorial-recent-small-subcortical-infarcts-results-from-bilateral-pyramidal-tract-damage
#1
Simon Fandler, Thomas Gattringer, Daniela Pinter, Lukas Pirpamer, Florian Borsodi, Sebastian Eppinger, Kurt Niederkorn, Christian Enzinger, Franz Fazekas
Background Dysphagia occurs in up to 20% of patients with a recent small subcortical infarct, even when excluding brainstem infarcts. Aim To examine the impact of lesion topography and concomitant cerebrovascular lesions on the occurrence of dysphagia in patients with a single supratentorial recent small subcortical infarct. Methods We retrospectively identified all inpatients with magnetic resonance imaging-confirmed supratentorial recent small subcortical infarcts over a five-year period. Dysphagia was determined by speech-language therapists...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29770122/acute-unilateral-audiovestibulopathy-due-to-embolic-labyrinthine-infarction
#2
Zhong Liqun, Kee-Hong Park, Hyo-Jung Kim, Sun-Uk Lee, Jeong-Yoon Choi, Ji-Soo Kim
Introduction: Labyrinthine infarction is a cause of acute audiovestibulopathy, but can be diagnosed only in association with other infarctions involving the brainstem or cerebellar areas supplied by the anterior inferior cerebellar artery (AICA) since current imaging techniques cannot visualize an infarction confined to the labyrinth. This case series aimed to establish embolic labyrinthine infarction as a mechanism of isolated acute audiovestibulopathy. Methods: We analyzed clinical features, imaging findings, and mechanisms of embolism in 10 patients (8 men, age range: 38-76) who had developed acute audiovestibulopathy in association with an obvious source of embolism and concurrent acute embolic infarctions in the non-anterior inferior cerebellar artery territories...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29723487/clinical-investigation-and-characterization-of-vertebrobasilar-dolichoectasia-and-vertebral-artery-dominance
#3
Xiangfang Meng, Wei Ding, Xijun Wu, Pingwei Di
In clinical practice, the vertebral arteries of a patient are often found to be not equal in size and the basilar artery may not be situated in the center. Our observational study showed that vertebral dominance and basilar bending are common, and their occurrence is related to advanced age and hypertension. The right vertebral dominance tends to coincide with left basilar bending, and, vice versa, the left vertebral dominance tends to coincide with right basilar bending. The left vertebral dominance is more common than the right dominance...
April 2018: Discovery Medicine
https://www.readbyqxmd.com/read/29718002/vertebral-artery-dissection-masquerading-as-concussion-in-an-adolescent
#4
Gogi Kumar, Bryan Ludwig, Vipul V Patel
OBJECTIVE: Educate providers about the clinical presentation and consequences of delaying diagnosis of traumatic vertebral artery dissection with thromboembolic ischemic strokes in the pediatric population. Vertebral artery dissection is often difficult to diagnose and can be a potentially devastating cause of ischemic stroke. METHODS: Review of the chart, peer review/discussion, and imaging interpretation. RESULTS: A 16-year-old boy was admitted with confusion after a head and neck trauma was sustained while wrestling...
May 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29705052/malignant-middle-cerebral-artery-mca-infarction-in-people-over-85-years-old-diagnosis-management-and-risk-factors
#5
REVIEW
Żanna Pastuszak, Zbigniew Czernicki, Waldemar Koszewski, Adam Stępień, Anna Piusińska-Macoch
INTRODUCTION: Malignant ischemic stroke of the middle cerebral artery (MCA) territory causes neurological deterioration due to the effects of space occupying cerebral edema. The prognosis is poor, and death usually occurs as a result of brainstem compression. There is no information on ischemic stroke, especially the malignant ones, in patients over 85 years old. AIM: The aim of this retrospective study was to evaluate the disease course, risk factors, survival rate and treatment of MCA malignant infarction in people over 85 years old...
December 16, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/29681824/bilateral-ageusia-and-tongue-anesthesia-following-unilateral-brainstem-infarct-a-case-report-with-a-brief-review-of-the-literature
#6
Christian Saleh, Simona Negoias, Franca Wagner, Marie-Luise Mono
We present the case of a 63-year-old male patient who suffered bilateral ageusia following a unilateral left-sided mesencephalon infarct. To the best of our knowledge, this is the first description of a mesencephalon lesion leading to ageusia. We discuss the literature on this rare but important symptom following a stroke.
January 2018: Case Reports in Neurology
https://www.readbyqxmd.com/read/29680945/cilostazol-is-effective-to-prevent-stroke-associated-pneumonia-in-patients-receiving-tube-feeding
#7
Shizuka Netsu, Atsushi Mizuma, Masaki Sakamoto, Sachiko Yutani, Eiichiro Nagata, Shunya Takizawa
Stroke-associated pneumonia (SAP) is a frequent complication in acute ischemic stroke (IS) patients, especially those receiving tube feeding (TF). In this retrospective study, we investigated whether or not cilostazol, a pluripotent phosphodiesterase III-specific inhibitor with anti-platelet and vasculogenic effects, can prevent SAP in these patients and reduce their duration of stay in intensive care unit/hospitalization. We recruited 158 IS patients receiving TF. Patients' characteristics (including age, gender, past history), National Institute of Health Stroke Scale and serum albumin level on admission, concomitant medications associated with SAP prevention (including cilostazol), and stroke characteristics (bilateral subcortical white matter lesion, brainstem involvement, large infarction, and asymptomatic hemorrhagic infarction) were compared between the SAP(-) and SAP(+) groups...
April 21, 2018: Dysphagia
https://www.readbyqxmd.com/read/29669602/cerebral-vasculitis-and-lateral-rectus-palsy-two-rare-central-nervous-system-complications-of-dengue-fever-two-case-reports-and-review-of-the-literature
#8
H M M Herath, J S Hewavithana, C M De Silva, O A R Kularathna, N P Weerasinghe
BACKGROUND: Dengue fever is a common mosquito-borne viral illness with a clinical spectrum ranging from a simple febrile illness to potentially life-threatening complications such as dengue hemorrhagic fever and dengue shock syndrome. Dengue infection can affect many organs, including the central nervous system. The neurological manifestations reported in dengue infections are meningitis, encephalitis, stroke, acute disseminated encephalomyelitis, and Guillain-Barré syndrome. CASE PRESENTATION: We report the cases of two interesting patients with confirmed dengue infection who presented with complications of possible central nervous system vasculitis and cranial nerve palsy...
April 19, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29626028/lesson-of-the-month-2-a-rare-presentation-of-stroke-diagnosis-made-on-magnetic-resonance-imaging
#9
Danielle Berenson, Luke Nuttall, Eluzai Hakim, Khaled Abdel-Aziz
Bilateral thalamic infarcts are uncommon posterior circulation strokes. The artery of Percheron (AOP) is a rare anatomical variant involving a singular arterial supply to both thalami and occlusion leads to bilateral thalamic infarction.We report the case of a 71-year-old man who presented with decreased consciousness (fluctuating Glasgow Coma Scale score of 5-7). He had a background of atrial fibrillation and was anticoagulated with dabigatran, a novel oral anticoagulant. Computed tomography (CT) scan showed a mildly reduced attenuation in the region of the left thamalus...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29618068/occipital-artery-to-posterior-cerebral-artery-bypass-using-descending-branch-of-the-lateral-circumflex-femoral-artery-graft-for-treatment-of-fusiform-unruptured-posterior-cerebral-artery-aneurysm-3-dimensional-operative-video
#10
Kristine Ravina, Ian A Buchanan, Robert C Rennert, Ben A Strickland, Joseph N Carey, Jonathan J Russin
Posterior cerebral artery (PCA) aneurysms can be technically challenging lesions due to the intricacy of perforating branches and the relationship to cranial nerves and the brainstem. Fusiform aneurysms of the perimesencephalic segment of the PCA are a rare finding which does not favor direct clip occlusion or reconstruction. In such cases, proximal parent vessel occlusion is an option for aneurysm treatment. Extracranial-intracranial (EC-IC) bypass can be used to revascularize beyond the lesion when considering proximal occlusion...
April 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29607917/-cadasil-with-cysteine-sparing-notch3-mutation-manifesting-as-dissociated-progression-between-cognitive-impairment-and-brain-image-findings-in-3-years-a-case-report
#11
Keisuke Tachiyama, Yuji Shiga, Yutaka Shimoe, Ikuko Mizuta, Toshiki Mizuno, Masaru Kuriyama
A 55-year-old man with no history of stroke or migraine presented to the clinic with cognitive impairment and depression that had been experiencing for two years. Neurological examination showed bilateral pyramidal signs, and impairments in cognition and attention. Brain MRI revealed multiple lacunar lesions and microbleeds in the deep cerebral white matter, subcortical regions, and brainstem, as well as diffuse white matter hyperintensities without anterior temporal pole involvement. Cerebral single-photon emission computed tomography (SPECT) revealed bilateral hypoperfusion in the basal ganglia...
March 31, 2018: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/29559783/association-between-etiology-and-lesion-site-in-ischemic-brainstem-infarcts-a-retrospective-observational-study
#12
Gozde Baran, Tugce Ozdemir Gultekin, Oguz Baran, Cigdem Deniz, Salim Katar, Gulsen Babacan Yildiz, Talip Asil
Background and purpose: To assess the anatomical distribution of the ischemic strokes of the brainstem, the effect of anatomical distribution on clinical features and prognosis, and the association between etiology and anatomical involvement. Methods: A retrospective search of the patient database of our institution was performed for a total of 227 patients who were admitted to the Department of Neurology, Medical Faculty of Bezmialem Vakif University between January 2012 and September 2014...
2018: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29546365/postmortem-histopathologic-analysis-of-neurosyphilis-a-report-of-3-cases-with-clinicopathologic-correlations
#13
Chenhui Mao, Jing Gao, Liri Jin, Bin Peng, Yupu Guo
Neurosyphilis occurs in the late stage of systemic syphilis infection; early diagnosis and treatment are crucial to the prognosis. We review 3 autopsy cases with different subtypes of neurosyphilis, that is cases with meningovascular, general paresis, and a combination of the 2, respectively. We investigated the gross morphology and leptomeninges, vessels, cerebral cortex, white matter, brainstem, cerebellum, olfactory bulb and spinal cord microscopically. We found that meningovascular inflammation exists in both early and late phases of neurosyphilis, not only in the meningovascular subtype...
March 12, 2018: Journal of Neuropathology and Experimental Neurology
https://www.readbyqxmd.com/read/29521288/clinical-and-radiological-features-of-wallerian-degeneration-of-the-middle-cerebellar-peduncles-secondary-to-pontine-infarction
#14
Zhi-Yong Zhang, Zhi-Qin Liu, Wei Qin, Ya-Wen Chen, Zun-Jing Liu
Background: Wallerian degeneration (WD) of bilateral middle cerebellar peduncles (MCPs) can occur following pontine infarction, but its characteristics have not yet been clarified because of the low incidence. Thus, the present study discussed the clinical and radiological features to improve the awareness of this disease. Methods: Clinical and radiological information from consecutive individuals diagnosed with WD of bilateral MCPs following pontine infarction in three hospitals over the past 4 years between October 2012 and October 2016 were retrospectively investigated and compared with a control group (patients with pontine infarction had no secondary WD)...
March 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29466399/acute-basilar-thrombosis-recanalization-following-intravenous-thrombolysis-is-dependent-on-thrombus-length
#15
Hendrik Janssen, Hartmut Brückmann, Monika Killer, Suzette Heck, Grete Buchholz, Juergen Lutz
INTRODUCTION: We investigated whether thrombus length measured in Computed Tomography Angiography (CTA) is predictive of the success rate of intravenous thrombolysis (IVT) in acute basilar occlusion and whether recanalization can be achieved by additional mechanical endovascular thrombectomy. METHODS: In 51 patients with acute basilar thrombosis thrombus length was measured on CTA images before intravenous thrombolysis (IVT) with rt-PA was started. After 114 minutes on average success of IVT was evaluated either by CTA or DSA...
2018: PloS One
https://www.readbyqxmd.com/read/29454181/brainstem-dysfunction-heralding-disseminated-cryptococcosis
#16
Prachaya Srivanitchapoom, Yuvadee Pitakpatapee, Panitta Sitthinamsuwan, Sith Sathornsumetee
Cryptococcal meningoencephalitis is one of the most common central nervous system infections affecting immunocompromised patients. However, brainstem involvement is extremely rare and may represent a diagnostic challenge to clinicians. We report a non-HIV infected, chronically immunosuppressed, patient with fatal disseminated cryptococcosis presented with subcutaneous masses at both thighs and progressive brainstem dysfunction. Magnetic resonance imaging demonstrated multiple brainstem infarcts likely derived from small vessel vasculopathy...
April 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29443779/cerebral-infarction-due-to-malposition-of-cervical-pedicle-screw-a-case-report
#17
Jun Zhang, Rongming Xu, Zheng Li, Weibin Zha
RATIONALE: Malposition of cervical pedicle screw (CPS) has a risk of vertebral artery (VA) injury which sometimes may cause unexpected and catastrophic outcome. A rare case of delayed onset of cerebral infarction caused by malposition of CPS was reported. PATIENT CONCERNS: A 23-year-old man who underwent a posterior cervical reduction and fusion of C4-5 using CPS fixation and allograft for cervical spine injury is presented. The patient suffered progressively weakness and numbness for both of upper and lower extremities 1 day after the operation...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29434137/ipsiversive-ocular-torsion-skew-deviation-and-hearing-loss-as-initial-signs-of-anterior-inferior-cerebellar-artery-infarction
#18
Tameto Naoi, Mitsuya Morita, Tadataka Kawakami, Shigeru Fujimoto
A 67-year-old man with hypertension and type 2 diabetes mellitus was admitted to our hospital because of left hearing loss and vertical diplopia. A neurological examination showed ocular torsion, skew deviation, and sensorineural hearing loss in the left ear. Brainstem and cerebellar neurological signs were not observed. Left middle cerebellar peduncle infarction was evident on magnetic resonance imaging. He was treated with antiplatelet, however, the infarct progressed after this administration. Ocular tilt reaction (OTR) involves the triad of ocular torsion, skew deviation, and head tilt...
February 9, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29411449/caide-dementia-risk-score-alzheimer-and-cerebrovascular-pathology-a-population-based-autopsy-study
#19
B Hooshmand, T Polvikoski, M Kivipelto, M Tanskanen, L Myllykangas, M Mäkelä, M Oinas, A Paetau, A Solomon
BACKGROUND: CAIDE Dementia Risk Score is a tool for estimating dementia risk in the general population. Its longitudinal associations with Alzheimer or vascular neuropathology in the oldest old are not known. AIM: To explore the relationship between CAIDE Dementia Risk Score at baseline and neuritic plaques, neurofibrillary tangles, cerebral infarcts and cerebral amyloid angiopathy (CAA) after up to 10-year follow-up in the Vantaa 85 +  population. METHODS: Study population included 149 participants aged ≥85 years, without dementia at baseline, and with available clinical and autopsy data...
January 25, 2018: Journal of Internal Medicine
https://www.readbyqxmd.com/read/29382617/hypertrophic-olivary-degeneration-neurosurgical-perspective-and-literature-review
#20
Mehmet Resid Onen, Kelli Moore, Ulas Cikla, Melih Ucer, Bradley Schmidt, Aaron S Field, Mustafa K Baskaya
BACKGROUND: Hypertrophic olivary degeneration (HOD) occurs because of posterior fossa or brainstem lesions that disrupt the dentato-rubro-olivary tract, well known as the Guillain-Mollaret triangle. Clinical and radiologic hallmarks of this condition are palatal myoclonus and T2 hyperintensity of the inferior olivary complex on magnetic resonance imaging (MRI), respectively. Because symptomatic HOD can complicate the recovery of patients with posterior fossa or brainstem lesions, the purpose of this study is to evaluate clinical and imaging findings of patients with HOD...
April 2018: World Neurosurgery
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