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brainstem stroke

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https://www.readbyqxmd.com/read/29231792/patient-selection-for-mechanical-thrombectomy-in-posterior-circulation-emergent-large-vessel-occlusion
#1
Scott Raymond, Natalia Sana Rost, Pamela Whitney Schaefer, Thabele Leslie-Mazwi, Joshua A Hirsch, Ramon Gilberto Gonzalez, James Rabinov
Triage of posterior circulation stroke from emergent large-vessel occlusion (pc-ELVO) is challenging owing to the stuttering clinical course and potential for rapid decline. Growing clinical data support the use of mechanical thrombectomy in pc-ELVO, but there are limited data addressing the clinical and imaging criteria for patient selection. We present our triage algorithm used to select patients for endovascular therapy (EVT) in the setting of pc-ELVOS. We use a consecutive retrospective database from 2004 to 2016 to describe the practice patterns and prognostic factors for pc-ELVO patients treated using both medical and EVT...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29226021/holmes-tremor-secondary-to-a-stabbing-lesion-in-the-midbrain
#2
Rubens Gisbert Cury, Egberto Reis Barbosa, Christian Freitas, Luis Filipe de Souza Godoy, Wellingson Silva Paiva
Background: The development of Holmes tremor (HT) after a direct lesion of the midbrain has rarely been reported in the literature, although several etiologies have been linked with HT, such as stroke, brainstem tumors, multiple sclerosis, head trauma, or infections. Phenomenology Shown: A 31-year-old male, having been stabbed in the right eye, presented with a rest and action tremor in the left upper limb associated with left hemiparesis with corresponding post-contrast volumetric magnetic resonance imaging T1 with sagittal oblique reformation showing the knife trajectory reaching the right midbrain...
2017: Tremor and Other Hyperkinetic Movements
https://www.readbyqxmd.com/read/29213030/acute-bilateral-ophthalmoplegia-due-to-vertebrobasilar-dolichoectasia-a-report-of-two-cases
#3
Haifa Alabri, Whitfield D Lewis, Sunil Manjila, Ayham M Alkhachroum, Michael A De Georgia
BACKGROUND Vertebrobasilar dolichoectasia (VBD) is a complex progressive arterial disease characterized by dilation, elongation, and tortuosity of the vertebral and basilar arteries, and may be congenital or acquired. VBD may lead to progressive compression of the brainstem, cranial nerve abnormalities, and intracranial hemorrhage, but may also be associated with arterial thrombosis, with ischemic stroke as the most common clinical outcome. CASE REPORT Two cases of VBD are presented, both with acute bilateral ophthalmoplegia and cranial nerve palsies, and vertebrobasilar arterial thrombosis that resulted in ischemic stroke...
December 7, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29209479/a-brief-psychotic-episode-with-depressive-symptoms-in-silent-right-frontal-lobe-infarct
#4
Salziyan Badrin, Noraini Mohamad, Nor Akma Yunus, Maryam Mohd Zulkifli
Psychiatric symptoms may be related to a silent cerebral infarct, a phenomenon that has been described previously in literature. Acute psychosis or other neuropsychiatric symptoms including depression may present in stroke patients and patients with lesions either within the prefrontal or occipital cortices, or in subcortical areas such as the basal ganglia, thalamus, mid-brain, and brainstem. Psychosis in clinical stroke or in silent cerebral infarction is uncommon and not well documented in the literature...
November 2017: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/29208342/pediatric-stroke-related-to-lyme-neuroborreliosis-data-from-the-swiss-neuropaediatric-stroke-registry-and-literature-review
#5
O Monteventi, M Steinlin, M Regényi, E Roulet-Perez, P Weber, J Fluss
BACKGROUND: Cerebrovascular complications of Lyme neuroborreliosis (LNB) are poorly documented in the paediatric population. METHODS: We performed a retrospective analysis from prospectively registered cases of acute ischemic stroke (AIS) from the Swiss NeuroPaediatric Stroke Registry (SNPSR) from 2000 to 2015. Only cases with serologically confirmed LNB were included. In addition, a literature review on paediatric stroke cases secondary to Lyme neuroborreliosis in the same time frame was performed...
November 24, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29187935/-haemorrhagic-stroke-of-the-brainstem-secondary-to-postpartum-eclampsia-about-a-case-and-literature-review
#6
REVIEW
Khadija Ennaqui, Assia Makayssi, Houssine Boufettal, Naima Samouh
Strokes are rare but severe accidents during pregnancy and post-partum period. They are responsible for high mortality and morbidity rates. Pre-eclampsia, eclampsia, and strokes are significantly related. Endothelial dysfunction, alteration of brain self-regulation and severe hypertension are, probably, the cause of many strokes in pregnant women and during postpartum period. We report a case of hemorrhagic stroke of the brainstem in a nonmonitored 21-year old patient at 38 weeks pregnant admitted with severe preeclampsia complicated by eclampsia and then by haemorrhagic stroke of the brainstem on the second post-operative day after cesarean section performed due to suspicion of retroplacental haematoma arisen since her admission...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29162502/vagus-nerve-magnetic-modulation-facilitates-dysphagia-recovery-in-patients-with-stroke-involving-the-brainstem-a-proof-of-concept-study
#7
Wang-Sheng Lin, Chen-Liang Chou, Miao-Hsiang Chang, Yuh-Mei Chung, Fu-Gong Lin, Po-Yi Tsai
BACKGROUND & AIMS: Stroke involving the brainstem (SBS) causes severe oropharyngeal dysphagia (OD). Research on the therapeutic efficacy of vagus nerve modulation (VNM) by using repetitive transcranial magnetic stimulation (rTMS) in SBS patients with OD has been limited thus far. We aimed to assess the effect of VNM by using rTMS in improving swallowing function after SBS. METHOD: We conducted a sham-controlled, double-blinded, parallel pilot study in 28 SBS patients with OD randomly allocated to a real rTMS group (n = 13; TMSreal) or a sham group (n = 15; TMSsham)...
November 7, 2017: Brain Stimulation
https://www.readbyqxmd.com/read/29155435/periventricular-white-matter-hyperintensities-and-functional-decline
#8
Mandip S Dhamoon, Ying-Kuen Cheung, Ahmet Bagci, Noam Alperin, Ralph L Sacco, Mitchell S V Elkind, Clinton B Wright
BACKGROUND/OBJECTIVES: We previously showed that global brain white matter hyperintensity volume (WMHV) was associated with accelerated long-term functional decline. The objective of the current study was to determine whether WMHV in particular brain regions is more predictive of functional decline. DESIGN: Prospective population-based study. SETTING: Northern Manhattan magnetic resonance imaging (MRI) study. PARTICIPANTS: Individuals free of stroke at baseline (N = 1,195; mean age 71 ± 9; n = 460 (39%) male)...
November 20, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29137102/lateral-medullary-infarction-with-similar-features-of-brown-sequard-syndrome-caused-by-vertebrobasilar-dysplasia-and-klippel-feil-syndrome-a-case-report
#9
Jingzhe Han, Duanhua Cao, Guomei Ma, Tingting Wang, Ye Ji, Zhilei Kang
RATIONALE: Patients with Klippel-Feil syndrome (KFS) are always anomaly associated with vertebrobasilar dysplasia. That may present commonly as infarction of brainstem, medulla, and cerebellum. In this article, we reported a rare case of lateral medullary infarction (LMI) with similar features of Brown Sequard syndrome caused by vertebrobasilar dysplasia and KFS, and the 2 rare conditions that are causally related. The case is being reported because of its unusual and rare presentation...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29128343/post-stroke-depression-mechanisms-and-pharmacological-treatment
#10
REVIEW
Roberto Federico Villa, Federica Ferrari, Antonio Moretti
Depression, the most frequent psychiatric disorder following ischaemic stroke, negatively affects survivals' functional outcome, response to rehabilitation and quality of life. Approximately, one-third of them are affected by post-stroke depression (PSD), making it a serious social and public health problem and anti-depressant preventive and curative therapies worth investigating. However, a two-way association between depression and stroke has been also established: stroke increases the risk of PSD, but depression is an independent risk factor for stroke...
November 9, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29095902/rehabilitative-skilled-forelimb-training-enhances-axonal-remodeling-in-the-corticospinal-pathway-but-not-the-brainstem-spinal-pathways-after-photothrombotic-stroke-in-the-primary-motor-cortex
#11
Naohiko Okabe, Naoyuki Himi, Emi Maruyama-Nakamura, Norito Hayashi, Kazuhiko Narita, Osamu Miyamoto
Task-specific rehabilitative training is commonly used for chronic stroke patients. Axonal remodeling is believed to be one mechanism underlying rehabilitation-induced functional recovery, and significant roles of the corticospinal pathway have previously been demonstrated. Brainstem-spinal pathways, as well as the corticospinal tract, have been suggested to contribute to skilled motor function and functional recovery after brain injury. However, whether axonal remodeling in the brainstem-spinal pathways is a critical component for rehabilitation-induced functional recovery is not known...
2017: PloS One
https://www.readbyqxmd.com/read/29081427/clinical-and-video-head-impulse-test-in-the-diagnosis-of-posterior-circulation-stroke-presenting-as-acute-vestibular-syndrome-in%C3%A2-the-emergency-department
#12
Ayse Guler, Funda Karbek Akarca, Cenk Eraslan, Ceyda Tarhan, Cem Bilgen, Tayfun Kirazli, Nese Celebisoy
INTRODUCTION: Head impulse test (HIT) is the critical bedside examination which differentiates vestibular neuritis (VN) from posterior circulation stroke (PCS) in acute vestibular syndrome (AVS). Video-oculography based HIT (vHIT) may have aadditional strength in making the differentiation. METHODS: Patients admitted to the emergency department of a tertiary-care medical center with AVS were studied. An emergency specialist and a neurologist performed HIT. vHIT was conducted by an neuro-otology research fellow...
2017: Journal of Vestibular Research: Equilibrium & Orientation
https://www.readbyqxmd.com/read/29059697/stimulation-of-the-mesencephalic-locomotor-region-for-gait-recovery-after-stroke
#13
Felix Fluri, Uwe Malzahn, György A Homola, Michael K Schuhmann, Christoph Kleinschnitz, Jens Volkmann
OBJECTIVE: One-third of all stroke survivors are unable to walk, even after intensive physiotherapy. Thus, other concepts to restore walking are needed. Because electrical stimulation of the mesencephalic locomotor region (MLR) is known to elicit gait movements, this area might be a promising target for restorative neurostimulation in stroke patients with gait disability. The present study aims to delineate the effect of high-frequency stimulation of the MLR (MLR-HFS) on gait impairment in a rodent stroke model...
November 2017: Annals of Neurology
https://www.readbyqxmd.com/read/29040967/improvement-and-aggravation-of-spontaneous-unruptured-vertebral-artery-dissection
#14
Tomoya Shibahara, Masahiro Yasaka, Yoshiyuki Wakugawa, Koichiro Maeda, Takeshi Uwatoko, Takahiro Kuwashiro, Gregory Y H Lip, Yasushi Okada
BACKGROUND: Intracranial vertebral artery dissection (VAD) is a well-recognized cause of stroke in young and middle-aged individuals, especially in Asian populations. However, a long-term natural course remains unclear. We investigated the long-term time course of VAD using imaging findings to examine the rate and predisposing factors for improvement. METHODS: We registered 56 consecutive patients (40 males; mean age, 51.8 ± 10.7 years) with acute spontaneous VAD and retrospectively investigated neuroimaging and clinical course within 1 month and at 3 months ± 2 weeks, 6 months ± 2 weeks, and 12 months ± 2 weeks after onset to ascertain predisposing factors and time course for improvement...
October 17, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/29037758/the-association-of-vertebrobasilar-calcification-with-etiological-subtypes-stroke-recurrence-and-outcome-in-acute-brainstem-ischemic-stroke
#15
Elif Gökçal, Elvin Niftaliyev, Tuğçe Özdemir, Mehmet Kolukısa, Talip Asil
Arterial calcification (AC), a frequent finding on imaging studies, has been reported as a risk factor for ischemic stroke. However few studies have explored the association of AC with etiological subtypes and prognostic implications. The purpose of this study was to investigate the association of AC with demograhics, risk factors and etiological subtypes and to determine whether it predicts stroke recurrence and functional outcome in patients with acute brainstem ischemic stroke. We analyzed our database consisting of patients who were diagnosed as acute brainstem ischemic stroke admitted within 24hours of onset...
October 9, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/29035724/factors-associated-with-post-stroke-suicidal-death
#16
Jin Pyo Hong, Subin Park, Sung-Ho Ahn, Jong S Kim
BACKGROUND AND PURPOSE: The aim of this study was to estimate the relative risk of suicidal death compared to the general population and to identify risk factors for suicidal death among stroke patients. METHODS: Our sample consisted of 7175 patients who were diagnosed with stroke and admitted at Asan Medical Center from January 2005 to December 2012. Information on suicidal death was obtained from the database of the Korean National Statistical Office. The standardized mortality ratio (SMR) for post-stroke suicide was estimated...
October 7, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28972274/motor-system-plasticity-after-unilateral-injury-in-the-developing-brain
#17
REVIEW
Preston T J A Williams, Yu-Qiu Jiang, John H Martin
In maturity, motor skills depend on the corticospinal tract (CST) and brainstem pathways that together synapse on interneurons and motoneurons in the spinal cord. Descending signals to spinal neurons that mediate voluntary control can be distinguished from peripheral sensory signals, primarily for feedback control. These motor system circuits depend initially on developmental genetic mechanisms to establish their connections and neural activity- and use-dependent synaptic refinement during the early postnatal period to enable motor skills to develop...
December 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28969106/duplicated-and-hypoplastic-v4-segment-of-vertebral-artery-along-with-duplication-of-anterior-inferior-cerebellar-artery-a-case-report
#18
S S S N Rajasekhar, K Aravindhan, Dharmaraj Wamanrao Tamgire
Variations of V3 and V4 segments of Vertebral Artery (VA) are very rare. We report an extremely rare case of hypoplastic and duplicated V4 segment of right VA along with variant origin of right Anterior Inferior Cerebellar artery (AICA) from right Posterior Inferior Cerebellar artery (PICA). AICA was duplicated, with one vessel arising from PICA and another arising from distal Hypoplastic Vertebral Artery (HVA). HVA should be considered for the diagnosis of acute stroke of brainstem and cerebellum. Knowledge about VA variations is important to prevent iatrogenic injuries during surgeries involving posterior cranial fossa...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28899286/restless-legs-syndrome-related-to-hemorrhage-of-a-thoracic-spinal-cord-cavernoma
#19
Malik Hamdaoui, Elisabeth Ruppert, Henri Comtet, Ulker Kilic-Huck, Valérie Wolff, Marc Bataillard, Patrice Bourgin
CONTEXT: Restless legs syndrome (RLS) is a common neurological disorder characterized by an irresistible urge to move the lower limbs often accompanied by unpleasant sensations in the legs, worsened at rest and in the evening. Symptoms are improved by movement. Its pathophysiology remains poorly understood. Lesion-related RLS has been reported, mainly in cases of stroke-related RLS involving the brainstem and lenticulostriate nuclei. Only few data of RLS in a context of spinal cord injury have been reported...
September 12, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28881113/cerebral-arterial-stenosis-in-patients-with-spontaneous-intracerebral-hemorrhage
#20
Pil-Wook Chung, Yu Sam Won
OBJECTIVE: Spontaneous intracerebral hemorrhage (ICH) and ischemic stroke share common vascular risk factors such as aging and hypertension. Previous studies suggested that the rate of recurrent ICH and ischemic stroke might be similar after ICH. Presence of cerebral arterial stenosis is a potential risk factor for future ischemic stroke. This study investigated the prevalence and factors associated with cerebral arterial stenosis in Korean patients with spontaneous ICH. METHODS: A total of 167 patients with spontaneous ICH were enrolled...
September 2017: Journal of Korean Neurosurgical Society
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