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medullary infarction

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https://www.readbyqxmd.com/read/28910237/effects-of-once-weekly-exenatide-on-cardiovascular-outcomes-in-type-2-diabetes
#1
Rury R Holman, M Angelyn Bethel, Robert J Mentz, Vivian P Thompson, Yuliya Lokhnygina, John B Buse, Juliana C Chan, Jasmine Choi, Stephanie M Gustavson, Nayyar Iqbal, Aldo P Maggioni, Steven P Marso, Peter Öhman, Neha J Pagidipati, Neil Poulter, Ambady Ramachandran, Bernard Zinman, Adrian F Hernandez
Background The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. Methods We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke...
September 14, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28878917/management-of-a-patient-with-opalski-s-syndrome-in-intensive-care-unit
#2
Ozer Aynaci, Funda Gok, Alper Yosunkaya
Opalski syndrome is a rare vascular brainstem syndrome which is accepted as a variant of Wallenberg syndrome. Opalski syndrome should be considered in acute conditions in which typical symptoms of lateral medullary infarct are accompanied by ipsilateral hemiparesis. Other brain stem syndromes are distinguished from Opalski syndrome by the presence of contralateral hemiparesis.
September 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28816948/medial-medullary-infarction-caused-by-antineutrophil-cytoplasmic-antibody-related-vasculitis-case-report-and-review-of-the-literature
#3
Kumi Yanagiha, Kazuhiro Ishii, Tomoyuki Ueno, Aiki Marushima, Akira Tamaoka
RATIONALE: Medial medullary infarction accounts for less than 1% of brain infarctions, and medial medullary infarctions is very rarely caused by antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. PATIENT CONCERNS: We report the case of a 76-year-old man at low risk of arteriosclerosis who presented with disorders on the left side including gaze-evoked nystagmus, paralysis of the extremities, pyramidal signs, sensory disturbance, and dysesthesia. Brain magnetic resonance imaging also showed right medial medullary infarction...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28814097/prominent-deep-medullary-veins-a-predictive-biomarker-for-stroke-risk-from-transient-ischemic-attack
#4
Yang Duan, Zhihua Xu, Hongyi Li, Xiaonan Cai, Cancan Chang, Benqiang Yang
Background Deep medullary veins (DMVs) are a biomarker of severity and prognosis in patients with acute cerebral infarction. However, their clinical significance remains unclear in patients with transient ischemic attack (TIA). Purpose To determine whether prominent deep medullary veins (PDMVs) are a predictive biomarker for stroke risk after TIA. Material and Methods Clinical and imaging data of 49 patients with TIA and 49 sex- and age-matched controls were studied. PDMVs were defined as DMVs with a score of 3 (TDMVs) or asymmetric DMVs (ADMVs), and the relationship between PDMVs and clinical features was analyzed...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28799869/predictive-factors-of-medullary-infarction-after-endovascular-internal-trapping-using-coils-for-vertebral-artery-dissecting-aneurysms
#5
Masanori Aihara, Isao Naito, Tatsuya Shimizu, Masahiro Matsumoto, Ken Asakura, Naoko Miyamoto, Yuhei Yoshimoto
OBJECTIVE The first choice of treatment in cases of vertebral artery dissecting aneurysms (VADAs) is endovascular internal trapping (EIT) of the dissecting segment using coils. However, this procedure carries the risk of medullary infarction, and the risk factors for this complication are not well understood. This study investigated the risk factors causing medullary infarction. METHODS One hundred patients who underwent EIT for VADAs were included in this study. Ninety-three patients presented with subarachnoid hemorrhage...
August 11, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28769139/three-atypical-manifestations-of-granulomatosis-with-polyangiitis-lateral-medullary-syndrome-anterior-cheek-mass-and-melting-scleritis-of-eye
#6
Saeedeh Shenavandeh, Peyman Petramfar
Granulomatosis with polyangiitis (GPA, formerly Wegener granulomatosis) is a vasculitis with various organ involvement. There have been a few cases of CNS stroke and rare cases of lateral medullary infarction (LMI) as a manifestation of GPA. Also there have been reports of sinuses, nose and laryngeal masses mistakenly referred as carcinomas and subsequently GPA was diagnosed in their pathological reports. Another severe fulminant manifestation can be necrotizing scleritis leading to perforation of sclera. Therefore, here we present some rare and fulminant manifestations of GPA in 3 separate cases for further emphasis of the unusual manifestations of GPA that should always be kept in mind...
2017: Reumatologia
https://www.readbyqxmd.com/read/28678575/ischemic-white-matter-lesions-associated-with-medullary-arteries-classification-of-mri-findings-based-on-the-anatomic-arterial-distributions
#7
Toshiaki Akashi, Shoki Takahashi, Shunji Mugikura, Shiho Sato, Takaki Murata, Atsushi Umetsu, Kei Takase
OBJECTIVE: The purposes of this article are to describe the important role of the medullary arteries in the pathogenesis of cerebral vascular disease and to present a classification of MRI findings of ischemic white matter lesions for use in elucidating pathogenesis. CONCLUSION: From the viewpoint of the anatomy of the medullary arteries, the pattern of medullary artery-related ischemic changes and infarcts can be classified into four types: 1, ischemic leukoaraiosis; 2, infarcts involving individual medullary arteries; 3, watershed infarcts; and 4, territorial infarcts...
July 5, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28664015/central-hypoventilation-syndrome-complicated-with-lateral-medullary-infarction-after-endovascular-treatment-of-the-vertebral-artery-dissecting-aneurysm-a-case-report
#8
Katsuhiro Tanaka, Hideki Kanamaru, Atsunori Morikawa, Kenji Kawaguchi
Lateral medullary infarction rarely leads to central hypoventilation syndrome (CHS). CHS is a life-threatening disorder characterized by hypoventilation during sleep. We report the first case of CHS as a complication of lateral medullary infarction after endovascular treatment. A 65-year-old man presented twice with severe headache. Computed tomography revealed subarachnoid hemorrhage and cerebral angiography showed a right vertebral dissecting aneurysm involving the posterior inferior cerebellar artery. After emergent endovascular patent artery occlusion, he developed Wallenberg syndrome and experienced apnea and a conscious disturbance episode due to CHS on postoperative days 6 and 16...
October 2016: NMC Case Rep J
https://www.readbyqxmd.com/read/28647416/related-factors-of-asymmetrical-vein-sign-in-acute-middle-cerebral-artery-stroke-and-correlation-with-clinical-outcome
#9
Jinchao Yu, Liming Wang, Zhenzhi Li, Shanshan Wang, Guangbin Wang
OBJECTIVE: The aim of our study was to analyze the related factors of asymmetrical cortical vein sign (ACVS) and asymmetrical medullary vein sign (AMVS) on susceptibility-weighted imaging (SWI) in patients with acute middle cerebral artery (MCA) stroke and whether their presence can be used as an independent predictor for clinical outcome. METHODS: According to the presence of ACVS and AMVS on SWI, 124 patients with acute MCA stroke within 3 days were divided into several different groups...
October 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28644251/risk-factors-etiological-classification-topographical-location-and-outcome-in-medullary-infarctions
#10
Elif Gökçal, Gözde Baran, Elvin Niftaliyev, Vildan Güzel, Talip Asil
An understanding of the etiological mechanisms is important for therapeutic decisions and prognostic evaluation of patients with ischemic stroke. The object of this study was to evaluate the risk factors, etiological subtypes, and topography of lesion in patients with medullary infarctions (MIs). Besides, we also investigated early neurological deterioration, new vascular events, and functional outcome of all patients at 3-month follow-up. We analyzed our database consisting of patients who were diagnosed with acute MI and who were admitted within 24 hours of onset...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28642018/clinical-study-of-27-patients-with-medial-medullary-infarction
#11
Takayoshi Akimoto, Katsuhiko Ogawa, Akihiko Morita, Yutaka Suzuki, Satoshi Kamei
BACKGROUND: Medial medullary infarction (MMI) is a rare ischemic stroke. Frequency of each neurological finding in MMI was different in each study. METHODS: We retrospectively evaluated the medical records of patients with cerebral infarction who were admitted between March 1998 and October 2015. Patients in our study were diagnosed as having MMI by magnetic resonance image examination. RESULTS: Of 2727 patients with ischemic stroke, 27 patients (20 males and 7 females) had MMI...
October 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28606950/pathophysiology-of-takotsubo-syndrome
#12
REVIEW
Francesco Pelliccia, Juan Carlos Kaski, Filippo Crea, Paolo G Camici
Originally described by Japanese authors in the 1990s, Takotsubo syndrome (TTS) generally presents as an acute myocardial infarction characterized by severe left ventricular dysfunction. TTS, however, differs from an acute coronary syndrome because patients have generally a normal coronary angiogram and left ventricular dysfunction, which extends beyond the territory subtended by a single coronary artery and recovers within days or weeks. The prognosis was initially thought to be benign, but subsequent studies have demonstrated that both short-term mortality and long-term mortality are higher than previously recognized...
June 13, 2017: Circulation
https://www.readbyqxmd.com/read/28592198/reversible-drug-induced-antiphospholipid-syndrome
#13
J Risse, M Vieira, F Beuret, N Petitpain, S Zuily, D Wahl
We report an original case of reversible antiphospholipid syndrome (APS) due to minocycline in a young male patient who experienced recurrent strokes while taking minocycline. He started minocycline therapy (50 mg twice daily) at 15 years old for acne. After three years of treatment, the patient experienced a lateral medullary syndrome. He was treated with aspirin while minocycline was continued. Eighteen months later, the patient complained about horizontal binocular diplopia. MRI revealed an infarct of the oculomotor nerve nucleus...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28567027/transient-vestibulopathy-in-wallenberg-s-syndrome-pathologic-analysis
#14
Jorge C Kattah, Ali S Saber Tehrani, Sigrun Roeber, Meena Gujrati, Sarah E Bach, David E Newman Toker, Ari M Blitz, Anja K E Horn
OBJECTIVE: To report an unusual lateral medullary stroke (LMS) associated with transient unidirectional horizontal, nystagmus, and decreased horizontal vestibulo-ocular reflex (h-VOR) gain that mimicked a peripheral vestibulopathy. MRI suggested involvement of caudal medial vestibular nucleus (MVN); however, the rapid resolution of the nystagmus and improved h-VOR gain favored transient ischemia without infarction. Decreased h-VOR gain is expected with peripheral vestibular lesions within the labyrinth or superior vestibular nerve; less frequently lateral pontine strokes involving the vestibular root entry, the vestibular fascicle, or neurons within the MVN may be responsible...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28552150/developmental-venous-anomalies
#15
Michael A Mooney, Joseph M Zabramski
Developmental venous anomalies (DVAs) are relatively common lesions, present in up to 3% of the population. The defining characteristic of these lesions is the confluence of radially oriented veins into a single dilated venous channel. DVAs are also known as cerebral venous angiomas, cerebral venous malformations, and cerebral venous medullary malformations. They are the most common type of cerebral vascular malformation found on autopsy studies, and they are often encountered as incidental findings on neuroimaging studies...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28521609/adrenal-obliteration-by-balloon-occluded-retrograde-venous-ethanol-injection-in-a-swine-model
#16
Akitoshi Inoue, Shinichi Ohta, Norihisa Nitta, Shizuka Tsuboi, Akinaga Sonoda, Yuki Tomozawa, Shobu Watanabe, Kenichi Mukaisho, Kiyoshi Murata
PURPOSE: To evaluate the effects of adrenal obliteration by balloon-occluded retrograde venous ethanol injection. MATERIAL AND METHODS: We inserted a micro-balloon catheter into the left adrenal vein of six pigs and retrogradely injected absolute ethanol (0.06 ml/kg) under balloon occlusion. Two pigs were sacrificed on day 3, 7, and 14 after the procedure, respectively. We evaluated adrenal cortical and medullary hormones of the left renal vein, venograms, magnetic resonance imaging scans obtained before and after the procedure, autopsy and microscopic findings, and the weight of the bilateral adrenal glands...
May 19, 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/28509611/efficacy-of-high-resolution-cone-beam-ct-in-the-evaluation-of-perforators-in-vertebral-artery-dissection
#17
Kenji Shimada, Michihiro Tanaka, Keisuke Kadooka, Hiromu Hadeishi
Introduction A major complication of internal coil trapping for vertebral artery dissection (VAD) is medullary infarction associated with perforator occlusion. Currently, higher spatial resolution imaging can be obtained with high-resolution cone-beam computed tomography (VASO CT), and the efficacy of perforator visualization adjacent to VAD was examined. Methods Eight patients who underwent internal coil trapping or stent-supported coil embolization underwent VASO CT to evaluate perforators around VAD. Visualization of perforators was compared with conventional digital subtraction angiography (DSA) and three-dimensional rotational angiography (3D-RA)...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28484930/heart-shaped-bilateral-medullary-pyramidal-infarction-as-a-pathognomonic-finding-of-anterior-spinal-artery-occlusion
#18
Sammy Searcy, Oluwaseun O Akinduro, Andrew Spector, Jang W Yoon, Benjamin L Brown, William D Freeman
BACKGROUND: Unilateral anterior spinal artery (ASA) occlusion resulting in bilateral medullary pyramidal (BMP) infarction is a rare and devastating stroke subtype. We present two cases highlighting the diagnostic and clinical challenges of BMP infarction. METHODS: Case reports and literature review. RESULTS: A 57-year-old man rapidly had severe vomiting and diarrhea 2 h after a meal. Examination revealed bulbar weakness and areflexic tetraplegia...
May 8, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28460653/evolution-and-persistence-of-torsional-downbeat-nystagmus-in-lateral-medullary-infarction
#19
Seong-Hae Jeong, Hyun-Jin Jo, Ae Young Lee, Jae Moon Kim, Ji-Soo Kim, Min Kyun Sohn
No abstract text is available yet for this article.
May 2, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28431180/collagenosis-of-the-deep-medullary-veins-an-underrecognized-pathologic-correlate-of-white-matter-hyperintensities-and-periventricular-infarction
#20
Julia Keith, Fu-Qiang Gao, Raza Noor, Alex Kiss, Gayathiri Balasubramaniam, Kelvin Au, Ekaterina Rogaeva, Mario Masellis, Sandra E Black
White matter hyperintensities (WMH) are prevalent. Although arteriolar disease has been implicated in their pathogenesis, venous pathology warrants consideration. We investigated relationships of WMH with histologic venous, arteriolar and white matter abnormalities and correlated findings with premortem neuroimaging. Three regions of periventricular white matter were sampled from archived autopsy brains of 24 pathologically confirmed Alzheimer disease (AD) and 18 age-matched nonAD patients. Using trichrome staining, venous collagenosis (VC) of periventricular veins (<150 µm in diameter) was scored for severity of wall thickening and occlusion; percent stenosis by collagenosis of large caliber (>200 µm) veins (laVS) was measured...
April 1, 2017: Journal of Neuropathology and Experimental Neurology
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