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medullary infarction

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https://www.readbyqxmd.com/read/28644251/risk-factors-etiological-classification-topographical-location-and-outcome-in-medullary-infarctions
#1
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
#2
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...
June 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28606950/pathophysiology-of-takotsubo-syndrome
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/28329371/rare-spinal-cord-infarction-in-a-patient-with-acute-type-b-aortic-dissection
#12
Yuji Sekine, Takeshi Nishina, Yuichi Ueda
A 69-year-old man was admitted to our hospital with acute epigastric discomfort and subsequent paraplegia. Computed tomography revealed acute type B aortic dissection with a thrombosed false lumen. Magnetic resonance imaging did not reveal spinal cord infarction. Paraplegia resolved completely within 1 h. However, on the following day, the patient developed motor impairment in the left leg, sensory disorder of the bilateral legs and urinary retention. The symptoms gradually improved with conservative medical therapy...
June 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28293537/a-rare-case-of-concomitant-sicca-keratopathy-and-ipsilateral-central-facial-palsy-in-wallenberg-s-dorsolateral-medullary-syndrome
#13
Deborah De Bruyn, Elisabeth Van Aken, Kristien Herman
Objective: To describe a patient with a right-sided supranuclear facial palsy and concomitant sicca keratopathy of the right eye following right-sided dorsolateral medullary infarction. Methods: Our patient underwent a complete ophthalmologic and neurologic examination including biomicroscopy, fundus examination, cranial nerve examination, Shirmer I test, and magnetic resonance imaging of the brain. Results: A 61-year-old woman presented in emergency with a central facial nerve palsy on the right side and truncal ataxia...
2017: GMS Ophthalmology Cases
https://www.readbyqxmd.com/read/28258876/the-use-of-tissue-plasminogen-activator-in-the-treatment-of-wallenberg-syndrome-caused-by-vertebral-artery-dissection
#14
Alexis Salerno, Bradford V Cotter, Michael E Winters
BACKGROUND: Acute cerebrovascular accident (CVA) is a devastating cause of patient morbidity and mortality. Up to 10% of acute CVAs in young patients are caused by dissection of the vertebral or carotid artery. Wallenberg syndrome results from a CVA in the vertebral or posterior inferior artery of the cerebellum and manifests as various degrees of cerebellar dysfunction. The administration of a thrombolytic medication has been recommended in the treatment of patients with stroke caused by cervical artery dissection...
May 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28250306/body-lateropulsion-and-cerebellar-tremor-in-a-patient-with-pontine-infarction
#15
Ai Hosaka, Ryoya Tsunoda, Tetsuto Yamaguchi, Yasuro Shibagaki
Body lateropulsion is known to be caused commonly by lateral medullary lesions but rarely by pontine lesions. It is also known to be associated with lesions of the dorsal spinothalamic tract or ascending graviceptive pathways. We herein report the case of a 75-year-old woman presenting with contralateral lateropulsion and cerebellar tremor caused by pons infarction. To our knowledge, this is the first case report of pontine infarction causing both lateropulsion and cerebellar tremor. Our case may be helpful in anatomical studies of ascending graviceptive pathways...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28208139/mri-based-neuroanatomical-predictors-of-dysphagia-dysarthria-and-aphasia-in-patients-with-first-acute-ischemic-stroke%C3%A2
#16
Heather L Flowers, Mohammed A AlHarbi, David Mikulis, Frank L Silver, Elizabeth Rochon, David Streiner, Rosemary Martino
BACKGROUND: Due to the high post-stroke frequency of dysphagia, dysarthria, and aphasia, we developed comprehensive neuroanatomical, clinical, and demographic models to predict their presence after acute ischemic stroke. METHODS: The sample included 160 randomly selected first-ever stroke patients with confirmed infarction on magnetic resonance imaging from 1 tertiary stroke center. We documented acute lesions within 12 neuroanatomical regions and their associated volumes...
February 16, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28092225/comparison-of-dysphagia-outcomes-between-rostral-and-caudal-lateral-medullary-infarct-patients
#17
Min Ho Chun, Daeha Kim, Min Cheol Chang
OBJECTIVE: A detailed knowledge of dysphagia outcomes in lateral medullary infarct (LMI) patients would enable proper establishment of swallowing therapy goals and strategies. However, little is known about the impact of infarct location on dysphagia outcomes in patients with LMI. METHODS: Twenty patients with rostral LMI (rostral group) and 20 patients with caudal LMI (caudal group) participated in the study. All patients underwent swallowing therapy, which included compensatory treatments and strengthening exercises, for >3 months...
January 31, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28089423/crossed-cheiro-oral-syndrome-a-warning-sign-for-medullary-involvement-and-neurological-deterioration
#18
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...
May 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27960164/clinical-stroke-syndromes
#19
REVIEW
Jong S Kim, Louis R Caplan
The main mechanism of stroke in patients who have extracranial atherosclerosis is artery to artery embolism, occasionally associated with hemodynamic disturbances. Although these mechanisms are also important in patients with intracranial atherosclerosis, branch occlusion and in-situ thrombotic occlusion play a relatively more important role in these patients. Accordingly, clinical stroke syndromes differ between extracranial atherosclerosis and intracranial atherosclerosis. In anterior circulation, middle cerebral artery atherosclerosis frequently produces subcortical infarction by way of branch occlusion...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27906952/conus-medullaris-infarction-after-a-right-l4-transforaminal-epidural-steroid-injection-using-dexamethasone
#20
Christopher G Gharibo, Michael Fakhry, Sudhir Diwan, Alan D Kaye
BACKGROUND: For decades, epidural steroid injections have been an effective tool in the management of many pain related conditions, including lumbar radiculopathy. Transforaminal epidural steroid injections in particular have been reported to potentially result in central nervous system infarctions which have not been reported with interlaminar epidural steroid injections, while providing comparable efficacy. This rare, catastrophic complication has been attributed by some authors to be due to vascular injury secondary to vasospasm, thrombus formation, dissection, as well as concerns with placing the needle at the so-called "safe triangle...
November 2016: Pain Physician
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