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https://www.readbyqxmd.com/read/29778364/prevention-of-cardiovascular-events-in-asian-patients-with-ischaemic-stroke-at-high-risk-of-cerebral-haemorrhage-picasso-a-multicentre-randomised-controlled-trial
#1
Bum Joon Kim, Eun-Jae Lee, Sun U Kwon, Jong-Ho Park, Yong-Jae Kim, Keun-Sik Hong, Lawrence K S Wong, Sungwook Yu, Yang-Ha Hwang, Ji Sung Lee, Juneyoung Lee, Joung-Ho Rha, Sung Hyuk Heo, Sung Hwan Ahn, Woo-Keun Seo, Jong-Moo Park, Ju-Hun Lee, Jee-Hyun Kwon, Sung-Il Sohn, Jin-Man Jung, Jose C Navarro, Dong-Wha Kang
BACKGROUND: The optimal treatment for patients with ischaemic stroke with a high risk of cerebral haemorrhage is unclear. We assessed the efficacy and safety of cilostazol versus aspirin, with and without probucol, in these patients. METHODS: In this randomised, controlled, 2 × 2 factorial trial, we enrolled patients with ischaemic stroke with a history of or imaging findings of intracerebral haemorrhage or two or more microbleeds from 67 centres in three Asian countries...
June 2018: Lancet Neurology
https://www.readbyqxmd.com/read/29768958/bevacizumab-induced-atypical-hemolytic-uremic-syndrome-and-treatment-with-eculizumab
#2
Anusha Vakiti, Daulath Singh, Ravi Pilla, Muhamad A Moustafa, Kelly W Fitzpatrick
Bevacizumab (Avastin) is a recombinant humanized monoclonal antibody used for the management of various solid malignancies including colorectal, lung, brain, renal, and ovarian cancers as well as age-related macular degeneration of the eye. It is a vascular endothelial growth factor inhibitor which exhibits its action by blocking the growth of blood vessels in cancerous tissue. Common side effects include hypertension, fatigue, headaches, and increased risk of infections. Atypical hemolytic uremic syndrome is a serious side effect associated with bevacizumab due to its anti-angiogenic effect...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29751998/does-somatostatin-have-a-role-to-play-in-migraine-headache
#3
REVIEW
Geoffrey A Lambert, Alessandro S Zagami
Migraine is a condition without apparent pathology. Its cardinal symptom is the prolonged excruciating headache. Theories about this pain have posited pathologies which run the gamut from neural to vascular to neurovascular, but no observations have detected a plausible pathology. We believe that no pathology can be found for migraine headache because none exists. Migraine is not driven by pathology - it is driven by neural events produced by triggers - or simply by neural noise- noise that has crossed a critical threshold...
April 17, 2018: Neuropeptides
https://www.readbyqxmd.com/read/29744017/spontaneous-recanalization-after-carotid-artery-dissection-the-case-for-an-ultrasound-only-monitoring-strategy
#4
Sarah Lumsden, Gabor Rosta, Jean Bismuth, Alan B Lumsden, Zsolt Garami
Dissection of the internal carotid artery (ICA) accounts for 5% to 25% of ischemic strokes in young adults. We report a case of spontaneous recanalization of a traumatic ICA dissection in which carotid duplex (CDU) and transcranial color-coded duplex ultrasound (TCCD) were used. A 47-year-old male presented with intermittent episodes of headache, blurry vision, anisocoria, and loss of taste sensation following a whiplash injury while body surfing. Magnetic resonance angiogram (MRA) of the neck revealed absent flow in the cavernous ICA and a clot at the skull base...
October 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29741225/prediction-of-vascular-abnormalities-on-ct-angiography-in-patients-with-acute-headache
#5
Imanda M E Alons, Ben F J Goudsmit, Korné Jellema, Marianne A A van Walderveen, Marieke J H Wermer, Ale Algra
OBJECTIVES: Patients with acute headache increasingly undergo CT-angiography (CTA) to evaluate underlying vascular causes. The aim of this study is to determine clinical and non-contrast CT (NCCT) criteria to select patients who might benefit from CTA. METHODS: We retrospectively included patients with acute headache who presented to the emergency department of an academic medical center and large regional teaching hospital and underwent NCCT and CTA. We identified factors that increased the probability of finding a vascular abnormality on CTA, performed multivariable regression analyses and determined discrimination with the c-statistic...
May 9, 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29732160/granular-cell-tumour-of-the-neurohypophysis-an-unusual-cause-of-hypopituitarism
#6
Carlos Tavares Bello, Patricia Cipriano, Vanessa Henriques, João Sequeira Duarte, Conceição Canas Marques
Granular cell tumours (GCT) are rare, slow-growing, benign neoplasms that are usually located in the head and neck. They are more frequent in the female gender and typically have an asymptomatic clinical course, being diagnosed only at autopsy. Symptomatic GCT of the neurohypophysis are exceedingly rare, being less than 70 cases described so far. The authors report on a case of a 28-year-old male that presented to the Endocrinology clinic with clinical and biochemical evidence of hypogonadism. He also reported minor headaches without any major visual symptoms...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29707473/hemangioma-of-the-cavernous-sinus-a-case-series
#7
Dylan A Noblett, Jennifer Chang, Atrin Toussi, Arthur Dublin, Kiarash Shahlaie
Introduction  Cavernous sinus hemangiomas (CSHs) are rare, vascular, extra-axial tumors that are diagnosed with a combination of imaging and biopsy. We describe the clinical presentations, imaging findings, and management of two male patients with CSHs. Case Report  Case 1 describes a 57-year-old man who presented with vision changes and cranial nerve palsies. Initial imaging and surgical biopsy were nondiagnostic. Follow-up Tc-99m tagged red blood cell (RBC) imaging supported CSH diagnosis. He was treated with surgical resection and radiotherapy...
April 2018: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/29706150/neurosyphilis-mighty-imitator-forays-with-benign-presentation-and-unique-neuroimaging-findings
#8
Harmanpreet Tiwana, Aiesha Ahmed
Background: Common causes of temporal lobe hyper intensities are central nervous system infections like herpes simplex encephalitis, Lyme disease, limbic encephalitis and vascular pathology like Cerebral Autosomal Dominant Arteriopathy with Subcortical infarcts and Leukoencephalopathy. Methods: Personal assessment, laboratory data analysis and neuroimaging for the patient who was admitted to a central Pennsylvania tertiary care referral centre were conducted. Results: A 52-year-old male presented with a 1-year history of diffuse dysesthesia in upper and lower extremities with associated intermittent headaches and neck stiffness...
April 30, 2018: Sexual Health
https://www.readbyqxmd.com/read/29686555/diagnosing-deep-cerebral-venous-thrombosis
#9
Usaamah Mahmood Khan, Crystal S Janani, Marian P LaMonte
Cerebral venous thrombosis (CVT) is a relatively rare vascular disorder involving the formation of a thrombus in the venous system of the cerebral vasculature. The nonspecificity of clinical symptoms seen with CVT elicits significant diagnostic challenges with the potential of serious morbidity and mortality associated with delays in therapeutic intervention. We present a case of CVT in a young patient who presented with loss of consciousness with no headache or focal deficits, the usual type of presentation...
January 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29685360/incidental-lad-stenosis-identified-on-non-gated-chest-cta
#10
Nicholas Chan, Brian M Yuen, Ji Yang, Stuart L Cohen, Loukas Boutis, John N Makaryus
A 57-year-old male former smoker presented to the Emergency Department (ED) with blurry vision, headache, and generalized weakness. He was hypoxic on room air and ECG showed sinus tachycardia. A CT pulmonary angiogram was ordered in the ED and revealed no pulmonary embolism but incidentally noted a likely significant stenosis in the proximal LAD. Subsequent cardiac catheterization revealed a 90% stenotic lesion with percutaneous coronary intervention leading to symptom resolution. Unlike coronary CTA, CTPA is performed with non-ECG gated helical scanning and generates motion artifacts associated with myocardial contraction...
April 14, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29682048/choroidal-type-of-vein-of-galen-aneurysmal-malformation-in-adult-patient-with-unusual-presentation-of-orthostatic-headache
#11
Kapil Pareek, Trilochan Shrivastava, Virendra Deo Sinha
Vein of Galen aneurysmal malformations (VGAMs) are rare vascular malformations occurring commonly in the pediatric age group. They comprise only 1% of all intracranial vascular malformations, but in pediatric population, they represent 30% of all intracranial vascular malformations. They are of two types-mural and choroidal. Choroidal type of VGAM is more primitive and most severe form of disease. It usually causes high cardiac output failure in newborn period because of multiple high flow fistulas. Adult presentation of choroidal type VGAM is very rare, and only few cases have been reported in literature so far...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29668636/spinal-dural-arteriovenous-fistula-presenting-with-subarachnoid-hemorrhage-a-case-report
#12
Jingzhe Han, Duanhua Cao, Hongmei Wang, Ye Ji, Zhilei Kang, Jianguo Zhu
RATIONALE: Subarachnoid hemorrhage (SAH) is a common and serious disease and one of the most important differential diagnoses in the emergency department. PATIENT CONCERNS: A 39-year-old female patient with a 12 years' history of migraine, presented with a sudden headache combined with motor aphasia. Physical examination suggested probable positive neck resistance. SAH was confirmed by magnetic resonance imaging. In addition, spinal digital subtraction angiography and spinal vascular computed tomography angiography indicated spinal arteriovenous malformation (SAVM)...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29666728/a-rare-benign-tumor-in-a-14-year-old-girl
#13
Meral Hassan Abualjadayel, Osama Y Safdar, Maysaa Adnan Banjari, Sherif El Desoky, Ghadeer A Mokhtar, Raed A Azhar
Background: Oncocytomas are the second most common benign renal neoplasm but, unfortunately, they are difficult to differentiate from renal cell carcinoma. Renal oncocytomas are rare and have mostly been reported in adults. To our knowledge, this is only the sixth pediatric reported case of renal oncocytoma worldwide. Case Presentation: A 14-year-old Yemeni girl with a recurrent history of urinary tract infections came to our clinic complaining of left flank pain with a frontal headache...
2018: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29658630/lumbar-sympathectomy-versus-prostanoids-for-critical-limb-ischaemia-due-to-non-reconstructable-peripheral-arterial-disease
#14
REVIEW
Indrani Sen, Sunil Agarwal, Prathap Tharyan, Rachel Forster
BACKGROUND: Peripheral arterial disease (PAD) is a common circulatory problem that can lead to reduced blood flow to the limbs, which may result in critical limb ischaemia (CLI), a painful manifestation that occurs when a person is at rest. The mainstay of treatment for CLI is surgical or endovascular repair. However, when these means of treatment are not suitable, due to anatomical reasons or comorbidities, treatment for pain is limited. Lumbar sympathectomy and prostanoids have both been shown to reduce pain from CLI in people who suffer from non-reconstructable PAD, but there is currently insufficient evidence to determine if one treatment is superior...
April 16, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29656154/acute-recanalization-of-a-partially-thrombosed-large-intracranial-aneurysm
#15
E Atallah, E Valle-Giler, T Elarjani, N Chalouhi, S Tjoumakaris, R H Rosenwasser, N Herial, M R Gooch, H Zarzour, P Jabbour
BACKGROUND: Thrombosed large intracranial aneurysms(TLIAs) are not continuously contemplated as stable lesions. Completely occluded large IAs' spontaneous recanalization has been previously described. CASE DESCRIPTION: We report the case of a middle-aged patient presenting with agitation, acute headache, visual field defects and left hemiparesis. A large thrombosed Posterior Communicating (PCom) artery aneurysm was identified with an infarct at the same arterial territory on neuroimaging studies...
April 12, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29652661/combined-brain-and-heart-magnetic-resonance-imaging-in-systemic-vasculitides-fiction-or-real-need
#16
REVIEW
Sophie I Mavrogeni, George Kitas, Hildo J Lamb, Klearchos Psychoyios, Theodoros Dimitroulas, Loukia Koutsogeorgopoulou, Kyriaki Boki, Vasiliki Vartela, Genovefa Kolovou, George Markousis-Mavrogenis, Cees G Kallenberg, Loic Guillevin, Dimitrios Vassilopoulos
Systemic vasculitides (SVs) is a group of diseases characterised by inflammation/necrosis of the blood vessel wall in various organs. Simultaneous brain and heart involvement is a cause of increased morbidity/mortality in SV. We aimed to present evidence of concurrent brain/heart involvement in SV and the role of a combined brain/heart magnetic resonance imaging (MRI) in their risk stratification. Cerebral vasculitis (CV) can be presented as focal deficits, seizures, headache, neuropsychiatric manifestations or cognitive dysfunction and cardiovascular disease (CVD) as myocardial/vascular inflammation, perfusion/function defects and fibrosis...
April 10, 2018: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29629229/ambiguity-in-the-dural-tail-sign-on-mri
#17
Ramesh S Doddamani, Rajesh K Meena, Dattaraj Sawarkar
Background: Meningiomas give rise to the dural tail sign (DTS) on contrast-enhanced magnetic resonance imaging (CEMRI). The presence of DTS does not always qualify for a meningioma, as it is seen in only 60-72% of cases. This sign has been described in various other lesions like lymphomas, metastasis, hemangiopericytomas, schwannomas and very rarely glioblastoma multiforme (GBM). The characteristics of dural-based GBMs are discussed here, as only eleven such cases are reported in the literature till date...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29617854/microsurgical-treatment-of-bowhunter-s-syndrome-3-dimensional-operative-video
#18
Vijay Agarwal, Daniel L Barrow
We present the case of a 56-yr-old previously healthy male who presented with an approximately 1-yr history of intermittent dizziness, near syncope, and holocephalic headaches when turning his head to the left side for a prolonged period of time. He had a distant history of a previous anterior cervical discectomy and fusion at the C6-7 level. He was neurologically intact. Static, dynamic, and vascular imaging confirmed hypoplasia of the right vertebral artery and dominance of the left vertebral artery that completely filled the posterior circulation...
March 29, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29616298/intracranial-malignant-peripheral-nerve-sheath-tumor-variant-an-unusual-neurovascular-phenotype-sarcoma-case-invading-through-the-petrous-bone
#19
Oliver D Mrowczynski, Robert J Greiner, Malika Kapadia, Julie C Fanburg-Smith, Mark R Iantosca, Elias B Rizk
INTRODUCTION: Intracranial malignant peripheral nerve sheath tumor (MPNST) is exceedingly rare. Previously reported cases of intracranial MPNST have been associated with development within a prominent cranial nerve. METHODS: This is the first report of an MPNST with both nerve sheath and vascular phenotype that follows the neurovascular bundle, without arising in a major cranial nerve or in the setting of neurofibromatosis type 1 (NF1). RESULTS: The patient is a 14-year-old boy with a history of worsening headaches for the past several months, left-sided hearing loss, nausea, vomiting, and vertigo...
April 3, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29611106/direct-acting-antiviral-drugs-for-chronic-hepatitis-c-and-risk-of-major-vascular-events-a-systematic-review
#20
REVIEW
Eleonora Tamborini Permunian, Lorenzo Gervaso, Victor Gerdes, Lorenzo Moja, Luigina Guasti, Alessandro Squizzato
Direct-acting antiviral drugs (DAAs) were recently approved for treating hepatitis C virus-related chronic hepatitis. As advanced chronic liver disease may predispose patients to thrombotic events, it is still uncertain whether DAAs may influence the actual risk of major arterial and venous thrombotic events. We performed a systematic review to assess the incidence of major vascular events in patients receiving DAAs for HCV chronic hepatitis during phase-III randomized controlled trials (RCTs). Two reviewers identified studies through Pubmed database until October 2015...
April 2, 2018: Internal and Emergency Medicine
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