Recurrent stroke in a patient with vitamin B12 deficiency and MTHFR mutation

We report an unusual case of recurrent stroke in a patient with vitamin B12 deficiency who was also homozygous for the methylene tetrahydrofolate reductase (MTHFR) gene mutation. The patient was a 35-year-old male vegetarian with no known medical history who initially presented with global aphasia, slurred speech, right facial weakness, and right-sided hemiplegia and was found to have a stroke (NIH Stroke Scale score of 25). At that time a CT scan of the head ruled out intracranial hemorrhage and a CT angiogram of the head and neck was done. The patient was found to have occlusion of the M1 segment of the left middle cerebral artery. Because he was within the time frame for thrombolytics, systemic thrombolysis with alteplase was given without improvement. He therefore underwent a cerebral angiogram that demonstrated occlusion of the M1 segment of the left middle cerebral artery and very poor leptomeningeal collaterals from the left anterior and posterior cerebral artery territories (figure 1). He underwent mechanical thrombectomy of the left middle cerebral artery thrombus with Penumbra aspiration device (Penumbra Inc., Alameda, CA) and SOLITAIRE stentriever (Covidien, Irvine, CA) with complete recanalization of the occluded segment (figure 2). He had a remarkable early recovery as the hemiplegia resolved. During the hospital course he was placed on a statin and low-dose aspirin and was later discharged to a rehabilitation unit for treatment of his right-sided hemiparesis and...
Source: Neurology Clinical Practice - Category: Neurology Authors: Tags: Stroke in young adults, Stroke prevention, Hematologic, All Cerebrovascular disease/Stroke Case Source Type: research

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Source: Advances in Dermatology and Allergology - Category: Dermatology Tags: Postepy Dermatol Alergol Source Type: research
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Source: Folia Morphologica - Category: Anatomy Tags: Folia Morphol (Warsz) Source Type: research
CONCLUSION: Treadmill exercise improved motor function and short-term memory through increasing synaptic plasticity and neurogenesis in photothrombotic stroke mice. Treadmill exercise can be used as an effective treatment strategy to improve brain function related to stroke. PMID: 32482055 [PubMed]
Source: International Neurourology Journal - Category: Urology & Nephrology Tags: Int Neurourol J Source Type: research
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Source: Food Chemistry - Category: Food Science Source Type: research
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Source: Dentomaxillofacial Radiology - Category: Radiology Tags: Dentomaxillofac Radiol Source Type: research
Conclusions: The posterior and inferior parts of the degenerative arthritic glenoid appears thinner than the nonarthritic glenoid. Thus, caution has to be taken when drilling the screw hole or inserting screws into the posteroinferior parts, where the glenoid is thinner than 15 mm on average, to avoid penetration of the far cortex. PMID: 32489545 [PubMed - in process]
Source: Clinics in Orthopedic Surgery - Category: Orthopaedics Tags: Clin Orthop Surg Source Type: research
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Authors: Park I, Oh MJ, Shin SJ Abstract For proper treatment of recurrent anterior instability of the shoulder with a bone defect, the defect size should be assessed preoperatively with three-dimensional computed tomography or magnetic resonance imaging. In general, the risk of postoperative recurrence of instability is estimated on the basis of preoperative imaging of bipolar bone defects: more than 20%-25% glenoid bone loss and off-track Hill-Sachs lesions have been considered risk factors for recurrence. In patients with a glenoid bone defect more than 20%-25%, a bone graft procedure, such as the Latarjet proce...
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Source: Journal of Musculoskeletal Neuronal Interactions - Category: Neurology Tags: J Musculoskelet Neuronal Interact Source Type: research
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