Acute pediatric stroke—what’s the hurry? A case for emergency physician-performed echocardiography

We describe a case of acute ischemic stroke for which emergent, physician-sonographer–performed transthoracic echocardiography (TTE) changed his outcome. The patient in this case presented with left-sided hemiparesis, with subsequent CT Angiography (CTA) imaging and follow-on neurosurgical embolectomy for a proximal middle cerebral artery occlusion after which showed early recovery of muscular deficit.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Case Report Source Type: research

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ConclusionTooth loss was independently associated with CAB and predicted a poorer functional outcome among IS and TIA patients.Clinical relevanceClinical assessment of tooth loss may provide important information on risk for CAB and poorer functional outcome among stroke patients.
Source: Clinical Oral Investigations - Category: Dentistry Source Type: research
Conclusion: Compared to pCT, DECT within 36 h after IV thrombolysis for acute ischemic stroke, changes the radiological diagnosis of post-treatment ICH to “CS only” in a small proportion of patients. Studies are warranted of whether the altered radiological reports have an impact on patient management, for example initiation timing of antithrombotic secondary prevention.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
A 65-year-old man with a history of Wallenberg syndrome caused by vertebral artery dissection at 62 years old was admitted to our hospital with nausea, vertigo, right facial dysesthesia, right hemiplegia, crossed sensory disturbance (sensory loss and numbness in the right face and left body below the neck), and right limb ataxia. Magnetic resonance imaging (MRI) performed 80 minutes after onset revealed no acute ischemic stroke lesions, but magnetic resonance angiography (MRA) demonstrated complete occlusion of the right vertebral artery.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Case Report Source Type: research
Transcarotid artery revascularization (TCAR) is a novel, hybrid approach to treating carotid disease in the treatment of stroke and stroke prevention. Early results of this hybrid approach to carotid stenting using flow reversal have been promising, with reported stroke rates around 1-2.8%1,2. Currently, carotid stenting, regardless of approach, is performed with uncovered stents, which incurs the risk of plaque protrusion through the stent and in-stent restenosis. Overall, plaque protrusion is a rare event, with a reported incidence of 2.8% on angiography, but it is associated a high rate of ischemic complications (up to 66.7%) 3.
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Clinical Research, Basic Science Source Type: research
CONCLUSIONS: In the present cases, although ischemic stroke was serious and precluded surgical indication for ATAAD, carotid artery stenting before surgery for ATAAD resulted in good clinical outcomes. Performing carotid artery stenting before surgery for ATAAD is challenging but achievable, and is a valid treatment option depending on the individual cases. PMID: 32397860 [PubMed - as supplied by publisher]
Source: Interventional Neuroradiology - Category: Radiology Tags: Interv Neuroradiol Source Type: research
Conclusions: Transcirculation approaches may be used to access the target lesion when the parent artery cannot be crossed through conventional antegrade routes. These techniques are feasible but should be reserved as a bailout maneuver when anterograde MT is not possible. Newer endovascular devices have improved neurological and angiographic outcomes in transcirculation cases.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusion: This study suggests that IA embolisation may be performed by a recently trained INR with good clinical and anatomical outcomes. Published on 2020-05-06 10:29:10
Source: Journal of the Belgian Society of Radiology - Category: Radiology Source Type: research
Hemodynamic changes occurring at the segments of arterial bifurcations, up and down stream of stenotic vessels appear to play a critical role in the development of atherosclerosis. Therefore, we hypothesized that basilar artery (BA) geometry may be related to the distribution of atherosclerotic plaque. In this retrospective cross-sectional study, all patients hospitalized with ischemic stroke and intracranial atherosclerotic disease were sifted from March 2017 to October 2017. Sixty-seven patients with intracranial atherosclerotic disease (39 with and 28 without BA atherosclerosis) were analyzed. Magnetic resonance imagin...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
AbstractAcute aortic syndromes (AASs) are deadly cardiovascular emergencies involving the thoracic aorta. AASs are relatively rare conditions, have unspecific signs and symptoms (including truncal pain, syncope, neurologic deficit and limb ischemia) and require contrast-enhanced tomography angiography (CTA) of the chest and abdomen for conclusive diagnosis and subsequent therapeutic planning. In the Emergency Department (ED), most patients with potential signs/symptoms of AASs are finally found affected by other alternative diagnoses. Hence, misdiagnosis and delayed diagnosis of AASs are major concerns. In critically ill p...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research
ConclusionNCCT ILV measured automatically by the Brainomix software might be considered a valuable radiological outcome measure.
Source: Neuroradiology - Category: Radiology Source Type: research
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