Benefits of MRI for Patients With Low-risk Transient or Persistent Minor Neurologic Deficits

More than 1 million patients receive a diagnosis of stroke or transient ischemic attack (TIA) in the United States each year. These patients are at increased risk of stroke during the first few weeks after the initial event, with the greatest risk during the first 2 days. Evidence-based secondary preventive measures are available to lower the risk of recurrent ischemic events, but for these measures to be effectively implemented, patients with stroke or TIA must be rapidly and correctly identified. Accurate diagnosis is important because some secondary preventive strategies carry risks of their own and are usually not appropriate for patients who did not have a TIA or stroke. Patients presenting with motor weakness, aphasia, or prolonged symptoms are at highest risk for recurrent stroke and are typically more comprehensively evaluated. Therefore, these patients are more likely to receive a more conclusive diagnosis and are likely to receive secondary prevention strategies promptly.
Source: JAMA Neurology - Category: Neurology Source Type: research

Related Links:

CONCLUSIONS: We identified no significant differences in C-FIM outcomes (gain, efficiency and effectiveness) either in LOS between PWA and patients without aphasia, though C-FIM differences were significant at admission and discharge. Aphasia was a significant predictor of C-FIM gain and C-FIM at discharge. PMID: 32967590 [PubMed - as supplied by publisher]
Source: Topics in Stroke Rehabilitation - Category: Neurology Authors: Tags: Top Stroke Rehabil Source Type: research
We report an extremely rare case of a 27-year-old woman presenting with ischemic stroke as an initial manifestation of moyamoya disease in the first trimester of pregnancy. We conducted an artificial abortion when her neurological symptoms rapidly became refractory to optimal antithrombotic treatments. The progression of neurologic deficits stopped immediately after abortion, resulting in recovery to independence, with slight motor aphasia and right hemiparesis due to improved cerebral flow. We highlight rapid artificial abortion combined with antithrombotic treatment for patients of moyamoya disease with pregnancy-associa...
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Case Report Source Type: research
Authors: Hashimoto G, Wada S, Morita T, Tomohara S, Hara K, Kumabe M, Matsushima T, Kadowaki M, Hamaguchi M, Kuwashiro T, Yasaka M, Okada Y Abstract An 84-year-old man developed motor aphasia and right hemiparesis on postoperative day 1 after orchiectomy for suspected malignant lymphoma. He had a history of thoracic endovascular aortic repair for aortic aneurysm using a bypass graft from the right subclavian artery to the left common carotid artery (CCA); however, the graft had become occluded six months later. Brain magnetic resonance imaging revealed acute cerebral infarctions in the left frontal lobe. Carotid ul...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Authors: Takeshita S, Ogata T, Tsugawa J, Tsuboi Y Abstract A 47-year-old woman, who was diagnosed to have systemic lupus erythematosus (SLE), was admitted because she suffered a severe ischemic stroke three weeks after experiencing a transient attack of aphasia. Diffusion-weighted MR imaging revealed high intensity at the borderzone of the middle cerebral artery (MCA), while the proximal portion of the left MCA was occluded with its vascular wall enhanced by gadolinium. Intravenous methylprednisolone and heparin were administrated without any symptomatic benefit. She developed severe right hemiparesis with aphasia...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Conclusion: We showed that repeated attachment of the styloid process and ICA may trigger an ICA dissection during head rotation. This finding would be helpful for understanding the causes of vascular Eagle syndrome. PMID: 32637216 [PubMed]
Source: Surgical Neurology International - Category: Neurosurgery Tags: Surg Neurol Int Source Type: research
A 43-year-old male pet shop owner on leflunomide for seronegative rheumatoid arthritis presented locally with strange behavior and aphasia, preceded by flu-like symptoms and high fevers. Initial workup revealed cerebrospinal fluid lymphocytic pleocytosis (22 cells, 74% lymphocytes), for which he was started on empiric antimicrobial therapy. Magnetic resonance imaging of the brain revealed extensive, bilateral ischemic strokes (Figure). A transesophageal echocardiogram was negative. He was then transferred to our institution for further evaluation.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Clinical Communication to the Editor Source Type: research
A 43-year-old male pet shop owner on leflunomide for seronegative rheumatoid arthritis presented locally with strange behavior and aphasia, preceded by flu-like symptoms and high fevers. Initial workup revealed cerebrospinal fluid lymphocytic pleocytosis (22 cells, 74% lymphocytes), for which he was started on empiric antimicrobial therapy. A brain MRI revealed extensive, bilateral ischemic strokes (Figure 1). A transesophageal echocardiogram (TEE) was negative. He was then transferred to our institution for further evaluation.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Clinical Communication to the Editor 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
Cortical deafness is an extremely rare clinical manifestation that originates mainly from bilateral cortical lesions in the primary auditory cortex. Its main clinical manifestation is the bilateral sudden loss of hearing. Diagnosis is difficulty due to its rarity and similarity with other language and communication disorders, such as Wernicke's aphasia, auditory agnosia or verbal deafness. Herein, we present a case report of a young woman with a sudden bilateral loss of auditory comprehension. Initially, a psychiatric nature of the disorder was considered, but the persistence of the symptoms, lead to the diagnosis of corti...
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Case Report Source Type: research
Aphasia is one of the most severe symptoms in stroke patients, affecting one-third of acute stroke patients. We aimed to investigate the prevalence and outcomes of aphasia in patients with acute ischemic stroke (AIS).
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
More News: Aphasia | Brain | Ischemic Stroke | Neurology | Stroke | USA Health