Left Atrial Enlargement Could Be Detected on Extended Computed Tomography Angiography
To the Editor In a secondary analysis of the New Approach Rivaroxaban Inhibition of Factor Xa in a Global Trial Versus ASA to Prevent Embolism in Embolic Stroke of Undetermined Source trial, Healey and colleagues determined that for patients with embolic stroke of undetermined source and left atrial enlargement rivaroxaban treatment was associated with a 74% reduction in recurrent stroke. The authors suggest that left atrial enlargement could become a new determinant in secondary stroke prevention.
A 51-year-old Japanese woman was admitted to our hospital because of speech difficulty following severe headache. Neurological examination showed dysarthria and tongue weakness on the right side, indicating right hypoglossal nerve palsy. Needle electromyography of the right side of the tongue showed fibrillation potentials. Magnetic resonance angiography and computed tomography angiography revealed a right, persistent, primitive hypoglossal artery (PPHA) that met Lie's diagnostic criteria. Digital subtraction angiography showed an extended PPHA with irregular caliber in the portion running through the right hypoglossal canal.
ConclusionBaseline cut off thrombus appearance predicts a higher number of thrombectomy maneuvers. In day to day practice this may prepare the neurointerventionalist for a more challenging endovascular procedure ahead. Stroke etiology, clinical outcomes and thrombus-specific characteristics did not show any associations with the thrombus appearance.
Background: Extracranial carotid artery (ECA) tortuosity may influences successful recanalization rates of mechanical thrombectomy in acute ischemic stroke (AIS), yet the relationship between ECA tortuosity and the prognosis of patients with anterior circulation AIS who cannot undergo endovascular treatment remains uncertain. We hypothesized that increased tortuosity of the ECA leads to unfavorable outcomes in such patients. Methods: Patients with anterior circulation AIS who underwent computed tomography angiography of the head and neck in our hospital between March 2018 and November 2018 were retrospectively analyzed.
CONCLUSIONS: According to the results of postoperative DW-MRI, retrograde perfusion itself might not increase the incidence of postoperative cerebral embolism in properly selected cardiac surgery patients undergoing routine preoperative CTA examination. PMID: 31776305 [PubMed - as supplied by publisher]
Study Design. Retrospective cohort study. Objective. Compare a novel two-step algorithm for indicating a computed tomography angiography (CTA) in the setting of a cervical spine fracture with established gold standard criteria. Summary of Background Data. As CTA permits the rapid detection of blunt cerebrovascular injuries (BCVI), screening criteria for its use have broadened. However, more recent work warns of the potential for the overdiagnosis of BCVI, which must be considered with the adoption of broad criteria. Methods. A novel two-step metric for indicating CTA screening was compared with the American Coll...
CONCLUSIONS: Preoperative coronary angiography in patients affected by infective endocarditis provides relevant information in a significant proportion of patients and can be performed safely. PMID: 31734140 [PubMed - as supplied by publisher]
In Reply We agree with Popkirov that left atrial volume is a better marker of incident atrial fibrillation than atrial diameter; however, we did not have these data available at all of the sites participating in the New Approach Rivaroxaban Inhibition of Factor Xa in a Global Trial Versus ASA to Prevent Embolism in Embolic Stroke of Undetermined Source (NAVIGATE-ESUS) trial. Recently completed and ongoing studies will help determine if our observation has a clinical role and may provide additional data on left atrial size and function. Once all of these data are available, guidelines committees will likely make recommendat...
Conclusion The current study demonstrates that in patients with severe aortic valve stenosis or regurgitation and mitral valve prosthesis, the implantation of a self-expanding aortic valve via the transfemoral route is safe and feasible, with maintained long-term results.
Publication date: Available online 4 November 2019Source: Journal of Clinical NeuroscienceAuthor(s): Atilla Özcan Özdemir, Ezgi Sezer Eryıldız, Fatma Ger Akarsu, Zehra Uysal Kocabaş, Özlem AykaçAbstractThe Alberta Stroke Program Early Computed Tomography Score (ASPECTs) on noncontrast CT (NCCT) is widely used for the decision of endovascular therapy (ET) in randomized controlled trials. CT angiography source images (CTA-SI) is another method to evaluate ischemic brain damage. We aimed to evaluate the association between pretreatment ASPECTs on CTA-SI and post-treatment clinical and radiological out...
Conclusion Progressive stroke was the initial symptom of the neurosyphilis. Disease progression is rapid and difficult to control with a single course of penicillin.