Pediatric posterior cerebral artery stroke as a presentation of atlantoaxial dislocation
We report an uncommon case of posterior circulation stroke in a young patient due to occlusion of posterior cerebral artery with reducible atlantoaxial dislocation (AAD). Plain dynamic radiography showed reducible AAD and intra-arterial digital subtraction angiography demonstrated occlusion of left posterior cerebral artery. Patient underwent stabilization of craniovertebral junction by occipito cervical fixation using occipit-C2/C3 lateral mass screws and rod fixation and has since experienced no recurrent symptoms. Vertebrobasilar insufficiency is a known entity in a patient with reducible AAD; however, isolated involvement of posterior cerebral artery is very rare. So this condition should be kept in mind, and necessary interventions must be undertaken at the earliest to avoid further irreversible brain damage.
CONCLUSIONS: PulseRider is being used in both on- and off-label cases following FDA approval. The clinical and radiographic outcomes are comparable in real-world experience to the outcomes observed in earlier studies. Further experience is needed with the device to determine its role in the neurointerventionalist's armamentarium, especially with regard to its off-label use. PMID: 31703202 [PubMed - as supplied by publisher]
ConclusionsAlthough prospective study of AIS patients at a radiography department is indispensable, CB-CTA performed in an angiography-suite might be useful to evaluate patients with ELVO.
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this techniqu...
CONCLUSIONSAcute occlusion of the ICA on the contralateral side from an STA-MCA bypass is a rare, but potentially serious, complication of revascularization surgery for MMD. It highlights the importance of the hemodynamic interrelationships that exist between the two hemispheres, a concept that has been previously underappreciated. Induced hypertension during the acute period may provide adequate cerebral blood flow via developing collateral vessels, and good outcomes may be achieved with aggressive supportive management and expedited contralateral revascularization. PMID: 30554188 [PubMed - as supplied by publisher]
By SAURABH JHA Medical Imaging and the Price of Corn After the Napoleonic wars, the price of corn in England became unaffordable. The landowners were blamed for the high price, which some believed was a result of the unreasonably high rents for farm land. Economist David Ricardo disagreed. According to Ricardo, detractors had the directionality wrong. It was the scarcity of corn (the high demand relative to its supply) that induced demand for the most fertile land. That is, the rent did not increase the price of corn. The demand for corn raised the rent. Rent was a derived demand. Directionality is important. Getting dire...
By SAURABH JHA Medical Imaging and the Price of Corn After the Napoleonic wars, the price of corn in England became unaffordable. The landowners were blamed for the high price, which some believed was a result of the unreasonably high rents for farm land. Economist David Ricardo disagreed. According to Ricardo, detractors had the directionality wrong. It was the scarcity of corn (the high demand relative to its supply) that induced demand for the most fertile land. That is, the rent did not increase the price of corn. The demand for corn raised the rent. Rent was a derived demand. Directionality is important. Getting direc...
CONCLUSIONS The pilot study suggested that our proposed classification of COICA may be useful as an adjunctive guide to determine the technical feasibility and safety of revascularization for symptomatic COICA using endovascular techniques. Additionally, successful revascularization may lead to a significant decrease in SBP postprocedure. A Phase 2b trial in larger cohorts to assess the efficacy of endovascular revascularization using our COICA classification is warranted. PMID: 29775153 [PubMed - as supplied by publisher]
Conclusion: We introduced a novel C1-C2 transarticular screw-placement technique in which the trajectory went through the ipsilateral VA foramen due to already extent VA occlusion. PMID: 29184713 [PubMed]
Conclusion Supraaortic vessel tortuosity significantly influences ICA-AT in mechanical thrombectomy for an acute large vessel. There furthermore was a trend for lower successful recanalization rates with increasing ICA-AT. PMID: 28944705 [PubMed - as supplied by publisher]
Conclusions—One of 10 people with periprocedural RBIs during cardiac surgeries and invasive vascular diagnostic procedures resulted in strokes or transient ischemic attacks, which may serve as a potential surrogate marker of procedural proficiency and perhaps as a predictor of risk for periprocedural strokes.