Recovery of Hypersomnia Concurrent With Recovery of an Injured Ascending Reticular Activating System in a Stroke Patient: A Case Report

We report on a stroke patient who showed recovery of hypersomnia concurrent with the recovery of an injured ascending reticular activating system (ARAS), which was demonstrated by diffusion tensor tractography (DTT). A 70-year-old female patient underwent coiling of the left ruptured posterior communicating artery after subarachnoid hemorrhage and both extraventricular drainage for management of an intraventricular hemorrhage. At 2 months after onset, when she started rehabilitation, she exhibited intact consciousness, with the full score on the Glasgow Coma Scale: 15. However, she showed severe hypersomnia: she always fell asleep without external stimulation and the Epworth Sleepiness Scale (EPS) score was 24 (full score: 24, cut off for hypersomnia: 10). She underwent comprehensive rehabilitative therapy, including neurotropic drugs, physical therapy, and occupational therapy. Her hypersomnia has shown improvement as 14 (3 months after onset), 11 (4 months after onset), 7 (12 months after onset), and 6 (24 months after onset), respectively. On 2-month DTT, narrowing of both lower dorsal and ventral ARASs was observed on both sides: in particular, among 4 neural tracts of the lower ARAS, the right lower ventral ARAS was the narrowest. By contrast, on 24-month DTT, the 4 narrowed neural tracts of both lower dorsal and ventral ARASs were thickened compared with those of 2-month DTT. Recovery of hypersomnia with recovery of an injured lower ARAS on DTT was observed in a stro...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

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According to a Gallup poll released in 2019, Americans are among the most stressed people in the world. We are connected to our smartphones 24/7, and we seldom take vacations. Can all this stress put you at risk for a stroke? Stress is also personal. Some people can handle high-stress situations, while others may not be able to function under stress. Dr. Andrew J. Ringer, chairman of Mayfield Brain and Spine, says there isn’t an easy answer to that question. “There are no studies that directly…
Source: bizjournals.com Health Care:Pharmaceuticals headlines - Category: Pharmaceuticals Authors: Source Type: news
Authors: Li YM, Jiang C, He L, Li XX, Hou XX, Chang SS, Lip GYH, Du X, Dong JZ, Ma CS Abstract BACKGROUND There is a growing recognition of sex-related disparities in atrial fibrillation (AF). However, limited data is available in Chinese AF patients. MATERIAL AND METHODS We compared symptoms, quality of life (QoL), and treatment of AF according to sex from the China AF Registry study. RESULTS We studied 14 723 patients with non-valvular AF, of whom 5645 patients (38.3%) were female. Women were older than men (67.5±10.6 vs. 62.2±12.2). Compared to men, women had more comorbidities and a higher proport...
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
In this report, we did a post-hoc analysis of cardiovascular and renal outcomes over 10 years following randomisation, including a 5 years post-intervention follow-up. As in the original trial, the primary endpoint was a composite of first cardiovascular event, including cardiovascular mortality, cardiovascular morbidity (non-fatal myocardial infarction and non-fatal stroke), revascularisation, and non-traumatic amputation, up to Dec 31, 2014. Analyses were based on the intention-to-treat principle. ADDITION-Europe is registered with ClinicalTrials.gov, NCT00237549.Findings343 general practices were randomly assigned to ro...
Source: The Lancet Diabetes and Endocrinology - Category: Endocrinology Source Type: research
Employing multiple artificial intelligence (AI) algorithms to attack a task...Read more on AuntMinnie.comRelated Reading: Practical Considerations of AI: Part 6 -- Ready, fire, aim Deep-learning algorithm bolsters lung cancer detection AI needs robust clinical evaluation in healthcare Deep-learning model characterizes PET/CT findings Can AI find brain hemorrhage as well as radiologists?
Source: AuntMinnie.com Headlines - Category: Radiology Source Type: news
Publication date: Available online 20 November 2019Source: Neurochemistry InternationalAuthor(s): Linlin Yuan, Shibo Sun, Xiaohan Pan, Liqin Zheng, Yuting Li, Jingyu Yang, Chunfu WuAbstractStroke is the leading cause of long-term motor disability and cognitive impairment beside the acute brain injury. Recently, neurogenesis has become an attractive strategy for the chronic recovery of stroke. Our previous study showed that pseudoginsenoside-F11 (PF11), an ocotillol-type saponin, isolated from leaves of Panax pseudoginseng subsp, exerted neuroprotective effects on stroke by alleviating autophagy/lysosomal defects and repres...
Source: Neurochemistry International - Category: Neuroscience Source Type: research
This study was performed to assess whether presence of MAC and its severity predict cardio-embolic stroke in elderly patients with first diagnosed AF.Methods: In this cross-sectional study, 72 elderly patients suffering from acute cardio-embolic stroke with first diagnosed AF and 79 elderly control group patients with first diagnosed AF and without stroke were investigated. A parasternal short-axis view at the level of the mitral annulus was used for MAC measurements. The severity of MAC was measured from the anterior to posterior edge at its greatest width.Results: MAC thicknesses were significantly higher in the stroke g...
Source: Acta Cardiologica - Category: Cardiology Tags: Acta Cardiol Source Type: research
We present a patient with SAH and refractory vasospasm. After coil embolization of the aneurysm and initial near complete improvement, the patient developed severe DCI causing coma. Medical therapy failed and angiography showed severe vasospasm complicated by chronic occlusion of distal left ICA. Balloon angioplasty of proximal right ICA was attempted but failed, as a micro wire could not be advanced into the distal ICA and proximal ACA, MCA, and basilar arteries. Intra-arterial verapamil injection produced transient improvement but angioplasty could not be performed. Due to severe bilateral cerebral hypoperfusion, continu...
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research
AbstractThere is still a debate about the safety and efficacy of an aspirin free strategy after percutaneous coronary intervention (PCI). Hence, we performed a meta-analysis comparing aspirin free strategy to dual antiplatlets therapy (DAPT). Randomized trials (RCTs) comparing aspirin free strategy to DAPT in patients who received PCI were included. The primary outcome of interest was bleeding, defined per the Bleeding Academic Research Consortium (BARC). Secondary outcomes included major adverse cardiovascular and cerebrovascular events (MACE); defined as all-cause mortality, myocardial infarction or stroke, the individua...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
Background: Thiazide diuretics may improve bone mineral density. However, results are inconsistent for studies evaluating the association between thiazides and risk of osteoporotic fracture. We performed an updated meta-analysis of cohort studies to determine the association between thiazides use and fracture risk.Methods: Relevant studies were identified via systematic search of PubMed and Embase. A random-effect model was used for meta-analysis. Subgroup analyses were performed to explore the potential influences of study characteristics on the outcome.Results: Seventeen cohort studies with 3,537,504 participants were in...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
AbstractPurpose of ReviewCardiovascular disease (CVD) remains the number one cause of death in the USA. In women, coronary heart disease (CHD) accounts for 22% of deaths with an additional 6.2% of deaths secondary to stroke. The prevalence of CVD increases as women age; after the age of 75, the incidence will exceed that reported for men. The risk for CVD in women is systematically underestimated. Both healthcare providers and women need a better understanding of the mechanism and role of traditional CVD risk factors (CVDRF) in women, and the newer identified non-traditional CVDRF which are unique to women and the resultin...
Source: Current Obstetrics and Gynecology Reports - Category: OBGYN Source Type: research
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