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Postreperfusion Blood Pressure Variability After Endovascular Thrombectomy Affects Outcomes in Acute Ischemic Stroke Patients With Poor Collateral Circulation
Conclusion: Postreperfusion BP management by decreasing BPV may have influence on improving clinical outcome in cases of poor collateral circulation among patients achieving successful recanalization after ERT. Introduction Endovascular recanalization therapy (ERT) has been adopted as standard stroke care in patients with acute ischemic stroke (1–6). Time to recanalization and degree of recanalization are the most important predictors of clinical outcomes after ERT (7). Before recanalization, an effort to reduce the time from symptom onset to reperfusion is critical for penumbral salvage. After recanalization...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Facial Colliculus and Opalski Stroke Syndromes Caused by Vertebral Artery Dissection. Case Report (P4.349)
Conclusion: Brainstem stroke syndromes are challenging to localize before brain imaging. In this case two embolic strokes happened. The first in the right facial colliculus causing the right 6th and 7th cranial nerves palsy. The second happened in the left lateral medulla extending below the pyramidal decussation causing a classical left lateral medullary syndrome with ipsilateral hemiparesis, which constitute a left Opalski stroke syndrome.Disclosure: Dr. Alghamdi has nothing to disclose. Dr. Ayoub has nothing to disclose. Dr. Alzahrani has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Alghamdi, S., Ayoub, O., Alzahrani, N. Tags: Cerebrovascular Case Reports Source Type: research

Sudden bilateral anterior cerebral infarction: unusual stroke associated with unusual vascular anomalies
We describe a 38-year-old male smoker and heavy alcohol user, who awoke with sudden onset of weakness of both lower limbs, and bladder and bowel incontinence. He had consumed excessive amounts of alcohol the previous night. There was no significant past medical history including other vascular risk factors and cardiovascular disease. On admission, he was mute and abulic. The frontal release signs including the forced grasping and the snout reflex were present. Routine full blood count and biochemical analysis were normal. MRI of the brain showed bilateral, nearly symmetrical ACA infarction (figure 1A–C). Time-of-flig...
Source: Postgraduate Medical Journal - January 21, 2013 Category: Journals (General) Authors: Krishnan, M., Kumar, S., Ali, S., Iyer, R. S. Tags: Urology, Open access, Drugs: cardiovascular system, Echocardiography, Stroke, Venous thromboembolism, Radiology, Physiotherapy, Sports and exercise medicine, Clinical diagnostic tests, Radiology (diagnostics) Images in medicine Source Type: research

A Chinese Family With Adult-Onset Leigh-Like Syndrome Caused by the Heteroplasmic m.10191T > C Mutation in the Mitochondrial MTND3 Gene
Conclusion The m.10191T>C mutation in the mtDNA of the complex I (CI) subunit of MTND3 results in the substitution of a highly conserved amino acid (p.Ser45Pro) within the ND3 protein, leading to CI dysfunction through impaired enzyme catalysis rather than impaired stability or assembly, causing a broad clinical spectrum of disorders (26). Patients with the m.10191T>C mutation are rare. In the present study, we report on a family of patients with the extremely rare adult-onset Leigh-like syndrome with the m.10191T>C mutation. Including the two patients from our reported family, the m.10191T...
Source: Frontiers in Neurology - April 17, 2019 Category: Neurology Source Type: research

Efficacy of trazodone for treating paroxysmal sympathetic hyperactivity presenting after thalamic hemorrhage: A case report.
Authors: Morinaga Y, Nii K, Sakamoto K, Inoue R, Mitsutake T, Hanada H Abstract Paroxysmal sympathetic hyperactivity (PSH) is a clinical condition characterized by abnormal paroxysmal surges in sympathetic nervous system activity. PSH is known to occur after severe head injury and hypoxic encephalopathy. Cases of PSH that develop after stroke have been reported worldwide; however, PSH is not commonly reported in the field of stroke research in Japan. Some studies have suggested that gabapentin may improve the symptoms of PSH. To our knowledge, this is the first case report demonstrating the efficacy of trazodone fo...
Source: Drug Discoveries and Therapeutics - July 23, 2019 Category: Drugs & Pharmacology Tags: Drug Discov Ther Source Type: research

The Case Files: Traumatic Carotid Dissection
By Hsiao, Jonie MD   A 30-year-old man who was right-hand dominant presented 10 days after sustaining left-sided face and head trauma from a fall from a skateboard at an unknown speed. He lost consciousness for several seconds, and initially developed a headache with nausea and vomiting. A non-contrast head CT performed at another hospital done two days after the incident was reportedly negative.   He now presents primarily with concerns about the appearance of his left eye. He has notable anisocoria and a droopy eyelid. His left pupil is notably smaller, 2 mm, compared with the right eye, 5 mm. Both are reactive. The re...
Source: The Case Files - June 4, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Reversible Cerebral Vasoconstriction Syndrome Presenting as Coma (P4.354)
Conclusions: RCVS rarely can present with coma and multifocal infarctions. Exact pathophysiology remains unknown but disruption of sympathetic tone and endothelial dysfunction have been implicated. A high index of suspicion is required to minimize disease complications and prevent improper withdrawal of care.Disclosure: Dr. Khan has nothing to disclose. Dr. Adcock has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Khan, M., Adcock, A. Tags: Cerebrovascular Case Reports Source Type: research

The Typical Thunderclap Headache of Reversible Cerebral Vasoconstriction Syndrome and its Various Triggers
During the last 10 years, reversible cerebral vasoconstriction syndrome (RCVS) has emerged as the most frequent cause of thunderclap headache (TCH) in patients without aneurysmal subarachnoid hemorrhage, and as the most frequent cause of recurrent TCHs. The typical TCHs of RCVS are multiple, recurring over a few days to weeks, excruciating, short‐lived, and brought up by exertion, sexual activities, emotion, Valsalva maneuvers, or bathing, among other triggers. All these triggers induce sympathetic activation. In a minority of cases with RCVS, TCH heralds stroke and rarely death. Early diagnosis of RCVS in patients who p...
Source: Headache: The Journal of Head and Face Pain - March 25, 2016 Category: Neurology Authors: Anne Ducros, Valérie Wolff Tags: Review Article Source Type: research

The Typical Thunderclap Headache of Reversible Cerebral Vasoconstriction Syndrome and its Various Triggers.
Abstract During the last 10 years, reversible cerebral vasoconstriction syndrome (RCVS) has emerged as the most frequent cause of thunderclap headache (TCH) in patients without aneurysmal subarachnoid hemorrhage, and as the most frequent cause of recurrent TCHs. The typical TCHs of RCVS are multiple, recurring over a few days to weeks, excruciating, short-lived, and brought up by exertion, sexual activities, emotion, Valsalva maneuvers, or bathing, among other triggers. All these triggers induce sympathetic activation. In a minority of cases with RCVS, TCH heralds stroke and rarely death. Early diagnosis of RCVS i...
Source: Headache - March 25, 2016 Category: Neurology Authors: Ducros A, Wolff V Tags: Headache Source Type: research

Pial arteriovenous fistula with appearance of hemorrhagic tumor: A case report
Conclusions: It is noteworthy that PAVF with a large thrombus may appear as a tumor in the initial diagnosis, and therefore it is necessary to perform an intracranial vascular examination in patients with tumor stroke symptoms.
Source: Medicine - October 16, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Cutaneomeningospinal Angiomatosis (Cobb Syndrome) in a Young Patient.
Abstract Cobb Syndrome (Spinal Arteriovenous Metameric Syndrome 1-31 (SAMS 1-31)) is a rare, non-hereditary disorder. Approximately 100 cases of CS have been described to date. The actual incidence may be much higher since only symptomatic patients were documented. In particular, post mortem studies suggest a possibly higher incidence of this syndrome. The main clinical manifestations of this syndrome include skin stains of vascular nature on the torso, in combination with spinal vascular malformations localized in one and the same metameric or spinal segment. A rare diagnosis of this syndrome in patients over 18 ...
Source: CNS and Neurological Disorders Drug Targets - February 17, 2021 Category: Drugs & Pharmacology Authors: Putilina M, Teplova N, Dvornikov A Tags: CNS Neurol Disord Drug Targets Source Type: research

Cutaneomeningospinal Angiomatosis (Cobb Syndrome) in a Young Patient
CNS Neurol Disord Drug Targets. 2021 Feb 17. doi: 10.2174/1871527320666210218083550. Online ahead of print.ABSTRACTCobb Syndrome (Spinal Arteriovenous Metameric Syndrome 1-31 (SAMS 1-31)) is a rare, non-hereditary disorder. Approximately 100 cases of CS have been described to date. The actual incidence may be much higher since only symptomatic patients were documented. In particular, post mortem studies suggest a possibly higher incidence of this syndrome. The main clinical manifestations of this syndrome include skin stains of vascular nature on the torso, in combination with spinal vascular malformations localized in one...
Source: CNS and Neurological Disorders Drug Targets - February 19, 2021 Category: Drugs & Pharmacology Authors: Marina Putilina Nataliya Teplova Anton Dvornikov Source Type: research

Macular dystrophy associated with the mitochondrial DNA A3243G mutation: pericentral pigment deposits or atrophy? Report of two cases and review of the literature
Conclusion: Observation of RPE abnormalities in the context of suggestive systemic findings should prompt mtDNA testing.
Source: BMC Ophthalmology - Latest articles - June 6, 2014 Category: Opthalmology Authors: Alejandra DaruichAlexandre MatetFrançois-Xavier Borruat Source Type: research

E-029 symptomatic hemodynamic depression occurring before balloon inflation during carotid angioplasty/stenting
ConclusionDuring CAS, hemodynamic depression is caused by the stretch-induced stimulation of the carotid sinus baroreceptors located in the adventitial walls of the carotid bulb. This baroreceptor activation caused by balloon dilatation and stent deployment causes increased afferent signals to the caudal medulla by way of the carotid sinus and glossopharyngeal nerves. The medulla subsequently responds by increasing parasympathetic impulses and decreasing sympathetic vascular tone, which results in bradycardia and hypotension. Reported incidences of HD as well as individual hemodynamic parameters following CAS procedures va...
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Lee, J. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

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