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Modern Treatment of Asymptomatic Carotid Stenosis —The Importance of Both Medical Therapy and Carotid Endarterectomy
Each year there are approximately 700  000 new ischemic strokes in the US, and 10% to 15% of them are caused by thromboembolism from a previously asymptomatic carotid stenosis (ACS). Three large randomized clinical trials, published in the 1990s and early 2000s, have demonstrated a significant benefit of carotid endarterectomy (CEA) i n preventing stroke in patients with severe ACS compared with medical therapy alone. They showed a 50% relative risk reduction in 5-year stroke rate and an approximately 1% per year absolute stroke risk reduction. Over the course of the past 2 decades, there has been significant improvement...
Source: JAMA Surgery - June 8, 2022 Category: Sports Medicine Source Type: research

Millard-Gubler Syndrome Associated with Cerebellar Ataxia in a Patient with Isolated Paramedian Pontine Infarction – A Rarely Observed Combination with a Benign Prognosis: A Case Report
We report the case of a 55-year-old male patient having presented to the Yehuleshet Specialty Clinic 6 years back with sudden-onset dysarthria and appendicular ataxia of 10 days duration. He reported having right hemibody weakness and blurred vision, which have significantly improved since then. He had a history of smoking of 30 pack-years. However, he quit smoking 8 years ago. There was no history of prior stroke, transient ischemic attack, diabetes, hypertension, head trauma, or dyslipidemia. On examination, he had horizontal left gaze palsy with horizontal nystagmus suggesting left-sided 6th cranial nerve palsy. He had ...
Source: Case Reports in Neurology - April 13, 2021 Category: Neurology Source Type: research

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) – Still to be Considered in the Presence of Vascular Risk Factors
We report a 46-year-old male with a 9 and 3-month history of progressive unilateral lower limb weakness and dysarthria, respectively. He had a history of diabetes mellitus but no hypertension, hyperlipidemia, or smoking history. Both parents had a stroke at the age of 65 years. Neurological examination was significant for moderate dysarthria and reduced right upper limb dexterity. Magnetic resonance imaging (MRI) of the brain revealed extensive white matter disease, lacunar infarcts, and a few microhemorrhages. Electron microscopy of his skin biopsy showed electron-dense deposits of extracellular osmiophilic granular mater...
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research

Consecutive Slides on Axial View Is More Effective Than Transversal Diameter to Differentiate Mechanisms of Single Subcortical Infarctions in the Lenticulostriate Artery Territory
Conclusion: Consecutive slides on axial view (≥4 consecutive slices) might be more effective than transversal diameter to identify the atherosclerotic mechanisms of SSIs in the lenticulostriate artery territory. Clinical Trial Registration: http://www.clinicaltrials.gov. Unique identifier: NCT00664846 Introduction Single subcortical infarctions (SSIs) have been considered to be caused by lipohyalinosis degeneration in small artery disease, traditionally called lacunar infarct (1). However, atherosclerosis occurring in the parental artery blocking the orifice of the branch artery or atherosclerosis in the p...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Interaction of incidental microbleeds and prior use of antithrombotics with early hemorrhagic transformation: Causative or protective ?
Conclusion: Presence of incidental CMBs was not associated with increased risk for early HT of an ischemic stroke. Interestingly, the prior intake of antiplatelets was found to be protective against HT of ischemic stroke.
Source: Annals of Indian Academy of Neurology - November 21, 2016 Category: Neurology Authors: Konark Malhotra Monica Khunger Bichun Ouyang David S Liebeskind Yousef M Mohammad Source Type: research

Value of Eye Movement Exam in Aiding Precise Localization in Stroke (P1.016)
We present an unusual presentation of midbrain stroke presenting with bilateral ptosis in an African American male with vascular risk factors and concurrent use of bevacizumab. This case illustrates how detailed knowledge of anatomy and detailed neurologic exam remain valuable tools for localizing and diagnosing subtle presentations of common neurologic disease. Case description: A 69 year-old African American man with vascular risk factors including hypertension, hyperlipidemia and poorly controlled diabetes experienced sudden onset horizontal diplopia associated with fatigue. The patient presented to the Emergency Depart...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Khandker, N., Schmerler, D., Mahajan, S., Serra, A., Strbian, D. Tags: Cerebrovascular Disease and Interventional Neurology I ePosters Source Type: research