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Teaching NeuroImages: Giant cell arteritis presenting with acute ischemic strokes due to diffuse intracranial stenoses
A 72-year-old woman with unremarkable medical history was admitted with acute ischemic strokes (AIS) in multiple arterial distributions in anterior and posterior circulation (figure 1A and supplemental data at Neurology.org). Elevated erythrocyte sedimentation rate (98 mm/h) prompted the evaluation of superficial temporal arteries (STA) with duplex sonography (halo sign; figure 1B) and contrast angiography (right STA [figure 2A] and multiple intracranial arterial stenoses [figure 2, A–D]). STA biopsy confirmed the diagnosis of giant cell arteritis (GCA; figure 1, C and D).
Source: Neurology - October 9, 2017 Category: Neurology Authors: Kargiotis, O., Safouris, A., Petrou, V. N., Magoufis, G., Stamboulis, E., Tsivgoulis, G. Tags: MRI, Ultrasound, Vasculitis, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research

Ultrasound Criteria for Assessment of Vertebral Artery Origins (P4.251)
Conclusions:Ultrasound has good sensitivity and excellent specificity for detecting vertebral origin occlusion. Flow velocity can be used to screen for severe stenosis of vertebral artery at origin.Disclosure: Dr. Rice has nothing to disclose. Dr. Strohm has nothing to disclose. Dr. Raber has nothing to disclose. Dr. Katzan has received personal compensation for activities with Pfizer, Genentech, Inc, and Cardionet, Inc Dr. Uchino has nothing to disclose. Dr. Hussain has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Rice, C., Strohm, T., Raber, L., Katzan, I., Uchino, K., Hussain, M. Tags: Acute and Diagnostic Imaging in Ischemic Stroke and TIA Source Type: research

Multiple Acute Ischemic Strokes due to Cerebral AVM Vascular Steal Phenomenon (P2.298)
Conclusions:This is a case of multiple bilateral cortical and subcortical ischemic strokes in a setting of a large, long-standing cerebral AVM and an otherwise unremarkable stroke workup. TCD showed severely dampened VMR bilaterally which strongly suggests a failure of cerebral auto-regulation and a potential vascular steal phenomenon secondary to the AVM.Disclosure: Dr. Bhatt has nothing to disclose. Dr. Cajigas has nothing to disclose. Dr. Malik has nothing to disclose. Dr. Koch has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Bhatt, N., Cajigas, I., Malik, A., Koch, S. Tags: Subarachnoid Hemorrhage, Intracranial Aneurysm, and Other Cerebrovascular Malformations Source Type: research

Recent Nationwide Trends in Transcranial Doppler Utilization During Acute Ischemic Stroke Hospitalizations (P4.296)
Conclusions:Over the last decade there has been a slight but steady decrease in the use of TCD during AIS hospitalizations in the US. Future studies should examine the cost-utility of TCD, especially with the advent of endovascular stroke treatment systems.Disclosure: Dr. Liu has nothing to disclose. Dr. Lunagariya has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Feng has nothing to disclose. Dr. Ovbiagele has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Liu, Y., Lunagariya, A., Patel, U., Patel, A., Feng, W., Ovbiagele, B. Tags: In-Hospital Stroke Care Source Type: research

The relationship between chemerin levels and carotid intima-media thickness in patients with ischemic stroke (P1.262)
Conclusions:Consequently, this study showed that serum chemerin levels may play role in atherosclerosis and ischemic stroke.Study Supported by: Fırat University (FÜBAP)Disclosure: Dr. Demir has nothing to disclose. Dr. Atas has nothing to disclose. Dr. Aytaç has nothing to disclose. Dr. Gonen has nothing to disclose. Dr. Erten has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Demir, C., Ataş, I., Aytac, E., Gonen, M., Erten, Z. Tags: Genetic Stroke Syndromes, Biomarkers, and Translational/Basic Research Source Type: research

Is there a correlation between embolic strokes of undetermined source (ESUS) and patent foramen ovale (PFO)? - A contrasted Transcranial Doppler Ultrasound (cTCD) study. (P6.287)
Conclusions:Massive shunt (the so-called "curtain pattern") during Valsalva maneuver at cTCD was predictive of ESUS in patients with stroke and PFO. The presence of RLS at rest was not statiscally relevant, probably because of the small sample size.Disclosure: Dr. Scavasine has nothing to disclose. Dr. Chamma has nothing to disclose. Dr. Bruch has nothing to disclose. Dr. Braga has nothing to disclose. Dr. Bazan has nothing to disclose. Dr. Massaro has nothing to disclose. Dr. Germiniani has nothing to disclose. Dr. Lange has nothing to disclose. Dr. Zetola has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Scavasine, V., Chamma, J., Bruch, T., Braga, G., Bazan, R., Massaro, A., Germiniani, F., Lange, M., Zetola, V. Tags: Prevention of Cerebrovascular Disease Source Type: research

Ischemic stroke in a patient with Parry-Romberg syndrome (P4.064)
Conclusions:The only other reported patient with PRS and stroke was also found to have a PFO. It is possible that the elevated ANA seen in this patient correlates with propensity towards small venous clots not seen on ultrasound. This may lead to paradoxical emboli and ischemic strokes. It is important to note this potential association between PRS and ischemic stroke in young patients without other known risk factors. It would be worthwhile to treat this subset of patients with medications for secondary stroke prevention.Disclosure: Dr. Ebiana has nothing to disclose. Dr. Singh has nothing to disclose. Dr. Khosa has nothi...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Ebiana, V., Singh, S., Khosa, S., Moheb, N., Trikamji, B., Rao, N., Mishra, S. Tags: General Neurology: Vascular Neurology Source Type: research

Reducing Resource Utilization and Improving Efficiency Using A Separate Activation for Emergent Large Vessel Occlusion Ischemic Strokes (P5.264)
Conclusions:Partitioning of the acute stroke management process with a separate activation for probable large vessel occlusions resulted in a reduction of vascular imaging utilization and did not result in slower door-to-groin times.Study Supported by: No funding.Disclosure: Dr. Tan has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Shaykhinurov has nothing to disclose. Dr. Rodrigazo has nothing to disclose. Dr. Neiswander has nothing to disclose. Dr. Majidi has nothing to disclose. Dr. Burger has nothing to disclose. Dr. Leon Guerrero has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Tan, M., Patel, S., Shaykhinurov, E., Rodrigazo, M. C., Neiswander, B., Majidi, S., Burger, K., Guerrero, C. L. Tags: Acute Cerebrovascular Interventional Therapies Source Type: research

More to Atherosclerosis than Stenosis: Symptomatic Carotid Artery with Intraplaque Hemorrhage (P5.285)
Conclusions:Current guidelines only address the degree of arterial narrowing when recommending carotid revascularization procedures for secondary stroke prevention. The most recent AHA-ASA guideline advises against revascularization procedures in less than 50% CA stenosis. These guidelines do not account for plaque morphology that may predict a high risk of early stroke recurrence as demonstrated by our patient.Disclosure: Dr. Rai has nothing to disclose. Dr. Thaler has received personal compensation for activities with St. Jude Medical WL and Gore Associates as a consultant. Dr. Leung has nothing to disclose. Dr. Madan ha...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Rai, S., Thaler, D., Leung, L., Madan, N., Salehi, P. Tags: SubAcute Interventional Therapies in Cerebrovascular Disease Source Type: research

Achieving LDL
Conclusions: Achieved LDL<70 vs. 70-120 mg/dL in ischemic stroke patients was associated with a pattern of reduced atherosclerotic plaque progression at one year, but this difference did not reach statistical significance. Future larger studies are warranted.Disclosure: Dr. Zhang has nothing to disclose. Dr. Liu has nothing to disclose. Dr. Hua has nothing to disclose. Dr. Song has nothing to disclose. Dr. Ji has nothing to disclose. Dr. Ren has nothing to disclose. Dr. Song has nothing to disclose. Dr. Liu has nothing to disclose. Dr. Feng has nothing to disclose. Dr. Ovbiagele has nothing to disclose. Dr. Ding has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Zhang, Q., Liu, S., Hua, Y., Song, H., Ji, X., Ren, Y., Song, Y., Liu, R., Feng, W., Ovbiagele, B., Ding, J. Tags: Carotid Disease Source Type: research

Intracranial and Extracranial Stenosis interact with White Matter Disease in the Pathogenesis of Post Stroke Dementia (P5.210)
Conclusions: Patients with concomitant extracranial and intracranial stenosis have highest risks of developing PSD. Burden of WMH further influences the impact of stenosis on cognition.Disclosure: Dr. Ben Wee has nothing to disclose. Dr. Choong has nothing to disclose. Dr. Chander has nothing to disclose. Dr. Kandiah has received honorarium and CME sponsorship from Lundbeck, Novartis and Eisai.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Ben Wee, C., Choong, A., Chander, R., Kandiah, N. Tags: Aging and Dementia: Disease Models and Mechanisms Source Type: research

Etiologic Epidemiology of Ischemic Stroke (A Study About 2450 Cases) (P1.120)
Conclusions: The main etiology of ischemic stroke in elderly person was lacunar infract followed by atherosclerosis and atrial fibrillation. In Young adults, etiology differs according to country. In our study Carotid dissection takes the first place in patients with age under 45 years old Etiological investigations and a swift implementation of strategy for the prevention of the risk factors are important faced with increased incidence of ischemic stroke. Despite a complete assessment, ischemic stroke etiology can remain indeterminate.Disclosure: Dr. bouzidi has nothing to disclose. Dr. AYADI has nothing to disclose. Dr. ...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Bouzidi, N., Ayadi, B., Bouchhima, I., Turki, E., Damak, M., Mhiri, C. Tags: Cerebrovascular Disease: Epidemiology Source Type: research

Cranial Ultrasonography in Term Infants and Stroke: When Is It Useful? (P6.333)
Conclusion: Cranial ultrasonography has poor sensitivity in detecting ischemic infarcts in term infants. Advanced neuroimaging should be pursued if there is high clinical suspicion for ischemic infarcts in the neonatal period and beyond.Disclosure: Dr. Mondok has nothing to disclose. Dr. Friedman has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Mondok, L. J., Friedman, N. Tags: Child Neurology and Developmental Neurology: Other Source Type: research

Median Nerve Ultrasound During the Acute Stroke Period: A New Method of Early Detection (P3.299)
Conclusions: The results suggest that physical exam and BCTQ are not useful for detecting CTS in the setting of ischemic stroke. Median nerve US may be a helpful diagnostic adjunct in early identification and intervention for CTS.Disclosure: Dr. Lin has nothing to disclose. Dr. Loochtan has nothing to disclose. Dr. Hobson-Webb has received personal compensation for activities with Genzyme and Sanofi for speaking. Dr. Hobson-Webb holds stock and/or stock options in Aerpio Therapeutics. Dr. Hobson-Webb has received research support from Valerion Therapuetics and C
Source: Neurology - April 3, 2016 Category: Neurology Authors: Lin, C., Loochtan, A., Hobson-Webb, L. Tags: Neurorehabilitation Source Type: research

Infantile basal ganglia stroke after mild head trauma
A 13-month-old boy presented to our hospital with a history of right hemiparesis and right facial paresis for 2 days. These symptoms occurred several hours after a fall from a bed to the ground. An MRI of the brain showed an ischemic lesion and cerebral ultrasound examinations demonstrated bilaterally hyperechogenic lenticulostriate arteries (figure).
Source: Neurology - June 8, 2015 Category: Neurology Authors: Yang, S.-T., Lee, W.-T., Hung, K.-L., Chang, C.-L. Tags: Childhood stroke, Ultrasound, Brain trauma, Pediatric stroke; see Cerebrovascular Disease/ Childhood stroke NEUROIMAGES Source Type: research

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