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Perioperative stroke arising from the interplay of patent foramen ovale, atrial septal aneurysm, and right diaphragm paralysis during endoscopic surgery
A number of risk factors and mechanisms have been associated with vulnerability to perioperative stroke, yet there remains the need to increase awareness of this potential complication, its risks, and consequences. A case of a 59 year old man who underwent a prolonged laparoscopic-thoracoscopic diaphragmatic plication procedure for paralyzed right hemidiaphragm is reported. His past medical history included coronary artery disease, diabetes mellitus type II, hypertension, and hyperlipidemia. Routine transthoracic echocardiogram performed 6 months prior to surgery was unremarkable, noting normal ejection fraction, no valvul...
Source: Journal of Clinical Anesthesia - September 25, 2013 Category: Anesthesiology Authors: Ioanna Apostolidou, Kamini Sundarbose, Sarah L. Richards, Mojca R. Konia Tags: Correspondence Source Type: research

Headache linked with incidence of metabolic syndrome: Comment on migraine, headache and development of metabolic syndrome: An 11-year follow-up in the HUNT study
A considerable body of evidence from large-population studies has linked migraine, particularly with aura, to somewhat increased risk for stroke, coronary heart disease, and subclinical infarct-like lesions as well as to adverse risk profiles for cardiovascular disease (CVD), including hyperlipidemia, obesity, hypertension, and family history of premature CVD . Although the biological mechanisms remain uncertain, this area of research has importance for public health, especially because both migraine and CVD are common in the general population. Understanding the mechanisms that link migraine with various manifestations of...
Source: Pain - May 17, 2013 Category: Anesthesiology Authors: Jameson D. Voss, Ann I. Scher Tags: Commentaries Source Type: research

Bilateral carotid artery dissection in a severe preeclamptic setting: An unusual cause of postpartum headache.
Abstract A 30-year-old woman with severe preeclampsia presented at 27weeks of amenorrhea with left headache, neck pain, blurred vision and numbness of left hemiface that resolved spontaneously within 2hours. A week later, hypertension remained poorly controlled despite combination of nicardipine and labetalol intravenous therapy; an urgent caesarean section was eventually performed due to onset of HELLP syndrome. At day 5 postpartum, the patient had a Horner syndrome with right ipsilateral disabling tinnitus. A CT-angiography of supra-aortic trunks was performed urgently; it showed a bilateral carotid arterial dis...
Source: Annales Francaises d'Anesthesie et de Reanimation - April 1, 2013 Category: Anesthesiology Authors: Hoffmann C, Augé M, Falzone E, Martel-Jacob S, Mercier FJ Tags: Ann Fr Anesth Reanim Source Type: research

A Woman With a History of Stroke and a Mass in the Aorta
A 65-YEAR-OLD WOMAN presented with an acute onset of slurred speech and left facial droop. She had a past medical history of Raynaud's disease, well-controlled hypertension, and moderate tricuspid regurgitation, which was being followed by serial transthoracic echocardiographic examinations. A duplex ultrasound of the carotid and vertebral arteries was negative, whereas a magnetic resonance imaging scan of her brain revealed a subacute embolic cerebral infarction. A transesophageal echocardiographic (TEE) examination also was performed during the workup, revealing the presence of moderate-to-severe tricuspid regurgitation ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 26, 2012 Category: Anesthesiology Authors: Robina Matyal, Angela Wang, Bilal Mahmood, Kamal Khabbaz, Feroze Mahmood Tags: Diagnostic Dilemmas Source Type: research

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