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Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Embolic Strokes and Relapsing Infective Endocarditis Due to Neisseria Subflava (P1.316)
CONCLUSIONS: N.subflava can be a causative agent for relapsing infective endocarditis complicated with embolic strokes. The management of stroke in the setting of IE is different and it is important to be aware of it to avoid complications.Disclosure: Dr. Rodriguez Alvarez has nothing to disclose. Dr. Pillai has nothing to disclose. Dr. Khanna has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Rodriguez Alvarez, M., Pillai, A., Khanna, R. Tags: Other Bacterial Infections Source Type: research

Recurrent ischemic strokes and headaches originating from Lambl's excrescence (P2.273)
CONCLUSIONS: The association between recurrent strokes and late-age onset migraine with aura should raise clinical suspicion of a cardiogenic valvular etiology. Early TEE use is necessary to diagnose cardiac valvular strands like LE. LE associated with migraine headaches should prompt a treatment with anti-thrombotic agent. While anticoagulants and cardiothoracic surgery are indicated for recurrent strokes, a combined antiplatelet therapy was effective in our patient.Disclosure: Dr. Dumitrascu has nothing to disclose. Dr. Tsimerinov has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Dumitrascu, O., Tsimerinov, E. Tags: Cerebrovascular Disease and Interventional Neurology: PFO and Other Cardiac Disease Source Type: research

Progressive multifocal leukoencephalopathy during fumarate monotherapy of psoriasis
In September 2013, a 69-year-old Caucasian man who was anti–JC virus (JCV) antibody positive was admitted to our hospital with slowly progressing right hemiparesis and aphasia lasting for approximately 6 months. Medical history revealed arterial hypertension, biological aortic valve replacement, and psoriasis vulgaris, treated with 3–6 tablets daily of dimethylfumarate (DMF; 120 mg)/ethylhydrogenfumarate (EHF; 95 mg) (Fumaderm, Biogen Idec, Ismaning, Germany) since December 2008 (table e-1 at Neurology.org/nn). No other immunosuppressive pretreatment had been given. In April/May 2013, the patient recognized a s...
Source: Neurology Neuroimmunology and Neuroinflammation - March 12, 2015 Category: Neurology Authors: Hoepner, R., Faissner, S., Klasing, A., Schneider, R., Metz, I., Bellenberg, B., Lukas, C., Altmeyer, P., Gold, R., Chan, A. Tags: Multiple sclerosis, Encephalitis, Viral infections Clinical/Scientific Notes Source Type: research

Pontine infarction responsible for wall-eyed bilateral internuclear ophthalmoplegia syndrome
A 68-year-old man with hypertension, cardiac arrhythmia, and a mechanical heart valve replacement treated with vitamin K antagonists was admitted for the acute onset of diplopia. Neuro-ophthalmologic examination showed a bilateral exotropia in primary gaze position (wall-eyed) with bilateral adduction deficit that did not improve by convergence (figure, video at Neurology.org/cp). In lateral gaze, a horizontal nystagmus of the abducting eyes appeared. Vertical saccades were normal (video). Pupils were symmetric and reactive to light. Brain MRI with diffusion-weighted images showed an acute pontine ischemic lesion (figure)....
Source: Nature Clinical Practice - December 8, 2014 Category: Neurology Authors: Mathis, T., Ducray, F., Tilikete, C., Vighetto, A., Biotti, D. Tags: Clinical neurology examination, All Neuro-ophthalmology, Ocular motility, Diplopia (double vision), All Cerebrovascular disease/Stroke Cases Source Type: research

Stroke in Patients With Aortic Stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis Study Clinical Sciences
Conclusions— In patients with aortic stenosis not prescribed oral anticoagulation, atrial fibrillation, AVR with concomitant coronary artery bypass grafting, and CHA2DS2-VASc score were the major predictors of stroke. Incident stroke was strongly associated with mortality. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00092677.
Source: Stroke - June 23, 2014 Category: Neurology Authors: Greve, A. M., Dalsgaard, M., Bang, C. N., Egstrup, K., Ray, S., Boman, K., Rossebo, A. B., Gohlke-Baerwolf, C., Devereux, R. B., Kober, L., Wachtell, K. Tags: Thrombosis risk factors, CV surgery: valvular disease, Acute Cerebral Infarction Clinical Sciences Source Type: research

Post-Surgical Cognitive Outcomes (S62.001)
CONCLUSIONS:Patients who undergo AVR demonstrate persistent cognitive decline characterized by diminished learning on tests of memory and language and related to perioperative clinical stroke. These findings underscore the importance of ischemic neurologic complications of surgery and the need for improved stroke prevention and treatment strategies.Study Supported by: R01HL084375 to T.F.F.Disclosure: Dr. Giovannetti has nothing to disclose. Dr. Fanning has nothing to disclose. Dr. Ratcliffe has nothing to disclose. Dr. Price has nothing to disclose. Dr. Messe has received personal compensation for activities with GlaxoSmit...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Giovannetti, T., Fanning, M., Ratcliffe, S., Price, C., Messe, S., Selnes, O., Acker, M., Floyd, T., Szeto, W., Bavaria, J. Tags: Cerebrovascular Disease and Interventional Neurology: Cognitive and Behavioral Source Type: research