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Spontaneous Dissection of Both Vertebral Arteries Diagnosed with Three-Dimensional T1-Weighted Image
A 48-year-old woman spontaneously developed occipital pain, without any other neurological deficit. A brain magnetic resonance angiography showed narrowing, irregular dilatation, and aneurysmal formation in both the vertebral arteries (VA). According to these findings and the clinical course, we diagnosed the patient with spontaneous VA dissection. There was no finding suggesting cerebral infarction or subarachnoid hemorrhage. Three-dimensional T1-weighted magnetic resonance imaging performed 27days after first onset of headache revealed a crescent-shaped high-intensity lesion in both the VA walls.
Source: Journal of Stroke and Cerebrovascular Diseases - March 17, 2019 Category: Neurology Authors: Takanori Iwamoto, Naoki Oyama, Takaya Kitano, Toshiaki Goda, Junichi Uemura, Yoshiki Yagita Tags: Case Reports Source Type: research

T2*-Weighted MRI Detected Dilated Cerebral Veins in a Patient With Acute-Phase Cerebral Venous Sinus Thrombosis —A Case Report
We describe a 45-year-old man who presented with nausea, vomiting, and strong occipital headache on the right side. Although no abnormalities on neurological examination or computed tomography imaging were found on admission, peripheral blood cell counts showed polycythemia (hemoglobin 20.6 g/dL) and electrocardiography demonstrated atrial fibrillation. Therefore, anticoagulant treatment with heparin was started immediately. On the following day, the occipital headache continued. Brain T2*-weighted (T2*WI) magnetic resonance imaging (MRI) and, to a lesser extent, susceptibility-weighted imaging showed dilation of numerous ...
Source: Journal of Stroke and Cerebrovascular Diseases - June 2, 2019 Category: Neurology Authors: Takuya Kiyohara, Chie Abe, Mio Yokoi, Yusuke Sakaki, Yasuhiro Kumai Tags: Case Report Source Type: research

Carotid-Cavernous Sinus Fistula caused by Persistent Primitive Trigeminal Artery Aneurysm rupture: A case report
Carotid-Cavernous sinus fistula (CCF) caused by a ruptured aneurysm of persistent primitive trigeminal artery (PPTA) is exceptionally rare. Herein, we reported the case of a 64-year-old female who presented with headache, pulsatile tinnitus, and diplopia. Angiography showed a PPTA and CCF. Three-dimensional digital subtraction angiograms revealed a direct shunt between the PPTA aneurysm and the left cavernous sinus. The trigeminal carotid fistula was successfully treated with detachable coils and Onyx, and the PPTA was preserved.
Source: Journal of Stroke and Cerebrovascular Diseases - August 18, 2019 Category: Neurology Authors: Yu Fan, Yuechun LI, Tianyou Zhang, Changchun Jiang, Peng Zhang Tags: Case Report Source Type: research

A Case of Cerebral Venous Thrombosis and Deep Venous Thrombosis Due to Hyperthyroidism with Increased Factor VIII Activity
A 48-year-old woman was admitted to our hospital because of headache and fever. She was diagnosed with aseptic meningitis. Five days later, she had a seizure and developed left hemiparesis. Magnetic resonance imaging showed hyperintensity in the right parietal area on fluid attenuated inversion recovery imaging. She was diagnosed as having cerebral venous thrombosis (CVT) because the suprasagittal sinus was invisible on the venographic studies. Moreover, deep venous thrombosis (DVT) was detected in her left lower extremity.
Source: Journal of Stroke and Cerebrovascular Diseases - September 10, 2019 Category: Neurology Authors: Mutsumi Yokoyama, Ryotaro Yamashita, Masayuki Furuya, Maiko Yamazaki, Kazuo Koyama, Fumiaki Tanaka Tags: Case Report Source Type: research

Hemicrania Continua Subsequent to Vertebral Artery Dissection: A Case Report
We herein report the case of a 45-year-old woman who developed a continuous hemicranial headache subsequent to vertebral artery dissection (VAD). After remission of VAD, the patient repeatedly experienced right forehead and temporal region throbbing headache, accompanied by nausea, ocular hyperemia and lacrimation of the right eye, nasal congestion, and rhinorrhea. Magnetic resonance angiography did not reveal the recurrence of dissection. Daily use of indomethacin (190.8 mg/day) showed an excellent effect on the headache, suggesting that the patient had developed hemicrania continua subsequent to VAD.
Source: Journal of Stroke and Cerebrovascular Diseases - October 10, 2019 Category: Neurology Authors: Hiromitsu Tabata, Hiroshi Kitaguchi Source Type: research

Reversible Cerebral Angiopathy after Viral Infection in a Pediatric Patient with Genetic Variant of RNF213
We report a case of reversible cerebral angiopathy after viral infection in a pediatric patient with genetic variant of RNF213 mutation. The patient had developed a severe headache after hand, foot, and mouth disease.
Source: Journal of Stroke and Cerebrovascular Diseases - December 6, 2019 Category: Neurology Authors: Ikuma Echizenya, Kikutaro Tokairin, Masahito Kawabori, Ken Kazumata, Kiyohiro Houkin Source Type: research

Hypoglossal Nerve Palsy due to Compression by a Persistent Primitive Hypoglossal Artery: Case Report
A 51-year-old Japanese woman was admitted to our hospital because of speech difficulty following severe headache. Neurological examination showed dysarthria and tongue weakness on the right side, indicating right hypoglossal nerve palsy. Needle electromyography of the right side of the tongue showed fibrillation potentials. Magnetic resonance angiography and computed tomography angiography revealed a right, persistent, primitive hypoglossal artery (PPHA) that met Lie's diagnostic criteria. Digital subtraction angiography showed an extended PPHA with irregular caliber in the portion running through the right hypoglossal canal.
Source: Journal of Stroke and Cerebrovascular Diseases - December 11, 2019 Category: Neurology Authors: Hiroki Hikichi, Tatsuya Ueno, Masatoshi Iwamura, Haruo Nishijima, Akira Arai, Chieko Suzuki, Hiroshi Midorikawa, Jin-ichi Nunomura, Masahiko Tomiyama Tags: Case Report Source Type: research

Cardiac-Neurovascular Adverse Effects Responsible to Contrast Transcranial Doppler: A Case Report
Introduction and Case Presentation: A 44-year-old female patient suffered migraines and underwent contrast-enhanced transcranial Doppler (c-TCD). During the rapid injection of contrast agent, she suffered chest tightness, palpitation, decreased consciousness, perimouth numbness, and headache, respectively. Meanwhile, “curtain” pattern of air embolic signals lasted up to 115 seconds in her decreased right middle cerebral artery accompanied with arrhythmia. The microair embolic signals lasted as long as 340 seconds.
Source: Journal of Stroke and Cerebrovascular Diseases - January 13, 2020 Category: Neurology Authors: Xiuyun Mo, Zhengzheng Xuan, Weijun Zhang, Wei Wang, Jingxin Zhong Tags: Case Report Source Type: research

A Novel Heterozygous Variant in Exon 19 of NOTCH3 in a Saudi Family with Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy
Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL; OMIM #125310) is the most common cause of monogenic familial cerebral small vessel disease. It typically manifests at middle adulthood with highly variable clinical features including migraine with aura, recurrent transient ischemic attacks or ischemic strokes, mood disorders, and progressive cognitive decline. It is caused by mutations in the NOTCH3 gene, which maps to the short arm of chromosome 19 and encode for epidermal growth factor-like repeats.
Source: Journal of Stroke and Cerebrovascular Diseases - May 13, 2020 Category: Neurology Authors: Hussein Algahtani, Bader Shirah, Suzan Y. Alharbi, Mohammad H. Al-Qahtani, Angham Abdulrahman Abdulkareem, Muhammad Imran Naseer Tags: Case Report Source Type: research

Response to letter to the editor
We would like to thank Dr. Sombat Muengtaweepongsa et al. for the interest in our article. We agree with the opinion that the contrasted Transcranial Doppler(TCD) is a safe procedure and the incidence of adverse effects is low. But we notice that in the letter, it was mentioned that up to 20% patients suffered from adverse transient neurological symptoms, such as headache, dizziness and visual aura after contrasted TCD and the number was beyond our expectation. So we are curious about the reference of this statement.
Source: Journal of Stroke and Cerebrovascular Diseases - June 29, 2020 Category: Neurology Authors: Zheng-zheng Xuan, Xiu-yun Mo, Jing-xin Zhong Tags: Letter to the Editor Source Type: research

CT-Negative Subarachnoid Hemorrhage in the First Six Hours
There are no reported cases of negative CT head in the first six hours after a thunderclap headache in a patient found to have an aneurysmal subarachnoid hemorrhage (SAH).
Source: Journal of Stroke and Cerebrovascular Diseases - October 10, 2020 Category: Neurology Authors: Tia Chakraborty, Ali Daneshmand, Giuseppe Lanzino, Sara Hocker Tags: Case Report Source Type: research

Cerebral Venous Sinus Thromboses in Patients with SARS-CoV-2 Infection: Three Cases and a Review of the Literature
: Early studies suggest that acute cerebrovascular events may be common in patients with coronavirus disease 2019 (COVID-19) and may be associated with a high mortality rate. Most cerebrovascular events described have been ischemic strokes, but both intracerebral hemorrhage and rarely cerebral venous sinus thrombosis (CVST) have also been reported. The diagnosis of CVST can be elusive, with wide-ranging and nonspecific presenting symptoms that can include headache or altered sensorium alone.
Source: Journal of Stroke and Cerebrovascular Diseases - October 19, 2020 Category: Neurology Authors: Felix Nwajei, Pria Anand, Mohamad Abdalkader, Vanesa C. Andreu Arasa, Hugo J. Aparicio, Siavash Behbahani, Gioacchino Curiale, Ali Daneshmand, Hormuzdiyar Dasenbrock, Thomas Mayo, Asim Mian, Thanh Nguyen, Charlene Ong, J. Rafael Romero, Osamu Sakai, Court Source Type: research

Hydrocephalous as a Complication of Perimesencephalic Nonaneurysmal Subarachnoid Hemorrhage
JLSM, male, 71 years old, admitted into a private hospital in the city of Joinville, Brazil, complaining of persistent and severe headache. The patient reported onset of the condition three days before, after sexual activity, associated with nausea, vomiting and dizziness. He has a medical history of epilepsy, under regular use of Phenobarbital. The physical examination evidenced slight nuchal rigidity. Cranial computed tomography (CT) showed subarachnoid hemorrhage (SAH) in cisterns around the brainstem (Fig.
Source: Journal of Stroke and Cerebrovascular Diseases - October 20, 2020 Category: Neurology Authors: Guilherme Zini Reis, Fernanda Subtil de Moraes Machado, Wladimir Kummer de Paula, Fl ávio Diniz Ribas, Felipe Ibiapina dos Reis Tags: Case Report Source Type: research

Focal cerebral arteriopathy in a young adult following SARS-CoV2 reinfection
Ten days after SARS-Cov2 reinfection with mild gastrointestinal symptoms and headache that occurred 2 months after an initial infection, a previously healthy 37-year-old woman developed fluctuating facial and upper limb paresthesia and weakness. Diffusion-weighted magnetic resonance imaging revealed ischemic lesions in the right parietal region of different stages within the same vascular territory. A cerebral angiography demonstrated an isolated focal arteriopathy with no other arterial involvement.
Source: Journal of Stroke and Cerebrovascular Diseases - June 12, 2021 Category: Neurology Authors: Carla Zanferrari, Simona Fanucchi, Maria Teresa Sollazzo, Michela Ranieri, Daniel Volterra, Luca Valvassori Source Type: research

Recurrent Transient Neurological Deficit Due to Intracerebral Steal Phenomenon in Association with a Developmental Venous Anomaly
We report a symptomatic developmental venous anomaly (DVA) not causing parenchymal abnormality to provide a pathophysiologic clue in patients with recurrent transient neurologic deficit. A 32-year-old male presented with recurrent transient motor aphasia and headache in the left fronto-temporal region for three years. The symptoms usually lasted for one hour. Brain computed tomography (CT) angiography and magnetic resonance imaging using gradient recalled echo showed a prominent penetrating vein at the left frontal periventricular region.
Source: Journal of Stroke and Cerebrovascular Diseases - August 24, 2021 Category: Neurology Authors: Jean Hee Kim, Hyeyoung Jung, Woojun Kim, Jae Young An Tags: Case Report Source Type: research

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