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Aortic dissection diagnosed on stroke computed tomography protocol: a case report
ConclusionsWhen acute stroke is suspected due to neurological deficits, plain head CT is the first choice for imaging diagnosis. The addition of cervical CT angiography can reliably exclude stroke due to aortic dissection. CTP can identify ischemic penumbra, which cannot be diagnosed by plain head CT or diffusion-weighted magnetic resonance imaging. These combined stroke CT protocols helped us avoid missing an aortic dissection.
Source: Journal of Medical Case Reports - May 26, 2021 Category: General Medicine Source Type: research

Bilateral vertebral artery dissection and cerebellar stroke: a rare complication of massage.
We describe the case of a 39-year-old male, who presented to our emergency department after a one-day history of headache and vomiting, with associated sudden onset posterior neck pain and cerebellar signs following a massage. Computed tomography angiogram and brain demonstrated bilateral vertebral artery dissection and cerebellar stroke. He was admitted to hospital for monitoring and conservative management with antiplatelet therapy, resulting in a good outcome. This is the first reported case of bilateral vertebral artery dissection and stroke to be associated with massage. This case also suggests, unlike many reports in...
Source: New Zealand Medical Journal - April 5, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

Massive pulmonary embolism with acute cor pulmonale
A 51-year-old immobilised man, while recovering at stroke rehabilitation, complained of sudden onset chest pain prior to an unconscious collapse. Observations on arrival were heart rate 120 bpm, blood pressure 80/60 mm Hg and oxygen saturations of 90% on 10 L of oxygen. ECG demonstrated new right bundle branch block (RBBB) with classical S1Q3T3 repolarisation abnormality of acute right heart strain (figure 1A). Urgent CT pulmonary angiogram revealed saddle pulmonary embolism with extensive thrombus burden (figure 1B). Transthoracic echocardiogram (TTE) showed acute right ventricular (RV) overload with c...
Source: Postgraduate Medical Journal - July 25, 2016 Category: Journals (General) Authors: Nelson, A. J., Wong, G. R., Roberts-Thomson, R., Parvar, S. L. Tags: Journalology, Drugs: cardiovascular system, Echocardiography, Pain (neurology), Stroke, Hypertension, Interventional cardiology, Ischaemic heart disease, Venous thromboembolism, Radiology, Pulmonary embolism, Clinical diagnostic tests, Vascular surgery, E Source Type: research

Red blood cell transfusion to treat or prevent complications in sickle cell disease: an overview of Cochrane reviews.
CONCLUSIONS: This overview provides support from two high-quality Cochrane Reviews for the use of RBC transfusions in preventing stroke in children and adolescents at high risk of stroke (abnormal TCDs or SCI) and evidence that it may decrease the risk of SCI in children with abnormal TCD velocities. In addition RBC transfusions may reduce the risk of ACS and painful crisis in this population.This overview highlights the lack of high-quality evidence in adults with SCD and the number of reviews that have no evidence for the use of RBC transfusions across a spectrum of SCD complications. Also of concern is the variable and ...
Source: Cochrane Database of Systematic Reviews - August 1, 2018 Category: General Medicine Authors: Fortin PM, Hopewell S, Estcourt LJ Tags: Cochrane Database Syst Rev Source Type: research

En kvinne i 50- årene med residiverende svimmelhet.
En kvinne i 50-årene med residiverende svimmelhet. Tidsskr Nor Laegeforen. 2020 Aug 18;140(11): Authors: Eriksen E, Smebye KL, Mejlænder-Evjensvold M, Sandset EC Abstract BACKGROUND: Vasculitis caused by neuroborreliosis is one of many rare described causes of stroke. CASE PRESENTATION: A female smoker in her fifties presented with dizziness due to a left cerebellar infarction, and after general stroke workup atherosclerosis was considered the probable cause. In the preceding months she had experienced nonspecific intermittent headache, neck pain and dizziness initially attributed to prior head...
Source: Tidsskrift for den Norske Laegeforening - August 17, 2020 Category: General Medicine Authors: Eriksen E, Smebye KL, Mejlænder-Evjensvold M, Sandset EC Tags: Tidsskr Nor Laegeforen Source Type: research

Atrial myxoma with cerebellar signs: a case report
ConclusionAlthough rare, atrial myxoma has to be considered a cause of stroke and other embolic phenomenon causing multiorgan infarctions. Early and timely diagnosis of the condition can prevent further recurrence and inappropriate anticoagulant therapy. It would be pertinent to have echocardiography done in patients who present with a stroke, arrhythmias, and other constitutional symptoms. The tumor once detected must be removed surgically as early as possible, which not only reduces serious thromboembolic complications but can be potentially curative.
Source: Journal of Medical Case Reports - February 12, 2020 Category: General Medicine Source Type: research

Hydroxycarbamide versus chronic transfusion for maintenance of transcranial doppler flow velocities in children with sickle cell anaemia—TCD With Transfusions Changing to Hydroxyurea (TWiTCH): a multicentre, open-label, phase 3, non-inferiority trial
This study is registered with ClinicalTrials.gov, number NCT01425307. Findings Between Sept 20, 2011, and April 17, 2013, 159 patients consented and enrolled in TWiTCH. 121 participants passed screening and were then randomly assigned to treatment (61 to transfusions and 60 to hydroxycarbamide). At the first scheduled interim analysis, non-inferiority was shown and the sponsor terminated the study. Final model-based TCD velocities were 143 cm/s (95% CI 140–146) in children who received standard transfusions and 138 cm/s (135–142) in those who received hydroxycarbamide, with a difference of 4·54 (0·10–8·98). Non-i...
Source: The Lancet - December 7, 2015 Category: Journals (General) Source Type: research

Limb ischemia, an alarm signal to a thromboembolic cascade - renal infarction and nephrectomy followed by surgical suppression of the left atrial appendage.
We present the case of a 55-year-old male with mild hypertension and brief episodes of paroxysmal self-limiting atrial fibrillation (AF) since 2010. Despite a small cardioembolic risk score, CHA2DS2-Vasc=1 (Congestive heart failure, Hypertension, Age=75, Diabetes melitus, prior Stroke), the patient is effectively anticoagulated using acenocumarol. In December 2014, he showed signs of plantar transitory ischemia, for which he did not address the doctor. In early January 2015, he urgently presented at the hospital with left renal pain, caused by a renal infarction, diagnosed by computed tomography (CT) angiography. Left neph...
Source: Romanian Journal of Morphology and Embryology - August 17, 2016 Category: Journals (General) Tags: Rom J Morphol Embryol Source Type: research

Management and clinical outcome of stable coronary artery disease in Austria : Results from 5  years of the CLARIFY registry.
CONCLUSION: Characteristics of Austrian outpatients with stable CAD corresponded to those of patients with CAD in other developed countries. Medical treatments following the recommendations of the European guidelines were prescribed in the majority of patients; however, recommended goals of life style interventions including a heart rate less than 60 bpm and general risk factor management were not achieved by a high proportion of patients. Heart rate control and life style changes remain unmet needs of cardiovascular care in Austria. PMID: 28913755 [PubMed - as supplied by publisher]
Source: Wiener Klinische Wochenschrift - September 14, 2017 Category: General Medicine Authors: Lang IM, Badr-Eslam R, Greenlaw N, Young R, Steg PG Tags: Wien Klin Wochenschr Source Type: research

Anticoagulant treatment for subsegmental pulmonary embolism.
CONCLUSIONS: There is no randomised controlled trial evidence for the effectiveness and safety of anticoagulation therapy versus no intervention in patients with isolated subsegmental pulmonary embolism (SSPE) or incidental SSPE, and therefore we can not draw any conclusions. Well-conducted research is required before informed practice decisions can be made. PMID: 24771493 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - May 3, 2014 Category: Journals (General) Authors: Yoo HH, Queluz TH, El Dib R Tags: Cochrane Database Syst Rev Source Type: research

Myocardial injury in a 41-year-old male treated with methylphenidate: a case report
Conclusions: When interpreting troponin results it is important to take into account the context of the patient's clinical presentation, including the possibility of adverse drug reactions. The adverse drug reaction could include a combination of vasospasm and/or increased oxygen demand due to tachycardia. This case should be borne in mind before a diagnosis of myocardial infarction is given, or a decision to perform invasive coronary angiography is made in patients that use methylphenidate or related substances. Cardiac magnetic resonance imaging could be of diagnostic value in such cases.
Source: BioMed Central - July 29, 2014 Category: Journals (General) Authors: Lisa Drange HoleJan Schjøtt Source Type: research

Postpartum headache
Introduction Infection-associated headache, tension-type headache and migraine are the most prevalent headaches in the general population as well as in women. However, any new-onset headache occurring in a patient ‘at risk’ (on anticoagulant treatment, with a previous history of malignancy, etc) mandates prompt evaluation to exclude a serious underlying condition. Similarly, when headaches first present during pregnancy or post partum, a diagnostic evaluation is indicated even tough primary headaches are most common.1 Case A healthy 32-year-old woman was admitted with gradual-onset severe diffuse headache over ...
Source: Postgraduate Medical Journal - February 5, 2015 Category: Journals (General) Authors: Friedman, J., Gotler, J., Schattner, A. Tags: Emergency medicine, Journalology, Drugs: cardiovascular system, Drugs: CNS (not psychiatric), Headache (including migraine), Pain (neurology), Stroke, Pregnancy, Reproductive medicine, Ophthalmology, Venous thromboembolism, Radiology, Clinical diagnostic Source Type: research

Anticoagulant treatment for subsegmental pulmonary embolism.
CONCLUSIONS: There is no randomised controlled trial evidence for the effectiveness and safety of anticoagulation therapy versus no intervention in patients with isolated subsegmental pulmonary embolism (SSPE) or incidental SSPE, and therefore we can not draw any conclusions. Well-conducted research is required before informed practice decisions can be made. PMID: 26756331 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - January 12, 2016 Category: Journals (General) Authors: Yoo HH, Queluz TH, El Dib R Tags: Cochrane Database Syst Rev Source Type: research

Treatment of internal carotid artery dissection with Willis covered stent: A case report of recurrent limb weakness and no response to medical therapy.
Authors: Cai X, Guan J, Ren S, Wei Y, Peng X, Qiu W, Chen J Abstract Internal carotid artery dissection (ICAD) is a major cause of ischemic stroke in young and middle-aged patients. Patients may be asymptomatic or present with symptoms ranging from headache and neck pain to severe cerebral ischemic events. Conventional treatment is medical anticlotting therapy or involves the use of interventional tools, such as endovascular treatment. Anticoagulation or antiplatelet therapy are the primary treatment modalities used to prevent thromboembolic complications from arterial dissections, however, they are unsuitable in c...
Source: Experimental and Therapeutic Medicine - May 16, 2016 Category: Journals (General) Tags: Exp Ther Med Source Type: research

A simple risk score in acute ST-elevation myocardial infarction: Modified ACEF(age, creatinine, and ejection fraction) score.
CONCLUSION: The modified ACEF score is a predictor of cardiac mortality and morbidity during 1-year follow-up. PMID: 28081310 [PubMed - in process]
Source: Turkish Journal of Medical Sciences - January 14, 2017 Category: Journals (General) Tags: Turk J Med Sci Source Type: research

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