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Ultrasound Criteria for Diagnosing Spontaneous Cervical Artery Dissections
This article describes the diagnostic criteria and typical findings of spontaneous dissection, in which no dissecting membrane is to be expected as in aortic dissection. Traumatic dissections following blunt or penetrating injuries also present with different findings. Examiners should be aware of possible differential diagnoses whose ultrasound image may mimic a dissection. A frequently occurring but avoidable cause of misdiagnosis is idiopathic carotidynia. Ultrasound also enables differentiation between dissection and vasculitis or carotid web and detection of normal variants such as fenestration of the vertebral artery...
Source: Ultraschall in der Medizin - February 6, 2023 Category: Radiology Authors: Christian Arning Source Type: research

Progressive and Fatal Brainstem Stroke in Systemic Giant Cell Arteritis
A 74-year-old woman presented with acute worsening of a 6-month long history of vertigo and postural instability with MRI evidence of cerebellar and brainstem acute infarcts. Extensive neurovascular assessment revealed a severe vascular damage with multiple stenoses and occlusions along the vertebrobasilar axis (Figure 1). Duplex ultrasonography showed hypoechoic halo sign along facial artery, whereas PET-CT highlighted increased fluorine-18-fluorodeoxyglucose uptake along vertebral and other larger arteries, thus allowing a diagnosis of giant cell arteritis (Figure 2).1,2 Despite prompt treatment with high-dose steroids a...
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Poretto, V., Piffer, S., Bignamini, V., Tranquillini, E., Donner, D., Cavatorta, F. P., Barbareschi, M., Petralia, B., Giometto, B. Tags: MRI, PET, Ultrasound, Vasculitis Case Source Type: research

Stroke secondary to giant-cell arteritis: A literature review
Exp Ther Med. 2021 Aug;22(2):876. doi: 10.3892/etm.2021.10308. Epub 2021 Jun 15.ABSTRACTStroke is a leading cause of death and disability worldwide. In addition to the classical etiologies of stroke as atherosclerosis and cardioembolism there are many unusual, rare causes, which require a high level of clinical suspicion and further investigations for correct and early diagnosis and adequate treatment. Giant-cell arteritis or temporal arteritis, the most frequent vasculitis in the elderly population is one of the uncommon causes of stroke. In the setting of giant-cell arteritis, stroke more likely affects the vertebrobasil...
Source: Experimental and Therapeutic Medicine - July 1, 2021 Category: General Medicine Authors: Zoltan Bajko Rodica Balasa Smaranda Maier Anca Motataianu Laura Barcutean Sebastian Andone Adina Stoian Rares Cristian Filep Source Type: research

Herpes simplex virus 2 vasculitis as cause of ischemic stroke in a young immunocompromised patient
We report a case of a young woman with a left middle cerebral artery (MCA) ischemic stroke. The patient had history of HIV-1 infection, with periods of therapeutic non-compliance. Initial computed tomography (CT) imaging studies showed stenosis of the M1 segment of the left MCA, and magnetic resonance imaging (MRI) confirmed infarction of the MCA territory. Serial transcranial Doppler ultrasound revealed progressive occlusion of the MCA and stenosis of the left anterior cerebral artery. Systemic investigation for other causes of stroke was normal. Lumbar puncture revealed a mildly inflammatory cerebrospinal fluid, and HSV-...
Source: Journal of NeuroVirology - August 23, 2020 Category: Neurology Source Type: research

Propensity Score-Matched Analysis of Lesion Patterns in Stroke Patients With Patent Foramen Ovale and Patients With Spontaneous Intracranial Artery Dissection
Conclusion: The present study suggests that lesion patterns observed from DWI of patients with PFO and SIAD might provide clues to the etiology of infarcts. Single lesions (cortical or subcortical) might be a typical feature of PFO associated strokes, while multiple lesions in one vascular territory might be a specific feature of SIAD associated strokes. Introduction Both patent foramen ovale (PFO) and spontaneous intracranial artery dissection (SIAD) are important stroke risk factors, especially in young and middle-aged adults (1–3). About 25% of patients with ischemic stroke are cryptogenic (4), and PFO is ...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

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

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