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Stroke Due to Air Embolism Related to Laser Ablation of Accessory Vein (P4.357)
Conclusions: Air embolism leading to devastating stroke may occur few hours after laser treatment of varicose veins. Chest symptoms associated with the procedure should raise the possibility of air embolism. Immediate therapeutic measures like 100[percnt] oxygen, hyperbaric oxygen chamber and/or hypothermia should be considered to prevent neurologic complications.Disclosure: Dr. Kale has nothing to disclose. Dr. Javed has nothing to disclose. Dr. Pednekar has nothing to disclose. Dr. Sahni has nothing to disclose. Dr. Resor has nothing to disclose. Dr. Tenner has nothing to disclose. Dr. Ahluwalia-Singh has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Kale, P., Javed, B., Pednekar, N., Sahni, R., Resor, L., Tenner, M., Ahluwalia-Singh, B. Tags: Cerebrovascular Case Reports Source Type: research

Predictive value of free fatty acid levels in embolic stroke of undetermined source: A retrospective observational study
The present study aimed to investigate the predictive value of free fatty acid (FFA) in embolic stroke of undetermined source (ESUS) according to the presence of potential embolic sources (PES) after extensive etiologic evaluation. This was a retrospective observational study based on a single-center registry from January 2011 to July 2017. Stroke subtypes were determined through laboratory findings, brain, and angiographic imaging, carotid ultrasonography, transthoracic echocardiography, and 24-hour Holter monitoring. If ESUS was suspected, transesophageal echocardiography was additionally performed. Patients were classi...
Source: Medicine - October 2, 2020 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Amusia: Unique Presentation of Stroke (P6.261)
CONCLUSIONS:Even though music and speech are similar in principle and execution they are functions of different hemispheres of the brain. Unlike aphasia, anatomical localization of amusia has not been established but it is known that right non dominant hemisphere is concerned with musical ability. Impairment of musical ability in the presence of intact speech can be the only presenting finding in stroke. Their identification is the key to early and appropriate treatment.Study Supported by:NoneDisclosure: Dr. Ramchandani has nothing to disclose. Dr. Alsmaan has nothing to disclose. Dr. Schwarz has nothing to disclose. Dr. A...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Ramchandani, C., Alsmaan, F., Schwarz, H., Alkhoury, Z. Tags: Cerebrovascular Disease and Interventional Neurology: Case Reports Source Type: research

Teaching NeuroImages: Hyperdense posterior cerebral artery sign
A 38-year-old man presented to the emergency department with right-sided weakness, sensory loss, and hemianopsia. CT head showed a left hyperdense posterior cerebral artery sign (HPCAS) (figure 1). CT angiogram of the head confirmed a left posterior cerebral artery (PCA) occlusion (figure 2). MRI demonstrated a left PCA infarct. Transesophageal echocardiogram revealed an atrial septal aneurysm and patent foramen ovale. He was treated with antiplatelet therapy. The HPCAS has been considered a marker for acute ischemia in the PCA territory.1 Recognizing the HPCAS on CT in acute stroke may help in the diagnosis and treatment ...
Source: Neurology - November 10, 2014 Category: Neurology Authors: Capampangan, D. J., Lee-Ianotti, J. K., Riordan, K. C., Kramer, C. L. Tags: CT, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research

Cryptogenic Stroke Following Abdominal Free Flap Breast Reconstruction Surgery
Conclusion Surgeons and cardiologists should be aware of this cerebrovascular complication secondary to PFO following major reconstructive surgery such as microvascular breast reconstruction. It also serves to challenge microvascular surgeons to reconsider routine use of central venous pressure lines in free flap patients who might otherwise have good peripheral vessels for postoperative fluids and antibiotic administration.
Source: International Journal of Surgery Case Reports - November 11, 2014 Category: Surgery Source Type: research

Pearls & Oy-sters: Cerebral venous air embolism after central catheter removal: Too much air can kill
A 95-year-old woman with a history of hypertension presented from a long-term care facility for altered mental status in the context of dehydration and hypoglycemia. Multiple attempts to obtain a peripheral IV failed, and a triple lumen catheter was placed into the right internal jugular vein using the Seldinger technique under ultrasound guidance. No complications followed the procedure. The patient was then rehydrated and given multiple ampules of D50, leading to prompt resolution of the hypoglycemia and improvement in her mental status. After resolution of symptoms, the central line was removed, with the head of the bed...
Source: Neurology - March 30, 2015 Category: Neurology Authors: Bartolini, L., Burger, K. Tags: MRI, All Clinical Neurology, All Cerebrovascular disease/Stroke, Embolism RESIDENT AND FELLOW SECTION Source Type: research

Diagnostic and Management Challenges in Patients with Left Atrial Myxoma (P1.229)
Conclusions:Cardiac myxomas are rare tumors, mostly arising from the left atrium that may cause ischemic or hemorrhagic strokes, intracranial aneurysms, or myxomatous metastases.Disclosure: Dr. Orjuela has nothing to disclose. Dr. McGinley has nothing to disclose. Dr. Sweis has nothing to disclose. Dr. Prabhu has nothing to disclose. Dr. Bakhos has nothing to disclose. Dr. Biller has received personal compensation in an editorial capacity for the Journal of Stroke and Cerebrovascular Diseases, Frontier in Neurology and Up-To-Date.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Orjuela, K., McGinley, M., Sweis, R., Prabhu, V., Bakhos, M., Biller, J. Tags: Cardiac Mechanisms and Complications of Stroke Source Type: research

Acute Ischemic Stroke in a Young Woman With No Known Risk Factors.
CONCLUSION: Onset of neurologic symptoms can be immediate or delayed in patients undergoing venous foam sclerotherapy. Early recognition of neurologic deficits resulting from paradoxical gas embolism and its treatment with hyperbaric oxygen can prevent permanent disability. PMID: 29677415 [PubMed - in process]
Source: WMJ - March 1, 2018 Category: General Medicine Authors: Abdelhamid N, Farooq S, Sarraj A Tags: WMJ Source Type: research

Ischemic Stroke with Protein S Deficiency Treated by Apixaban
A 57-year-old man with atherosclerosis obliterans was admitted with sudden-onset sensory aphasia and right hemiparesis. Brain MRI revealed acute cerebral infarctions in the left temporal lobe and magnetic resonance angiography showed occlusion of the posterior branch of the left middle cerebral artery. Transesophageal echocardiography and ultrasonography respectively confirmed a patent foramen ovale and deep vein thrombosis in the bilateral femoral veins. Blood findings showed low protein S antigen, low protein S activity, and a missense mutation of the PROS 1 gene.
Source: Journal of Stroke and Cerebrovascular Diseases - January 12, 2020 Category: Neurology Authors: Ikkei Ohashi, Shinichi Wada, Fumitaka Yoshino, Takahiro Kuwashiro, Shinya Matsumoto, Taeko Hotta, Dongchong Kang, Yasushi Okada, Shun Shimohama, Masahiro Yasaka Tags: Case Report Source Type: research

Recurrent Patent Foramen Ovale-Related Cerebral Infarcts Alternately Causing Bilateral Hand Paresis
Isolated hand paresis is a rare presentation of stroke, which mostly results from a lesion in the cortical hand motor area, a knob-like area within the precentral gyrus. I report the case of a patient who experienced recurrent ischemic stroke alternately involving bilateral hand knob areas, causing isolated hand paresis. There was no abnormal finding on brain and neck magnetic resonance angiography, transthoracic echocardiography, and 48-h Holter monitoring, and there were no abnormal immunologic and coagulation laboratory findings. The only embolic source was found to be a patent foramen ovale, which was proven on transes...
Source: Case Reports in Neurology - August 31, 2017 Category: Neurology Source Type: research

Left Atrial Enlargement Could Be Detected on Extended Computed Tomography Angiography —Reply
In Reply We agree with Popkirov that left atrial volume is a better marker of incident atrial fibrillation than atrial diameter; however, we did not have these data available at all of the sites participating in the New Approach Rivaroxaban Inhibition of Factor Xa in a Global Trial Versus ASA to Prevent Embolism in Embolic Stroke of Undetermined Source (NAVIGATE-ESUS) trial. Recently completed and ongoing studies will help determine if our observation has a clinical role and may provide additional data on left atrial size and function. Once all of these data are available, guidelines committees will likely make recommendat...
Source: JAMA Neurology - November 11, 2019 Category: Neurology Source Type: research

Management of paradoxical embolism in a patient with coexisting patent foramen ovale and masked pulmonary arteriovenous fistula: A case report
Rationale: Paradoxical embolism (PE) is an important cause of cryptogenic stroke, particularly in young patients, which usually have a relation with an unexpected route in circulation. Here we report a rare case of cryptogenic stroke carried 2 uncommon malformations. Patient concerns: A 48-year-old female experienced double neurological events in just 2 months. Diagnosis: Patent foramen ovale was diagnosed with transesophageal echocardiography and successfully occluded in the first admission due to stroke. In the second admission, chest tomographic angiography found a chordae shadow in the right middle lobe, was th...
Source: Medicine - April 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Decompressive craniectomy for malignant middle cerebral artery infarction in a 16-year old boy: a case report
ConclusionsThis case highlights the preponderance of cryptogenic stroke in younger patients and its etiological elusiveness. It further demonstrates that age is predictive in terms of survival and functional outcome in the context of malignant middle cerebral artery infarction.
Source: Journal of Medical Case Reports - December 19, 2016 Category: Journals (General) Source Type: research

Angiography vs transesophageal echocardiography ‐guided patent foramen ovale closure: A propensity score matched analysis of a two‐center registry
ConclusionsThe use of intra‐procedural transesophageal echocardiography (TEE) guidance for PFO closure allows lower residual shunt rate, radiological exposure, and adverse events, mainly driven by a significant reduction in percutaneous reintervention.
Source: Echocardiography - February 19, 2018 Category: Cardiology Authors: Paolo Scacciatella, Ilaria Meynet, Mauro Giorgi, Lorenza M. Biava, Ivana Matranga, Luigi Biasco, Pierluigi Omed è, Fulvio Orzan, Fiorenzo Gaita Tags: ORIGINAL INVESTIGATION Source Type: research

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