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Recurrent stroke in a patient with vitamin B12 deficiency and MTHFR mutation
We report an unusual case of recurrent stroke in a patient with vitamin B12 deficiency who was also homozygous for the methylene tetrahydrofolate reductase (MTHFR) gene mutation. The patient was a 35-year-old male vegetarian with no known medical history who initially presented with global aphasia, slurred speech, right facial weakness, and right-sided hemiplegia and was found to have a stroke (NIH Stroke Scale score of 25). At that time a CT scan of the head ruled out intracranial hemorrhage and a CT angiogram of the head and neck was done. The patient was found to have occlusion of the M1 segment of the left middle cereb...
Source: Neurology Clinical Practice - February 12, 2017 Category: Neurology Authors: Zacharia, G., Shani, D., Ortiz, R. A. Tags: Stroke in young adults, Stroke prevention, Hematologic, All Cerebrovascular disease/Stroke Case Source Type: research

Opportunities for intervention: stroke treatments, disability and mortality in urban Tanzania
ConclusionsThe 90-day mortality of stroke presenting at MNH is 50%, much higher than in higher income settings. Although severe stroke presentations are a major factor, efforts to improve the quality of care and prevent complications of stroke are urgently needed. Acute stroke interventions with low number needed to treat represent challenging long-term goals.
Source: International Journal for Quality in Health Care - August 28, 2018 Category: International Medicine & Public Health Source Type: research

Temporal Trends and Patient Characteristics Associated With Drug Utilisation After First-Ever Stroke: Insights From Chronic Disease Registry Data in Singapore.
CONCLUSION: This study reveals changes in prescription behaviour over time in a multiethnic Asian population with first-ever stroke. Patient characteristics including younger age, Malay ethnicity and certain comorbidities (i.e. hyperlipidaemia, atrial fibrillation) were associated with the combined use of all 3 guideline medications among ischaemic stroke patients. PMID: 32301477 [PubMed - in process]
Source: Ann Acad Med Singapo... - February 29, 2020 Category: General Medicine Authors: Yeo SH, Toh MPH, Lee SH, Seet RC, Wong LY, Yau WP Tags: Ann Acad Med Singapore Source Type: research

Ischemic stroke in a patient with Parry-Romberg syndrome (P4.064)
Conclusions:The only other reported patient with PRS and stroke was also found to have a PFO. It is possible that the elevated ANA seen in this patient correlates with propensity towards small venous clots not seen on ultrasound. This may lead to paradoxical emboli and ischemic strokes. It is important to note this potential association between PRS and ischemic stroke in young patients without other known risk factors. It would be worthwhile to treat this subset of patients with medications for secondary stroke prevention.Disclosure: Dr. Ebiana has nothing to disclose. Dr. Singh has nothing to disclose. Dr. Khosa has nothi...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Ebiana, V., Singh, S., Khosa, S., Moheb, N., Trikamji, B., Rao, N., Mishra, S. Tags: General Neurology: Vascular Neurology Source Type: research

ABI and stroke: Action at a distance and a call to action
Stroke is a catastrophic clinical event and is justifiably feared by both patients and physicians alike. Given the aging demographic of western populations, the morbid consequences of stroke are also a growing burden on healthcare resources . For example, projections show that by 2030 an additional 3.4 million US adults will have suffered a stroke, a 20.5% increase in prevalence from 2012 . The majority of strokes are ischemic and a consequence of either thromboembolism or atherosclerosis or both. Fortunately, effective primary prevention therapies exist, including aspirin and statins , which can reduce the risk of ischemi...
Source: Atherosclerosis - April 10, 2014 Category: Cardiology Authors: John W. McEvoy, Khurram Nasir Tags: Invited Commentaries Source Type: research

Cerebral Infarction in a Case of Parry-Romberg Syndrome
Our objective is to report a rare coexistence of Parry-Romberg disease and ischemic stroke. Here, we report the case of a 34-year-old woman with Parry-Romberg syndrome who developed cerebral infarction. This patient developed sudden left-sided weakness and was admitted to our hospital. Magnetic resonance imaging revealed acute cerebral infarction in the posterior limb of the right internal capsule. The patient had been diagnosed with Parry-Romberg syndrome at the age of 12, and she had a history of migraine without aura. Transesophageal echocardiography revealed a patent foramen ovale, but no atrial septal aneurysm or deep...
Source: Journal of Stroke and Cerebrovascular Diseases - May 9, 2013 Category: Neurology Authors: Yuji Tomizawa, Ryota Tanaka, Kiyoshi Sekiguchi, Yutaka Oji, Yasutaka Tanaka, Kazuo Yamashiro, Nobutaka Hattori Tags: Case Reports Source Type: research

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

Data from New VOYAGER PAD Analyses at ACC.22 Reinforce Benefit of XARELTO ® (rivaroxaban) Plus Aspirin in Patients with Peripheral Artery Disease (PAD) and Various Co-Morbid Conditions
RARITAN, N.J., April 1, 2022 – The Janssen Pharmaceutical Companies of Johnson & Johnson today announced data from new analyses from the Phase 3 VOYAGER PAD clinical trial reinforcing the benefit of the XARELTO® (rivaroxaban) vascular dose (2.5 mg twice daily plus aspirin 100 mg once daily) in reducing severe vascular events in patients with PAD after lower-extremity revascularization (LER), a procedure that restores blood flow to the legs. Data from the two analyses demonstrate the role that the XARELTO® vascular dose plays in PAD patients with and without chronic kidney disease (CKD) and in PAD patients with and ...
Source: Johnson and Johnson - April 1, 2022 Category: Pharmaceuticals Tags: Innovation Source Type: news

A Case of Transient Global Amnesia: A Review and How It May Shed Further Insight into the Neurobiology of Delusions
Conclusion In closing, our patient’s episode of TGA combined with her emotional and perceptual response lends credence to the proposal of a “fear/paranoia” circuit in the genesis of paranoid delusions—a circuit incorporating amygdala, frontal, and parietal cortices. Here, neutral or irrelevant stimuli, thoughts, and percepts come to engender fear and anxiety, while dysfunction in frontoparietal circuitry engenders inappropriate social predictions and maladaptive inferences about the intentions of others.[54] Hippocampus relays information about contextual information based on past experiences and the current situat...
Source: Innovations in Clinical Neuroscience - April 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Anxiety Disorders Behavioral and Cognitive Neurology Case Report Cognition Current Issue Dementia Medical Issues Neurologic Systems and Symptoms Psychiatry Schizophrenia delusions hippocampus neurobiology Transient global amnesia Source Type: research

E-107 Carotid artery stenting in patients with symptomatic non-stenotic carotid artery disease - a case series
ConclusionsIn this case series performed over a 10-year period at a high-volume stroke center we show that CAS is safe and efficient in patients with SyNC. Previous studies have established safety and effectiveness of CES in patients presenting with SyNC, however there is a paucity of reports in the literature regarding the effect of CAS in this patient population. Recent guidelines have brought specific attention to high-risk plaque characteristics which suggest that plaque instability plays a major role in the onset of ischemic events, regardless of lumen narrowing. Advanced imaging techniques, such as Optical Coherence ...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Nedelcu, S., Kuhn, A., Singh, J., Puri, A. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

Cardiovascular risk in vasculitis
Best Pract Res Clin Rheumatol. 2023 Jun 9:101831. doi: 10.1016/j.berh.2023.101831. Online ahead of print.ABSTRACTThe present review summarizes the burden, risk factors, biomarkers of and therapeutic consideration for cardiovascular disease in systemic vasculitis. Ischemic heart disease (IHD) and stroke are intrinsic features of Kawasaki disease, Takayasu arteritis, Giant Cell Arteritis (GCA), and Behcet's disease. The risk of IHD and stroke is increased in anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) and cryoglobulinemic vasculitis. Behcet's disease could present with venous thromboembolism. The risk of...
Source: Cell Research - June 11, 2023 Category: Cytology Authors: Durga Prasanna Misra Aman Sharma George A Karpouzas George D Kitas Source Type: research

Cortical hemiballism: A case of hemiballismus associated with parietal lobe infarct
Conclusion: Lesions affecting various areas outside the STN can cause hemiballism and usually carries a good prognosis with spontaneous resolution. Acute thrombolytic therapy may be considered on an individual basis. Treatment with antipsychotics can be useful for severe and recurring symptoms.
Source: North American Journal of Medical Sciences - December 30, 2015 Category: Journals (General) Authors: Pragya ShresthaJanak AdhikariDilli PoudelRanjan PathakParas Karmacharya Source Type: research

Pharmacologic Interventions to Prevent Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer-Type Dementia: A Systematic Review.
Conclusion: Evidence does not support use of the studied pharmacologic treatments for cognitive protection in persons with normal cognition or MCI. Primary Funding Source: Agency for Healthcare Research and Quality. PMID: 29255847 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - December 19, 2017 Category: Internal Medicine Authors: Fink HA, Jutkowitz E, McCarten JR, Hemmy LS, Butler M, Davila H, Ratner E, Calvert C, Barclay TR, Brasure M, Nelson VA, Kane RL Tags: Ann Intern Med Source Type: research

Preventable Cases of Oral Anticoagulant-Induced Bleeding: Data From the Spontaneous Reporting System
Conclusion: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - April 29, 2019 Category: Drugs & Pharmacology Source Type: research

The Timing Hypothesis and Hormone Replacement Therapy: A Paradigm Shift in the Primary Prevention of Coronary Heart Disease in Women. Part 2: Comparative Risks
A major misperception concerning postmenopausal hormone replacement therapy (HRT) is that the associated risks are large in magnitude and unique to HRT, but over the past 10 years, sufficient data have accumulated so that the magnitude and perspective of risks associated with the primary coronary heart disease prevention therapies of statins, aspirin, and postmenopausal HRT have become more fully defined. Review of randomized controlled trials indicates that the risks of primary prevention therapies and other medications commonly used in women's health are of similar type and magnitude, with the majority of these risks ca...
Source: Journal of the American Geriatrics Society - May 20, 2013 Category: Geriatrics Authors: Howard N. Hodis, Wendy J. Mack Tags: Updates on Aging Source Type: research

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