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A Case of Recurrent Ischemic Stroke Involving Subacute, Progressive Intracranial Cerebral Arterial Sclerosis Prior to Diagnosis with -mutated Polycythemia Vera
A 58-year-old man presenting with no vascular risk factors visited our hospital with right hemiparesis and total aphasia. Diffusion-weighted magnetic resonance imaging of the brain showed multiple hyperintensities in watershed distributions in the left hemisphere. Magnetic resonance angiography (MRA) revealed stenosis of the middle cerebral artery, despite normal MRA findings 2 months prior. One year after the first stroke, the patient experienced a recurrent ischemic stroke involving the left anterior choroidal artery, pulmonary embolism, and deep venous thrombosis.
Source: Journal of Stroke and Cerebrovascular Diseases - September 29, 2015 Category: Neurology Authors: Tomohisa Nezu, Shiro Aoki, Kazuhide Ochi, Sayaka Sugihara, Tetsuya Takahashi, Naohisa Hosomi, Hirofumi Maruyama, Masayasu Matsumoto Tags: Case Studies Source Type: research

Thrombus Characteristics Are Related to Collaterals and Angioarchitecture in Acute Stroke.
CONCLUSIONS: Clot length and baseline collateral status are independent predictors of clot hyperdensity on NCCT and blooming artifact on gradient recall echo. Longer clots are more likely to be hyperdense and to bloom more, probably because portions of these clots are freshly formed locally due to of stasis of blood around the original clot. This stasis could be because of poor collaterals and inefficient angio-architecture within the cerebral arterial tree. PMID: 26365832 [PubMed - as supplied by publisher]
Source: The Canadian Journal of Neurological Sciences - September 14, 2015 Category: Neurology Authors: Qazi EM, Sohn SI, Mishra S, Almekhlafi MA, Eesa M, d'Esterre CD, Qazi AA, Puig J, Goyal M, Demchuk AM, Menon BK Tags: Can J Neurol Sci Source Type: research

Successful Systemic Thrombolysis in an Adolescent With Acute Ischemic Stroke
Conclusions: Despite the lack of evidence regarding the safety and the efficacy of recombinant tissue plasminogen activator in pediatric stroke, this treatment option should be considered, especially in adolescents presenting within 3 hours from symptom onset in centers with consolidated experience in adult thrombolysis.
Source: The Neurologist - September 1, 2015 Category: Neurology Tags: Case Report/Case Series Source Type: research

Cavernous Sinus Thrombosis in Children: Imaging Characteristics and Clinical Outcomes Brief Reports
Conclusions— CAN and infarcts were common in this modest cohort of children with CST. Despite the high incidence of CAN and infarction, outcomes were often favorable. Although this is the largest cohort of childhood CST reported to date, large multicenter cohorts are needed to confirm our findings and determine the preferred therapeutic strategies for childhood CST.
Source: Stroke - August 24, 2015 Category: Neurology Authors: Press, C. A., Lindsay, A., Stence, N. V., Fenton, L. Z., Bernard, T. J., Mirsky, D. M. Tags: Computerized tomography and Magnetic Resonance Imaging, Anticoagulants, Antiplatelets Brief Reports Source Type: research

Younger Stroke Patients With Large Pretreatment Diffusion-Weighted Imaging Lesions May Benefit From Endovascular Treatment Clinical Sciences
Conclusions— There was a growing risk for poor outcome and symptomatic intracerebral hemorrhage with increasing pretreatment DWI lesion volumes. Nevertheless, favorable outcome was achieved in every third patient with DWI lesions >70 mL after successful endovascular reperfusion, whereas after poor or failed reperfusion, outcome was favorable in only every 12th patient. Therefore, endovascular treatment might be considered in patients with large DWI lesions, especially in younger patients.
Source: Stroke - August 24, 2015 Category: Neurology Authors: Gilgen, M. D., Klimek, D., Liesirova, K. T., Meisterernst, J., Klinger-Gratz, P. P., Schroth, G., Mordasini, P., Hsieh, K., Slotboom, J., Heldner, M. R., Broeg-Morvay, A., Mono, M.-L., Fischer, U., Mattle, H. P., Arnold, M., Gralla, J., El-Koussy, M., Jun Tags: Acute Cerebral Infarction, Thrombolysis, Other Stroke Treatment - Medical Clinical Sciences Source Type: research

White Matter Lesions Double the Risk of Post-Thrombolytic Intracerebral Hemorrhage Clinical Sciences
Conclusions— WMLs visible on computed tomography are associated with a more than doubled risk of sICH in patients treated with intravenous thrombolysis for acute ischemic stroke.
Source: Stroke - July 27, 2015 Category: Neurology Authors: Curtze, S., Haapaniemi, E., Melkas, S., Mustanoja, S., Putaala, J., Sairanen, T., Sibolt, G., Tiainen, M., Tatlisumak, T., Strbian, D. Tags: Computerized tomography and Magnetic Resonance Imaging, Thrombolysis Clinical Sciences Source Type: research

Bilateral Frontal Cerebral Infarctions Presenting as Ascending Weakness: Case Report (P1.023)
CONCLUSIONS: To our knowledge there are only a few case reports describing bilateral frontal cerebral infarctions due to a single A2 segment of the anterior cerebral artery. Bilateral cerebral infarctions should be considered in patients with symmetric weakness, especially in those with vascular risk factors who do not have features consistent with an alternative etiology. Reflexes are an important feature in distinguishing between central and peripheral lesions and should be closely monitored in these patients. Timely diagnosis will enable early delivery of thrombolytic therapy to these patients improving outcomes.Disclos...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Mijalski, C., Khan, M., Silver, B. Tags: Cerebrovascular Disease and Interventional Neurology: Case Reports Source Type: research

Transient Neurologic Deficit Presenting with Cortical Vein Thrombosis Caused by Intracranial Hypotension: Case Report (P1.028)
CONCLUSION We hypothesized that intracranial hypotension led to venous engorgement (based on the Monroe-Kelli doctrine) and the subsequent cortical vein thrombosis, which then produced vasogenic edema, cortical irritability, and focal seizure that mimicked ischemic stroke. Based on our findings, clinicians should consider intracranial hypotension in patients presenting with dural sinus or cortical vein thrombosis, and orthostatic headache or imaging findings of dural enhancement.Disclosure: Dr. Plancher has nothing to disclose. Dr. Flaherty has received personal compensation for activities with CSL Behring as a consultant ...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Plancher, J. M.-O., Flaherty, M. Tags: Cerebrovascular Disease and Interventional Neurology: Case Reports Source Type: research

Occult Anterograde Flow Is an Under-Recognized but Crucial Predictor of Early Recanalization With Intravenous Tissue-Type Plasminogen Activator Clinical Sciences
Conclusions— Occult anterograde flow through thrombus can be assessed by perfusion computed tomography T0 maps and predicts early recanalization with intravenous tissue-type plasminogen activator robustly.
Source: Stroke - March 23, 2015 Category: Neurology Authors: Ahn, S. H., d'Esterre, C. D., Qazi, E. M., Najm, M., Rubiera, M., Fainardi, E., Hill, M. D., Goyal, M., Demchuk, A. M., Lee, T. Y., Menon, B. K. Tags: Fibrinolysis, Computerized tomography and Magnetic Resonance Imaging, Thrombolysis Clinical Sciences Source Type: research

Susceptibility vessel sign on T2* magnetic resonance imaging and recanalization results of mechanical thrombectomy with stent retrievers: a multicentre cohort study
ConclusionsThe success of recanalization in acute stroke patients treated with stent retrievers was related to thrombus length but not to the presence of SVS.
Source: European Journal of Neurology - March 19, 2015 Category: Neurology Authors: S. Soize, A. L. Batista, C. Rodriguez Regent, D. Trystram, M. Tisserand, G. Turc, I. Serre, W. Ben Hassen, M. Zuber, D. Calvet, J.‐L. Mas, J.‐F. Meder, J. Raymond, L. Pierot, C. Oppenheim, O. Naggara Tags: Original Article Source Type: research

Tenecteplase-Tissue-Type Plasminogen Activator Evaluation for Minor Ischemic Stroke With Proven Occlusion Clinical Sciences
Conclusions— Administration of TNK–tissue-type plasminogen activator in minor stroke with intracranial occlusion is both feasible and safe. A larger randomized controlled trial is needed to prove that this treatment is efficacious. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01654445.
Source: Stroke - February 23, 2015 Category: Neurology Authors: Coutts, S. B., Dubuc, V., Mandzia, J., Kenney, C., Demchuk, A. M., Smith, E. E., Subramaniam, S., Goyal, M., Patil, S., Menon, B. K., Barber, P. A., Dowlatshahi, D., Field, T., Asdaghi, N., Camden, M.-C., Hill, M. D., for the TEMPO-1 Investigators Tags: Computerized tomography and Magnetic Resonance Imaging, Thrombolysis Clinical Sciences Source Type: research

Oral direct thrombin inhibitor as an alternative in the management of cerebral venous thrombosis: a series of 15 patients
ConclusionsWe report the largest series of cerebral vein thrombosis patients treated with dabigatran. Clinical outcome was excellent in most patients and not different from other studies. Dabigatran could possibly be considered an alternative to warfarin; nevertheless, further prospective assessment with randomized controlled studies is warranted.
Source: International Journal of Stroke - February 1, 2015 Category: Neurology Authors: Marcelo D. Mendonça, Raquel Barbosa, Vera Cruz‐e‐Silva, Sofia Calado, Miguel Viana‐Baptista Tags: Research Source Type: research

Cerebral venous sinus thrombosis may be associated with hepatitis B virus infection: a preliminary finding.
Conclusion: Hepatitis B virus infection may be a risk factor for CVST. PMID: 25591420 [PubMed - as supplied by publisher]
Source: Neurological Research - January 18, 2015 Category: Neurology Tags: Neurol Res Source Type: research

Imaging of occlusive thrombi in acute ischemic stroke
Thrombi, or clots, often occlude proximal segments of the cerebral arterial circulation in acute ischemic stroke. Thromboembolic occlusion or thrombi superimposed on atherosclerotic plaque are the principal focus of acute stroke therapies such as thrombolysis or thrombectomy. We review the imaging characteristics of thrombi on multimodal computed tomography and magnetic resonance imaging, angiography, and ultrasonography, summarizing recent studies that facilitate therapeutic decision‐making from these noninvasive studies. Information about the location, size, and imaging characteristics can be ascertained using these te...
Source: International Journal of Stroke - December 26, 2014 Category: Neurology Authors: Gregory G. Gasparian, Nerses Sanossian, Mark S. Shiroishi, David S. Liebeskind Tags: Review Source Type: research

Crohns disease with central nervous system vasculitis causing subarachnoid hemorrhage due to aneurysm and cerebral ischemic stroke
We report a 39-year-old male who presented with headache, vomiting, and left-sided weakness in the known case of CD. Cross-sectional imaging (computed tomography and magnetic resonance imaging,) showed right gangliocapsular acute infarct with supraclinoid cistern subarachnoid hemorrhage (SAH). Cerebral digital substraction angiography (DSA) showed dilatation and narrowing of right distal internal carotid artery (ICA). Left ICA was chronically occluded. His inflammatory markers were significantly raised. Imaging features are suggestive of cerebral vasculitis. Arterial and venous infarcts due to thrombosis are known in CD. O...
Source: Annals of Indian Academy of Neurology - November 5, 2014 Category: Neurology Authors: Shaileshkumar S GargePooja D VyasPranav D ModiSharad Ghatge Source Type: research

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