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Intravenous Thrombolysis in Posterior Circulation Stroke
Conclusions: Up to date, no data about PCIS and IVT are available from RTCs. Based on limited results from retrospective clinical studies and case series, IVT is safer for use in PCIS than in ACIS. Patients with brainstem ischemia, vertebral artery occlusion, and absence of basilar or posterior cerebral artery occlusion could be considered for treatment with IVT even in borderline cases. Time to IVT in PCIS seems to be a less crucial factor than in ACIS. IVT for PCIS may be beneficial even after 4.5 h from symptom onset. Introduction History of Intravenous Thrombolysis—The Most Relevant Studies Intravenous...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Misdiagnosis of lamotrigine toxicity as posterior circulation transient ischemic attack or stroke.
CONCLUSION: Emergency departments will frequently call a stroke alert for patients taking LTG and presenting with symptoms consistent with LTG toxicity, particularly in seniors at greater risk of stroke. This adds not only expense but also radiation and contrast exposure from computed tomography (CT) studies. We recommend that a rapid LTG assay be made available and always ordered in patients receiving LTG, avoiding the considerable expense of an unnecessary stroke evaluation. PMID: 32652284 [PubMed - as supplied by publisher]
Source: Epilepsy and Behaviour - July 7, 2020 Category: Neurology Authors: Ramey P, Osborn M, Kirshner H, Abou-Khalil B Tags: Epilepsy Behav Source Type: research

A single-site retrospective study of pediatric arterial ischemic stroke etiology, clinical presentation, and radiologic features.
CONCLUSIONS: PAIS occurs more frequently in younger children and this group most frequently presents with convulsion as the initial symptom. The overall etiologies of PAIS may be different from those of adult stroke and the involved regions may be distinguishing features of PAIS or its different forms, but more research is required. PMID: 24034087 [PubMed - in process]
Source: Chinese Medical Journal - September 1, 2013 Category: Journals (General) Authors: Sun D, Wu XM, Wang ZW, Jin RM, Liu ZS, Liu F, Huang S, Wang HQ, Hu JS Tags: Chin Med J (Engl) Source Type: research

Stroke of a cardiac myxoma origin
Conclusion: Cardiac myxoma stroke is rare. Often does it affect young females. For an improved diagnostic accuracy, magnetic resonance imaging of the brain and echocardiography are imperative for young stroke patients in identifying the cerebral infarct and determining the stroke of a cardiac origin. Immediate thrombolytic therapy may completely resolve the cerebral stroke and improve the neurologic function of the patients. An early surgical resection of cardiac myxoma is recommended in patients with not large territory cerebral infarct. Resumo Objetivo: As características clínicas do acidente vascular cerebral causado ...
Source: Revista Brasileira de Cirurgia Cardiovascular - June 19, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Methotrexate Neurotoxicity Mimicking Stroke (P2.296)
Conclusion: It is important for clinicians to recognize methotrexate-induced neurotoxcity as a possible stroke mimic.Disclosure: Dr. Pham has nothing to disclose. Dr. Ermak has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Pham, Q., Ermak, D. Tags: Cerebrovascular Disease and Interventional Neurology: Inflammation and Immunology Source Type: research

E-088 successful mechanical thrombectomy for basilar artery stroke in a 22-month old child
We present the case of a 22-month-old with basilar artery occlusion successfully treated with mechanical thrombectomy.The patient presented to the emergency department with altered mental status and gait ataxia. She "felt limp", her breathing was shallow, and her gaze dysconjugate. Her medical history included congenital heart defects with multiple cardiac procedures.In the emergency department, she fell with attempted ambulation. Labs were normal, as was a chest x-ray, and EKG. A computerized tomography (CT) scan of the head suggested left cerebellar hemisphere attenuation. The differential included arrhythmia, stroke, or...
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Roark, C., Savastano, L., Wilkinson, D., Shastri, R., Vadlamudi, V., Chaudhary, N., Pandey, A., Gemmete, J. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

Intravenous Thrombolysis at 3.5 Hours From Onset of Pediatric Acute Ischemic Stroke
We report the case of a 14-year-old girl who presented with right-sided weakness and ataxia, loss of sensation, and altered mental status. Magnetic resonance imaging with diffusion-weighted imaging showed an acute lesion in the distribution of the left posterior cerebral artery, and magnetic resonance angiogram demonstrated occlusion of the third branch of the left posterior cerebral artery. With parental consent, clinicians decided to infuse an adult dose of weight-adjusted intravenous alteplase at 3.5 hours from onset of symptoms, with subsequent improvement in National Institutes of Health Stroke Scale score from 11 to ...
Source: Pediatric Emergency Care - January 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Severe heat stroke complicated by multiple cerebral infarctions: a case report
ConclusionsEarly management of heat stroke using anti-DIC, anti-bacterial, and fluid resuscitation therapy can help prevent complications such as intracranial hemorrhaging.
Source: Journal of Medical Case Reports - January 28, 2021 Category: General Medicine Source Type: research

Early Diagnosis of Posterior Fossa Stroke with Brainstem Evoked Potentials (I1-3B)
Conclusion: BAP is more sensitive for diagnostic purposes towards posterior fossa small strokes and should be considered in patients when the initial MRI brain is negative. This will allow for correct diagnosis and treatment regimen without causing a delay for the patient.Disclosure: Dr. Duggal has nothing to disclose. Dr. Ahmed has nothing to disclose. Dr. Duggal has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Duggal, N., Ahmed, I., Duggal, N. Tags: New Windows into the Brain: Technological Advances in Frontline Neurologic Diagnosis via the Visual and Oculomotor Systems Data Blitz Presentations Source Type: research

Eagle Syndrome: A Rare Cause of Stroke in a Young Patient
We report the case of a 26-year-old man who presented to the emergency department because he noticed that his right hand had become clumsy. He first noticed this symptom five days before his presentation, but he noticed that his symptom had improved significantly since it began. He reported that he had episodes of neck pain and pain around the ear. He visited the family physician clinic several times for this complaint and was diagnosed as having a temporomandibular joint disorder. Neurological examination revealed decreased muscle strength in the right upper limb with a power of 4/5 along with a sensory deficit. The coord...
Source: Pain Physician - February 15, 2022 Category: Anesthesiology Authors: Hussain A Alobaidi Ali A Alfaran Hawa H Algazwi Fatimah I Alkhater Hussain M Alshooalah Abdulrahman K Alanzi Ibrahim A Almindil Abdullah K Alqasim Aisha A Faqeeh Amani A Almutairi Ghaida H Alnaqa Najla H Alnaqa Renad M Alasmari Razan M Almashouf Faisal Al Source Type: research

Portal–Left Atrium Shunt Leading to Stroke
A 37-year-old man presented acutely with a stroke, ataxia, and left upper limb weakness. His medical history was positive for congenital low-grade liver fibrosis and for a single episode of paresthesia of the left upper limb (4 y previously). Magnetic resonance imaging showed acute ischemic lesions in the right cerebellum and temporal region (). Chest radiography, blood tests, and echocardiography were normal. Computed tomography demonstrated dilatation of the portal vein and gastroesophageal varix arising from the left gastric vein (arrowhead) and reaching the left atrium (arrow), which is partially contrasted in the veno...
Source: Journal of Vascular and Interventional Radiology : JVIR - February 27, 2014 Category: Radiology Authors: Umberto G. Rossi, Giovanni Gandini, Maurizio Cariati Source Type: research

Profile of Patients with Cerebral Venous Sinus Thrombosis with Cerebellar Involvement
Conclusions: Cerebellar involvement in CVT is very rare, and high index of suspicion is required for diagnosis. Imaging with CT and MRI will help in confirming the diagnosis. Conventional anticoagulation is effective in treatment. Mortality was 33%, and there was no disability in survivors.
Source: Journal of Stroke and Cerebrovascular Diseases - November 14, 2013 Category: Neurology Authors: Girish B. Kulkarni, Veerendrakumar Mustare, Mirza M. Abbas Tags: Original Articles Source Type: research

Stroke in a Young Swimmer
Conclusions: Important differential diagnoses of cervicocephalic arterial dissection include other vascular or neurological causes of head and neck pain and/or local neurological syndromes and other causes of brain ischemia such as cardiac emboli, atherosclerosis, and vasculopathy of brain vessels. It is important that sports medicine practitioners pay attention to this less-diagnosed cause of stroke in young athletes.,Introduction: Arterial dissections are important causes of stroke in the young population. Dissection has been reported in association with some sports. It seems that this report is among the first ones of t...
Source: Asian Journal of Sports Medicine - June 19, 2015 Category: Sports Medicine Source Type: research

Vertebral Artery Dissection Causing Stroke After Trampoline Use
Conclusions: Vertebral artery dissection is a relatively common cause of stroke in the pediatric age group. Trampoline use has been associated with significant risk of injury to the head and neck. Patients who are small and/or young are most at risk. In this case, minor trauma secondary to trampoline use could be a possible mechanism for vertebral artery dissection and subsequent strokes. The association in this case warrants careful consideration because trampoline use could pose a significant risk to pediatric users.
Source: Pediatric Emergency Care - November 1, 2015 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

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