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Avellis syndrome with ipsilateral prosopalgia, glossopharyngeal neuralgia, and central post-stroke pain: A case report and literature review
We reported a case of Avellis syndrome who manifested as the typical reported manifestations. The patient, what’s more, presented with ipsilateral trigeminal, glossopharyngeal neuralgia, and central poststroke pain which were described for the first time. It is of great significance for clinicians to recognize the typical as well as other manifestations which helps to make a clear diagnosis.
Source: Medicine - September 30, 2022 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Posterior fossa transient ischemic attack in the setting of bilateral persistent hypoglossal arteries: A case report and literature review
We reported a 54-year old female with posterior fossa TIA due to the coexisting bilateral persistent hypoglossal arteries and left internal carotid artery stenosis. Diagnosis: The patient was diagnosed with posterior fossa TIA, bilateral persistent hypoglossal arteries and left internal carotid artery stenosis. Interventions: The patient was given aspirin 100 mg/qd and advised to avoid excessive neck movement. Outcomes: Symptoms of intermittent subjective dizziness accompanied by nausea were relieved. Lessons: Although requires no special treatment, PHA could be accompanied by hypoplasia of ve...
Source: Medicine - November 12, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Two cases of rt-PA with dual antiplatelet therapies with capsular warning syndrome
Rationale: Capsular warning syndrome (CWS) is a term to describe stereotyped lacunar transient ischemic attacks (TIAs). Patients with CWS are at high risk of developing completed stroke. However, the exact pathophysiology of CWS is still unclear, and there is no conclusive clinical strategy for CWS patients. Patient symptoms: Two cases of middle-aged men with hypertension, hyperlipidemia, and diabetes mellitus presented with fluctuating right-sided weakness, numbness, and dysarthria. Diagnoses: These two patients were diagnosed with CWS. Interventions: Recombinant tissue plasminogen activator (rt-P...
Source: Medicine - March 5, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Acute ischemic stroke due to unruptured small aneurysm of internal carotid artery: A case report
Rationale: Intracranial small aneurysm is a rare cause of ischemic stroke, and been described only in sparse case reports. The exact pathophysiology, treatment strategies, and prognosis remain incompletely understood. Patient concerns: A 42-year-old man presented with an acute onset weakness of the right limbs. Diagnoses: Neuroimaging evaluation confirmed a diagnosis of acute ischemic stroke and left internal carotid artery (ICA) small aneurysm. Interventions: The patient underwent oral anti-platelet therapy (100 mg aspirin daily). Outcomes: The patient recovered to normal status within 4 weeks following an...
Source: Medicine - October 9, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

r-tPA with loading dose of clopidogrel and aspirin therapies for capsular warning syndrome attributed to middle cerebral artery atherosclerotic stenosis: A CARE-compliant case report
Rationale: The capsular warning syndrome (CWS) is a rare and special type of transient ischemic attacks (TIAs) syndrome. The pathophysiology of CWS is very complicate, and intracranial atherosclerotic stenosis (ICAS) is rare cause. Moreover, the effective and standard therapy has not yet been established. Patient concerns: A 47-year-old man experienced repeated and exacerbated TIAs of right hemiparesis and dysarthria. Fourteen hours after the first episode of TIAs, he developed more severe right hemiparesis and dysarthria, the National Institute of Health Stroke Scale (NIHSS) score was 12 points, and did not recover i...
Source: Medicine - February 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Not Just Acid Reflux: The Need to Think Worst First
Discussion Heart disease is the leading cause of death in the United States.1 This year, 720,000 Americans will have a new coronary event—defined as first hospitalized myocardial infarction (MI) or coronary heart disease death—and around 335,000 will have a recurrent event. Approximately 35% of people who experience a coronary event in a given year and around 14% of patients who have an acute coronary syndrome will die from it.1 Roughly 60% of patients with an acute coronary syndrome are transported to the emergency department via ambulance.2–4. Up to one-third of patients experiencing an MI may not complain of chest...
Source: JEMS Special Topics - January 13, 2019 Category: Emergency Medicine Authors: Stephen Sanko, MD, FACEP Tags: Exclusive Articles Cardiac & Resuscitation Source Type: news

Bilateral visual loss and cerebral infarction after spleen embolization in a trauma patient with idiopathic thrombocytopenic purpura: A case report
We report a case of acute ischemic stroke following orthopedic surgery in a patient with post-SAE reactive thrombocytosis. Patient concerns: A 37-year-old woman with idiopathic thrombocytopenic purpura (ITP) suffered from multiple trauma scheduled for open reduction and internal fixation for right tibial and left radius fracture five days after SAE. The patient did not have any thromboembolic complications, although the platelet counts increased from 43 × 109/L to 568 × 109/L within two days after SAE. Surgery was completed under general anesthesia with tracheal intubation without complications. The patient co...
Source: Medicine - April 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Refractory Mycoplasma pneumoniae pneumonia with concomitant acute cerebral infarction in a child: A case report and literature review
We present a 7-year-old boy with severe M pneumoniae pneumonia who developed impaired consciousness, aphasia, and reduced limb muscle power 7 days postadmission. Diagnoses: Mycoplasma pneumoniae pneumonia with concomitant acute cerebral infarction. Interventions: The patient recovered with aggressive antibiotic therapy, antiinflammation therapy with methylprednisolone, and gamma immunoglobulin and anticoagulation therapy with aspirin and low molecular weight heparin along with rehabilitation training. Outcomes: At 8 days postadmission, his consciousness was improved and at the 6-month follow-up visit, his muscle p...
Source: Medicine - March 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Rapid improvement of angiostenosis due to isolated middle cerebral artery dissection: A case report
AbstractRationale:Intracranial arterial dissection is a rare cause of ischemic stroke, and isolated middle cerebral artery dissection (MCAD) is extremely rare, having been described only in sparse case reports. The etiology, clinicoradiological features, and treatment strategies are not yet well understood.Patient concerns:A 49-year-old man presented with rapidly progressive aphasia and motor disturbance of the right limbs.Diagnoses:Neuroimaging evaluation confirmed a diagnosis of MCAD and cerebral infarction.Interventions:The patient underwent oral anti-platelet therapy (100 mg aspirin daily).Outcomes:The patient recove...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

WATCHMAN device-related thrombus successfully treated with apixaban: A case report
Rationale: Among atrial fibrillation patients with high risk of bleeding, left atrial appendage occlusion has emerged as an alternative to long-term oral anticoagulation therapy for stroke prevention. Device-related thrombus remains a major concern because it may result in recurrent embolic events. To date, there is no consensus on the optimal method of treating device-related-thrombus. Patient concerns: A 78-year-old man with atrial fibrillation had an episode of intracranial hemorrhage while taking warfarin. He subsequently underwent percutaneous placement of a 30-mm Watchman device to the left atrial appendage. He ...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Spontaneous recanalization of atherosclerotic middle cerebral artery occlusion: Case report
Rationale: Intracranial vascular atherosclerotic occlusion is one of the most common causes of ischemic stroke world wide. The involvement of large intracranial vessels, in particular, the middle cerebral artery, is usually associated with unfavorable outcomes in patients. Spontaneous recanalization of atherosclerotic occlusion is relatively rare. Patient concerns: The first patient was a 43-year-old male with slurred speech and left-sided weakness for a duration of 24 hours. The second was a 59-year-old male with left-sided weakness over a period of 13 hours. The last was a 49-year-old female patient presented with a...
Source: Medicine - July 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Use of susceptibility-weighted imaging in assessing ischemic penumbra: A case report
We reported a 65-year-old man complained of paroxysmal hemiplegia of his right limbs and anepia for 2 days, whereas the symptoms lasted for about 12 hours when he admitted to the hospital. Diagnosis: We diagnosed it as acute ischemic stroke caused by the left middle cerebral artery stenosis. Interventions: Susceptibility-weighted imaging (SWI), multimodal magnetic resonance imaging (MRI) work-up which includes conventional MRI sequences (T1WI, T2WI, and FLAIR), DWI, PWI. Outcomes: His DWI-SWI mismatch was comparable to that of DWI-PWI at admission, suggesting that DWI-SWI could predict ischemic penumbra in patient wit...
Source: Medicine - February 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Intracranial dermoid cyst rupture-related brain ischemia: Case report and hemodynamic study
Rationale: Spontaneous rupture of intracranial dermoid cyst is a rare but serious clinical event that can result in cerebral ischemia. Cerebral vasospasm and vasculitis are considered as potential mechanisms of dermoid cyst rupture-related cerebral ischemia. However, the hemodynamic mechanisms between cerebral ischemia and dermoid cyst rupture are not well known. Patient concerns: A 55-year-old, right-handed man was admitted to our hospital with sudden receptive aphasia and right-sided hypoalgesia. Brain magnetic resonance imaging (MRI) revealed a ruptured dermoid cyst and watershed infarcts in the left hemisphere. Then b...
Source: Medicine - January 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Case report: Rapid improvement of crossed cerebellar diaschisis after intravascular laser irradiation of blood in a case of stroke
Rationale: Crossed cerebellar diaschisis (CCD) is a poor prognostic factor after stroke because without immediate cerebral reperfusion no further improvements in the patient's condition can be achieved. We investigated the clinical effects of intravascular laser irradiation therapy (ILIB) on CCD and evaluated the therapeutic effect in the sub-acute post-stroke stage. Patient concerns: The 77-year-old male with cerebral infarction in the territory of the right anterior cerebral artery only underwent conservative treatment including hydration and aspirin in the acute post-stroke stage. Diagnosis: He was diagnosed as stroke...
Source: Medicine - January 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Stroke survivors', caregivers' and GPs' attitudes towards a polypill for the secondary prevention of stroke: a qualitative interview study
Conclusions Participants acknowledged potential advantages in a polypill approach for secondary prevention of stroke; however, significant concerns remain. Further research on the efficacy of a polypill is needed to reassure practitioners whose concerns around inflexibility and treatment suitability are likely to influence the decision to prescribe a polypill for secondary prevention of stroke. Acceptability among survivors, caregivers and GPs is likely to determine the uptake and subsequent use of a polypill in the future.
Source: BMJ Open - May 12, 2016 Category: Journals (General) Authors: Jamison, J., Graffy, J., Mullis, R., Mant, J., Sutton, S. Tags: Open access, Cardiovascular medicine, Qualitative research Source Type: research