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An Embolic Stroke in a Patient With PROC p.Lys193del
We report a 58-year-old woman who suddenly developed brain infarction with weakness of the left lower extremity and left perioral dysesthesia during postoperative tamoxifen therapy for breast cancer and prednisolone therapy for rheumatoid arthritis. Diffusion-weighted images detected multiple areas of hyperintensity in the posterior circulation system of the brain. Despite extensive examinations, we could not identify any embolic sources except hypoplasia of the right vertebral artery. We found decreased activity of protein C against its antigen level (activity: 59% versus antigen: 122%) with enhanced activity of coagulati...
Source: Journal of Stroke and Cerebrovascular Diseases - February 10, 2020 Category: Neurology Authors: Kana Ueki, Kuniyuki Nakamura, Yoshinobu Wakisaka, Shinichi Wada, Yoji Yoshikawa, Shinya Matsumoto, Taeko Hotta, Dongchong Kang, Takanari Kitazono, Tetsuro Ago Tags: Case Report Source Type: research

Ischemic Stroke due to Virologically-Confirmed Varicella Zoster Virus Vasculopathy: A Case Series
Background: Limited data are available regarding the characteristics and prognosis of patients with stroke due to varicella zoster virus (VZV) vasculopathy. Methods: We studied 4 patients (2 men and 2 women; age, 38-63 years) from a single center who developed acute ischemic stroke due to VZV vasculopathy. The virological diagnosis was confirmed by detecting VZV DNA and/or the IgG antibody to VZV in the cerebrospinal fluid. Results: Three patients were taking immunosuppressive agents, including prednisolone and/or methotrexate, at baseline.
Source: Journal of Stroke and Cerebrovascular Diseases - November 1, 2018 Category: Neurology Authors: Takao Hoshino, Sono Toi, Kunio Toda, Yumiko Uchiyama, Hiroshi Yoshizawa, Mutsumi Iijima, Yuko Shimizu, Kazuo Kitagawa Source Type: research

Embolic Stroke due to Carotidynia Potentially Associated with Moving Carotid Artery Caused by Swallowing
A 63-year-old woman with end-stage renal disease on maintenance hemodialysis discontinued her medication for rheumatoid arthritis with prednisolone and azathioprine. One month later, she was admitted because of consciousness disturbance and right hemiparesis. Diffusion-weighted brain magnetic resonance imaging (MRI) revealed multiple hyperintensities in her left frontal and parietal lobes. She also developed high fever and left neck pain. Carotid ultrasonography showed calcified plaque with vessel wall swelling at the bifurcation of the left common carotid artery (LCCA) and surrounding hypoechoic soft tissue.
Source: Journal of Stroke and Cerebrovascular Diseases - November 15, 2017 Category: Neurology Authors: Yoshitaka Yamaguchi, Mikito Hayakawa, Naoto Kinoshita, Chiaki Yokota, Toshiya Ishihara, Kazunori Toyoda Tags: Case Studies Source Type: research

Efficacy of Extracranial–Intracranial Bypass for Progressive Middle Cerebral Artery Occlusion Associated with Active Sjögren's Syndrome: Case Report
Sjögren syndrome affecting the major cerebral arteries is rare, and an optimal therapeutic strategy to counteract such a lesion has not yet been established. We herein report a case of a 39-year-old woman with a history of primary Sjögren syndrome, which had previously been treated with immunosuppressive therapy, manifesting with a crescendo transient ischemic attack because of left middle cerebral artery stenosis. Despite the administration of high doses of prednisolone and azathioprine for active Sjögren syndrome, the frequency of crescendo transient ischemic attacks increased with the progression of stenosis and magn...
Source: Journal of Stroke and Cerebrovascular Diseases - August 4, 2014 Category: Neurology Authors: Hiroyuki Sakata, Miki Fujimura, Kenichi Sato, Hiroaki Shimizu, Teiji Tominaga Tags: Case Reports Source Type: research

Elevated Platelet Microparticle Levels after Acute Ischemic Stroke with Concurrent Idiopathic Thrombocytopenic Purpura
We report a 60-year-old woman with idiopathic thrombocytopenic purpura who experienced acute infarction of the middle cerebral artery. She was treated with an antiplatelet agent and prednisolone to limit platelet activation and destruction. In parallel with clinical amelioration, levels of plasma platelet microparticles (PMPs), a procoagulant factor in platelet activation, decreased after treatment but increased after reduction of the prednisolone dose, resulting in progression of vascular stenosis. Immunosuppressive therapy with cyclosporine normalized plasma PMP levels, and no additional vascular events occurred during t...
Source: Journal of Stroke and Cerebrovascular Diseases - June 10, 2013 Category: Neurology Authors: Masahiko Ichijo, Satoru Ishibashi, Takuya Ohkubo, Shosaku Nomura, Nobuo Sanjo, Takanori Yokota, Hidehiro Mizusawa Tags: Case Reports Source Type: research