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Total 65 results found since Jan 2013.

Lateral medullary infarction with similar features of Brown Sequard syndrome caused by vertebrobasilar dysplasia and Klippel–Feil syndrome: A case report
Rationale: Patients with Klippel–Feil syndrome (KFS) are always anomaly associated with vertebrobasilar dysplasia. That may present commonly as infarction of brainstem, medulla, and cerebellum. In this article, we reported a rare case of lateral medullary infarction (LMI) with similar features of Brown Sequard syndrome caused by vertebrobasilar dysplasia and KFS, and the 2 rare conditions that are causally related. The case is being reported because of its unusual and rare presentation. Patient concerns: A 38-year-old female presented with acute unsteadiness, along with a tendency to lean to the left side while walk...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Cardiovascular risk factors in patients with combined central retinal vein occlusion and cilioretinal artery occlusion: Case report
AbstractRationale:To analyze cardiovascular risk factors and comorbidity of acute unilateral visual loss due to combined central retinal vein occlusion (CRVO) and cilioretinal artery occlusion (CLRAO).Patient concerns:Among patients with retinal vein or artery occlusion hospitalized at the Department of Ophthalmology between January 2011 and August 2017, subjects with combined CRVO/CLRAO were selected. All of them underwent ophthalmologic and cardiologic examination, including fluorescein angiography, optical coherence tomography, 12-lead electrocardiogram, transthoracic and transesophageal echocardiography, carotid Dopple...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Clinical application of susceptibility-weighted imaging in the evaluation of leptomeningeal collateralization
The feasibility of using susceptibility-weighted imaging (SWI) in a clinical setting was assessed for quantifying leptomeningeal collateralization. Eighteen patients with stroke and acute infarction underwent diffusion-weighted imaging, SWI, perfusion-weighted imaging, and magnetic resonance angiography within 3 days after symptom onset. Lesions were evaluated by the Alberta Stroke Program Early CT score (ASPECTS), based on mean transit time, SWI, and cerebral blood volume (CBV). For evaluating ischemic penumbra and leptomeningeal collateralization, the SWI-ASPECTS significantly correlated, respectively, with mean transi...
Source: Medicine - December 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

MELAS and macroangiopathy: A case report and literature review
We reported a case of MELAS that presented right distal internal carotid arterial (ICA) stenosis and reviewed 12 similar previously reported cases involving intracranial large blood vessels. Patient concerns: A 38-year-old man suffered from recurrent stroke-like episodes (SE) such as alternating hemiparesis (right lesion 3 years ago and current left lesion), cortical blindness and seizure for 3 years, and was previously misdiagnosed as cerebral infarction. Magnetic Resonance Angiography (MRA) and Digital Subtraction Angiography (DSA) revealed right distal ICA stenosis and sparse cortex blood vessels, which were related ...
Source: Medicine - December 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Pial arteriovenous fistula with appearance of hemorrhagic tumor: A case report
Conclusions: It is noteworthy that PAVF with a large thrombus may appear as a tumor in the initial diagnosis, and therefore it is necessary to perform an intracranial vascular examination in patients with tumor stroke symptoms.
Source: Medicine - October 16, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Intracardiac thrombus in a patient with mitral bioprosthesis and atrial fibrillation treated with direct oral anticoaugulant: A case report
Rationale: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with increased morbidity, especially stroke and heart failure. There is also increasing awareness that atrial fibrillation is a major cause of embolic events which in 75% of cases are complicated by cerebrovascular accidents. Patient concerns: A 50-year-old woman with mitral bioprosthesis under warfarin for nonvalvular atrial fibrillation was referred to our Coronary Intensive Care Unit due to acute myocardial infarction without evidence of significant coronary artery stenosis. Diagnoses: Cardiovascular examination...
Source: Medicine - June 11, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Reversible cerebral vasoconstriction syndrome with basilar artery stenosis: A case report
Conclusions: A headache in young patients with risk factors of atherosclerosis, such as smoking history, uncontrolled hypertension, and dyslipidemia may be caused by reversible cerebral vasoconstriction syndrome or ischemic stroke, which has fatal neurological complications. Therefore, reversible cerebral vasoconstriction syndrome or ischemic stroke should be suspected and appropriately evaluated in such patients, even if the headache is not the thunderclap type.
Source: Medicine - September 24, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Prognostic factors for acute posterior circulation cerebral infarction patients after endovascular mechanical thrombectomy: A retrospective study
This article was to analyze the factors influencing the prognosis of posterior circulation cerebral infarction (PCCI) patients, retrospectively. One hundred forty five patients diagnosed with PCCI in Nanyang Central Hospital between June 25, 2016 and October 14, 2019 were included and underwent cerebral vascular mechanical thrombectomy. The clinical data of those patients were collected. The patients were followed up for 3 months to observe the prognostic efficacy and explore the influencing factors for poor prognosis. The potential prognostic factors for PCCI patients after emergency endovascular mechanical thrombect...
Source: Medicine - April 29, 2022 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Risk Score Model for the Assessment of Coronary Artery Disease in Asymptomatic Patients With Type 2 Diabetes
Abstract: No model has been developed to predict significant coronary artery disease (CAD) on coronary computed tomographic angiography (CCTA) in asymptomatic type 2 diabetes. Therefore, we sought to develop a model for the prediction of significant CAD on CCTA in these patients. We analyzed 607 asymptomatic patients with type 2 diabetes who underwent CCTA. The cardiac event was defined as a composite of cardiac death, nonfatal myocardial infarction, acute coronary syndrome, and coronary revascularization. Significant CAD (diameter stenosis ≥50%) in at least one coronary artery on CCTA was observed in 188 (31.0%). During...
Source: Medicine - January 1, 2015 Category: Internal Medicine Tags: Article: Observational Study Source Type: research

An Update of the Mayo Clinic Cohort of Patients With Adult Primary Central Nervous System Vasculitis: Description of 163 Patients
This study is based on a cohort of 163 consecutive patients with PCNSV who were examined at the Mayo Clinic over a 29-year period from 1983 to 2011. The aim of the study was to define the characteristics of these patients, which represents the largest series in adults reported to date. A total of 105 patients were diagnosed by angiographic findings and 58 by biopsy results. The patients diagnosed by biopsy more frequently had at presentation cognitive dysfunction, greater cerebrospinal fluid total protein concentrations, less frequent cerebral infarcts, and more frequent leptomeningeal gadolinium-enhanced lesions on magnet...
Source: Medicine - May 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Clinical Impact and Cost-Effectiveness of Coronary Computed Tomography Angiography or Exercise Electrocardiogram in Individuals Without Known Cardiovascular Disease
Abstract: It is not clear whether screening by coronary computed tomographic angiography (CCTA) and/or exercise electrocardiogram (ECG) can improve clinical outcomes and reduce costs in individuals without known cardiovascular disease (CVD). In total, 71,811 consecutive individuals without known CVD who underwent general health examinations were enrolled. Using propensity-score matching according to screening tests, 1-year clinical outcomes and 6-month total and coronary artery disease–related medical costs were analyzed in separate groups: group 1 (CCTA [n = 2578] vs no screening [n = 5146]), group 2 (exercise E...
Source: Medicine - May 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Validation of Scoring Systems That Predict Outcomes in Patients With Coronary Artery Disease Undergoing Coronary Artery Bypass Grafting Surgery
This study aims to validate the predictive ability of different risk scoring systems with regard to long-term outcomes after CABG. This single-center study retrospectively re-evaluated the Synergy Between PCI with TAXUS and Cardiac Surgery (SYNTAX) score; EuroSCORE; age, creatinine, and ejection fraction (ACEF) score; modified ACEF score; clinical SYNTAX; logistic clinical SYNTAX score (logistic CSS); and Parsonnet scores for 305 patients with LMCAD who underwent CABG. The endpoints were 5-year rate of all-cause death and major adverse cardio-cerebral events (MACCEs), including cardiovascular (CV) death, myocardial infarct...
Source: Medicine - June 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Comparison of extracranial artery stenosis and cerebral blood flow, assessed by quantitative magnetic resonance, using digital subtraction angiography as the reference standard
Abstract: Extracranial arteriosclerosis usually indicates a high risk of ischemic stroke. In the past, a clinical decision following diagnosis was dependent on the percentage of vessel stenosis determined by an invasive technique. We aimed to develop a quantitative magnetic resonance (QMR) technique to evaluate artery structure and cerebral hemodynamics noninvasively. QMR and digital subtraction angiography (DSA) were performed in 67 patients with suspected cerebral vascular disease at our hospital. Accuracy, sensitivity, positive predictive values (PPVs), negative predictive values (NPVs), and Pearson correlation coeffic...
Source: Medicine - November 1, 2016 Category: Internal Medicine Tags: Research Article: Diagnostic Accuracy Study 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

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