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Usefulness of hyperintense acute reperfusion marker sign in patients with transient neurologic symptom
It aimed to investigate the incidence and final diagnosis of hyperintense acute reperfusion marker (HARM) signs in patients initially suspected of having a transient ischemic attack (TIA). In retrospective manner, a series of consecutive series of patients who arrived at the emergency department and was initially assessed as TIA within 12 hours of symptom onset between July 2015 and December 2016 were enrolled. Conventional magnetic resonance imaging protocol including diffusion-weighted imaging (DWI) and pre- and post-contrast fluid attenuation inversion recovery imaging (FLAIR) was conducted to evaluate the ischemic l...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

New Microbleeds After Thrombolysis: Contiguous Thin-Slice 3T MRI
Abstract: We aimed to determine the frequency of new microbleeds after intravenous thrombolysis using contiguous thin-slice 3T magnetic resonance imaging. We retrospectively examined clinical and imaging data from 121 consecutive acute ischemic stroke patients who underwent magnetic resonance imaging before and 24 hours after intravenous thrombolysis. Of the included patients, 44 (36.4%) were women, with a median age of 69 years (range, 35–94 years). A total of 363 baseline microbleeds were observed in 57 patients and 8 new microbleeds in 6 patients. Multiple regression analysis indicated that baseline infarct volume (od...
Source: Medicine - October 1, 2014 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

New Cerebral Microbleeds After Mechanical Thrombectomy for Large-Vessel Occlusion Strokes
We examined independent factors associated with new CMBs after mechanical thrombectomy. We analyzed the association of the presence, burden, and distribution of new CMBs with clinical outcome. A total of 187 consecutive patients with serial GRE were enrolled in this study. CMBs were evident in 36 (19.3%) patients before mechanical thrombectomy. New CMBs occurred in 41 (21.9%) patients after mechanical thrombectomy. Of the 68 new CMBs, 45 appeared in the lobar location, 18 in the deep location and 5 in the infratentorial location. The presence of baseline CMBs was associated with new CMBs after mechanical thrombectomy (OR 5...
Source: Medicine - November 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Sonolysis in Prevention of Brain Infarction During Cardiac Surgery (SONORESCUE): Randomized, Controlled Trial
This study provides class-II evidence that sonolysis during CABG or valve surgery reduces the risk of larger, new ischemic lesions in the brain. www.clinicaltrials.gov (NCT01591018).
Source: Medicine - May 1, 2016 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

Case report: acute demyelinating encephalomyelitis following viper bite
We present a rarely seen central nervous system complication, acute demyelinating encephalomyelitis, after a treated Deinagkistrodon's viper bite. On April 5, 2015, a 50-year-old male farmer was bitten on his right leg by a Deinagkistrodon's viper. The bite rendered the victim unconscious for 14 days, during which he was treated with tetanus toxoid and polyvalent antisnake venom. Acute demyelinating encephalomyelitis (ADEM) was suspected after magnetic resonance imaging of the brain. After a high dose of methylprednisolone was used as diagnostic treatment, the patient started recovering fast. ADEM is a rare complication ...
Source: Medicine - November 1, 2016 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

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

Seizure syndrome as a first manifestation of solitary tumor-like mass lesion of PACNS: Two case reports
Rationale: Primary angiitis of the central nervous system (PACNS) is an inflammatory disease involving cerebrovascular and parenchymal, and solitary tumor-like mass lesion of PACNS (TLML-PACNS) is frequently misdiagnosed as neoplastic or other inflammatory diseases. However, seizure syndrome as a first manifestation of TLML-PACNS has rarely reported before. Patient concerns: Here, we report 2 cases of seizure syndrome, which was the first sign that presented prior to the diagnosis of TLML-PACNS by brain biopsy. Diagnoses: A mass lesion in the white and gray matters was detected by magnetic resonance imaging. The patholog...
Source: Medicine - March 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Vertebrobasilar system computed tomographic angiography in central vertigo
This article reveals the opportunity to diagnose posterior circulation abnormalities causing central vertigo with a feasible method such as CTA.
Source: Medicine - March 1, 2017 Category: Internal Medicine Tags: Research Article: Diagnostic Accuracy Study Source Type: research

Clinical predictors for the manifestation of late gadolinium enhancement after acute myocardial infarction
We examined 136 patients after first ST-elevated myocardial infarction by CMR after a median of 4 days (range: 2–7). Patients with manifestation of LGE were matched to patients without LGE by means of age and gender. Clinical follow-up with a combined primary endpoint including myocardial reinfarction, congestive heart failure, stroke, death and development of left ventricular thrombus was reported after 24 months. Patients with manifestation of LGE had a significant longer time of symptom-to-intervention, a higher prevalence of anterior AMI, and more proximal culprit lesions. Furthermore, left ventricular ejection frac...
Source: Medicine - May 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Incidence and risk factors of leukoaraiosis from 4683 hospitalized patients: A cross-sectional study
This study revealed that the incidence of LA is high in hospitalized patients in China; moreover, age, sex, hypertension, diabetes mellitus, smoking, drinking, and abnormal HCY and LDL-C levels were found to be associated with overall LA risk, LA onset, or LA progression. These results provide insight into strategies for the prevention and treatment of LA.
Source: Medicine - September 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

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

Bilateral thalamic and mesencephalic infarctions with hypopituitarism as long-term complications postradiotherapy: A case report
Conclusion: To our knowledge, this is the first report of bilateral thalamic and mesencephalic infarction together with hypopituitarism following radiotherapy for NPC.
Source: Medicine - August 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Intravascular large B-cell lymphoma presenting as multiple stroke: A case report
Conclusion: IVLBCL is an aggressive disease with high mortality. Timely diagnosis and treatment can be lifesaving.
Source: Medicine - October 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

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