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Anticoagulant management by low-dose of low molecular weight heparin in patients with nonvalvular atrial fibrillation following hemorrhagic transformation and complicated with venous thrombosis: Five case reports and literature review
For patients with nonvalvular atrial fibrillation (NVAF) following hemorrhagic infarction (HI)/hemorrhage transformation (HT) and complicated with venous thrombosis, the management of anticoagulation is controversial. Our study intends to explore the safety and effectiveness of using low-dose of low molecular weight heparin (LMWH) to treat NVAF patients with HI (or HT) and complicated with venous thrombosis. Between January 2018 and January 2019, NVAF related acute ischemic stroke patients with HT/HI, hospitalized in the department of neurology or rehabilitation in our hospital, are enrolled retrospectively. Among them,...
Source: Medicine - February 19, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Bringing prevost's sign into the third dimension: Artificial intelligence estimation of conjugate gaze adjusted length (CGAL) and correlation with acute ischemic stroke
Conjugate gaze deviation is associated with acute ischemic stroke (AIS), although previously only measured on a 2D plane. The current study evaluates 3D imaging efficacy to assess conjugate gaze deviation and correlate direction and strength of deviation to neuro-clinical findings. A retrospective analysis of 519 patients who had CT scans for suspected AIS at our institution. Direction and angle of eye deviation were calculated based on 2D axial images. Volumetric reconstruction of CT scans allowed for calculation of 3D conjugate gaze adjusted length (CGAL). Angle, direction, and vector strength of both 2D and 3D scans ...
Source: Medicine - December 4, 2020 Category: Internal Medicine Tags: Research Article: Quality Improvement Study Source Type: research

Japanese encephalitis (JE) mimicking acute ischemic stroke: A case report
Conclusion: Diagnosis of JE that mimicked acute stroke at onset and with no fever can be challenging. Recognition of disease development, MRI and Japanese encephalitis virus immunoglobulinM findings are helpful in early definitive diagnosis.
Source: Medicine - November 6, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Acute basilar artery occlusion with recurrent shivering: A case report
Rationale: Shivering is an important physiological response of the body that causes muscle tremors to maintain temperature homeostasis. Traumatic brain injuries that affect the hypothalamus cause hypothermia, and physical removal of suprasellar tumors causes thermoregulation imbalance. However, no study has reported shivering due to ischemic stroke. Patient concerns: A 58-year-old male patient was admitted to our emergency department to evaluate severe stenosis of the basilar artery. While waiting for further examination, he exhibited coarse shivering and severe dysarthria. Diagnosis: Brain computed tomography angi...
Source: Medicine - September 25, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Successful dabigatran reversal after subdural hemorrhage using idarucizumab in a mobile stroke unit: A case report
Rationale: Idarucizumab is a specific reversal agent for patients with bleeding related to the anticoagulant dabigatran. There are no prior descriptions of Idarucizumab administration in the prehospital setting for intracranial hemorrhage. Patient concerns: An 82-year-old woman treated with dabigatran for atrial fibrillation developed acute focal weakness. This led to activation of emergency medical services and assessment in the mobile stroke unit (MSU). Diagnosis: Computed tomography of the brain performed in the MSU revealed an acute subdural hematoma. Interventions: The patient was treated with Idarucizumab ...
Source: Medicine - May 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Risk factors of haemorrhagic transformation for acute ischaemic stroke in Chinese patients receiving intravenous thrombolysis: A meta-analysis
Conclusion: The systematic review showed that male, age, diabetes, NIHSS, OTT, atrial fibrillation, post stroke, infarct size, and ischemic signs of CT were significantly correlated with hemorrhagic transformation (HT). PROSPERO Registration number: CRD42019127499.
Source: Medicine - February 1, 2020 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis 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

Pulmonary arteriovenous malformation exhibiting recanalization >10 years after coil embolization: Two case reports
We described the first 2 cases diagnosed with PAVM recanalization>10 years after the first catheter embolization. These cases suggest that patients with PAVMs should undergo life-long follow-up after catheter embolization.
Source: Medicine - January 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Young male with syphilitic cerebral arteritis presents with signs of acute progressive stroke: A case report
Conclusion Progressive stroke was the initial symptom of the neurosyphilis. Disease progression is rapid and difficult to control with a single course of penicillin.
Source: Medicine - November 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Interventional recanalization as a treatment of carotid stump syndrome caused by right internal carotid artery occlusion: A case report
Rationale: Carotid stump syndrome is a cerebral infarction caused by an embolus formed subsequent to the vortex of blood flow from the occluded stump, which then moves through the collateral vessels into the brain. The covered stent and stent-assisted coil embolization stump are the effective interventions for the carotid artery stump. Patient concerns: A 71-year-old man twice experienced left limb weakness; diffusion weighted imaging confirmed the diagnosis of cerebral infarction. Cervical computed tomography angiography, intracranial magnetic resonance angiography, and digital subtraction angiography were conducted ...
Source: Medicine - September 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Acute onset bilateral hearing loss in dorsomedial pontine hemorrhage: A Case report
We report herein a rare case of acute onset bilateral hearing loss caused by nontraumatic pontine hemorrhage. Pontine hemorrhage is often associated with disturbance of consciousness; however, care is required as latent communication disorder due to impaired hearing is possible regardless of the state of consciousness.
Source: Medicine - August 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Systematic review with network meta-analysis: Diagnostic values of ultrasonography, computed tomography, and magnetic resonance imaging in patients with ischemic stroke
Conclusion: This network meta-analysis provides supporting evidence to the idea that DWI has a higher diagnostic value regarding ischemic stroke among MRI methods, and CTP has a poor diagnostic value among CT methods, which provide therapeutic considerations for Ischemic stroke intervention.
Source: Medicine - July 1, 2019 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Ischemic stroke in the combined territories of the septum pellucidum and the cingulate gyrus: A case report and literature review
Conclusions: Infarction in the septum pellucidum and cingulate gyrus is rare and has atypical clinical manifestations. Physical examination may not yield obvious positive signs. False-negative computed tomography findings of the head may result in misdiagnosis. Thus, it is necessary to perform whole-brain magnetic resonance imaging in time. Moreover, ScA protection should be paid attention to during surgery for anterior communicating artery aneurysm.
Source: Medicine - June 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Acute cholecystitis as a rare and overlooked complication in stroke patients: A retrospective monocentric study
This study aims to evaluate the clinical incidence, manifestations, and predictive factors of AC in stroke patients. A retrospective cohort study was conducted between January 2013 and December of 2017 of all stroke patients (n = 2699) who have been admitted to our stroke center of the university hospital. We evaluated patient demographics, presenting symptoms, vital signs, laboratory results, mean initial consecutive fasting time, mean total fasting time, modified Rankin Scale (mRS), as well as radiological findings of abdominal computed tomography (CT) or ultrasonography. AC was diagnosed in 28 of the 2699 patients...
Source: Medicine - March 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

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