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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

Cerebrovascular risk factors for patients with cerebral watershed infarction: A case–control study based on computed tomography angiography in a population from Southwest China
Abstract: To determine cerebrovascular risk factors for patients with cerebral watershed infarction (CWI) from Southwest China. Patients suffering from acute ischemic stroke were categorized into internal CWI (I-CWI), external CWI (E-CWI), or non-CWI (patients without CWI) groups. Clinical data were collected and degrees of steno-occlusion of all cerebral arteries were scored. Arteries associated with the circle of Willis were also assessed. Data were compared using Pearson chi-squared tests for categorical data and 1-way analysis of variance with Bonferroni post hoc tests for continuous data, as appropriate. Multivariate...
Source: Medicine - July 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Worse clinical outcomes following percutaneous coronary intervention with a high SYNTAX score: A systematic review and meta-analysis
Conclusions: Compared with CABG, worse clinical outcomes were observed following PCI in patients with a high SYNTAX score, confirming with evidence, published clinical literatures. Therefore, CABG should be recommended to CAD patients who have been allotted a high SYNTAX score.
Source: Medicine - June 1, 2017 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis 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

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

Is carotid sonography a useful tool for predicting functional capabilities in ischemic stroke patients following carotid artery stenting?
Abstract: Carotid stenosis is a major cause of stroke and timely intervention with stenting manipulation can significantly reduce the risk of secondary stroke. The impact of stenting procedures on patient functional capabilities has not yet been explored. The primary aim of this study was to examine associations between periprocedural carotid sonography parameters and post-treatment functional capabilities in stroke patients. Sixty-seven patients who received carotid stenting at 1 angiography laboratory were included. Prestenting and poststenting carotid duplex data were recorded and resistance index (RI) differences at v...
Source: Medicine - March 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Utility of Duranta, a wireless patch-type electrocardiographic monitoring system developed in Japan, in detecting covert atrial fibrillation in patients with cryptogenic stroke: A case report
Rationale: Subcutaneous implantable electrocardiographs are highly effective in detecting covert atrial fibrillation (AF) in cryptogenic stroke. However, these invasive devices are not indicated for all cryptogenic stroke patients, and noninvasive improvements over conventional Holter-type ambulatory electrocardiography are needed. We evaluated the clinical application and effectiveness of Duranta (ImageONE Co., Ltd.), a wireless patch-type electrocardiographic monitoring system developed in Japan for chronically ill patients or home-based patients at the end of life. A Duranta device was used to detect covert AF in patien...
Source: Medicine - February 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

Distinctive patterns on CT angiography characterize acute internal carotid artery occlusion subtypes
Abstract: Noninvasive computed tomography angiography (CTA) is widely used in acute ischemic stroke, even for diagnosing various internal carotid artery (ICA) occlusion sites, which often need cerebral digital subtraction angiography (DSA) confirmation. We evaluated whether clinical outcomes vary depending on the DSA-based occlusion sites and explored correlating features on baseline CTA that predict DSA-based occlusion site. We analyzed consecutive patients with acute ICA occlusion who underwent DSA and CTA. Occlusion site was classified into cervical, cavernous, petrous, and carotid terminus segments by DSA confirmation...
Source: Medicine - February 1, 2017 Category: Internal Medicine Tags: Research Article: Observational 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

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

Correlation Between the Integrity of the Circle of Willis and the Severity of Initial Noncardiac Cerebral Infarction and Clinical Prognosis
This study was designed to investigate the effect of different circles of Willis types on stroke severity and prognosis in patients with noncardiac stroke. A total of 376 patients with noncardiac ischemic stroke, who were treated by the specialty team of cerebrovascular diseases at the First Affiliated Hospital of Sun Yat-sen Hospital, were successively enrolled in this study. The detailed clinical characteristics of the patients were recorded upon admission, including risk factors of vascular disease and National Institutes of Health Stroke Scale (NIHSS) scores. The patients were divided into groups of different circles ...
Source: Medicine - March 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

A Case Report of Locked-in Syndrome Due to Bilateral Vertebral Artery Dissection After Cervical Spine Manipulation Treated by Arterial Embolectomy
Abstract: Cervical spine manipulation (CSM) is a commonly spinal manipulative therapies for the relief of cervical spine-related conditions worldwide, but its use remains controversial. CSM may carry the potential for serious neurovascular complications, primarily due to vertebral artery dissection (VAD) and subsequent vertebrobasilar stroke. Here, we reported a rare case of locked-in syndrome (LIS) due to bilaterial VAD after CSM treated by arterial embolectomy. A 36-year-old right-handed man was admitted to our hospital with numbness and weakness of limbs after treating with CSM for neck for half an hour. Gradually, alt...
Source: Medicine - February 1, 2016 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Imaging-Based Patient Selection and Endovascular Therapy of Ischemic Stroke: A Stratified Meta-Analysis
Abstract: The positive results of recent trials for the treatment of acute ischemic stroke have highlighted the importance of imaging selection before endovascular therapy. We performed a stratified meta-analysis to confirm this new understanding. We searched EMBASE, PubMed, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov in April 2015 for randomized controlled trials evaluating the effect of endovascular treatment in patients with acute ischemic stroke. The meta-analysis was stratified by whether computed tomographic angiography (CTA) was used to select patients. Outcome data were pooled using fixed...
Source: Medicine - September 1, 2015 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Cardiac Myxoma With Unusual Obstructive and Embolic Presentations: Concurrent Stroke and Angiography-Negative Myocardial Infarction—A Case Report
We present a case of cardiac myxoma with atypical presentations of concurrent stroke and angiography-negative myocardial infarction. The case emphasizes the importance of basic echocardiography and timely surgery in the management of cardiac myxoma. An elderly woman presented to the emergency department in an unconscious state. Electrocardiogram and elevated cardiac enzymes suggested acute myocardial infarction; however, immediate coronary angiography proved patency. Basic echocardiography revealed an oscillating left atrial myxoma obstructing inflow through the mitral valve. After regaining consciousness while in the inte...
Source: Medicine - September 1, 2015 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research