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An Anatomical Variation in the Cervical Carotid Artery of a Young Stroke Patient: A Case Report.
We report the case of a young stroke patient with a small right-parietal-lobe infarction whose cervical carotid artery showed anatomical variation. The right internal carotid artery (ICA) originated at the C2 level of the external carotid artery with protrusion at the right carotid bifurcation. The vessel wall of the protrusion showed a high signal intensity on T1-weighted magnetic resonance carotid plaque imaging. The protrusion, considered a remnant of the ICA, possibly caused the stroke due to the formation of thrombi as a result of changes in blood flow and viscosity. PMID: 30146606 [PubMed - as supplied by publisher]
Source: Internal Medicine - August 29, 2018 Category: Internal Medicine Tags: Intern Med Source Type: research

Embolic Stroke Due to a Mural Thrombus in the Ascending Aorta Following Cisplatin-based Chemotherapy.
Authors: Ochiai Y, Tsunogae M, Ueda M Abstract A 59-year-old woman with small-cell lung carcinoma achieved tumor disappearance after cisplatin-based chemotherapy (CBC) and radiation treatment but subsequently experienced right hemiparesis and aphasia. Brain magnetic resonance imaging revealed a left middle cerebral artery territory acute infarction and left internal carotid artery occlusion. Ultrasonography revealed a mobile thrombus in the left common and internal carotid arteries, and contrast computed tomography revealed a mural thrombus in the ascending aorta. Based on these findings, embolic stroke due to aort...
Source: Internal Medicine - October 24, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Endovascular Coil Embolization for Recurrent Bow Hunter's Stroke
Intern Med. 2022 May 14. doi: 10.2169/internalmedicine.8906-21. Online ahead of print.ABSTRACTBow hunter's stroke is a rare cause of vertebrobasilar infarction. There is no consensus regarding the optimal treatment. We herein report a case of bow hunter's stroke successfully treated by endovascular treatment. A 70-year-old man presented with central vertigo. Magnetic resonance imaging (MRI) showed posterior circulation infarcts. Dynamic angiography revealed thrombus formation and hypoperfusion of the right vertebral artery upon head rotation to the left. Endovascular parent artery occlusion of the right vertebral artery wa...
Source: Internal Medicine - May 15, 2022 Category: Internal Medicine Authors: Fumiya Kutsuna Yoichi Morofuji Eri Shiozaki Daiki Uchida Masahiro Tokuda Hiroshi Iwanaga Tomonori Ono Ichiro Kawahara Wataru Haraguchi Keisuke Tsutsumi Source Type: research

Correlation between the Occlusion Site and Clinical Outcome after Acute Ischemic Stroke.
Conclusion Early mild clinical recovery did not predict a good outcome. The occlusion site was a stronger predictor of clinical improvement after IVtPA administration. PMID: 26666600 [PubMed - in process]
Source: Internal Medicine - December 19, 2015 Category: Internal Medicine Tags: Intern Med Source Type: research

Carotid Artery Stenting for Acute Ischemic Stroke Patients after Intravenous Recombinant Tissue Plasminogen Activator Treatment.
Authors: Deguchi I, Hayashi T, Neki H, Yamane F, Ishihara S, Tanahashi N, Takao M Abstract We herein report three ischemic stroke patients who underwent emergency carotid artery stenting after receiving intravenous tissue plasminogen activator (t-PA) treatment. All patients received antiplatelet medications immediately before stent placement for loading as well as dual antiplatelet therapy after stenting. Under high-dose and dual antiplatelet therapy, none of the three patients showed symptomatic intracranial hemorrhaging. However, one case showed reocclusion of the placed stent after acute thrombosis. As a result,...
Source: Internal Medicine - October 13, 2016 Category: Internal Medicine Tags: Intern Med Source Type: research

Bilateral Vertebral Artery Aneurysms at the Atlantoaxial Joint Level Causing Recurrent Stroke.
Authors: Komatsu K, Ozaki A, Iwasaki K, Matsumoto S Abstract Vertebral arteries (VAs) are vulnerable to mechanical stress between the atlas and axis, and subsequent VA dissection can cause posterior circulation infarction. We herein present a rare but informative case of bilateral VA aneurysms that caused recurrent stroke. The localization of the aneurysms and dynamic angiography with neck movement suggested a pathogenesis related to chronic mechanical injury of the VAs, though no skeletal abnormality was detected. The recurrences stopped and both aneurysms shrank after neck collar fixation and after the combinatio...
Source: Internal Medicine - November 18, 2016 Category: Internal Medicine Tags: Intern Med Source Type: research

Successful Delayed Aortic Surgery for a Patient with Ischemic Stroke Secondary to Aortic Dissection.
Authors: Morihara R, Yamashita T, Deguchi K, Tsunoda K, Manabe Y, Takahashi Y, Yunoki T, Sato K, Nakano Y, Kono S, Ohta Y, Hishikawa N, Abe K Abstract The diagnosis of aortic dissection (AD) is sometimes difficult within the limited time window of recombinant tissue plasminogen activator (tPA) for ischemic stroke (IS). A 60-year-old man developed sudden left hemiparesis due to IS. During tPA infusion, his blood pressure dropped and consciousness declined. After transfer to our hospital, carotid duplex ultrasonography led to a diagnosis of AD. Emergency surgery was postponed because of the risk of hemorrhagic transf...
Source: Internal Medicine - August 12, 2017 Category: Internal Medicine Tags: Intern Med Source Type: research

A Case of Stroke-like Migraine Attacks after Radiation Therapy (SMART) Syndrome Followed by Cerebral Infarction.
Authors: Takahashi H, Kimura T, Yuki N, Yoshioka A Abstract A 36-year-old man with a history of irradiation for acute lymphoblastic leukemia developed headache with cortical dysfunction lasting for 4 weeks. The clinical features were consistent with stroke-like migraine attacks after radiation therapy (SMART) syndrome. Six months later, he developed cerebral infarction due to occlusions of the left anterior and middle cerebral arteries. This is the first case report describing SMART syndrome followed by severe cerebral infarction. Although an association between the two episodes was not assumed, this case indicates...
Source: Internal Medicine - March 3, 2018 Category: Internal Medicine Tags: Intern Med Source Type: research

Ischemic Stroke Caused by Carotid Stump at the Common Carotid Artery.
Authors: Hashimoto G, Wada S, Morita T, Tomohara S, Hara K, Kumabe M, Matsushima T, Kadowaki M, Hamaguchi M, Kuwashiro T, Yasaka M, Okada Y Abstract An 84-year-old man developed motor aphasia and right hemiparesis on postoperative day 1 after orchiectomy for suspected malignant lymphoma. He had a history of thoracic endovascular aortic repair for aortic aneurysm using a bypass graft from the right subclavian artery to the left common carotid artery (CCA); however, the graft had become occluded six months later. Brain magnetic resonance imaging revealed acute cerebral infarctions in the left frontal lobe. Carotid ul...
Source: Internal Medicine - August 1, 2020 Category: Internal Medicine Tags: Intern Med Source Type: research

Tumor Cells Detected in Retrieved Thrombus: A Case of Cancer-associated Stroke
Intern Med. 2021 Mar 8. doi: 10.2169/internalmedicine.6201-20. Online ahead of print.ABSTRACTA 51-year-old man with a history of renal cell carcinoma presented with sudden aphasia, right hemiparesis, and dysesthesia. MRA showed left middle cerebral artery occlusion, and he was diagnosed with acute ischemic stroke and treated with intravenous recombinant tissue plasminogen activator and endovascular thrombectomy. The pathological diagnosis of the retrieved thrombus was consistent with the already-known pathological findings of the primary renal cell carcinoma. Therefore, a diagnosis of cerebral embolism caused by tumor cell...
Source: Internal Medicine - March 8, 2021 Category: Internal Medicine Authors: Kaoru Nakanishi Hiroyuki Kawano Yuki Yamagishi Hiroshi Kamma Yoshiaki Shiokawa Teruyuki Hirano Source Type: research

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