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Recovery of an injured arcuate fasciculus via transcallosal fiber in a stroke patient: A case report
We report on a patient whose arcuate fasciculus (AF) and corticobulbar tract (CBT) recovered following an infarct in the middle cerebral artery (MCA) territory, demonstrated on serial diffusion tensor tractography (DTT). Patient concerns: The patient showed moderate conduction aphasia on the Western Aphasia Battery with an aphasia quotient of 46.5‰ (spontaneous speech: 35.0‰, auditory comprehension: 36.0‰, and naming: 53.1‰) at 1 month after onset. His aphasia improved with an aphasia quotient of 49‰ (spontaneous speech: 71.0‰, auditory comprehension: 52.0‰, and naming: 59.0‰) at 10 months after onse...
Source: Medicine - August 6, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Perfusion image guided mechanical thrombectomy combined with tirofiban successfully revascularize systemic lupus erythematosus related acute large vessel occlusion: A case report
Rationale: Systemic lupus erythematosus (SLE) is an important cause of stroke, more than a half the cases present as acute ischemic stroke. Thrombolysis is an effective choice in most cases, but for large vessel occlusion, mechanical thrombectomy is more effective. Here we reported a case of SLE-related stroke with left middle cerebral artery (MCA) occlusion, who was successfully treated by MT and tirofiban. Patient concern: A 38-year-old female suffered from right hemiplegia and aphasia for 8 hours. She was diagnosed with SLE 20 years ago, and neuropsychiatric SLE was considered 8 months before this onset...
Source: Medicine - May 7, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Y-configuration double-stent-retriever thrombectomy for refractory thrombus in middle cerebral artery bifurcation: A case report
Rationale: Stent retriever mechanical thrombectomy is a recommended treatment for acute ischemic stroke. However, refractory thrombus in artery bifurcation can reduce the rate of successful revascularization. Patient concerns: A 72-year-old male, owing to the acute onset of almost complete right-sided hemiplegia and global aphasia, received bridging therapy. National Institutes of Health Stroke Scale score was 16 at the time of admission. Diagnoses: Cerebral digital subtraction angiography revealed occlusion of the M1 segment of the left MCA. Interventions: Thrombectomy with 3 passes of the Solitai...
Source: Medicine - March 19, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Thrombolysis in an acute ischemic stroke patient with rivaroxaban anticoagulation: A case report
Rationale: Whether intravenous recombinant tissue plasminogen activator (r-TPA) therapy can be administered in acute ischemic stroke patients treated with novel oral anticoagulants (NOACs), including rivaroxaban, remains controversial. Patient concerns: A 76-year-old woman with nonvalvular atrial fibrillation, who had been receiving 15 mg rivaroxaban once daily, was brought to the emergency department with right-side hemiparesis and aphasia. The onset of neurological deficits occurred 8 hours after the last dose of rivaroxaban administration. Diagnosis: The patient was diagnosed with acute ischemic stroke. Int...
Source: Medicine - February 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Resolution of left ventricular thrombus by edoxaban after failed treatment with warfarin overdose: A case report
Rationale: Although novel oral-anticoagulants are widely used in patients with atrial fibrillation (AF) for stroke prevention, there was only limited evidence for their use in left ventricular (LV) thrombus. Patient concerns: A 41-year-old man who presented with acute onset of right-hand clumsiness and aphasia even under high international normalized ratio (INR: 7.64) from warfarin use. He was previously treated with warfarin for the LV thrombus and non-valvular AF. Brain magnetic resonance imaging (MRI) showed multiple acute infarction in the cortex of the bilateral frontal lobes, left parietal lobe, and bilateral ce...
Source: Medicine - January 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Cerebral venous sinus thrombosis presenting with multifocal intracerebral hemorrhage and subarachnoid hemorrhage: A case report
Rationale: Multifocal cerebral hemorrhage refers to the cerebral hemorrhage in 2 or more lesions at the same time or 48 h in the brain caused by various causes, which has an acute onset, high mortality rate, and poor clinical treatment effect. Subarachnoid hemorrhage (SAH) is caused by the direct flow of blood into the subarachnoid cavity due to the rupture of the diseased vessels at the base or surface of the brain. Cerebral venous sinus thrombosis (CVST) affects approximately 5 people per million and accounts for approximately 1% of all stroke events. CVST with both SAH and multifocal intracerebral hemorrhage (ICH) a...
Source: Medicine - December 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Changes in the corpus callosum during the recovery of aphasia: A case report
Rationale: The corpus callosum, which is the most important fiber pathway linking the bilateral hemispheres, plays a key role in information access, as well as the functional coordination and reorganization between the bilateral hemispheres. However, whether the corpus callosum will undergo structural changes during the recovery of aphasia is still unclear. In the current study, a Chinese aphasic patient with stroke was reported to develop changes in the corpus callosum after speech therapy. Patient concerns: A 33-year-old right-handed male patient had aphasia only without limb paralysis at 14 months after stroke. Di...
Source: Medicine - June 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Refractory Mycoplasma pneumoniae pneumonia with concomitant acute cerebral infarction in a child: A case report and literature review
We present a 7-year-old boy with severe M pneumoniae pneumonia who developed impaired consciousness, aphasia, and reduced limb muscle power 7 days postadmission. Diagnoses: Mycoplasma pneumoniae pneumonia with concomitant acute cerebral infarction. Interventions: The patient recovered with aggressive antibiotic therapy, antiinflammation therapy with methylprednisolone, and gamma immunoglobulin and anticoagulation therapy with aspirin and low molecular weight heparin along with rehabilitation training. Outcomes: At 8 days postadmission, his consciousness was improved and at the 6-month follow-up visit, his muscle p...
Source: Medicine - March 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Rapid improvement of angiostenosis due to isolated middle cerebral artery dissection: A case report
AbstractRationale:Intracranial arterial dissection is a rare cause of ischemic stroke, and isolated middle cerebral artery dissection (MCAD) is extremely rare, having been described only in sparse case reports. The etiology, clinicoradiological features, and treatment strategies are not yet well understood.Patient concerns:A 49-year-old man presented with rapidly progressive aphasia and motor disturbance of the right limbs.Diagnoses:Neuroimaging evaluation confirmed a diagnosis of MCAD and cerebral infarction.Interventions:The patient underwent oral anti-platelet therapy (100 mg aspirin daily).Outcomes:The patient recove...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

A case report of parenchymal hematoma after intravenous thrombolysis in a rivaroxaban-treated patient: Is it a true rivaroxaban hemorrhagic complication?
AbstractRationale:To date, the only treatment approved for acute ischemic strokes is thrombolysis. Whether intravenous thrombolysis may be safe in patients taking direct oral anticoagulants (DOACs) is currently a matter of debate.Patient concerns:A 74-year-old woman, who was on rivaroxaban 20 mg/d for nonvalvular atrial fibrillation, was admitted to our stroke unit with left-sided hemiparesis and aphasia. The onset of neurologic deficits had occurred 5 hours after the last rivaroxaban dose.Diagnosis:An acute ischemic stroke was diagnosed.Interventions:The patient was administered thrombolytic treatment with intravenous r...
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

rTMS treatments combined with speech training for a conduction aphasia patient: A case report with MRI study
We report the case of a 39-year-old woman who was initially diagnosed with conduction aphasia following a left hemisphere stroke. Interventions: The rTMS location comprised the left Broca area, and a frequency of 5 Hz for 20 min/d for 10 days during a 2-week period was used. She had received speech rehabilitation training 1 month after stroke. Functional magnetic resonance imaging (fMRI) and diffusion tensor imaging were used to investigate the functional and microstructural changes before and after rTMS treatment. Outcomes: The results demonstrated that the Western Aphasia Battery scores significantly improved for l...
Source: Medicine - August 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Non-invasive Brain Stimulation in the Treatment of Post-stroke and Neurodegenerative Aphasia: Parallels, Differences, and Lessons Learned
Catherine Norise, Roy H. Hamilton
Source: Frontiers in Human Neuroscience - January 23, 2017 Category: Neuroscience 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

“Hopeless, Sorry, Hopeless”: Co-constructing Narratives of Care With People Who Have Aphasia Post-stroke
Despite widespread support for user involvement in health care, people with aphasia (PWA) report feeling ignored and disempowered in care contexts. They also rarely have the opportunity to give feedback on their experiences of care post-stroke. However, it is important for health care professionals to hear this feedback, both to understand the broader illness narrative and potentially to inform improved practice. Health care professionals who work with PWA should be trained and supported to co-construct narratives of feedback on care. In this article, I consider the knowledge, skills, and attitudes underpinning co-construc...
Source: Topics in Language Disorders - July 1, 2015 Category: Speech Therapy Tags: Original Articles Source Type: research

Developing complex interventions: lessons learned from a pilot study examining strategy training in acute stroke rehabilitation.
Conclusions:It is feasible and acceptable to administer both intervention protocols as an adjunct to acute inpatient rehabilitation, and strategy training shows promise for reducing disability. PMID: 24113727 [PubMed - as supplied by publisher]
Source: Clinical Rehabilitation - October 10, 2013 Category: Rehabilitation Authors: Skidmore ER, Dawson DR, Whyte EM, Butters MA, Dew MA, Grattan ES, Becker JT, Holm MB Tags: Clin Rehabil Source Type: research