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Comment on vaccine associated benign headache and cutaneous hemorrhage after ChAdOx1 nCoV-19 vaccine
Dear Editor, we would like to share ideas on the publication “Vaccine associated benign headache and cutaneous hemorrhage after ChAdOx1 nCoV-19 vaccine: A cohort study1.” If these symptoms are a minor form of VITT, with a possibility for worsening, such as in the case of a second vaccination dose, or a new entity of vaccine consequences, Schultz et al. ex plored this1. The combination of headaches and subcutaneous hemorrhage, according to Schultz et al., did not indicate VITT, and no other distinct coagulation problem or cerebral pathology was discovered.
Source: Journal of Stroke and Cerebrovascular Diseases - January 23, 2023 Category: Neurology Authors: Rujittika Mungmunpuntipantip, Viroj Wiwanitkit Tags: Letter to the Editor Source Type: research

Response to Letter to the Editor
We thank the authors for their interest in our article and the thoughtful comments. As they correctly point out, the association between the first vaccination with ChAdOx1 nCov -19 vaccine and the described symptoms in our article does not prove any causality. However, cutaneous hemorrhages and headaches were frequently reported side effects after vaccination with ChAdOx1 nCov-19 in the Norwegian corona study cohort in young and previously healthy subjects. In lack of previous experience, there was a fear that these symptoms may have represented a mild form of VITT.
Source: Journal of Stroke and Cerebrovascular Diseases - January 20, 2023 Category: Neurology Tags: Letter to the Editor Source Type: research

Vaccine associated benign headache and cutaneous hemorrhage after ChAdOx1 nCoV-19 vaccine: A cohort study
Fatal complications have occurred after vaccination with ChAdOx1 nCoV-19, a vaccine against Covid-19. Vaccine-induced immune thrombotic thrombocytopenia (VITT) with severe outcome is characterized by venous thrombosis, predominantly in cerebral veins, thrombocytopenia and anti-PF4/polyanion antibodies. Prolonged headaches and cutaneous hemorrhages, frequently observed after the ChAdOx1 nCoV-19 vaccine, have therefore caused anxiety among vaccinees. We investigated whether these symptoms represent a mild form of VITT, with a potential for aggravation, e.g.
Source: Journal of Stroke and Cerebrovascular Diseases - November 17, 2022 Category: Neurology Authors: Nina Haagenrud Schultz, Arne Vasli Lund S øraas, Ingvild Hausberg Sørvoll, Çigdem Akalin Akkök, Annette Vetlesen, Jagjit Singh Bhamra, Maria Therese Ahlen, Pål Andre Holme, Anne-Hege Aamodt, Karolina Skagen, Thor Håkon Skattør, Mona Skjelland, Mark Source Type: research

Ischemic stroke is a potential complication of uncontrolled inflammation in mevalonate kinase deficiency – A case report
Mevalonate kinase deficiency (MKD) is an autosomal recessive monogenic autoinflammatory disease (AID) characterized by recurrent antigen-independent systemic inflammation attacks, interleukin-1beta hypersecretion, fever and pain.1 Neurological manifestations include headaches, fatigue, retinal dystrophy, ataxia and development delay.2
Source: Journal of Stroke and Cerebrovascular Diseases - October 12, 2022 Category: Neurology Authors: Justine Blais, Didier Bonneville-Roussy, Hannah Laure Elfassy, Sylvain Lanthier Tags: Case Report Source Type: research

Diagnostic accuracy of MR vessel wall imaging at 2 weeks to predict morphological healing of vertebral artery dissection
Patients with non-hemorrhagic intracranial vertebral artery dissection (VAD) exhibit various symptoms including severe occipital headache alone or focal neurological deficits caused by vertebrobasilar artery ischemia.1 The majority of non-hemorrhagic VAD have a benign clinical course and spontaneously resolve.2, 3 The time course of changes in the imaging characteristics of VAD remains unclear and a follow-up management strategy has not yet been established.4 Since cerebrovascular dissections occur within the cerebrovascular wall, it is important to evaluate the vascular wall to determine whether the dissection has healed spontaneously.
Source: Journal of Stroke and Cerebrovascular Diseases - August 26, 2022 Category: Neurology Authors: Yukishige Hashimoto, Toshinori Matsushige, Reo Kawano, Michitsura Yoshiyama, Takeshi Hara, Shohei Kobayashi, Chiaki Ono, Shigeyuki, Sakamoto, Nobutaka Horie Source Type: research

Infratentorial developmental venous anomaly concurrent with a cavernoma and dural arteriovenous fistula
A 32-year-old woman underwent a head computed tomography scan after a traffic accident. A calcification in the left cerebellar hemisphere was disclosed. She did not complain of any symptoms, but neurological examination revealed cerebellar ataxia. She did not have any preceding episodes since birth, such as acute-onset headache. Magnetic resonance imaging showed past hemorrhage of the calcification lesion suggestive of a cerebellar cavernoma. A dilated vascular structure was also observed (Fig.  1A, B).
Source: Journal of Stroke and Cerebrovascular Diseases - July 14, 2022 Category: Neurology Authors: Hirokuni Hashikata, Yoshinori Maki, Ryota Ishibashi, Masanori Goto, Hiroki Toda Tags: Case Report Source Type: research

“Recycling” A Failed Superficial Temporal Artery Indirect Bypass into a Double Barrel Direct Bypass in Moyamoya Disease
Moyamoya disease (MMD) is an idiopathic cerebrovascular disorder characterized by progressive stenosis and occlusion of the terminal branches of the internal carotid arteries1. Clinically, MMD is defined by recurrent transient ischemic attacks, strokes, headaches, and seizures. The clinical course of MMD is inconsistent with some patients experiencing sporadic vascular events while others exhibit fulminant disease and rapidly decline1,2. Surgical revascularization by indirect or direct bypass is the mainstay of treatment for moyamoya vasculopathy, although the superiority of direct vs.
Source: Journal of Stroke and Cerebrovascular Diseases - June 1, 2022 Category: Neurology Authors: Alexander G. Yearley, Joshua D. Bernstock, Ari D. Kappel, Jason A. Chen, Erickson Torio, Saksham Gupta, Pui Man Rosalind Lai, Nirav J. Patel Tags: Case Report Source Type: research

Migraine-Associated Common Genetic Variants Confer Greater Risk of Posterior vs. Anterior Circulation Ischemic Stroke ☆
To examine potential genetic relationships between migraine and the two distinct phenotypes posterior circulation ischemic stroke (PCiS) and anterior circulation ischemic stroke (ACiS), we generated migraine polygenic risk scores (PRSs) and compared these between PCiS and ACiS, and separately vs. non-stroke control subjects.
Source: Journal of Stroke and Cerebrovascular Diseases - May 13, 2022 Category: Neurology Authors: P. Frid, H. Xu, B.D. Mitchell, M. Drake, J. Wasselius, B. Gaynor, K. Ryan, A.K. Giese, M. Schirmer, K.L. Donahue, R. Irie, M.J.R.J. Bouts, E.C. McIntosh, S.J.T. Mocking, A.V. Dalca, E. Giralt-Steinhauer, L. Holmegaard, K. Jood, J. Roquer, J.W. Cole, P.F. Source Type: research

R558C NOTCH3 Mutation in a CADASIL Patient with Intracerebral Hemorrhage: A Case Report with Literature Review
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a monogenic cerebral small-vessel disease, which is characterized by migraine, recurrent ischemic strokes, psychiatric disorder, progressive cognitive decline, and occasionally intracerebral hemorrhage (ICH). ICH events have been reported in a high proportion of East Asian CADASIL patients with R544C mutation in exon 11 of NOTCH3; however, whether any other specific NOTCH3 mutation determines the ICH phenotype has yet to be explored.
Source: Journal of Stroke and Cerebrovascular Diseases - May 3, 2022 Category: Neurology Authors: Liuting Hu, Gang Liu, Yuhua Fan Tags: Case Report Source Type: research

PRES and RCVS: Two Distinct Entities or a Spectrum of the Same Disease?
Posterior reversible encephalopathy syndrome (PRES) is a disorder characterized by vasogenic edema predominantly in the parieto-occipital regions associated with acute onset of neurological symptoms including encephalopathy, seizures, headache, and visual disturbances. It has been classically associated with uncontrolled hypertension, renal failure, exposure to cytotoxic agents, or pre-eclampsia.1,2 Despite its name, PRES it is not universally posterior nor fully reversible. Up to 10-20% of patients can have persistent neurological sequelae,1 therefore prompt recognition and elimination of triggering factors is of paramount importance.
Source: Journal of Stroke and Cerebrovascular Diseases - April 5, 2022 Category: Neurology Authors: Valerie Jeanneret, Dinesh V. Jillella, Srikant Rangaraju, Olivia Groover, Ryan Peterson, Sitara Koneru, Fadi Nahab, Carlos S. Kase Tags: Short Communication Source Type: research

Fulminant reversible cerebral vasoconstriction syndrome in breakthrough COVID 19 infection
We report a case of fulminant reversible cerebrovascular constriction syndrome (RCVS) in a patient with breakthrough COVID 19 infection who was fully vaccinated. A 64 year old lady, fully vaccinated 2 months back, presented with headache, drowsiness, partial seizures, visual impairment and quadriplegia. Her nasopharyngeal swab was tested positive for SARS COV2 on real time PCR assay.
Source: Journal of Stroke and Cerebrovascular Diseases - November 25, 2021 Category: Neurology Authors: Somdattaa Ray, Vikram V Kamath, Arjun Raju P, Rajesh K.N, Shalini N Source Type: research

First Report: Rare RNF213 Variant Associated with Familial Moyamoya Disease in an African American Family
Moyamoya disease (MMD) is a rare progressive idiopathic cerebrovasculopathy. Symptoms include headache, seizures, and ischaemic or haemorrhagic stroke. In contrast, the vasculopathy in moyamoya syndrome is secondary to an inciting event or systemic disease. MMD has a bimodal distribution, peaking around ages 10 and 40.
Source: Journal of Stroke and Cerebrovascular Diseases - October 16, 2021 Category: Neurology Authors: N. Abimbola Sunmonu, Naveen Kumar Ambati, Matthew J. Thomas, Robin D. Ulep, Bradford Worrall Tags: Short Communication Source Type: research

Migraine with Visual aura and the Risk of Stroke- a Narrative Review
Patients with migraine with visual aura (MwvA) often present to eye care providers for evaluation. A thorough ophthalmological history and examination is needed to exclude ophthalmologic disorders. Additionally, it has been increasingly recognized that MwvA is associated with ischemic stroke (IS). The aim of this narrative review is to provide a comprehensive overview of the differential diagnosis of MwvA and its association with IS.
Source: Journal of Stroke and Cerebrovascular Diseases - August 27, 2021 Category: Neurology Authors: Meng-Chun Chiang, Oana M. Dumitrascu, Nikita Chhabra, Chia-Chun Chiang Tags: Review Article Source Type: research

Recurrent Transient Neurological Deficit Due to Intracerebral Steal Phenomenon in Association with a Developmental Venous Anomaly
We report a symptomatic developmental venous anomaly (DVA) not causing parenchymal abnormality to provide a pathophysiologic clue in patients with recurrent transient neurologic deficit. A 32-year-old male presented with recurrent transient motor aphasia and headache in the left fronto-temporal region for three years. The symptoms usually lasted for one hour. Brain computed tomography (CT) angiography and magnetic resonance imaging using gradient recalled echo showed a prominent penetrating vein at the left frontal periventricular region.
Source: Journal of Stroke and Cerebrovascular Diseases - August 24, 2021 Category: Neurology Authors: Jean Hee Kim, Hyeyoung Jung, Woojun Kim, Jae Young An Tags: Case Report Source Type: research

Pediatric Case of Life-Threatening Stroke Caused by Reversible Cerebral Vasoconstriction Syndrome with Spontaneous Cervical Internal Carotid Artery Vasospasm: A Case Report
Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by acute and severe headache, referred to as thunderclap, and transient segmental cerebral arterial vasoconstriction. The diagnostic criteria include 1) thunderclap headache with or without neurological deficits or seizures, 2) uniphasic course without new symptoms lasting for more than a month after clinical onset, 3) no evidence of aneurysmal subarachnoid hemorrhage, 4) normal or near-normal cerebrospinal fluid analysis findings, 5) multifocal segmental cerebral artery vasoconstriction on either catheter angiography or, indirectly, computed tomography ...
Source: Journal of Stroke and Cerebrovascular Diseases - August 12, 2021 Category: Neurology Authors: Yu Fujii, Yoshiki Hanaoka, Toshihiro Ogiwara, Jun-ichi Koyama, Tetsuyoshi Horiuchi Tags: Case Report Source Type: research

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