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Imaging Negative Stroke: Diagnoses and Outcomes in Intravenous Tissue Plasminogen Activator–Treated Patients
Conclusions: Because most INS patients were found to have NNCI, which may represent either transient ischemic attack or aborted stroke, and there were no intracerebral hemorrhages in the INS group, our data support the safety of administering IV t-PA to all patients in whom acute ischemic stroke is clinically suspected. We have demonstrated that NNCI patients and stroke mimics are common, and future larger scale prospective studies are required to delineate the true frequencies of each and to evaluate differences in outcomes.
Source: Journal of Stroke and Cerebrovascular Diseases - October 7, 2013 Category: Neurology Authors: Ilana Spokoyny, Rema Raman, Karin Ernstrom, Brett C. Meyer, Thomas M. Hemmen Tags: Original Articles Source Type: research

Reversible Cerebral Vasoconstriction Syndrome with Multivessel Cervical Artery Dissections and a Double Aortic Arch
Reversible cerebral vasoconstriction syndrome (RCVS) has been associated with exposure to vasoactive substances and few reports with cervical arterial dissections (CADs). We evaluated a 32-year-old woman with history of depression, migraines without aura, and cannabis use who presented with a thunderclap headache unresponsive to triptans. She was found to have bilateral occipital infarcts, bilateral extracranial vertebral artery dissections, bilateral internal carotid artery dissecting aneurysms, and extensive distal multifocal segmental narrowing of the anterior and posterior intracranial circulation with a “sausage on ...
Source: Journal of Stroke and Cerebrovascular Diseases - October 7, 2013 Category: Neurology Authors: Amre Nouh, Sean Ruland, Michael J. Schneck, David Pasquale, José Biller Tags: Case Reports Source Type: research

Stroke Mimics under the Drip-and-Ship Paradigm
Conclusion: The drip-and-ship paradigm and any psychiatric history predict the diagnosis of SM. None of the SM had thrombolysis-related complications, and all were discharged to home. These findings may explain the superior outcomes associated with the drip-and-ship paradigm in the treatment for AIS.
Source: Journal of Stroke and Cerebrovascular Diseases - August 19, 2013 Category: Neurology Authors: Sonal Mehta, Nirav Vora, Randall C. Edgell, Hesham Allam, Aws Alawi, Jennifer Koehne, Abhay Kumar, Eliahu Feen, Salvador Cruz-Flores, Amer Alshekhlee Tags: Original Articles Source Type: research

Awareness of Risk Factors and Warning Signs of Stroke in a Nigeria University
This study assessed awareness of stroke risk factors and warning signs among students and staff of Obafemi Awolowo University, Nigeria.Methods: This was a cross sectional survey involving 994 (500 students and 494 staff) respondents. Information on the awareness of stroke risk factors and warning signs was collected with the aid of a structured questionnaire. Descriptive and inferential statistics were used for data analysis.Results: Weakness (66.2%) was the most commonly identified warning sign of stroke with more staff (69.8%) identifying correctly than students (62.6%). Hypertension (83.4%) was the most commonly identif...
Source: Journal of Stroke and Cerebrovascular Diseases - August 1, 2013 Category: Neurology Authors: Adebimpe O. Obembe, Matthew O. Olaogun, Adesola A. Bamikole, Morenikeji A. Komolafe, Marufat O. Odetunde Tags: Original Articles Source Type: research

Isolated Cortical Vein Thrombosis Associated with Prothrombin Gene Mutation
We report a 47-year-old female patient who had a frontal hemorrhage with headache associated with contralateral hemiparesis and hemisensory deficit on presentation. This hemorrhagic stroke was localized in a nonarterial territory, and it was caused by ipsilateral and isolated thrombosis of the vein of Labbe found on catheter angiogram that demonstrated a filling defect of the vein of Labbe at its connection with the transverse sinus. There were no filling defects in the superficial middle cerebral veins. Our patient had a family history of cardiovascular disease, stroke, and factor V Leiden mutation and cigarette smoking a...
Source: Journal of Stroke and Cerebrovascular Diseases - July 8, 2013 Category: Neurology Authors: Elias A. Giraldo, Rohan Arora, Robert A. Koenigsberg Tags: Case Reports Source Type: research

Patent Foramen Ovale and Infarct Volume in Cryptogenic Stroke
Background: The causal relationship between patent foramen ovale (PFO) and stroke is controversial. We hypothesized that if PFO is a pathway of embolic source, there might be a correlation between PFO characteristics (ie, size or extent of shunt) and ischemic lesion burden (ie, infarct volume and number).Methods: From ischemic stroke patients admitted to Asan Medical Center between January 2000 and October 2007, we identified those who had (1) acute ischemic lesion on diffusion-weighted imaging within 5 days of symptom onset and (2) cryptogenic stroke and only PFO detected by transesophageal echocardiography. PFO characte...
Source: Journal of Stroke and Cerebrovascular Diseases - June 7, 2013 Category: Neurology Authors: Jin-Man Jung, Jong-Young Lee, Hye-Jin Kim, Youngrok Do, Sun U. Kwon, Jong S. Kim, Jae-Kwan Song, Dong-Wha Kang Tags: Original Articles Source Type: research

Endovascular Treatment of Chronic, Recurrent Headache Secondary to Chronic Cerebral Venous Sinus Thrombosis
We report 2 cases of chronic superior sagittal sinus thrombosis causing isolated intracranial hypertension. The patients were treated with intrasinus thrombolytic therapy.
Source: Journal of Stroke and Cerebrovascular Diseases - May 30, 2013 Category: Neurology Authors: Xin-Bin Guo, Lai-Jun Song, Sheng Guan Tags: Case Reports Source Type: research

Cerebral Infarction in a Case of Parry-Romberg Syndrome
Our objective is to report a rare coexistence of Parry-Romberg disease and ischemic stroke. Here, we report the case of a 34-year-old woman with Parry-Romberg syndrome who developed cerebral infarction. This patient developed sudden left-sided weakness and was admitted to our hospital. Magnetic resonance imaging revealed acute cerebral infarction in the posterior limb of the right internal capsule. The patient had been diagnosed with Parry-Romberg syndrome at the age of 12, and she had a history of migraine without aura. Transesophageal echocardiography revealed a patent foramen ovale, but no atrial septal aneurysm or deep...
Source: Journal of Stroke and Cerebrovascular Diseases - May 9, 2013 Category: Neurology Authors: Yuji Tomizawa, Ryota Tanaka, Kiyoshi Sekiguchi, Yutaka Oji, Yasutaka Tanaka, Kazuo Yamashiro, Nobutaka Hattori Tags: Case Reports Source Type: research

Nonaneurysmal Subarachnoid Hemorrhage after Udenafil Intake
We report a 67-year-old man who presented with severe headache after taking 50 mg of udenafil, a new phosphodiesterase 5 inhibitor. Computed tomographic imaging of the brain revealed a small amount of acute subarachnoid hemorrhage localized around basal cisterns (anterior to midbrain and pons). There were no aneurysms in the cerebral arteries, although vein of Galen stenosis was suspected after magnetic resonance venography. This case anecdotally suggests that phosphodiesterase 5 inhibition might trigger perimesencephalic subarachnoid hemorrhage with venous hypertension possibly associated with vein of Galen stenosis.
Source: Journal of Stroke and Cerebrovascular Diseases - May 6, 2013 Category: Neurology Authors: Eun-Kee Bae, Jong-Hyeon Ahn, Jeong-Jin Park Tags: Case Reports Source Type: research

Retrosplenial Amnesia without Topographic Disorientation Caused by a Lesion in the Nondominant Hemisphere
We report the case of a 68-year-old right-handed man who was admitted to our hospital because of sudden onset of headache. On admission, he presented with left homonymous hemianopsia, disorientation, and recent memory disturbance; however, he had normal remote memory and digit span. He was able to recall the room layout of his house and describe the route from the nearest station to his home on a map. However, at the hospital, he sometimes lost his way because of amnesia. Computed tomography (CT) and magnetic resonance imaging revealed a subcortical hematoma in the right occipital forceps and the parietal lobe, involving t...
Source: Journal of Stroke and Cerebrovascular Diseases - April 22, 2013 Category: Neurology Authors: Shinichiro Maeshima, Aiko Osawa, Fumitaka Yamane, Tomoyuki Yoshihara, Ryuzaburo Kanazawa, Shoichiro Ishihara Tags: Original Articles Source Type: research

Migraine Improves after Ischemic Stroke
Objective: To assess if migraine frequency spontaneously changes after stroke.Background: Patent foramen ovale (PFO) closure has been reported to decrease migraine attacks. Because many closures are carried out after an ischemic stroke, it is possible that migraine spontaneously improves after stroke.Methods: We have prospectively collected all patients with ischemic stroke and active migraine admitted to our stroke unit and have compared their migraine frequency before and 6, 12, and 24 months after stroke.Results: We studied 43 patients. Mean follow-up was 1.3 ± .5 years. The mean number of migraine attacks per month de...
Source: Journal of Stroke and Cerebrovascular Diseases - March 18, 2013 Category: Neurology Authors: Bruno Censori, Tania Partziguian, Marco Poloni Tags: Original Articles Source Type: research

Ipsilateral Sensorimotor Deficits in Lateral Medullary Infarction: A Case Report
The patient, a 32-year-old man, presented with sudden onset of occipital headache, vertigo, dysarthria, gait ataxia, right Horner syndrome, numbness of the right hand, and mild right hemiparesis. On magnetic resonance imaging, an acute small infarction was located on the right side of the caudal medulla extending dorsomedially. Magnetic resonance angiography showed severe right vertebral artery stenosis. Lateral medullary infarction associated with ipsilateral sensorimotor deficits in the limb is very rare, and the lesion probably involved the ipsilateral dorsal column or decussating lemniscal fibers and corticospinal fibe...
Source: Journal of Stroke and Cerebrovascular Diseases - December 10, 2012 Category: Neurology Authors: Tetsuro Sameshima, Akio Morita, Yumiko Yamaoka, Yasumitsu Ichikawa Tags: Case Reports Source Type: research

Clinical and Radiological Management and Outcome of Pregnancies Complicated by Cerebral Venous Thrombosis: A Review of 19 Cases
Conclusions: If magnetic resonance imaging is available, it should be used for the detection of CVT in all pregnant patients instead of computed tomography. Patients with parenchymal lesions, thrombophilia, and antiphospholipid syndrome had a greater risk of being left with neurologic sequelae. For pregnant patients with CVT, low molecular weight heparin in full anticoagulant doses should be continued throughout the pregnancy. Anticoagulant therapy did not appear to predispose patients to further intracranial hemorrhage.
Source: Journal of Stroke and Cerebrovascular Diseases - August 17, 2012 Category: Neurology Authors: Caner Feyzi Demir, Mehmet Fatih İnci, Fuat Özkan, Mustafa Yıldız, Hasan Özdemir Tags: Original Articles Source Type: research

Simultaneous Onset of Anterior and Middle Cerebral Artery Dissections with an Old Vertebral Artery Dissection
We report a patient with infarctions caused by simultaneous arterial dissections in the right anterior cerebral artery and the left middle cerebral artery and discuss the characteristic feature of this vascular disorder. A 53-year-old woman presented with a severe headache and a mild aphasia. Magnetic resonance imaging revealed multiple acute cerebral infarctions in the left temporal and right frontal lobes. The initial angiographic findings revealed arterial dissections of the anterior cerebral, left middle cerebral, and right vertebral arteries. The follow-up angiographic examination found improvement of the stenosis in ...
Source: Journal of Stroke and Cerebrovascular Diseases - April 16, 2012 Category: Neurology Authors: Tatsuya Kato, Takashi Yagi, Hideyuki Yoshioka, Masakazu Ogiwara, Toru Horikoshi, Hiroyuki Kinouchi Tags: Original Articles Source Type: research

Angiogram-Negative Subarachnoid Hemorrhage: Outcomes Data and Review of the Literature
We report data for 31 patients who presented to our institution from 2006 to the present. We performed a retrospective chart review, and report outcome data that include rates of rehemorrhage, hydrocephalus, vasospasm, permanent ischemic deficits, headaches, and outcomes based on modified Rankin Scale scores. We also performed a review of the literature and meta-analysis of the data therein. We compared rates of complications in the PMH subgroup and the diffuse-type hemorrhage subgroup. The chart review revealed no poor outcomes and no rehemorrhages in the patients with PMH. In the diffuse hemorrhage subgroup, 1 patient ha...
Source: Journal of Stroke and Cerebrovascular Diseases - April 1, 2012 Category: Neurology Authors: Scott Boswell, William Thorell, Steve Gogela, Elizabeth Lyden, Dan Surdell Tags: Original Articles Source Type: research

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