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Bilateral vertebral artery dissection complicated by posterior circulation stroke in a young man: A case report
Conclusion: VAD should be taken into consideration in differential diagnosis of posterior circulation stroke or transient ischemic attack in young patients. Intravenous thrombolytic therapy may be safe and effective for stroke-complicated cases. This case report demonstrates that expanded diagnostic protocol for acute ischemic stroke assures rapid and correct diagnosis.
Source: Medicine - October 29, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Intravenous Thrombolysis in Posterior Circulation Stroke
Conclusions: Up to date, no data about PCIS and IVT are available from RTCs. Based on limited results from retrospective clinical studies and case series, IVT is safer for use in PCIS than in ACIS. Patients with brainstem ischemia, vertebral artery occlusion, and absence of basilar or posterior cerebral artery occlusion could be considered for treatment with IVT even in borderline cases. Time to IVT in PCIS seems to be a less crucial factor than in ACIS. IVT for PCIS may be beneficial even after 4.5 h from symptom onset. Introduction History of Intravenous Thrombolysis—The Most Relevant Studies Intravenous...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Stroke Care: A Balanced Approach to the tPA Debate
In conclusion, alteplase is the only treatment available for acute ischemic stroke that is effective in some patients. In order to improve tPA effectiveness and minimize risks, patients with symptoms suggestive of an AIS should get rapid assessment and treatment with tPA after careful review of the contraindications. Given that smaller strokes can still be associated with considerable long term neurological morbidity, treatment should still be considered in those patients after weighing the risks and benefits and in consultation with the patient and family. Advanced age should also not be a limiting factor. Although the NI...
Source: EPMonthly.com - December 31, 2016 Category: Emergency Medicine Authors: Logan Plaster Tags: Uncategorized Source Type: news

The syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis mimicking an acute stroke
ConclusionsThe decision to thrombolyse or perform an LP in HaNDL patients mimicking a stroke is difficult in the acute setting. Perfusion CT can provide misleading results and CTA may be useful in ruling out occlusion of a cerebral vessel.
Source: European Journal of Neurology - April 22, 2016 Category: Neurology Authors: M. Guillan, A. DeFelipe‐Mimbrera, A. Alonso‐Canovas, M. C. Matute, R. Vera, A. Cruz‐Culebras, N. Garcia‐Barragan, J. Masjuan Tags: Original Article Source Type: research

Clostridium septicum Pneumocephalus
Conclusions Clostridium septicum is an uncommon and often fatal cause of nontraumatic pneumocephalus. This underscores the need for a high index of clinical suspicion in cases with unexplained pneumocephalus, as early diagnosis remains the key to survival. In survivors of C. septicum infection, subsequent colonoscopy should be considered to exclude undiagnosed or occult gastrointestinal malignancy.
Source: Neurocritical Care - March 31, 2016 Category: Neurology Source Type: research

Patient Factors Do Not Predict Thrombolysis in Stroke Mimics (P6.031)
CONCLUSIONS: Physician decision to administer thrombolysis in stroke mimic patients without clear contraindication is not associated with patient demographic or clinical factors. Our study is limited by its retrospective nature and small sample size, however continued data collection is in process.Disclosure: Dr. Gildersleeve has nothing to disclose. Dr. Pandurengan has nothing to disclose. Dr. Gonzales has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Gildersleeve, K., Pandurengan, R., Gonzales, N. Tags: Neurotherapeutics Source Type: research

Does a history of migraine affect the rate of thrombolysis in young stroke patients?
Conclusion. Migraine is associated with a low rate of thrombolytic therapy in young patients admitted with acute ischaemic stroke. Migraine patients admitted with acute ischaemic stroke are at risk of maltreatment. PMID: 24349822 [PubMed]
Source: Stroke Research and Treatment - December 2, 2014 Category: Neurology Tags: Stroke Res Treat Source Type: research

The Case Files: Traumatic Carotid Dissection
By Hsiao, Jonie MD   A 30-year-old man who was right-hand dominant presented 10 days after sustaining left-sided face and head trauma from a fall from a skateboard at an unknown speed. He lost consciousness for several seconds, and initially developed a headache with nausea and vomiting. A non-contrast head CT performed at another hospital done two days after the incident was reportedly negative.   He now presents primarily with concerns about the appearance of his left eye. He has notable anisocoria and a droopy eyelid. His left pupil is notably smaller, 2 mm, compared with the right eye, 5 mm. Both are reactive. The re...
Source: The Case Files - June 4, 2014 Category: Emergency Medicine Tags: Blog Posts 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