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Recurrent Cerebral Venous Thrombosis Treated with Direct Oral Anticoagulants in a Japanese Man with Hereditary Protein C Deficiency
We herein report a case involving a 32-year-old Japanese man with recurrent cerebral venous thrombosis due to hereditary protein C deficiency. He was admitted to our hospital with impaired consciousness. Brain magnetic resonance imaging demonstrated high intensities diffusely along the bilateral sulci and magnetic resonance venography revealed left transverse sinus and superior sagittal sinus stenoses. His father had a history of cerebral infarction and venous thrombosis. The protein C activity level examined by chromogenic synthetic substrate assay was markedly reduced.
Source: Journal of Stroke and Cerebrovascular Diseases - October 29, 2020 Category: Neurology Authors: Kazuyuki Saito, Kazuyuki Ishii, Konosuke Furuta, Masaki Kobayashi, Yoshiaki Wada, Eriko Morishita Tags: Case Report Source Type: research

Racial Disparities in Magnetic Resonance Imaging and Perfusion-Diffusion Mismatch
The central concept of mismatch between perfusion and diffusion targets identified by magnetic resonance imaging offers an approximation of the tissue at risk of infarction if reperfusion is not achieved. This measure is becoming increasingly relevant in determining eligibility for and prognosis following thrombolytic and endovascular treatments, particularly at extended time windows. A few studies have shown that Black stroke patients are more likely to suffer small-vessel ischemic strokes and fewer cardioembolic strokes occluding large vessels.
Source: Journal of Stroke and Cerebrovascular Diseases - April 16, 2020 Category: Neurology Authors: Benjamin Taylor King Tags: Poster 03 Source Type: research

A Case of Cerebral Venous Thrombosis and Deep Venous Thrombosis Due to Hyperthyroidism with Increased Factor VIII Activity
A 48-year-old woman was admitted to our hospital because of headache and fever. She was diagnosed with aseptic meningitis. Five days later, she had a seizure and developed left hemiparesis. Magnetic resonance imaging showed hyperintensity in the right parietal area on fluid attenuated inversion recovery imaging. She was diagnosed as having cerebral venous thrombosis (CVT) because the suprasagittal sinus was invisible on the venographic studies. Moreover, deep venous thrombosis (DVT) was detected in her left lower extremity.
Source: Journal of Stroke and Cerebrovascular Diseases - September 10, 2019 Category: Neurology Authors: Mutsumi Yokoyama, Ryotaro Yamashita, Masayuki Furuya, Maiko Yamazaki, Kazuo Koyama, Fumiaki Tanaka Tags: Case Report Source Type: research

Cerebral Venous Sinus Thrombosis Score and its Correlation with Clinical and MRI Findings
Background: It is plausible that extent of cerebral venous sinus thrombosis (CVST) may determine clinical severity, magnetic resonance imaging (MRI) lesion, and outcome, therefore this study was undertaken. Methods: A total of 160 CVST patients were included and their clinical details, risk factors, Glasgow Coma Scale score, and parenchymal lesion on MRI were noted. The extent of venous sinus thrombosis on magnetic resonance venography was assessed by using CVST score which was computed giving 1 point for each thrombosed sinus and 3 points to superior sagittal sinus (SSS).
Source: Journal of Stroke and Cerebrovascular Diseases - August 14, 2019 Category: Neurology Authors: Jayantee Kalita, Varun K. Singh, Neeraj Jain, Usha K. Misra, Sunil Kumar Source Type: research

Rapid Disappearance of Intraventricular Mobile Structures with Steroids in Eosinophilic Granulomatosis with Polyangiitis
Endomyocarditis in Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare complication, commonly involving an apical mass compatible with a thrombus. However, no previous report has discussed mobile structures detected by echocardiography in a patient with EGPA. A 53-year-old man with asthma presented with low-grade fever, consciousness disturbance, and vomiting. Magnetic resonance imaging showed multiple acute infarctions in the bilateral cerebrum and cerebellum. Remarkable eosinophilia was observed, and transthoracic echocardiography showed multiple mobile structures originating from the left ventricular septum.
Source: Journal of Stroke and Cerebrovascular Diseases - August 13, 2019 Category: Neurology Authors: Kenichi Sakuta, Shinji Miyagawa, Kenichiro Suzuki, Hiroshi Yaguchi Tags: Case Report Source Type: research

Dural Sinus Thrombosis with Nonsymptomatic Persistent Falcine Sinus: A Case Report
A 24-year-old woman was admitted to our hospital after convulsive status epilepticus. A cerebral magnetic resonance venography revealed a persistent fetal falcine sinus. Additionally, the posterior third of the superior sagittal sinus was hypoplastic and the abnormal deep venous drainage was accompanied. These abnormalities had already been detected by magnetic resonance imaging several years ago. In the present scan, we discovered a sinus thrombosis in the hypoplastic superior sagittal sinus. In the cerebral angiography, we observed delayed venous return in the left parieto-occipital lobe and hypothesized that cerebral ve...
Source: Journal of Stroke and Cerebrovascular Diseases - August 8, 2019 Category: Neurology Authors: Ayako Shioya, Ryota Mashiko, Masanari Shiigai, Yasunobu Nakai, Nobuyuki Takahashi, Hiroyuki Kobayashi, Toshiyuki Irie, Akira Tamaoka Tags: Case Report Source Type: research

T2*-Weighted MRI Detected Dilated Cerebral Veins in a Patient With Acute-Phase Cerebral Venous Sinus Thrombosis —A Case Report
We describe a 45-year-old man who presented with nausea, vomiting, and strong occipital headache on the right side. Although no abnormalities on neurological examination or computed tomography imaging were found on admission, peripheral blood cell counts showed polycythemia (hemoglobin 20.6 g/dL) and electrocardiography demonstrated atrial fibrillation. Therefore, anticoagulant treatment with heparin was started immediately. On the following day, the occipital headache continued. Brain T2*-weighted (T2*WI) magnetic resonance imaging (MRI) and, to a lesser extent, susceptibility-weighted imaging showed dilation of numerous ...
Source: Journal of Stroke and Cerebrovascular Diseases - June 2, 2019 Category: Neurology Authors: Takuya Kiyohara, Chie Abe, Mio Yokoi, Yusuke Sakaki, Yasuhiro Kumai Tags: Case Report Source Type: research

Short-Term Risk of Ischemic Stroke After Detection of Left Ventricular Thrombus on Cardiac Magnetic Resonance Imaging
Background: The short-term risk of ischemic stroke in patients with left ventricular (LV) thrombus identified via delayed-enhancement cardiac magnetic resonance (DE-CMR) imaging is uncertain. Methods: We performed a retrospective cohort study of patients who underwent DE-CMR for evaluation of LV systolic dysfunction at NewYork-Presbyterian Hospital/Weill Cornell between 2007 and 2016. We identified all hospitalized patients who had DE-CMR evidence of LV thrombus, and as controls, all hospitalized patients who had no DE-CMR evidence of LV thrombus; 2 control patients were randomly selected for each patient with LV thrombus.
Source: Journal of Stroke and Cerebrovascular Diseases - January 10, 2019 Category: Neurology Authors: Alexander E. Merkler, Javid Alakbarli, Gino Gialdini, Babak B. Navi, Santosh B. Murthy, Parag Goyal, Jiwon Kim, Richard B. Devereux, Monika M. Safford, Costantino Iadecola, Hooman Kamel, Jonathan W. Weinsaft Source Type: research

Early Magnetic Resonance Imaging Decreases Hospital Length of Stay in Patients with Ischemic Stroke
Imaging modalities are important part of stroke evaluation. Noncontrast head computed tomography (CT) is the initial imaging modality in acute stroke and although important to rule out acute hemorrhage and making a decision on thrombolytic treatment, ischemic changes may not be visible on CT for up to 24 hours. Magnetic resonance imaging (MRI) brain is an invaluable tool to confirm an ischemic stroke and facilitates stroke evaluation. Objective of this study was to investigate the correlation between time to MRI and length of hospital stay.
Source: Journal of Stroke and Cerebrovascular Diseases - November 3, 2018 Category: Neurology Authors: Bharti Manwani, Subhendu Rath, Nora S. Lee, Ilene Staff, Christoph Stretz, Janhavi Modak, Pasquale F. Finelli Source Type: research

Vernet's Syndrome Associated with Internal Jugular Vein Thrombosis
Our objective is to present a case of Vernet's syndrome (cranial nerve (CN) IX, X, and XI palsy) associated with cerebral venous thrombosis (CVT) in an internal jugular vein. The patient presented with acutely developed dysphagia. The weakness of the left sternocleidomastoid and trapezius muscles was observed. The initial magnetic resonance imaging and computed tomography (CT) with contrast enhancement showed contrast-filling defect in the left internal jugular vein inside the jugular foramen. The magnetic resonance venography with contrast enhancement revealed a partial filling defect in the left sigmoid sinus and total o...
Source: Journal of Stroke and Cerebrovascular Diseases - November 2, 2018 Category: Neurology Authors: Myungah Lee, Youngjae Heo, Taewon Kim Source Type: research

Thrombosed Aneurysm of the Posterior Inferior Cerebellar Artery and Lateral Medullary Ischemia as the Initial Presentation of Polyarteritis Nodosa: Case Report and Literature Review
A 27-year-old woman with a previously undiagnosed polyarteritis nodosa (PAN) developed lateral medullary stroke related to a thrombosed posterior inferior cerebellar artery (PICA)-origin aneurysm. A concurrent thrombosis of the PICA was identified on high-resolution 3-dimensional CUBE T1 magnetic resonance imaging sequence at 3  T. Body computed tomography angiography, magnetic resonance imaging–magnetic resonance angiography, and digital angiography revealed multiple tiny aneurysms of the visceral arteries and bilateral kidney infarcts.
Source: Journal of Stroke and Cerebrovascular Diseases - March 27, 2018 Category: Neurology Authors: Monique Boukobza, Antoine Dossier, Jean-Pierre Laissy Tags: Case Studies Source Type: research

Recurrent Stroke Due to Metastatic Pulmonary Tumor Emboli as an Important Clinical Entity
We present an autopsy case of repetitive stroke due to tumor emboli, indistinguishable from thromboembolism with a hypercoagulable state in its clinical course. A 72-year-old man diagnosed with stage IVA oropharyngeal squamous cell carcinoma received chemoradiotherapy. Follow-up imaging revealed mediastinal lymph nodes and pulmonary metastasis. One year later, the patient experienced right arm weakness, and brain magnetic resonance imaging showed acute ischemic lesions in multiple vascular territories.
Source: Journal of Stroke and Cerebrovascular Diseases - March 30, 2017 Category: Neurology Authors: Junji Takasugi, Manabu Sakaguchi, Naoki Oyama, Yasufumi Gon, Yasukazu Terasaki, Tsutomu Sasaki, Susumu Nakahara, Kenji Ohshima, Yumiko Hori, Eiichi Morii, Hideki Mochizuki Tags: Case Studies Source Type: research

Voxel-Based Lesion Mapping of Cryptogenic Stroke in Patients with Advanced Cancer: A Detailed Magnetic Resonance Imaging Analysis of Distribution Pattern
Ischemic stroke is one form of cancer-associated thrombosis that can greatly worsen a patient's performance status. The present investigation aimed to elucidate the characteristic distribution pattern(s) of cryptogenic stroke lesions using a voxel-based lesion-mapping technique and examine the differences in clinical manifestations between cryptogenic and conventional strokes in patients with advanced cancer.
Source: Journal of Stroke and Cerebrovascular Diseases - March 28, 2017 Category: Neurology Authors: Takamune Achiha, Masatoshi Takagaki, Hiroshi Oe, Mio Sakai, Hitoshi Matsui, Katsuhiko Nakanishi, Tomohiko Ozaki, Yasunori Fujimoto, Toshiki Yoshimine, Katsuyuki Nakanishi, Manabu Kinoshita Source Type: research

Cerebral Venous Sinus Thrombosis Presenting Feature of Systemic Lupus Erythematosus
CVST (cerebral venous sinus thrombosis) may sometimes be associated with autoimmune disorders that require specific treatment. The clinical and magnetic resonance imaging (MRI) findings of systemic lupus erythematosus (SLE) patients with CVST are presented and contrasted with CVST without SLE.
Source: Journal of Stroke and Cerebrovascular Diseases - January 4, 2017 Category: Neurology Authors: Rajesh Kumar Singh, Sanjeev Kumar Bhoi, Jayantee Kalita, Usha Kant Misra Source Type: research

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