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Dissection extending from extra- to intracranial arteries: A case report of progressive ischemic stroke
We reported a rare case of 33-year-old patient with progressive ischemic stroke due to dissection from an intimal tear in the right proximal internal carotid artery to distal middle cerebral artery. Diagnoses: 3D fat-saturated T1 VISTA imaging, owing to its comprehensive neck and head coverage, high spatial resolution, enables the reader to have several sections with good contrast covering the dissected arterial segment, even in the rare dissection involving extra- and intra-cranial arteries referred in this article. Interventions: Clopidogrel 75mg daily was prescribed, also the patient was given rehabilitation training....
Source: Medicine - May 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Atypical presentation of giant cell arteritis in a patient with vertebrobasilar stroke: A case report
Rationale: Giant cell arteritis (GCA) is known to present with typical manifestations like temporal headache and visual abnormalities. However, several cases with atypical manifestations were reported. Stroke occurs in 3% to 7% of patients with GCA. Patient concerns: A 67-year-old male patient with known hypertension presented with somnolence, disorientation and mild bilateral limb ataxia. The magnetic resonance imaging showed multiple acute infarctions in the territory of the vertebrobasilar system with occlusion of the left vertebral artery. Diagnosis: Ten months later, during a routine neurovascular follow-up, r...
Source: Medicine - August 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Anticoagulants for secondary prevention after acute myocardial infarction: Lessons from the past decade
This article is protected by copyright. All rights reserved.
Source: Fundamental and Clinical Pharmacology - February 1, 2014 Category: Drugs & Pharmacology Authors: Dan Atar, Christoph Bode, André Stuerzenbecher, Freek W. A. Verheugt Tags: Review Article Source Type: research

Spontaneous recanalization of atherosclerotic middle cerebral artery occlusion: Case report
Rationale: Intracranial vascular atherosclerotic occlusion is one of the most common causes of ischemic stroke world wide. The involvement of large intracranial vessels, in particular, the middle cerebral artery, is usually associated with unfavorable outcomes in patients. Spontaneous recanalization of atherosclerotic occlusion is relatively rare. Patient concerns: The first patient was a 43-year-old male with slurred speech and left-sided weakness for a duration of 24 hours. The second was a 59-year-old male with left-sided weakness over a period of 13 hours. The last was a 49-year-old female patient presented with a...
Source: Medicine - July 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

WATCHMAN device-related thrombus successfully treated with apixaban: A case report
Rationale: Among atrial fibrillation patients with high risk of bleeding, left atrial appendage occlusion has emerged as an alternative to long-term oral anticoagulation therapy for stroke prevention. Device-related thrombus remains a major concern because it may result in recurrent embolic events. To date, there is no consensus on the optimal method of treating device-related-thrombus. Patient concerns: A 78-year-old man with atrial fibrillation had an episode of intracranial hemorrhage while taking warfarin. He subsequently underwent percutaneous placement of a 30-mm Watchman device to the left atrial appendage. He ...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

r-tPA with loading dose of clopidogrel and aspirin therapies for capsular warning syndrome attributed to middle cerebral artery atherosclerotic stenosis: A CARE-compliant case report
Rationale: The capsular warning syndrome (CWS) is a rare and special type of transient ischemic attacks (TIAs) syndrome. The pathophysiology of CWS is very complicate, and intracranial atherosclerotic stenosis (ICAS) is rare cause. Moreover, the effective and standard therapy has not yet been established. Patient concerns: A 47-year-old man experienced repeated and exacerbated TIAs of right hemiparesis and dysarthria. Fourteen hours after the first episode of TIAs, he developed more severe right hemiparesis and dysarthria, the National Institute of Health Stroke Scale (NIHSS) score was 12 points, and did not recover i...
Source: Medicine - February 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Two cases of rt-PA with dual antiplatelet therapies with capsular warning syndrome
Rationale: Capsular warning syndrome (CWS) is a term to describe stereotyped lacunar transient ischemic attacks (TIAs). Patients with CWS are at high risk of developing completed stroke. However, the exact pathophysiology of CWS is still unclear, and there is no conclusive clinical strategy for CWS patients. Patient symptoms: Two cases of middle-aged men with hypertension, hyperlipidemia, and diabetes mellitus presented with fluctuating right-sided weakness, numbness, and dysarthria. Diagnoses: These two patients were diagnosed with CWS. Interventions: Recombinant tissue plasminogen activator (rt-P...
Source: Medicine - March 5, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research