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Total 65 results found since Jan 2013.

A clinical application study of a stent placement assessment
Discussion: Currently, no prospective controlled data exist regarding the efficacy and safety of carotid stenting in the acute phase. Previously, we had developed an ECASES stent placement system for acute carotid artery occlusion. The present study will evaluate the efficacy and safety of ECASES in a randomized, double-blind prospective study and clarify its guiding significance in acute atherosclerotic carotid artery occlusion surgery.
Source: Medicine - November 25, 2022 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research

Diffuse low-grade glioma misdiagnosed as acute cerebral infarction: A case report
We report a case of DLGG detected by computed tomography and magnetic resonance imaging (MRI). Patient concerns: A 58-year-old man suddenly phantom smells for half an hour and was previously healthy. Diagnoses: Computed tomography findings showed a leaf-shaped slightly hypodense shadow in the right temporal lobe with no obvious mass effect and an unclear boundary. MRI findings showed diffuse and slightly longer T1-weighted imaging (T1WI)/T2-weighted imaging (T2WI)signal in the right temporal lobe and hippocampus, slight hyperintensity on diffusion-weighted imaging, diffuse swelling in the right temporal lobe ...
Source: Medicine - September 2, 2022 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Intramedullary spinal cord abscess associated with right-to-left shunt via right superior vena cava draining into left atrium: A case report
We report the first case of ISCA associated with RSVC-LA RL shunt. Patient concerns: A 36-year-old man developed progressive paraparesis, dysuria, and spontaneous pain in the lumbar region and lower extremities. Spinal magnetic resonance imaging revealed an intramedullary lesion extended from Th12 to L2 with ring-shaped gadolinium enhancement. Cerebrospinal fluid (CSF) study exhibited a marked pleocytosis, and CSF culture grew Streptococcus intermedius. Cardiovascular computed tomography angiography identified RSVC-LA RL shunt, which caused transient acute cardiac syndrome due to air embolus. Diagnoses: The p...
Source: Medicine - July 1, 2022 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Prognostic factors for acute posterior circulation cerebral infarction patients after endovascular mechanical thrombectomy: A retrospective study
This article was to analyze the factors influencing the prognosis of posterior circulation cerebral infarction (PCCI) patients, retrospectively. One hundred forty five patients diagnosed with PCCI in Nanyang Central Hospital between June 25, 2016 and October 14, 2019 were included and underwent cerebral vascular mechanical thrombectomy. The clinical data of those patients were collected. The patients were followed up for 3 months to observe the prognostic efficacy and explore the influencing factors for poor prognosis. The potential prognostic factors for PCCI patients after emergency endovascular mechanical thrombect...
Source: Medicine - April 29, 2022 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Added value of systemic inflammation markers in predicting pulmonary infection in stroke patients: A retrospective study by machine learning analysis
This study aimed to develop machine learning (ML)-based predictive models for pulmonary infection. Between January 2008 and April 2021, a retrospective analysis of 1397 stroke patients who had CT angiography from skull to diaphragm (including CT of the chest) within 24 hours of symptom onset. A total of 21 variables were included, and the prediction model of pulmonary infection was established by multiple ML-based algorithms. Risk factors for pulmonary infection were determined by the feature selection method. Area under the curve (AUC) and decision curve analysis were used to determine the model with the best resolut...
Source: Medicine - December 30, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Endovascular therapy for acute basilar artery occlusion caused by vertebral artery dissection: Case report
We describes a case of basilar artery (BA) occlusion caused by extracranial VAD, in which we used a stent-retriever to achieve thrombectomy in the BA through the contralateral vertebral artery (VA). Patient concerns: A 32-year-old male presented with a sudden-onset headache accompanied by articulation disorder, left-sided weakness, and tinnitus in the left ear. Diagnosis: Digital subtraction angiography showed the V1 to V2 segment dissection of the left VA and occlusion of the BA. Interventions: Thrombectomy was performed through the thinner right VA with three passes of the Solitaire FR device 4 ×â...
Source: Medicine - November 24, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Vertebral artery hypoplasia as an independent risk factor of posterior circulation atherosclerosis and ischemic stroke
Vertebral artery hypoplasia (VAH) is a frequent anatomical variation of vertebral arteries, with emerging evidence suggesting that it contributes to posterior circulation ischemia. However, the relationship between VAH and ischemic stroke remains unknown. Hence, this study aimed to determine the prevalence of VAH in patients diagnosed with acute ischemic stroke who were followed up in a neurology clinic and to determine if it can potentially be a risk factor for atherosclerotic stenosis in vertebrobasilar circulation. This retrospective study included 609 patients diagnosed with acute ischemic stroke between January 1, ...
Source: Medicine - September 24, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Reversible cerebral vasoconstriction syndrome with basilar artery stenosis: A case report
Conclusions: A headache in young patients with risk factors of atherosclerosis, such as smoking history, uncontrolled hypertension, and dyslipidemia may be caused by reversible cerebral vasoconstriction syndrome or ischemic stroke, which has fatal neurological complications. Therefore, reversible cerebral vasoconstriction syndrome or ischemic stroke should be suspected and appropriately evaluated in such patients, even if the headache is not the thunderclap type.
Source: Medicine - September 24, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

The clinical outcomes of mechanical thrombectomy for proximal M1 occlusion involving lenticulostriate perforators: Is it worse than distal M1 occlusion? Retrospective observational study
Although the success rate of recanalization in acute intracranial artery occlusion is high, there is a poor rate of improvement in functional clinical outcome. The purpose of this study was to assess the functional outcome of mechanical thrombectomy for proximal M1 occlusion involving lenticulostriate arteries (LSAs) compared with distal M1 occlusion-sparing the LSAs. A retrospective analysis was conducted in patients with middle cerebral artery (MCA) M1 occlusions who had a successful recanalization subsequent to mechanical thrombectomy. The recanalization results were estimated using the thrombolysis in cerebral infar...
Source: Medicine - August 27, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Basilar dolichoectasia with intermural hematoma accompanied by cerebral microbleeds and white matter hyperintensities: A case report
Rationale: The clinical manifestations of basilar dolichoectasia (BD) are variable. The diagnosis is based on imaging measurements. Digital subtraction angiography displays only the dilated vascular lumen and lacks visualization of the arterial wall. High-resolution Magnetic resonance imaging (MRI) can identify intramural hematoma; therefore, it may be more suitable for the imaging evaluation of BD. However, most of the existing literature pertaining to BD lacks vascular wall assessment. Patient concerns: A 65-year-old Chinese man perceived weakness of the left upper and lower limb, double vision, dizziness, nau...
Source: Medicine - August 20, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Intracardiac thrombus in a patient with mitral bioprosthesis and atrial fibrillation treated with direct oral anticoaugulant: A case report
Rationale: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with increased morbidity, especially stroke and heart failure. There is also increasing awareness that atrial fibrillation is a major cause of embolic events which in 75% of cases are complicated by cerebrovascular accidents. Patient concerns: A 50-year-old woman with mitral bioprosthesis under warfarin for nonvalvular atrial fibrillation was referred to our Coronary Intensive Care Unit due to acute myocardial infarction without evidence of significant coronary artery stenosis. Diagnoses: Cardiovascular examination...
Source: Medicine - June 11, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

The diagnostic reliability and validity of noninvasive imaging modalities to assess leptomeningeal collateral flow for ischemic stroke patients: A systematic review and meta-analysis
Leptomeningeal collateral flow (LMF) is associated with infarct area and clinical outcome for ischemic stroke patients. Although LMF can be detected by multiple imaging methods, but their diagnostic performance is uncertain. The aim of this study was to evaluate the diagnostic validity or reliability of noninvasive image methods in assessing LMF. Databases included PubMed, Web of Science, Embase, and Cochrane Library. Original observational cohort studies. Ischemic stroke patients. Different noninvasive image methods to assess LMF. Newcastle–Ottawa Scale to evaluate the quality of the studies; forest pl...
Source: Medicine - May 7, 2021 Category: Internal Medicine Tags: Research Article: Meta-Analysis of Observational Studies in Epidemiology Source Type: research

Assessment of lesion-associated myocardial ischemia based on fusion coronary CT imaging – the FUSE-HEART study: A protocol for non-randomized clinical trial
Conclusion: In conclusion, FUSE-HEART will be a study based on modern imaging tools that will investigate the impact of a coronary artery stenosis on myocardial function and viability, using advanced fusion imaging technics derived from CCTA, sighting to validate plaque composition and morphology, together with inflammatory biomarkers, as predictors to myocardial viability.
Source: Medicine - April 9, 2021 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research

Y-configuration double-stent-retriever thrombectomy for refractory thrombus in middle cerebral artery bifurcation: A case report
Rationale: Stent retriever mechanical thrombectomy is a recommended treatment for acute ischemic stroke. However, refractory thrombus in artery bifurcation can reduce the rate of successful revascularization. Patient concerns: A 72-year-old male, owing to the acute onset of almost complete right-sided hemiplegia and global aphasia, received bridging therapy. National Institutes of Health Stroke Scale score was 16 at the time of admission. Diagnoses: Cerebral digital subtraction angiography revealed occlusion of the M1 segment of the left MCA. Interventions: Thrombectomy with 3 passes of the Solitai...
Source: Medicine - March 19, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Pial arteriovenous fistula with appearance of hemorrhagic tumor: A case report
Conclusions: It is noteworthy that PAVF with a large thrombus may appear as a tumor in the initial diagnosis, and therefore it is necessary to perform an intracranial vascular examination in patients with tumor stroke symptoms.
Source: Medicine - October 16, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research