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Total 65 results found since Jan 2013.

Utility of Duranta, a wireless patch-type electrocardiographic monitoring system developed in Japan, in detecting covert atrial fibrillation in patients with cryptogenic stroke: A case report
Rationale: Subcutaneous implantable electrocardiographs are highly effective in detecting covert atrial fibrillation (AF) in cryptogenic stroke. However, these invasive devices are not indicated for all cryptogenic stroke patients, and noninvasive improvements over conventional Holter-type ambulatory electrocardiography are needed. We evaluated the clinical application and effectiveness of Duranta (ImageONE Co., Ltd.), a wireless patch-type electrocardiographic monitoring system developed in Japan for chronically ill patients or home-based patients at the end of life. A Duranta device was used to detect covert AF in patien...
Source: Medicine - February 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Systematic review with network meta-analysis: Diagnostic values of ultrasonography, computed tomography, and magnetic resonance imaging in patients with ischemic stroke
Conclusion: This network meta-analysis provides supporting evidence to the idea that DWI has a higher diagnostic value regarding ischemic stroke among MRI methods, and CTP has a poor diagnostic value among CT methods, which provide therapeutic considerations for Ischemic stroke intervention.
Source: Medicine - July 1, 2019 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis 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

Imaging-Based Patient Selection and Endovascular Therapy of Ischemic Stroke: A Stratified Meta-Analysis
Abstract: The positive results of recent trials for the treatment of acute ischemic stroke have highlighted the importance of imaging selection before endovascular therapy. We performed a stratified meta-analysis to confirm this new understanding. We searched EMBASE, PubMed, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov in April 2015 for randomized controlled trials evaluating the effect of endovascular treatment in patients with acute ischemic stroke. The meta-analysis was stratified by whether computed tomographic angiography (CTA) was used to select patients. Outcome data were pooled using fixed...
Source: Medicine - September 1, 2015 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Is carotid sonography a useful tool for predicting functional capabilities in ischemic stroke patients following carotid artery stenting?
Abstract: Carotid stenosis is a major cause of stroke and timely intervention with stenting manipulation can significantly reduce the risk of secondary stroke. The impact of stenting procedures on patient functional capabilities has not yet been explored. The primary aim of this study was to examine associations between periprocedural carotid sonography parameters and post-treatment functional capabilities in stroke patients. Sixty-seven patients who received carotid stenting at 1 angiography laboratory were included. Prestenting and poststenting carotid duplex data were recorded and resistance index (RI) differences at v...
Source: Medicine - March 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Young male with syphilitic cerebral arteritis presents with signs of acute progressive stroke: A case report
Conclusion Progressive stroke was the initial symptom of the neurosyphilis. Disease progression is rapid and difficult to control with a single course of penicillin.
Source: Medicine - November 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

The resolution of carotid arterial thrombus by oral anticoagulation after IV thrombolysis for chemotherapy-induced stroke: A case report
Rationale: Cancer-related stroke has been regarded as an emerging subtype of ischemic event. Acute treatment for this subtype may include the antiplatelet agents, anticoagulants, or endovascular intervention. Patient concerns: A 63-year-old woman with sudden-onset right hemiparesis and conscious change was sent to our emergency department. The patient had underlying sigmoid adenocarcinoma and received chemotherapy FOLFIRI (FOL, folinic acid; F, fluorouracil; and IRI, irinotecan) with targeted therapy cetuximab following lower anterior resection since the diagnosis was made. Diagnoses: Brain magnetic resonance angio...
Source: Medicine - August 28, 2020 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

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

Elevated serum lipoprotein(a) as a risk factor for combined intracranial and extracranial artery stenosis in a child with arterial ischemic stroke: A case report
Rationale: Stroke is an uncommon disease in childhood with an estimated incidence of 1 to 6 per 100,000 and stenoocclusive arteriopathy is the main risk factor of recurrent pediatric arterial ischemic stroke (AIS). Dyslipidemia may influence strongly before puberty and in late adolescence when plasma levels are naturally highest. Patient concerns: An 11-year-old male presented with acute onset seizure, a drowsy mentality, and right hemiplegia. Diagnoses: Magnetic resonance (MR) angiogram demonstrated occlusion of distal basilar artery and left vertebral arteries. Serum Lp(a) was significantly increased as 269 nmol/L (normal
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

An overlooked cause in a patient with recurrent ischemic stroke: A case report
Rationale: The majority of ischemic strokes are due to cardioembolism, large vessel atherothromboembolism, small vessel occlusive disease, or other unusual mechanisms. In most clinical settings, many strokes without a well-defined etiology requires a thorough diagnostic evaluation, otherwise the underlying cause might be easily overlooked. Here we report on the rare cause of a patient with recurrent stroke. Patient concerns: A 50-year-old female patient had a 4-year history of recurrent acute onset of neurological deficits. Diagnoses: Contrast transcranial Doppler ultrasound detected a typical “curtain” appeara...
Source: Medicine - March 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Predictive value of free fatty acid levels in embolic stroke of undetermined source: A retrospective observational study
The present study aimed to investigate the predictive value of free fatty acid (FFA) in embolic stroke of undetermined source (ESUS) according to the presence of potential embolic sources (PES) after extensive etiologic evaluation. This was a retrospective observational study based on a single-center registry from January 2011 to July 2017. Stroke subtypes were determined through laboratory findings, brain, and angiographic imaging, carotid ultrasonography, transthoracic echocardiography, and 24-hour Holter monitoring. If ESUS was suspected, transesophageal echocardiography was additionally performed. Patients were classi...
Source: Medicine - October 2, 2020 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Cardiac Myxoma With Unusual Obstructive and Embolic Presentations: Concurrent Stroke and Angiography-Negative Myocardial Infarction—A Case Report
We present a case of cardiac myxoma with atypical presentations of concurrent stroke and angiography-negative myocardial infarction. The case emphasizes the importance of basic echocardiography and timely surgery in the management of cardiac myxoma. An elderly woman presented to the emergency department in an unconscious state. Electrocardiogram and elevated cardiac enzymes suggested acute myocardial infarction; however, immediate coronary angiography proved patency. Basic echocardiography revealed an oscillating left atrial myxoma obstructing inflow through the mitral valve. After regaining consciousness while in the inte...
Source: Medicine - September 1, 2015 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Early ST-segment elevation acute myocardial infarction after thrombolytic therapy for acute ischemic stroke: A case report
We report a case of STEMI occurring 40 minutes after thrombolytic therapy for AIS and discuss the possible mechanisms and therapeutic approaches. Patient concerns: A 87-year-old woman with a history of arterial hypertension was admitted for acute onset of right-sided limb weakness 2 hours before arrival at the emergency department. Forty minutes after intravenous recombinant tissue plasminogen activator (i.v. rtPA) administration for AIS, STEMI occurred (signaled by a third-degree atrioventricular block). Diagnoses: The diagnoses were AIS and STEMI. Coronary angiography confirmed right coronary artery occlusion. ...
Source: Medicine - December 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Discrepancy between perfusion- and diffusion-weighted images in ischemic stroke: A case report
Rationale: With the development of multi-slice computed tomography (CT) technology, perfusion CT angiography (p-CTA) is now widely used for the diagnosis of acute cerebral infarction. Although p-CTA has the advantage of distinguishing between an ischemic penumbra and an infarct core, more research is needed with respect to its clinical use. Patient concerns: A healthy 36-year-old man experienced sudden dizziness while swimming. His dizziness persisted irrespective of the change in position, and then improved during transport. He had no neurological abnormality when he arrived at the emergency room. Diagnoses: CT pe...
Source: Medicine - December 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research