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Airplane stroke syndrome
We describe the patient, stroke, and flight characteristics. Over the study period, 131 million passengers arrived at Melbourne airport. Our centre admitted 5727 stroke patients, of whom 42 (0.73%) had flight-related strokes. Flight-related stroke patients were younger (median age 65 versus 73, p<0.001), had similar stroke severity, and received intravenous thrombolysis more often than non-flight-related stroke patients. Seven patients had flight-related intracerebral haemorrhage. The aetiology of the ischaemic strokes was cardioembolic in 14/35 (40%), including seven patients with confirmed PFO, one with atrial sep...
Source: Journal of Clinical Neuroscience - February 20, 2016 Category: Neuroscience Source Type: research

Intravenous thrombolysis, mechanical embolectomy, and intracranial stenting for hyperacute ischemic stroke in a patient with moyamoya disease
Publication date: Available online 17 February 2016 Source:Journal of Clinical Neuroscience Author(s): Debora S. Argetsinger, Jeffrey W. Miller, Jeffrey J. Fletcher The Japanese translation of moyamoya means “puff of smoke” and refers to the angiographic appearance of dilated collateral vessels seen during chronic progressive narrowing of the intracranial supraclinoid portions of the internal carotid arteries. Despite cerebral ischemia being the most common presenting symptom, 20% to 40% of adults suffer a hemorrhagic stroke. Due to the lack of evidence and histopathologic findings, intravenous and endovascular re...
Source: Journal of Clinical Neuroscience - February 18, 2016 Category: Neuroscience Source Type: research

Isolated asymptomatic pulmonary arteriovenous malformation presenting with ischaemic stroke
Publication date: Available online 17 February 2016 Source:Journal of Clinical Neuroscience Author(s): Kelly L. Bertram, Anoop Madan, Judith Frayne Young onset stroke is uncommon, and may be due to conditions other than traditional vascular risk factors. A 42-year-old woman with an ischaemic stroke was found to have left atrial bubble study positivity on transthoracic echocardiogram (TTE) suggestive of patent foramen ovale, however she also had low peripheral oxygen saturation. Investigation revealed an isolated pulmonary arteriovenous malformation (PAVM), visible on admission chest radiograph. This can cause embolic ...
Source: Journal of Clinical Neuroscience - February 18, 2016 Category: Neuroscience Source Type: research

Direct admission to stroke centers reduces treatment delay and improves clinical outcome after intravenous thrombolysis
Publication date: Available online 9 January 2016 Source:Journal of Clinical Neuroscience Author(s): Dae-Hyun Kim, Hee-Joon Bae, Moon-Ku Han, Beom Joon Kim, Sang-Soon Park, Tai Hwan Park, Kyung Bok Lee, Kyusik Kang, Jong-Moo Park, Youngchai Ko, Soo Joo Lee, Jay Chol Choi, Joon-Tae Kim, Ki-Hyun Cho, Keun-Sik Hong, Yong-Jin Cho, Dong-Eog Kim, Jun Lee, Juneyoung Lee, Mi Sun Oh, Kyung-Ho Yu, Byung-Chul Lee, Hyun-Wook Nah, Jae-Kwan Cha We aimed to examine whether direct access to hospitals offering intravenous thrombolysis is associated with functional outcomes in patients with acute ischemic stroke tr...
Source: Journal of Clinical Neuroscience - January 11, 2016 Category: Neuroscience Source Type: research

Ten year clinical experience with stroke and cerebral vasculitis
Publication date: Available online 8 January 2016 Source:Journal of Clinical Neuroscience Author(s): Peter A. Kempster, Catriona A. McLean, Thanh G. Phan Angiitis of the central nervous system (CNS) is difficult to diagnose but potentially fatal. When stroke occurs in a younger individual or is associated with multiple infarcts on imaging, clinicians must decide how far to pursue a possible diagnosis of vasculitis. The aim of this study is to establish the prevalence of primary and secondary cerebral angiitis among patients presenting with stroke. Hospital attendances over a 10year period were surveyed by searching fo...
Source: Journal of Clinical Neuroscience - January 11, 2016 Category: Neuroscience Source Type: research

Management of moyamoya syndrome in patients with Noonan syndrome
We report four cases of Noonan syndrome patients presenting with headaches and/or sensorimotor strokes in childhood that caused unilateral sensorimotor impairment. Cerebral angiography and MRI revealed bilateral moyamoya syndrome. All patients underwent successful bilateral extracranial-to-intracranial revascularization. The first patient was a 10-year-old girl who presented following a hemorrhagic stroke and recovered well after indirect bypass. The second patient was an adult with a history of childhood stroke whose symptoms progressed in adulthood. She underwent a direct bypass and improved, but continued to experience ...
Source: Journal of Clinical Neuroscience - January 11, 2016 Category: Neuroscience Source Type: research

Rapid access point of care clinic for transient ischemic attacks and minor strokes
We present 24months of prospective data from a new model of care for transient ischemic attacks (TIA) and minor stroke, established at the Royal North Shore Hospital, a tertiary teaching hospital in Sydney, Australia. Prior to 2011, approximately 200 patients were admitted to our emergency department (ED) annually, following presentation with a suspected TIA. These patients had an average length of stay of 5.3days. Following the establishment of a twice weekly multidisciplinary, one stop, stroke prevention and hospital avoidance clinic, all patients with suspected TIA were investigated and treated as outpatients. There was...
Source: Journal of Clinical Neuroscience - December 18, 2015 Category: Neuroscience Source Type: research

Holmes’ tremor as a delayed complication of thalamic stroke
We present a 75-year-old man who developed a disabling tremor 1year after a posterolateral thalamic stroke. This tremor had low frequency (3–4Hz), did not disappear on focus and was exacerbated by maintaining a static posture and on target pursuit, which made it very difficult to perform basic functions. MRI demonstrated an old ischemic lesion at the left posterolateral thalamus. Treatment with levodopa led to symptom control. Lesions in the midbrain, cerebellum and thalamus may cause Holmes’ tremor. Delayed onset of symptoms is usually seen, sometimes appearing 2years after the original injury. This may be due to matu...
Source: Journal of Clinical Neuroscience - November 21, 2015 Category: Neuroscience Source Type: research

Electrocardiograph abnormalities in intracerebral hemorrhage
This study investigated the prevalence and type of electrocardiography (ECG) abnormalities, and their possible association with the clinical/radiological findings in 118 consecutive patients with non-traumatic, non-neoplastic intracerebral hemorrhage (ICH). ECG frequently demonstrates abnormalities in patients with ischemic stroke and subarachnoid hemorrhage, but little is known of ECG changes in ICH patients. Clinical and radiological information was retrospectively reviewed. ECG recordings that were obtained within 24hours of the initial hemorrhage were analyzed. Sixty-six patients (56%) had one or more ECG abnormalities...
Source: Journal of Clinical Neuroscience - September 11, 2015 Category: Neuroscience Source Type: research

Changes in differential gene expression during a fatal stroke
We present a young woman (with an identical twin sister) who arrived at the Emergency Department (ED) within 1hour of her initial stroke symptoms. Previous microarray studies have demonstrated differential expression of multiple genes between stroke patients and healthy controls. However, for many of these studies there is a significant delay between the initial symptoms and collection of blood samples, potentially leaving the important early activators/regulators of the inflammatory response unrecognised. Blood samples were collected from the patient for an analysis of differential gene expression over time during the evo...
Source: Journal of Clinical Neuroscience - August 29, 2015 Category: Neuroscience Source Type: research

Muscle haematoma due to antithrombotic treatment for ischaemic stroke
Publication date: July 2015 Source:Journal of Clinical Neuroscience, Volume 22, Issue 7 Author(s): Akiyuki Hiraga , Yoko Nakagawa , Ikuo Kamitsukasa , Takeshi Suzuki , Satoshi Kuwabara The purpose of this study was to evaluate the incidence and clinical features of muscle haematoma in ischaemic stroke patients. Muscle haematomas are rare complications that occur during antithrombotic treatment for acute ischaemic stroke. Clinical and laboratory records of ischaemic stroke patients with muscle haematomas in the last 3.5years were retrospectively reviewed. Muscular haematoma developed in three of 694 (0.4%) consecutive pat...
Source: Journal of Clinical Neuroscience - May 31, 2015 Category: Neuroscience Source Type: research

Dynamic changes in plasma tissue plasminogen activator, plasminogen activator inhibitor-1 and beta-thromboglobulin content in ischemic stroke
Publication date: Available online 19 May 2015 Source:Journal of Clinical Neuroscience Author(s): Ping Zhuang , Da Wo , Zeng-guang Xu , Wei Wei , Hui-ming Mao The aim of this paper is to investigate the corresponding variations of plasma tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) activities, and beta–thromboglobulin (β-TG) content in patients during different stages of ischemic stroke. Ischemic stroke is a common disease among aging people and its occurrence is associated with abnormalities in the fibrinolytic system and platelet function. However, few reports focus on the dynami...
Source: Journal of Clinical Neuroscience - May 20, 2015 Category: Neuroscience Source Type: research

Meta-analysis of telemonitoring to improve HbA1c levels: Promise for stroke survivors
Publication date: May 2015 Source:Journal of Clinical Neuroscience, Volume 22, Issue 5 Author(s): Bryan A Lieber , Blake Taylor , Geoff Appelboom , Kiran Prasad , Sam Bruce , Annie Yang , Eliza Bruce , Brandon Christophe , E. Sander Connolly Jr. Monitoring glycemic control is useful not only in the primary prevention of stroke in diabetics, but also in the rehabilitation from and secondary prevention of stroke. In an often functionally and neurocognitively impaired population, however, poor compliance with treatment regimens is a major problem. Wireless, telemonitoring glucometers – often integrated into the patient’...
Source: Journal of Clinical Neuroscience - April 28, 2015 Category: Neuroscience Source Type: research

Calcific emboli originating from the brachiocephalic trunk causing acute cerebral infarction and worm-like calcification in the right middle cerebral artery
We report, to our knowledge, the first patient with brachiocephalic trunk calcified plaque causing the ‘salted pretzel sign’ and worm-like calcification. Arterial stenosis or occlusion caused by atherosclerosis and thrombosis are responsible for the majority of cases of cerebral infarction. However, there are a number of other causes. Interestingly, these findings were not observed on a CT scan 10days before the stroke. Acute cerebral infarction with calcifications on unenhanced head CT scans should raise suspicion for disease in the carotid system. Identification of subtle findings of acute ischemic stroke on CT scans...
Source: Journal of Clinical Neuroscience - April 28, 2015 Category: Neuroscience Source Type: research

Minocycline-induced polyarteritis nodosa-like vasculitis presenting as brainstem stroke
This report shows that ischemic strokes may occur as a result of minocycline-induced vasculitis. While this is likely a rare association, recognition is important given the widespread use of minocycline and the potential for devastating consequences in a young population. Consequently, drug-induced vasculitis should be considered in patients with an ischemic stroke taking minocycline.
Source: Journal of Clinical Neuroscience - April 28, 2015 Category: Neuroscience Source Type: research

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