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A rare cause of stroke in young: PHACE syndrome (P1.253)
Conclusions:Neurocutaneous syndromes are typically diagnosed in childhood and can be a rare cause of stroke in young. Our patient suffered an ischemic stroke secondary to sequelae of undiagnosed PHACE syndrome. Early identification of neurocutaneous syndromes allows for proper surveillance, evaluation, and preventative education for development of complications.Disclosure: Dr. Fitzgerald has nothing to disclose. Dr. Chandra has nothing to disclose. Dr. Dannenbaum has nothing to disclose. Dr. Sharrief has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Fitzgerald, K., Chandra, S., Dannenbaum, M., Sharrief, A. Tags: Genetic Stroke Syndromes, Biomarkers, and Translational/Basic Research Source Type: research

Factors Associated with Proximal Carotid Axis Occlusion in Patients with Acute Stroke and Atrial Fibrillation
Conclusions: Female sex, advanced age, history of systemic embolism, and higher BNP level were independently associated with more proximal carotid axis occlusion. Patients with AF having these factors may be prone to have relatively large thrombi in the heart.
Source: Journal of Stroke and Cerebrovascular Diseases - October 7, 2013 Category: Neurology Authors: Yuki Sakamoto, Shoichiro Sato, Yuka Kuronuma, Kazuyuki Nagatsuka, Kazuo Minematsu, Kazunori Toyoda Tags: Original Articles Source Type: research

Repeated Episodes of Ischemic Stroke over a Short Period in a Patient with Essential Thrombocythemia on Anticoagulant Therapy
A 69-year-old man who had essential thrombocythemia, for which he was taking no medications, suddenly developed aphasia and right hemiplegia and was admitted to the hospital. He was thought to have had an embolic stroke and was initially treated with warfarin. Although the international normalized ratio was in the therapeutic range, he had 3 additional ischemic stroke episodes with the same symptoms after the index stroke. Magnetic resonance angiographic examinations revealed serial changes in middle cerebral artery stenosis. After administration of an antiplatelet agent and hydroxyurea, he had no additional strokes.
Source: Journal of Stroke and Cerebrovascular Diseases - August 14, 2012 Category: Neurology Authors: Masaki Naganuma, Kazuya Isoda, Shinsuke Nishi, Kiyotaka Ito, Teruyuki Hirano Tags: Case Reports Source Type: research

Stroke Care during the COVID-19 Pandemic: International Expert Panel Review
This study, prepared by a large international panel of stroke experts, assesses the rapidly growing research and personal experience with COVID-19 stroke and offers recommendations for stroke management in this challenging new setting: modifications needed for prehospital emergency rescue and hyperacute care; inpatient intensive or stroke units; posthospitalization rehabilitation; follow-up including at-risk family and community; and multispecialty departmental developments in the allied professions.Summary: The severe acute respiratory syndrome coronavirus 2 uses spike proteins binding to tissue angiotensin-converting enz...
Source: Cerebrovascular Diseases - March 23, 2021 Category: Neurology Source Type: research

Safety of intravenous thrombolysis for ischemic stroke in patients treated with warfarin
ObjectiveControversy surrounds the safety of intravenous (IV) tissue plasminogen activator (tPA) in ischemic stroke patients treated with warfarin. The European tPA license precludes its use in anticoagulated patients altogether. American guidelines accept IV tPA use with an international normalized ratio (INR) ≤ 1.7. The influence of warfarin on symptomatic intracerebral hemorrhage (SICH), arterial recanalization, and long‐term functional outcome in stroke thrombolysis remains unclear. MethodsWe analyzed data from 45,074 patients treated with IV tPA enrolled in the Safe Implementation of Thrombolysis in Stroke (SITS) ...
Source: Annals of Neurology - September 4, 2013 Category: Neurology Authors: Michael V. Mazya, Kennedy R. Lees, Romesh Markus, Risto O. Roine, Raymond C. S. Seet, Nils Wahlgren, Niaz Ahmed, Tags: Original Article Source Type: research

Dabigatran etexilate: management in acute ischemic stroke.
Abstract A 54-year-old man treated with dabigatran experienced new onset of a stroke with a score of 9 on the National Institutes of Health Stroke Scale. Administration of recombinant tissue plasminogen activator (rtPA) was not recommended because of the dabigatran therapy. Angiography showed occlusion of the left middle cerebral artery by an embolic thrombus. Suction thrombectomy achieved flow through the inferior division of the artery. Computed tomography of the head showed possible intracranial hemorrhage, and dabigatran reversal was attempted with prothrombin complex concentrate and recombinant factor VIIa. C...
Source: American Journal of Critical Care - March 1, 2013 Category: Nursing Authors: Javedani PP, Horowitz BZ, Clark WM, Lutsep HL Tags: Am J Crit Care Source Type: research

Safety of IV thrombolysis for ischemic stroke in patients treated with warfarin
Abstract Background: Controversy surrounds the safety of intravenous (IV) tissue plasminogen activator (tPA) in ischemic stroke patients treated with warfarin. The European tPA license precludes its use in anticoagulated patients altogether. American guidelines accept IV tPA use with an international normalized ratio (INR) ≤1.7. The influence of warfarin on symptomatic intracerebral hemorrhage (SICH), arterial recanalization and long‐term functional outcome in stroke thrombolysis remains unclear. Methods: We analysed data from 45074 patients treated with IV tPA enrolled in the SITS International Stroke Thrombolysis Reg...
Source: Annals of Neurology - June 6, 2013 Category: Neurology Authors: Michael V Mazya, Kennedy R Lees, Romesh Markus, Risto O Roine, Raymond CS Seet, Nils Wahlgren, Niaz Ahmed, Tags: Research Article Source Type: research

Simultaneous onset of myocardial infarction and ischemic stroke in a patient with atrial fibrillation: Multiple territory injury revealed on angiography and magnetic resonance
An 84-year-old man with a history of hypertension and paroxysmal atrial fibrillation (AF) who received no anticoagulant drugs experienced acute chest pain and transient loss of consciousness. He was transferred to our emergency room. His initial electrocardiogram showed sinus rhythm with ST-segment elevation in the I, aVL, and V1–V6 leads. His blood pressure was 158/92mmHg and his pulse was regular at 70beats per minute. A chest radiograph showed increased heart size and pulmonary vascular congestion. His troponin T level was elevated (more than 0.1ng/mL). He was diagnosed with ST-elevation myocardial infarction (MI) and...
Source: International Journal of Cardiology - February 4, 2014 Category: Cardiology Authors: Osamu Hashimoto, Kozo Sato, Yohei Numasawa, Joji Hosokawa, Masahiro Endo Tags: Online Letters to the Editor 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

A Case of Ischemic Stroke With Congenital Protein C Deficiency and Carotid Web Successfully Treated by Anticoagulant and Carotid Stenting
Conclusion: To our knowledge, this is the first report in which an immediate thrombus formation on the carotid web was observed in a patient with congenital protein C deficiency. In a case of acute ischemic stroke with carotid web, especially when congenital coagulopathy such as protein C deficiency is suspected, careful follow-up with ultrasound imaging should be performed.
Source: Frontiers in Neurology - February 17, 2020 Category: Neurology Source Type: research

Oral direct thrombin inhibitor as an alternative in the management of cerebral venous thrombosis: a series of 15 patients
ConclusionsWe report the largest series of cerebral vein thrombosis patients treated with dabigatran. Clinical outcome was excellent in most patients and not different from other studies. Dabigatran could possibly be considered an alternative to warfarin; nevertheless, further prospective assessment with randomized controlled studies is warranted.
Source: International Journal of Stroke - February 1, 2015 Category: Neurology Authors: Marcelo D. Mendonça, Raquel Barbosa, Vera Cruz‐e‐Silva, Sofia Calado, Miguel Viana‐Baptista Tags: Research Source Type: research

Validation of the 9-Point and 24-Point Hematoma Expansion Prediction Scores and Derivation of the PREDICT A/B Scores Clinical Sciences
Conclusions— The 9- and 24-point expansion scores demonstrate acceptable discrimination in an independent multicenter cohort; however, calibration was suboptimal for the 9-point score. The PREDICT A score showed improved discrimination for HE prediction but requires independent validation.
Source: Stroke - October 26, 2015 Category: Neurology Authors: Huynh, T. J., Aviv, R. I., Dowlatshahi, D., Gladstone, D. J., Laupacis, A., Kiss, A., Hill, M. D., Molina, C. A., Rodriguez-Luna, D., Dzialowski, I., Silva, Y., Kobayashi, A., Lum, C., Boulanger, J.-M., Gubitz, G., Bhatia, R., Padma, V., Roy, J., Kase, C. Tags: Acute Cerebral Hemorrhage, Angiography, Computerized tomography and Magnetic Resonance Imaging, Intracerebral Hemorrhage, Anticoagulants Clinical Sciences Source Type: research

Massive pulmonary embolism with acute cor pulmonale
A 51-year-old immobilised man, while recovering at stroke rehabilitation, complained of sudden onset chest pain prior to an unconscious collapse. Observations on arrival were heart rate 120 bpm, blood pressure 80/60 mm Hg and oxygen saturations of 90% on 10 L of oxygen. ECG demonstrated new right bundle branch block (RBBB) with classical S1Q3T3 repolarisation abnormality of acute right heart strain (figure 1A). Urgent CT pulmonary angiogram revealed saddle pulmonary embolism with extensive thrombus burden (figure 1B). Transthoracic echocardiogram (TTE) showed acute right ventricular (RV) overload with c...
Source: Postgraduate Medical Journal - July 25, 2016 Category: Journals (General) Authors: Nelson, A. J., Wong, G. R., Roberts-Thomson, R., Parvar, S. L. Tags: Journalology, Drugs: cardiovascular system, Echocardiography, Pain (neurology), Stroke, Hypertension, Interventional cardiology, Ischaemic heart disease, Venous thromboembolism, Radiology, Pulmonary embolism, Clinical diagnostic tests, Vascular surgery, E Source Type: research

E-114 Rescue suction mechanical thrombectomy of medium-small vessel occlusion in a pediatric patient presented with acute ischemic stroke
ConclusionEndovascular aspiration mechanical thrombectomy of MSVO is feasible in pediatric patients presenting with AIS and associated with good functional outcome. Additionally, when acute ongoing neurological deficit is present and CTA is inconclusive, a digital subtraction angiography is deemed needed to identify MSVO as the yields of CTA diminishes significantly beyond LVO. Further studies are required.Disclosures R. Hart: None. A. Singh: None. C. Manzanero: None. Y. Lodi: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Hart, R., Singh, A., Manzanero, C., Lodi, Y. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

Intra-Arterial Thrombectomy for Acute Ischemic Stroke Related to the Procoagulant Effect of Warfarin in A Patient with Atrial Fibrillation and Bioprosthetic Valve Replacement
CONCLUSION: This report describes the roles of endovascular therapy and NOAC in patients with similar highly complex conditions and has clinical relevance for therapeutic plans in the clinical setting.PMID:37674421
Source: Acta Neurologica Taiwanica - September 7, 2023 Category: Neurology Authors: Hsu-Tung Huang Yi-Ting Huang David Yen-Ting Chen Lung Chan Chien-Tai Hong Chen-Chih Chung Source Type: research

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