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Cervical Arterial Dissections and Association With Cervical Manipulative Therapy: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association AHA/ASA Scientific Statement
Conclusions— CD is an important cause of ischemic stroke in young and middle-aged patients. CD is most prevalent in the upper cervical spine and can involve the internal carotid artery or vertebral artery. Although current biomechanical evidence is insufficient to establish the claim that CMT causes CD, clinical reports suggest that mechanical forces play a role in a considerable number of CDs and most population controlled studies have found an association between CMT and VAD stroke in young patients. Although the incidence of CMT-associated CD in patients who have previously received CMT is not well established, an...
Source: Stroke - September 22, 2014 Category: Neurology Authors: Biller, J., Sacco, R. L., Albuquerque, F. C., Demaerschalk, B. M., Fayad, P., Long, P. H., Noorollah, L. D., Panagos, P. D., Schievink, W. I., Schwartz, N. E., Shuaib, A., Thaler, D. E., Tirschwell, D. L., on behalf of the American Heart Association Strok Tags: AHA Statements and Guidelines AHA/ASA Scientific Statement Source Type: research

Quality benchmarks for chest pain units and stroke units in Germany.
CONCLUSION: As reimbursement for emergency medicine in Germany was recently rearranged, quality benchmarking has gained incremental importance. Mandatory joint quality measurement in both concepts ensuring gap analysis and process improvement is encouraged. PMID: 31970463 [PubMed - as supplied by publisher]
Source: Herz - January 25, 2020 Category: Cardiology Tags: Herz Source Type: research

Bilateral vertebral artery dissection and cerebellar stroke: a rare complication of massage.
We describe the case of a 39-year-old male, who presented to our emergency department after a one-day history of headache and vomiting, with associated sudden onset posterior neck pain and cerebellar signs following a massage. Computed tomography angiogram and brain demonstrated bilateral vertebral artery dissection and cerebellar stroke. He was admitted to hospital for monitoring and conservative management with antiplatelet therapy, resulting in a good outcome. This is the first reported case of bilateral vertebral artery dissection and stroke to be associated with massage. This case also suggests, unlike many reports in...
Source: New Zealand Medical Journal - April 5, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

A Serious Diagnosis Lacking Common Symptoms
​BY JENNIFER TUONG; IVAN KHARCHENKO; JEAN LUC AGARD; & AHMED RAZIUDDIN, MDA 65-year-old man who had HIV well-controlled with highly active antiretroviral therapy, hypertension, sciatica, and restless leg syndrome presented to the emergency department with left leg pain. He also had had chemotherapy and radiation for anal cancer. The patient said the pain had started 45 minutes earlier when he was sitting on the toilet.He described the pain as sore in quality and 10/10 on the pain scale. He reported that it had started in his lower back and radiated to his left leg. He said he had had no trauma or weakness to the regi...
Source: The Case Files - May 28, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: research

A Case of Resolution of Thalamic Pain Syndrome Following Endovascular Stenting (P4.352)
Conclusions: CPSP may be in part due to chronic hypoperfusion. Endovascular stenting may have led to the resolution of the patient’s CPSP.Disclosure: Dr. Le has nothing to disclose. Dr. Rasmussen has nothing to disclose. Dr. Noonan has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Le, S., Rasmussen, J., Noonan, P. Tags: Cerebrovascular Case Reports Source Type: research

A Chinese Family With Adult-Onset Leigh-Like Syndrome Caused by the Heteroplasmic m.10191T > C Mutation in the Mitochondrial MTND3 Gene
Conclusion The m.10191T>C mutation in the mtDNA of the complex I (CI) subunit of MTND3 results in the substitution of a highly conserved amino acid (p.Ser45Pro) within the ND3 protein, leading to CI dysfunction through impaired enzyme catalysis rather than impaired stability or assembly, causing a broad clinical spectrum of disorders (26). Patients with the m.10191T>C mutation are rare. In the present study, we report on a family of patients with the extremely rare adult-onset Leigh-like syndrome with the m.10191T>C mutation. Including the two patients from our reported family, the m.10191T...
Source: Frontiers in Neurology - April 17, 2019 Category: Neurology Source Type: research

Internal Carotid Artery Stenosis and Flow Diversion: Relationship with Headache (P6.099)
Conclusion: Recognition of flow-diversion into the ECA as a possible mechanism for headaches may help in further understanding of ICA disease, its progression, and effects of carotid revascularization on quality of life. Headache as a likely surrogate marker of carotid stenosis with flow-diversion warrants more research, and may be critical in the early identification of significant ICA stenosis and prevention of TIA or stroke.Disclosure: Dr. Herial has nothing to disclose. Dr. Miran has nothing to disclose. Dr. Qureshi has nothing to disclose. Dr. Qureshi has nothing to disclose. Dr. Qureshi has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Herial, N., Miran, M. S., Saleem, M., Qureshi, I., Qureshi, A. Tags: Headache: Clinical Presentation/Diagnosis Source Type: research

E-248 Postpartum vertebral artery dissections: a report of 7 cases and literature review
ConclusionA limited cohort of 33 ppVADs exist in the literature. This study contributes 7 additional cases and suggests that, despite heterogenous management of ppVAD, the resulting outcomes were favorable.Disclosures V. Lazarov: None. A. Monteiro: None. F. Almayman: None. M. Waqas: None. J. Cappuzzo: None. E. Levy: None. A. Siddiqui: None.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Lazarov, V., Monteiro, A., Almayman, F., Waqas, M., Cappuzzo, J., Levy, E., Siddiqui, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research

Healing through music
The last time I had a mammogram, I got a big surprise — and it was a good one. A string quartet was playing just outside the doors of the breast imaging center, and my thoughts immediately shifted from “What are they going to find on the mammogram?” to “Is that Schubert, or Beethoven?” By the time my name was called, I had almost forgotten why I was there. The unexpected concert was the work of Holly Chartrand and Lorrie Kubicek, music therapists and co-coordinators of the Environmental Music Program at Massachusetts General Hospital. But bringing music to hospital corridors is just a sideline for music therapist...
Source: New Harvard Health Information - November 5, 2015 Category: Consumer Health News Authors: Beverly Merz Tags: Behavioral Health Mental Health Pain Management Surgery Source Type: news

The Typical Thunderclap Headache of Reversible Cerebral Vasoconstriction Syndrome and its Various Triggers
During the last 10 years, reversible cerebral vasoconstriction syndrome (RCVS) has emerged as the most frequent cause of thunderclap headache (TCH) in patients without aneurysmal subarachnoid hemorrhage, and as the most frequent cause of recurrent TCHs. The typical TCHs of RCVS are multiple, recurring over a few days to weeks, excruciating, short‐lived, and brought up by exertion, sexual activities, emotion, Valsalva maneuvers, or bathing, among other triggers. All these triggers induce sympathetic activation. In a minority of cases with RCVS, TCH heralds stroke and rarely death. Early diagnosis of RCVS in patients who p...
Source: Headache: The Journal of Head and Face Pain - March 25, 2016 Category: Neurology Authors: Anne Ducros, Valérie Wolff Tags: Review Article Source Type: research

Management and clinical outcome of stable coronary artery disease in Austria : Results from 5  years of the CLARIFY registry.
CONCLUSION: Characteristics of Austrian outpatients with stable CAD corresponded to those of patients with CAD in other developed countries. Medical treatments following the recommendations of the European guidelines were prescribed in the majority of patients; however, recommended goals of life style interventions including a heart rate less than 60 bpm and general risk factor management were not achieved by a high proportion of patients. Heart rate control and life style changes remain unmet needs of cardiovascular care in Austria. PMID: 28913755 [PubMed - as supplied by publisher]
Source: Wiener Klinische Wochenschrift - September 14, 2017 Category: General Medicine Authors: Lang IM, Badr-Eslam R, Greenlaw N, Young R, Steg PG Tags: Wien Klin Wochenschr Source Type: research

Successful Treatment of Growing Basilar Artery Dissecting Aneurysm by Pipeline Flow Diversion Embolization Device
We describe a case of successful management of a growing basilar artery dissecting aneurysm by the Pipeline flow diversion embolization device (PED). A 48-year-old woman presented with severe headache, neck pain, and altered consciousness. Computed tomography showed subarachnoid hemorrhage located in basal cisterns, with a pontine infarct shown on magnetic resonance imaging. Digital subtraction angiography showed dissecting aneurysm of the trunk of the basilar artery, with growth over time on repeated imaging. Repeated imaging demonstrated growth in size of the aneurysm. The aneurysm was treated with PED with complete obl...
Source: Journal of Stroke and Cerebrovascular Diseases - January 6, 2014 Category: Neurology Authors: Dasen Gong, Bernard Yan, Richard Dowling, Peter Mitchell Tags: Case Reports Source Type: research

Use of the Corus® CAD Gene Expression Test for Assessment of Obstructive Coronary Artery Disease Likelihood in Symptomatic Non-Diabetic Patients
Conclusions The Corus CAD test has been extensively evaluated since it was first derived, including with two prospective multi-center trials. Given the scope of the deleterious effects of CAD and the considerable costs involved in diagnosing obstructive CAD, a blood test that can help in this determination is certainly valuable. The Corus CAD test promises to have an important role in this regard particularly if it continues to perform this well in larger, more diverse cohorts.
Source: PLOS Currents Evidence on Genomic Tests - August 26, 2013 Category: Genetics & Stem Cells Authors: Jose Vargas Source Type: research

Severe Cerebral Vasospasm and Childhood Arterial Ischemic Stroke After Intrathecal Cytarabine
We report on 2 patients who developed widespread cerebral vasospasm and arterial ischemic strokes (AIS) after application of intrathecal (IT) cytarabine. In a 3-year-old child with acute lymphoblastic leukemia (ALL), left leg weakness, hyperreflexia, and clonus were noted 4 days after her first dose of IT cytarabine during the induction phase of her chemotherapy. Cerebral MRI revealed multiple acute cerebral ischemic infarcts and widespread cerebral vasospasm. A 5-year-old girl complained of right arm and leg pain and began limping 11 days after IT cytarabine. Symptoms progressed to right dense hemiplegia, left gaze deviat...
Source: PEDIATRICS - February 1, 2016 Category: Pediatrics Authors: Tibussek, D., Natesirinilkul, R., Sun, L. R., Wasserman, B. A., Brandao, L. R., deVeber, G. Tags: Hematology/Oncology, Cancer/Neoplastic, Neurology, Neurologic Disorders Case Report Source Type: research

Unique Presentation and Management of Stress Cardiomyopathy (Takotsubo) with Dynamic LVOT Obstruction
A 91-year-old female presented to the ER with acute chest pain, dizziness, severe hypotension, and diaphoresis. Symptoms were acute in onset after she heard that her sister had suffered from a stroke. Clinical examination revealed hypotension and a S4 heart sound was auscultated. EKG showed non - specific ST-T changes. Cardiac biomarkers were abnormal. Based on the clinical diagnosis patient underwent an urgent coronary angiogram. The LV angiogram was suggestive of stress cardiomyopathy (Takatsubo’s cardiomyopathy).
Source: Heart and Lung - June 30, 2016 Category: Intensive Care Authors: Brittany Nicole Johnson, A. Jordan, R. Nambiar Tags: Clinical Innovation Abstract Source Type: research

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