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Endovascular management of iatrogenic dissection into the petrous segment of the internal carotid artery during mechanical thrombectomy for acute stroke
Publication date: Available online 10 December 2019Source: Journal of Clinical NeuroscienceAuthor(s): David I. Bass, Melanie Walker, Louis J. Kim, Michael R. LevittAbstractIatrogenic dissection of the internal carotid artery is a well-known complication that can occur during mechanical thrombectomy for acute stroke. The vast majority of these injuries are limited to the cervical segment, and only in exceptional circumstances do they require surgical intervention. In the present case, extension of the lesion into the petrous segment of the carotid artery resulted in an acute neurologic decline necessitating emergent endovas...
Source: Journal of Clinical Neuroscience - December 11, 2019 Category: Neuroscience Source Type: research

Acute ischemic dissection of an “S”-shaped carotid artery: The “one-stop” value of using a detachable Solitaire AB stent
This study aimed to evaluate the efficacy and safety of endovascular repair using detachable Solitaire AB stents for acute ischemic dissection of “S”-shaped carotid arteries. From May 2015 to December 2016, a total of 127 patients with acute ischemic stroke (AIS) underwent endovascular treatment in our center. Among them, five AISs were due to acute dissection of an “S”-shaped carotid artery. Coexisting carotid embolism was identified in all five patients, who first underwent successful Solitaire AB stent-based retrieval of the embolism. All patients then underwent Solitaire AB stenting to reopen the occluded carot...
Source: Journal of Clinical Neuroscience - July 10, 2018 Category: Neuroscience Source Type: research

Acute bithalamic infarct manifesting as sleep-like coma: A diagnostic challenge
Publication date: December 2016 Source:Journal of Clinical Neuroscience, Volume 34 Author(s): Asaf Honig, Ruth Eliahou, Roni Eichel, Ari Aharon Shemesh, Tamir Ben-Hur, Eitan Auriel Bilateral thalamic infarction (BTI) typically presents as a sleep-like coma (SLC) without localizing signs, posing a diagnostic challenge that may lead the treating physician to search for toxic or metabolic causes and delay treatment. We review our experience with BTI of different etiologies, and emphasize the critical role of timely imaging, diagnosis, and management in a series of 12 patients with a presentation of SLC and acute BTI who were...
Source: Journal of Clinical Neuroscience - November 10, 2016 Category: Neuroscience Source Type: research

Successful endovascular repair of an unusual right-to-left shunt presenting with cerebral ischemia
We report a 54-year-old man with a stroke due to a unique right-to-left shunt who underwent successful endovascular treatment. This patient developed acute onset of right arm weakness with facial droop and aphasia which improved after intravenous thrombolysis. An MRI showed acute cerebral ischemia in the left middle cerebral artery and left posterior cerebral artery distribution. The patient developed recurrent stroke symptoms during agitated saline injection while undergoing a transthoracic echocardiogram which showed right-to-left shunting. Chest CT scan and conventional angiography revealed near occlusion of the superio...
Source: Journal of Clinical Neuroscience - November 3, 2014 Category: Neuroscience Source Type: research