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A Case of Ischemic Stroke due to Spontaneous Dissection of the Brachiocephalic to the Common Carotid Artery with a Fatal Course after Expansion to the Ascending Aorta
Intern Med. 2022 Feb 1. doi: 10.2169/internalmedicine.8931-21. Online ahead of print.ABSTRACTSpontaneous dissection of the brachiocephalic artery is rare, and there is insufficient evidence for optimal treatment. We herein report a case of ischemic stroke due to spontaneous dissection of the brachiocephalic to the right common carotid artery. The patient was treated medically but died suddenly 18 days after the onset because of aortic dissection. Although almost all reported cases of spontaneous dissection of the brachiocephalic artery have had good outcomes with medical management, it is important to note that sudden deve...
Source: Internal Medicine - February 3, 2022 Category: Internal Medicine Authors: Kazumasa Oura Mitsunobu Sato Mao Yamaguchi Oura Ryo Itabashi Tetsuya Maeda Source Type: research

Percutaneous Left Atrial Appendage Closure in a Patient with Diffuse Alveolar Hemorrhaging Associated with Anticoagulant Therapy and Atrial Fibrillation: A Case Report
Intern Med. 2021 Nov 27. doi: 10.2169/internalmedicine.8551-21. Online ahead of print.ABSTRACTDiffuse alveolar hemorrhaging (DAH) due to oral anticoagulation (OAC) is a life-threatening condition that leads to severe respiratory failure. There is a clinical dilemma in that OAC-induced DAH often forces the discontinuation of OAC therapy and the administration of high-dose corticosteroids, which increases the risk of stroke and cardiovascular events. We herein report the first case of OAC-induced DAH and atrial fibrillation (AF) in a patient who completely discontinued OAC therapy and high-dose corticosteroids after experien...
Source: Internal Medicine - November 29, 2021 Category: Internal Medicine Authors: Takaaki Ogoshi Masato Fukunaga Yu Suzuki Yusuke Taura Kazuhiro Yatera Source Type: research

Cardioembolic Stroke Due to Cardiac Sarcoidosis Diagnosed by Pathological Evaluation of the Retrieved Thrombus
Intern Med. 2021 Oct 26. doi: 10.2169/internalmedicine.7963-21. Online ahead of print.ABSTRACTA 70-year-old woman undergoing glucocorticoid therapy for cardiac sarcoidosis was brought to our hospital with the sudden onset of right hemiplegia and aphasia. Brain magnetic resonance imaging showed a high diffusion-weighted imaging signal in the left frontotemporal lobe and disruption of blood flow in the M1 segment of the left middle cerebral artery. Hence, she underwent thrombolysis and mechanical thrombectomy, resulting in marked improvement in her neurological symptoms. A pathologic evaluation of the thrombus suggested its ...
Source: Internal Medicine - October 28, 2021 Category: Internal Medicine Authors: Shogo Minomo Masahiko Ichijo Yohei Sato Ryoichi Miyazaki Takeshi Amino Tomoyuki Kamata Source Type: research

Locked-in Syndrome Due to Meningovascular Syphilis: A Case Report and Literature Review
Intern Med. 2021 Oct 19. doi: 10.2169/internalmedicine.8269-21. Online ahead of print.ABSTRACTWe herein report a 46-year-old man presenting with locked-in syndrome secondary to meningovascular syphilis. Brain magnetic resonance imaging (MRI) demonstrated multiple acute infarctions in the left ventromedial pons, right basis pontis, and left basal ganglia. His locked-in syndrome was hypothesized to have been caused by thrombosis of the small paramedian branches of the basilar artery due to syphilitic arteritis. This is a unique case of bilateral ventromedial pontine infarction caused by meningovascular syphilis that presente...
Source: Internal Medicine - October 21, 2021 Category: Internal Medicine Authors: Yuki Yokota Masaki Ishihara Satoko Ninomiya Kazutaka Mitsuke Satoshi Kamei Hideto Nakajima Source Type: research

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