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Total 126 results found since Jan 2013.

Natural History and Sequelae of Penetrating Aortic Ulcer
A man in his 70s with history of tobacco use and hypertension presented for transesophageal echocardiography after a recent diagnosis of ischemic stroke. This demonstrated a moderate right-to-left shunt on Valsalva release and no left atrial appendage thrombus. Assessment of the thoracic aorta revealed a complex penetrating aortic ulcer and saccular aneurysm with thrombus in the distal arch and proximal descending thoracic aorta (Figure). Computed tomography angiography confirmed the presence of multiple penetrating ulcerations with large saccular aneurysms.
Source: Mayo Clinic Proceedings - September 1, 2023 Category: Internal Medicine Authors: Raghav R. Julakanti, Prabhakar Shantha Rajiah, Krishnaswamy Chandrasekaran Tags: Medical image Source Type: research

Stroke: management and prevention
Acute stroke treatment requires clear protocols to rapidly triage patients – using appropriate investigations – for mechanical thrombectomy and intravenous thrombolysis. Computed tomography (CT) excludes haemorrhage, CT angiography locates the occluded vessel, and CT perfusion and perfusion magnetic resonance imaging identify viable tissue. An organized approach to str oke care in a specialist environment reduces disability and saves lives. Adoption of a ‘care bundle’ approach, including the active management of pyrexia and hyperglycaemia, and early screening for swallowing difficulties, is beneficial.
Source: Medicine - July 25, 2023 Category: Internal Medicine Authors: Gina Hadley, Ivie I. Gbinigie, Joyce S. Balami, Alastair M. Buchan Tags: Acute neurology Source Type: research

Cerebellopontine angle meningioma in a patient presented as acute cerebrovascular accident
CONCLUSION: Although stroke is the main cause of sudden onset ataxia in a patient with cerebrovascular risk factors, yet other less common causes may be found as in this case of CPA meningioma.PMID:37427233 | PMC:PMC10328571 | DOI:10.1097/MS9.0000000000000928
Source: Annals of Medicine - July 10, 2023 Category: Internal Medicine Authors: Mohamed Sheikh Hassan Ayhan K öksal Source Type: research

Differential Diagnosis of New Giant T-Wave Inversions
To the Editor The electrocardiogram (ECG) presented by Dr Cai and colleagues is indeed a great challenge. Two days after a fall, an older patient was admitted to the hospital with a hip fracture that was treated by external fixation and skin traction. On hospital day 2, the patient suddenly lost consciousness. An ECG immediately performed showed giant negative T waves (>20 mm) in the precordial leads and a QTc prolongation of 535 milliseconds. Cardiac troponin was elevated. Findings of computed tomography and magnetic resonance imaging (performed because of neurologic deficits) showed bilateral multifocal subacute ische...
Source: JAMA Internal Medicine - July 10, 2023 Category: Internal Medicine Source Type: research

'Dense Inverted Triangle Sign' in Cerebral Venous Thrombosis
Intern Med. 2022 Nov 30. doi: 10.2169/internalmedicine.0764-22. Online ahead of print.ABSTRACTThe early diagnosis of cerebral venous thrombosis in the emergency department is challenging. A 70-year-old man presented to the emergency department after falling with new-onset convulsions. Brain unenhanced computed tomography (CT) revealed right frontal hemorrhage indicative of traumatic subarachnoid hemorrhage (SAH). Brain unenhanced CT on day 2 revealed increased density in the anterior superior sagittal sinus (SSS), namely 'dense inverted triangle sign.' Brain magnetic resonance venography showed a filling defect in the ante...
Source: Internal Medicine - November 30, 2022 Category: Internal Medicine Authors: Akiyuki Hiraga Yutaka Watabe Satoshi Kuwabara Source Type: research

A clinical application study of a stent placement assessment
Discussion: Currently, no prospective controlled data exist regarding the efficacy and safety of carotid stenting in the acute phase. Previously, we had developed an ECASES stent placement system for acute carotid artery occlusion. The present study will evaluate the efficacy and safety of ECASES in a randomized, double-blind prospective study and clarify its guiding significance in acute atherosclerotic carotid artery occlusion surgery.
Source: Medicine - November 25, 2022 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research

Brain perfusion single photon emission computed tomography abnormality in MRI-negative stroke-like patients post COVID-19 vaccination
Stroke-like symptoms after COVID-19 vaccination was thought to be functional if there was no anatomical image abnormality. We aimed to analyze brain perfusion changes in these patients. A case-control study of brain perfusion single photon emission computed tomography (SPECT) of 12 vaccinated patients with left-sided stroke-like symptoms were compared with 12 age- and gender-matched normal interictal brain SPECTs using voxel-based analysis. Significant hyperperfusion was seen on the right side in postcentral, inferior parietal, mid temporal, parahippocampal, and caudate regions, and on the left side in the thalamus, hippoc...
Source: Medicine - November 25, 2022 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Screening for unilateral aldosteronism should be combined with the maximum systolic blood pressure, history of stroke and typical nodules
To determine factors associated with lateralization in primary aldosteronism (PA). The clinical data for PA patients hospitalized at the First Affiliated Hospital of Guangxi Medical University from October 2016 to March 2021 were included in this study. They were classified according to results derived from computed tomography (CT): bilaterally normal nodules (no typical nodules were found in either adrenal glands, only changes in unilateral adrenal hyperplasia thickening or bilateral adrenal hyperplasia thickening), unilateral nodules (typical nodule appears in unilateral adrenal gland, and there are no abnormalities in t...
Source: Medicine - October 28, 2022 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Neurophysiology tools to lower the stroke onset to treatment time during the golden hour: microwaves, bioelectrical impedance and near infrared spectroscopy
Ann Med. 2022 Dec;54(1):2658-2671. doi: 10.1080/07853890.2022.2124448.ABSTRACTReperfusion therapy administration timing in acute ischaemic stroke is the main determinant of patients' mortality and long-term disability. Indeed, the first hour from the stroke onset is defined the "golden hour", in which the treatment has the highest efficacy and lowest side effects. Delayed ambulance transport, inappropriate triage and difficulty in accessing CT scans lead to delayed onset to treatment time (OTT) in clinical practice. To date brain CT scan is needed to rule out intracranial haemorrhage, which is a major contraindication to t...
Source: Annals of Medicine - September 26, 2022 Category: Internal Medicine Authors: Lazzaro di Biase Adriano Bonura Maria Letizia Caminiti Pasquale Maria Pecoraro Vincenzo Di Lazzaro Source Type: research

Diffuse low-grade glioma misdiagnosed as acute cerebral infarction: A case report
We report a case of DLGG detected by computed tomography and magnetic resonance imaging (MRI). Patient concerns: A 58-year-old man suddenly phantom smells for half an hour and was previously healthy. Diagnoses: Computed tomography findings showed a leaf-shaped slightly hypodense shadow in the right temporal lobe with no obvious mass effect and an unclear boundary. MRI findings showed diffuse and slightly longer T1-weighted imaging (T1WI)/T2-weighted imaging (T2WI)signal in the right temporal lobe and hippocampus, slight hyperintensity on diffusion-weighted imaging, diffuse swelling in the right temporal lobe ...
Source: Medicine - September 2, 2022 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

An acute lower limb ischemia revealing a covid-19 infection: A case report
CONCLUSION: The coagulopathy responsible for venous and arterial thrombosis is a well-established complication of COVID-19. Arterial thromboembolic complications can be either stroke, acute coronary syndrome or peripheral acute ischemia. Therefore, patients with covid19 should be monitored more closely for thromboembolic complications.PMID:35999833 | PMC:PMC9389520 | DOI:10.1016/j.amsu.2022.104445
Source: Annals of Medicine - August 24, 2022 Category: Internal Medicine Authors: Rim El Mesnaoui Soumaila Nikiema Desire Massimbo Abbes El Mesnaoui Source Type: research

Intramedullary spinal cord abscess associated with right-to-left shunt via right superior vena cava draining into left atrium: A case report
We report the first case of ISCA associated with RSVC-LA RL shunt. Patient concerns: A 36-year-old man developed progressive paraparesis, dysuria, and spontaneous pain in the lumbar region and lower extremities. Spinal magnetic resonance imaging revealed an intramedullary lesion extended from Th12 to L2 with ring-shaped gadolinium enhancement. Cerebrospinal fluid (CSF) study exhibited a marked pleocytosis, and CSF culture grew Streptococcus intermedius. Cardiovascular computed tomography angiography identified RSVC-LA RL shunt, which caused transient acute cardiac syndrome due to air embolus. Diagnoses: The p...
Source: Medicine - July 1, 2022 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

54-Year-Old Woman With Altered Mental Status and Abdominal Pain
A 54-year-old woman was transferred to our medical center with altered mental status, abdominal pain, and hypotension. Her medical history included type 2 diabetes mellitus, hypertension, hyperlipidemia, active tobacco use, prior cholecystectomy, and a recent stroke. One month earlier, she presented to an outside facility with right-sided facial weakness and numbness. Brain magnetic resonance imaging (MRI) at that time revealed multiple small lacunar-type infarcts. Computed tomography (CT) angiography of the head and neck, 48-hour Holter monitoring, and transesophageal echocardiography did not reveal an embolic source.
Source: Mayo Clinic Proceedings - June 29, 2022 Category: Internal Medicine Authors: Caroline L. Matchett, Nikita Rafie, Jacob C. Jentzer Tags: Residents ’ Clinic Source Type: research