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Specialty: Internal Medicine
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Total 172 results found since Jan 2013.
A Japanese Case of CADASIL with a Rare Mutation in Exon 24 of the NOTCH3 Gene.
Authors: Ebihara Y, Mochizuki H, Ishii N, Mizuta I, Shiomi K, Mizuno T, Nakazato M
Abstract
A 50-year-old man with a family history of stroke and depression slowly developed brain lesions. Magnetic resonance imaging revealed hyperintense lesions in the diffuse white matter, external capsules, and temporal poles on T2-weighted imaging. A heterozygous mutation c.3879C>G in exon 24 of the NOTCH3 gene (p.Cys1293Trp) was detected, confirming a diagnosis of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Exon 24 mutations are rather rare and this represents the fir...
Source: Internal Medicine - May 23, 2018 Category: Internal Medicine Tags: Intern Med Source Type: research
Clinical impact of the alpha-galactosidase A gene single nucleotide polymorphism -10C>T: A single-center observational study
Single nucleotide polymorphisms (SNPs) in the alpha-galactosidase A gene region (GLA) have been discussed as potential cause of symptoms and organ manifestations similarly to those seen in Fabry disease (FD). However, due to scarce data, clinical implications remain limited. The aim of the present study was to investigate the clinical impact of -10C>T SNP in the GLA.
Prospective single-center observational study to determine the natural history and outcome of FD.
Subjects initially referred to the Fabry Center for Interdisciplinary Therapy Würzburg (FAZIT) for management of suspected FD (11 women, 2 men, mean age 42 ...
Source: Medicine - May 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Hypovolemia due to cerebral salt wasting may contribute to stroke in tuberculous meningitis
ConclusionIn TBM, stroke occurred in 39.5% of the patients, 50% of whom had CSW. Volume contraction due to CSW may contribute to stroke.
Source: QJM - April 9, 2018 Category: Internal Medicine Source Type: research
Bilateral visual loss and cerebral infarction after spleen embolization in a trauma patient with idiopathic thrombocytopenic purpura: A case report
We report a case of acute ischemic stroke following orthopedic surgery in a patient with post-SAE reactive thrombocytosis.
Patient concerns:
A 37-year-old woman with idiopathic thrombocytopenic purpura (ITP) suffered from multiple trauma scheduled for open reduction and internal fixation for right tibial and left radius fracture five days after SAE. The patient did not have any thromboembolic complications, although the platelet counts increased from 43 × 109/L to 568 × 109/L within two days after SAE. Surgery was completed under general anesthesia with tracheal intubation without complications. The patient co...
Source: Medicine - April 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Brain mapping for long-term recovery of gait after supratentorial stroke: A retrospective cross-sectional study
The recovery of independent gait after stroke is a main goal of patients and understanding the relationship between brain lesions and the recovery of gait can help physicians set viable rehabilitation plans. Our study investigated the association between variables of gait parameters and brain lesions.
Fifty poststroke patients with a mean age of 67.5 ± 1.3 years and an average duration after onset of 62.2 ± 7.9 months were included. Three-dimensional gait analysis and magnetic resonance imaging were conducted for all patients. Twelve quantified gait parameters of temporal-spatial, kinematic, and kinetic data wer...
Source: Medicine - April 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Effectiveness and neural mechanisms of home-based telerehabilitation in patients with stroke based on fMRI and DTI: A study protocol for a randomized controlled trial
This study is designed to determine the efficacy and explore the mechanism of motor recovery after home-based telerehabilitation in stroke patients with motor deficits.Methods/Design:In a single-blinded randomized controlled pilot study, patients with acute subcortical stroke (n = 40) are assigned to receive home-based telerehabilitation or conventional rehabilitation. Task-based or resting-state functional magnetic resonance imaging (rs-fMRI), diffusion tensor imaging (DTI), and Fugl–Meyer assessment (FMA) score will acquired before and after rehabilitation. Activation volume of bilateral primary motor (M1), supplem...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research
Cardiovascular risk factors in patients with combined central retinal vein occlusion and cilioretinal artery occlusion: Case report
AbstractRationale:To analyze cardiovascular risk factors and comorbidity of acute unilateral visual loss due to combined central retinal vein occlusion (CRVO) and cilioretinal artery occlusion (CLRAO).Patient concerns:Among patients with retinal vein or artery occlusion hospitalized at the Department of Ophthalmology between January 2011 and August 2017, subjects with combined CRVO/CLRAO were selected. All of them underwent ophthalmologic and cardiologic examination, including fluorescein angiography, optical coherence tomography, 12-lead electrocardiogram, transthoracic and transesophageal echocardiography, carotid Dopple...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Acute evaluation of the acute vestibular syndrome: differentiating posterior circulation stroke from acute peripheral vestibulopathies
Abstract
This review article aims to provide an evidence‐based approach to evaluating the patient who presents with acute prolonged, spontaneous vertigo in the context of the acute vestibular syndrome (AVS). Differentiation of posterior circulation stroke (PCS) presenting as an AVS has been regarded as an important diagnostic challenge for physicians involved in acute care. Current evidence suggests that a targeted approach to history taking and physical examination with emphasis on the oculomotor examination, more specifically the HINTS (Head Impulse/Nystagmus/Test‐of‐skew) examination battery, yields a higher sensi...
Source: Internal Medicine Journal - December 10, 2017 Category: Internal Medicine Authors: Benjamin K. T. Tsang, Alex S. K. Chen, Mark Paine Tags: Review Source Type: research
Usefulness of multiphase computed tomography angiography in a patient with transient ischemic attack in the hyperacute phase: A case report
We present a case of TIA, the cause of which was identified using multiphase computed tomography angiography (MCTA) in the hyperacute phase of the disease.Patient Concerns:The patient was a 57-year-old man who was admitted to the emergency department for right-side weakness persisting for 1 hour.Diagnoses:Occlusion of the proximal M3 segment of the left middle cerebral artery territory was found on the initial MCTA.Outcomes:The weakness completely resolved at 2 hours after symptom onset, and there was no acute infarction on the initial diffusion-weighted magnetic resonance imaging (MRI) on the same day. Follow-up MCTA ...
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Degeneration of paramedian nuclei in the thalamus induces Holmes tremor in a case of artery of Percheron infarction
Abstract
Rationale: Holmes’ tremor is an uncommon neurologic disorder following brain insults, and its pathogenesis is undefined. The interruption of the dento-rubro-thalamic tract and secondary deterioration of the nigrostriatal pathway are both required to initiate Holmes’ tremor. We used nuclear medicine imaging tools to analyze a patient with concurrent infarction in different zones of each side of the thalamus. Finding whether the paramedian nuclear groups of the thalamus were injured was a decisive element for developing Holmes’ tremor.
Patient concerns:
A 36-year-old woman was admitted to our department d...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Prognostic value of high-resolution magnetic resonance imaging in evaluating carotid atherosclerotic plaque in patients with ischemic stroke
Conclusion:
Our study conclusively intimated the promise of HRMRI as an evaluative tool for the determination of carotid atherosclerotic plaques in patients with IS.
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research
Lateral medullary infarction with similar features of Brown Sequard syndrome caused by vertebrobasilar dysplasia and Klippel–Feil syndrome: A case report
Rationale:
Patients with Klippel–Feil syndrome (KFS) are always anomaly associated with vertebrobasilar dysplasia. That may present commonly as infarction of brainstem, medulla, and cerebellum. In this article, we reported a rare case of lateral medullary infarction (LMI) with similar features of Brown Sequard syndrome caused by vertebrobasilar dysplasia and KFS, and the 2 rare conditions that are causally related. The case is being reported because of its unusual and rare presentation.
Patient concerns:
A 38-year-old female presented with acute unsteadiness, along with a tendency to lean to the left side while walk...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Altered effective connectivity of resting state networks by acupuncture stimulation in stroke patients with left hemiplegia: A multivariate granger analysis
Abstract
The aim of this study was to explore the response feature of resting-state networks (RSNs) of stroke patients with left hemiplegia by acupuncture stimulation.
Nineteen stroke patients with left hemiplegia and 17 controls were recruited in this study. Resting-state functional magnetic resonance imaging data before and after acupuncture were acquired using magnetic scanning. The independent component analysis (ICA) was employed to extract RSNs related to motion, sensation, cognition, and execution, including sensorimotor network (SMN), left and right frontoparietal network (LFPN and RFPN), anterior and posterior ...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Incidence and risk factors of leukoaraiosis from 4683 hospitalized patients: A cross-sectional study
This study revealed that the incidence of LA is high in hospitalized patients in China; moreover, age, sex, hypertension, diabetes mellitus, smoking, drinking, and abnormal HCY and LDL-C levels were found to be associated with overall LA risk, LA onset, or LA progression. These results provide insight into strategies for the prevention and treatment of LA.
Source: Medicine - September 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
rTMS treatments combined with speech training for a conduction aphasia patient: A case report with MRI study
We report the case of a 39-year-old woman who was initially diagnosed with conduction aphasia following a left hemisphere stroke.
Interventions: The rTMS location comprised the left Broca area, and a frequency of 5 Hz for 20 min/d for 10 days during a 2-week period was used. She had received speech rehabilitation training 1 month after stroke. Functional magnetic resonance imaging (fMRI) and diffusion tensor imaging were used to investigate the functional and microstructural changes before and after rTMS treatment.
Outcomes: The results demonstrated that the Western Aphasia Battery scores significantly improved for l...
Source: Medicine - August 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
