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posterior stroke OR cerebellar Stroke OR posterior Infarct

Zenshi Miyake, Yasushi Tomidokoro, Takao Tsurubuchi, Akira Matsumura, Noriaki Sakamoto, Masayuki Noguchi, Akira Tamaoka
RATIONALE: Intravascular large B-cell lymphoma (IVLBCL) is a type of malignant lymphoma in which neoplastic B cells proliferate selectively within the lumina of small- and medium-sized vessels. Patients with IVLBCL frequently develop neurological manifestations during their disease course. Patients are known to often develop various neurological manifestations, but there are only a few reports of IVLBCL whose initial symptoms are deafness and/or disequilibrium. PATIENT CONCERNS: A 66-year-old Japanese man was provisionally diagnosed with sudden sensorineural hearing loss...
February 2019: Medicine (Baltimore)
Paul R Freund, Laila Alshafai, Edward A Margolin
A 34-year-old man with chronic neck pain was treated with regular cervical paravertebral ozone injections. After his last injection, he experienced a syncopal episode and, upon awakening, was found to have ataxia, aphasia, hemiparesis, and left sixth nerve palsy. Computed tomographic angiography demonstrated intra-arterial gas in the right vertebral artery; multiple posterior circulation infarcts were seen on brain MRI. This case illustrates the potential dangers of paravertebral injections of ozone.
February 6, 2019: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Robert G Briggs, Dillon P Pryor, Andrew K Conner, Cameron E Nix, Camille K Milton, Joseph K Kuiper, Ali H Palejwala, Michael E Sughrue
BACKGROUND: Arterial disruption during brain surgery can cause devastating injuries to wide expanses of white and grey matter far beyond the tumor resection cavity. Such damage may occur as a result of disrupting blood flow through "en passage" arteries. Identification of these arteries is critical to prevent unforeseen neurologic sequelae during brain tumor resection. In this study, we discuss one such artery, termed the artery of aphasia (AoA), which when disrupted can lead to receptive and expressive language deficits...
February 5, 2019: World Neurosurgery
Jenna Kaye Wildman, Bassam H Rimawi
Cerebrovascular disease is not uncommon during pregnancy as a result of either venous or arterial occlusion, or a hemorrhagic event, resulting in ischemia. Pregnancy may alter the prognosis of these neurologic disorders, with increased risks of morbidity and mortality for the mother and the developing fetus. Etiologies of stroke during pregnancy and the postpartum period include preeclampsia, eclampsia, HELLP syndrome, posterior reversible encephalopathy syndrome (PRES), amniotic fluid embolism, postpartum angiopathy, postpartum cardiomyopathy, thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), cerebral venous thrombosis, CNS infections, and maternal thrombophilia...
January 2019: Case Reports in Women's Health
Adolfo Del Canto A, Francisca Montoya S, Roberto Marileo Z, Luis Cartier R
Giant cell arteritis is the most common vasculitis in patients aged over 50 years. We report an 89-year-old woman with significant weight loss and persistent frontal-occipital headaches lasting two months. The neurological examination at admission identified a decrease in visual acuity of the left eye, paralysis of the third cranial nerve of the right eye and alterations of body motility without objective signs of damage of the motor or sensitive pathways. Magnetic resonance imaging showed changes of the temporal artery wall and in both vertebral arteries, as well as bilateral cerebellar and occipital ischemic lesions...
November 2018: Revista Médica de Chile
Mehmet Celebisoy, Nese Celebisoy
Lesions located in the anterior cavernous sinus or posterior orbit are known to cause divisional oculomotor palsy. We herein report a patient with fascicular infarction causing superior division paresis of the nerve.
February 2019: Neuro-ophthalmology
Mohamed Al-Khaled
Dysphagia is a common neurological, often underdiagnosed symptom of an acute stroke, particularly, in patients suffering from a stroke in the posterior circulation, particularly brainstem infarction or a malign anterior circulation stroke, with altered consciousness. Up to 80% of acute stroke patients showed a dysfunction in swallowing, whereas the determined rate of dysphasia is depending on the stroke's severity, the type and timing of the dysphasia screening techniques. A quarter of the dysphasia patients developed a chronic swallowing dysfunction which severely affects the quality of life in addition to the malnutrition and dehydration risk ...
February 3, 2019: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Matthew John Harris, Mark Daniel Cossburn, George Pengas
A 52-year-old man experienced a relapse of neurosarcoidosis, characterised by obstructive hydrocephalus and multiple posterior circulation infarcts. He was taking methotrexate, but his prednisolone was being weaned because of adverse effects. Stroke is rare in neurosarcoidosis and typically relates to granulomatous inflammation with a predilection for the perforator arteries. Sarcoidosis generally responds well to corticosteroids; however, patients with leptomeningeal involvement usually require additional immunosuppression as relapses can occur on weaning of corticosteroids...
January 30, 2019: Practical Neurology
Ara Ko, Sang-Jun Lee, Young-Mock Lee
Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) is a type of mitochondrial disorder and stroke-like lesions are observed prominently in the brain magnetic resonance imaging. Those stroke-like lesions of MELAS patients are usually located in the posterior quadrants and do not correspond to typical vascular territories. This case illustrates that focal cerebellar infarction can be the sole initial sign of MELAS.
December 27, 2018: Journal of Inherited Metabolic Disease
Ko Woon Kim, Hunki Kwon, Young-Eun Kim, Cindy W Yoon, Yeo Jin Kim, Yong Bum Kim, Jong Min Lee, Won Tae Yoon, Hee Jin Kim, Jin San Lee, Young Kyoung Jang, Yeshin Kim, Hyemin Jang, Chang-Seok Ki, Young Chul Youn, Byoung-Soo Shin, Oh Young Bang, Gyeong-Moon Kim, Chin-Sang Chung, Seung Joo Kim, Duk L Na, Marco Duering, Hanna Cho, Sang Won Seo
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is thought to be a pure genetic form of subcortical vascular cognitive impairment (SVCI). The aim of this study was to compare white matter integrity and cortical thickness between typical CADASIL, a genetic form, and two sporadic forms of SVCI (with NOTCH3 and without NOTCH3 variants). We enrolled typical CADASIL patients (N = 11) and SVCI patients [with NOTCH3 variants (N = 15), without NOTCH3 variants (N = 101)]...
January 28, 2019: Scientific Reports
Xin Huang, Björn Redfors, Shmuel Chen, Bernard J Gersh, Roxana Mehran, Yiran Zhang, Thomas McAndrew, Ori Ben-Yehuda, Gary S Mintz, Gregg W Stone
OBJECTIVES: We sought to identify clinical, electrocardiographic (ECG), and angiographic characteristics that are predictive of 3-year mortality after primary percutaneous coronary intervention (PCI) in patients with non-anterior ST-elevation myocardial infarction (NA-STEMI) from the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial. BACKGROUND: Which patients with NA-STEMI undergoing PCI have a poor prognosis is uncertain...
January 28, 2019: Catheterization and Cardiovascular Interventions
Liping Wang, Panting Zhou, Zhihao Mu, Xiaojie Lin, Lu Jiang, Zhuo Cheng, Longlong Luo, Zhiming Xu, Jieli Geng, Yongting Wang, Zhijun Zhang, Guo-Yuan Yang
A rodent model of embolic middle cerebral artery occlusion is used to mimic cerebral embolism in clinical patients. Thrombolytic therapy is the effective treatment for this ischemic injury. However, it is difficult to detect thrombolysis dynamically in living animals. Synchrotron radiation angiography may provide a novel approach to directly monitor the thrombolytic process and assess collateral circulation after embolic stroke. Thirty-six adult Sprague-Dawley rats underwent the embolic stroke model procedure and were then treated with tissue plasminogen activator...
January 24, 2019: Translational Stroke Research
Kai-I Chuang, Kevin Li-Chun Hsieh, Cheng-Yu Chen
BACKGROUND: The imaging findings of hypoglycemic encephalopathy can be considerably similar to those of ischemic infarction or toxic leukoencephalopathy. We demonstrated unusual magnetic resonance (MR) imaging features of hypoglycemic encephalopathy which can be confused with other pathology both on imaging and acute clinical presentation. The diffusion-weighted imaging (DWI) and apparent diffusion coefficients (ADC) map findings in our case further supports the hypothesis of hypoglycemia-induced "excitotoxic injury" of glial cells and myelin sheath that might protect neuron axons from intracellular edema and irreversible damage...
January 24, 2019: BMC Medical Imaging
Robi N Maamari, Leanne Stunkel, Nathan H Kung, Cole J Ferguson, Jody Tanabe, Robert E Schmidt, Sonika Dahiya, Amar Dhand, Gregory P Van Stavern, Rithwick Rajagopal, George J Harocopos
A 21-year-old man experienced unilateral vision loss associated with multiple atrophic chorioretinal lesions. He was treated for a presumptive diagnosis of acute retinal necrosis, but his vision did not improve with antiviral therapy. Over the course of several weeks, his symptoms progressed to involve both eyes. The fellow eye showed characteristic yellow-white placoid lesions, prompting treatment with oral corticosteroids for acute posterior multifocal placoid pigment epitheliopathy (APMPPE). Despite high-dose therapy with prednisone 80 mg daily, the patient developed the acute onset of mental status changes within the next several days...
January 22, 2019: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Hyuk Sung Kwon, A-Hyun Cho, Min Hwan Lee, Dongwhane Lee, Da-Eun Jeong, Changwoon Choi, Ji-Wan Jang, Sungwook Yu, Jong-Ho Park, Sung Hyuk Heo, Ji-Sung Lee, Sun U Kwon
The imaging definition of lacunar infarcts is variable, particularly regarding their size and the presence of cavitation. We investigated the changes of diameter and evolution pattern of acute lacunar infarcts, and the factors associated with the evolution pattern. Patients with acute single subcortical hemispheric or brainstem ischemic lesions of penetrating arterial territories were included. Maximal diameters on initial diffusion-weighted image (DWI) and follow-up fluid-attenuated inversion recovery image (FLAIR), which performed > 12 months after initial DWI, were semi-automatically measured...
January 23, 2019: Journal of Neurology
Felipe Araujo Andrade Oliveira, Pedro Augusto Sampaio Rocha-Filho
INTRODUCTION: Although headaches attributed to ischemic strokes and transient ischemic attack occur frequently, they are often overlooked and underdiagnosed as manifestations of cerebrovascular disease. METHOD: This is a narrative review. RESULTS: The prevalence of headache attributed to ischemic stroke varies between 7.4% and 34% of cases and of headache attributed to transient ischemic attack, from 26% to 36%. Headache attributed to ischemic stroke is more frequent in younger patients, in migraineurs, in those who have suffered a larger stroke, a posterior circulation infarction, or a cortical infarction, and is less frequent in lacunar infarctions...
January 22, 2019: Headache
Junjiang Liu, Han Xiao, Zhiping Hu
Percheron infarction, arising from occlusion of the Artery of Percheron, is few, which can result in bilateral thalamic and mesencephalic infarctions. We herein showcase a confirmed case of the Percheron infarction at the admission day, in which the patient advanced into severe multiple posterior circulation infarcts, along with petechial hemorrhage within the infarcts, even given the right therapy without delay. It reminds us that whether we could or should take this special infarction as a forewarning of more harmful infarcts getting in the way, or at least a precaution of poor vessel condition...
January 14, 2019: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Hui Yang, Shuisheng Zhong, Yunxin Hu, Zeyan Bao
Basilar invagination (BI) is a congenital or acquired craniovertebral junction (CVJ) anomaly with odontoid process superiorly migrating into the foramen magnum. Compression of neural structures is the most relevant complication of BI. However BI is also a rare cause of ischemic stroke. In this case we reported a 30-year-old female with BI who developed recurrent ischemic stroke in posterior circulation. Before the onset of ischemic stroke, she didn't present neck pain or clinical signs of lower cranial nerve dysfunction, brainstem compression or transient ischemic attack...
January 17, 2019: British Journal of Neurosurgery
Masatoshi Takagaki, Manabu Kinoshita, Atsushi Kawaguchi, Akira Murasawa, Kazutami Nakao, Hajime Nakamura, Haruhiko Kishima
This study aimed to elucidate spatial characteristics for magnetic resonance imaging (MRI) of cardiogenic cerebral embolism, to determine imaging biomarkers predicting patient outcome and cerebral herniation in cardioembolic stroke. This retrospective study assessed 90 patients with cardiogenic cerebral embolism. All images from MRI were normalized using a voxel-based symptom lesion mapping technique. Patients were categorized into two subgroups based on the outcome and presence of cerebral herniation. Each subgroup was assessed individually...
2019: PloS One
Allison A King, Robert C McKinstry, Juan Wu, Mary Eapen, Regina Abel, Taniya Varughese, Naynesh Kamani, Shalini Shenoy
Stroke and cognitive decline are hallmarks of sickle cell disease (SCD). The natural history of SCD predicts progressive loss of 1 IQ point per year attributable to disease-related pathology. Hematopoietic cell transplantation (HCT) is curative by reverting to donor-derived erythropoiesis, but evidence that HCT can positively influence disease-induced cognitive decline is lacking. The Sickle Cell Unrelated Transplant Trial prospectively evaluated cognition and brain magnetic resonance imaging (MRI) findings at 2 years after reduced-intensity conditioning followed by unrelated donor HCT...
January 11, 2019: Biology of Blood and Marrow Transplantation
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