scholarly journals Acute prolonged motor aura resembling ischemic stroke after COVID − 19 vaccination (CoronaVac): the first case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Wanakorn Rattanawong ◽  
Wasan Akaratanawat ◽  
Supatporn Tepmongkol ◽  
Aurauma Chutinet ◽  
Jarturon Tantivatana ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Right Hemisphere ◽  
Vital Signs ◽  
Imaging Study ◽  
Left Hemiparesis ◽  
Focal Neurological Deficit ◽  
Acute Infarction ◽  
First Case ◽  
Case Presentations ◽  
The Right

Abstract Background We report the first case of a patient who suffered transient focal neurological deficit mimicking stroke following CoronaVac vaccination. However, instead of an ischemic stroke, motor aura was suspected. Case presentations A 24 year-old Thai female presented with left hemiparesis fifteen minutes after receiving CoronaVac. She also had numbness of her left arm and legs, flashing lights, and headaches. On physical examination, her BMI was 32.8. Her vital signs were normal. She had moderate left hemiparesis (MRC grade III), numbness on her left face, arms, and legs. Her weakness continued for 5 days. A brain CT scan was done showing no evidence of acute infarction. Acute treatment with aspirin was given. MRI in conjunction with MRA was performed in which no restricted diffusion was seen. A SPECT was performed to evaluate the function of the brain showing significant hypoperfusion of the right hemisphere. The patient gradually improved and was discharged. Discussions In this study, we present the first case of stroke mimic after CoronaVac vaccination. After negative imaging studies had been performed repeatedly, we reach a conclusion that stroke is unlikely to be the cause. Presumably, this phenomenon could possibly have abnormal functional imaging study. Therefore, we believed that it might be due to cortical spreading depression, like migraine aura, which we had conducted a literature review.

scholarly journals Unexpected Reading Dissociation in a Brazilian “nisei” with Crossed Aphasia

1994 ◽  
Vol 7 (3-4) ◽  
pp. 165-170 ◽  
Author(s):  
P. Caramelli ◽  
M. A. M. P. Parente ◽  
M. L. Hosogi ◽  
M. Bois ◽  
A. R. Lecours
Keyword(s):  
Reading Comprehension ◽  
Ischemic Stroke ◽  
Right Hemisphere ◽  
Written Language ◽  
Cerebral Hemispheres ◽  
Japanese Language ◽  
Writing System ◽  
Crossed Aphasia ◽  
The Right ◽  
Reading Impairments

There is an increased interest in reading impairments in the Japanese language, due to its particular writing system which includes two different scripts, Kanji (logograms) and Kana (phonograms). Reading dissociations between Kanji and Kana have been described, showing that each system is processed differently by the cerebral hemispheres. We describe the case of a 68 year old Brazilian “nisei” (i.e. born from Japanese parents) who had knowledge of both Japanese and Portuguese. He presented an ischemic stroke affecting the right hemisphere and subsequently developed a Broca's aphasia and an unexpected reading dissociation, with an impairment in Kana reading comprehension and a good performance in Kanji and in Portuguese. These findings suggest that the patient's right and left hemispheres have assumed opposite roles not only for oral but also for written language decodification.

scholarly journals Imaging of Acute Stroke patient with Covid-19: A serial case

2021 ◽  
Vol 3 (3) ◽  
pp. 45-55
Author(s):  
Wisniardhy Pradana ◽  
Yuyun Yueniwati
Keyword(s):  
Ct Scan ◽  
Parietal Lobe ◽  
Imaging Modality ◽  
Insular Cortex ◽  
Lentiform Nucleus ◽  
Acute Infarction ◽  
First Case ◽  
Different Types ◽  
Left Thalamus ◽  
The Right

Background: Coronavirus Disease 2019 (COVID-19) has been declared as a pandemic in March 2020 by WHO. Apart from respiratory symptoms, COVID-19 is also associated with various neurological manifestations, one of which is stroke. We reported three cases with diagnosis of stroke in confirmed COVID-19 patients. Case Presentation: Head CT scan without contrast in the three reported cases showed different types of strokes. The first case showed ischemia in the right insular lobe and right parietal lobe. The second case showed intracerebral hemorrhage in the left thalamus and intraventricular hemorrhage, whereas the third case showed acute infarction in right frontotemporal lobe, right lentiform nucleus, right insular cortex, that supports prelenticulostriate segment I MCA embolism. Conclusion: CT scan is an important imaging modality in stroke cases both in COVID-19 and non-COVID-19 cases. CT scans are good at detecting the presence of bleeding, widely available, faster to operate, and less expensive than MRI. The types of stroke in COVID-19 patients can appear as different types of stroke. Generally, it appears as ischemic stroke, but hemorrhagic stroke can also occur with a less frequent occurrence. Further research is needed to explain the exact correlation between stroke and COVID-19.

scholarly journals Overview of The Head CT-Scan in Stroke Patients who was Treated at Muhammadiyah Hospital Palembang

2021 ◽  
Vol 2 (1) ◽  
pp. 24
Author(s):  
Pratrisna Yusastra ◽  
Indriyani Indriyani ◽  
Budi Utama
Keyword(s):  
Ischemic Stroke ◽  
Ct Scan ◽  
Hemorrhagic Stroke ◽  
Right Hemisphere ◽  
Clinical Symptoms ◽  
Neurological Deficits ◽  
Thalamic Lesion ◽  
Stroke Patients ◽  
Head Ct ◽  
The Right

Background: Stroke is a collection of symptoms of neurological deficits due to sudden acute disturbance of brain function, both focal and global, caused by blockage or rupture of arteries and veins and proven by imaging and/or reflex pathology. Using CT-Scan, the description of acute phase stroke can be easier and can determine the appropriate treatment criteria for stroke. Purposes: To determine characteristic Head CT-Scan image of stroke patients hospitalized in Muhammadiyah Palembang Hospital. Methods: This study was conducted in a retrospective descriptive manner and obtained a sample of 41 stroke patients according to the inclusion and exclusion criteria using total sampling. Result: In this study, there were 28 patients (68.2%) with ischemic stroke and 13 patients (31.7%) with hemorrhagic stroke. Head CT-Scan image of ischemic stroke shows basal ganglia lesion (28.5%) and the right hemisphere lesions (57.1%) as the most predominant area. Head CT-Scan image of hemorrhagic stroke (58.3%) had intracerebral hemorrhage with the dominant thalamic lesion area (66.6%) and the right hemisphere (58.3%) had the most lesions with 8 patients (66, 6%) had a midline shift. Stroke patients were treated as experienced by the elderly (90.2%) and were dominated by the female sex (63.4%) and are dominated by clinical symptoms of hemiparesis (29.2%). Conclusion: Stroke patients at Muhammadiyah Palembang hospital dominated by ischemic stroke and on head CT Scan image predominantly shows lesions on the right cerebral hemisphere.

scholarly journals Dural metastasis masquerading as an en plaque meningioma

2015 ◽  
Vol 6 (03) ◽  
pp. 420-422 ◽  
Author(s):  
Ankur Kapoor ◽  
Amey Savardekar ◽  
Debajyaoti Chaterjee ◽  
Pravin Salunke ◽  
Rakesh K Vasishta ◽  
...  
Keyword(s):  
Right Hemisphere ◽  
Metastatic Lesion ◽  
Metastatic Adenocarcinoma ◽  
Left Hemiparesis ◽  
Clinical Progression ◽  
The Right ◽  
Dural Metastasis

ABSTRACTMetastatic adenocarcinoma mimicking meningioma is rare; and any metastatic lesion masquerading as an en plaque meningioma is extremely rare. We report the case of a 50-year-old female, who presented with headache and left hemiparesis for 1 month and on imaging showed a dural-based enhancing mass along the right hemisphere. The patient was operated with a working diagnosis of en plaque meningioma. Histopathology revealed metastatic adenocarcinoma. This report highlights an unusual radiological presentation of a metastatic lesion as dural based en plaque variety. Metastasis should be borne in mind for any en plaque lesion with rapid clinical progression.

ROLE OF AGNILEPA IN PAKSHAGHATA (ISCHEMIC STROKE): A CASE STUDY

2021 ◽  
Vol 12 (4) ◽  
pp. 4-8
Author(s):  
Padmavati Patil ◽  
Madhava Diggavi ◽  
Andanagouda S Patil
Keyword(s):  
Ischemic Stroke ◽  
Ct Scan ◽  
Rapid Onset ◽  
Focal Neurological Deficit ◽  
Before And After ◽  
Acute Infarct ◽  
Maximum Improvement ◽  
Acute Condition ◽  
The Right ◽  
Developed Nations

Stroke is defined as the rapid onset of focal neurological deficit resulting from diseases of the cerebral vasculature and its contents. Stroke represents the third most common cause of death in the developed nations. The prevalence of stroke in India is approximately 200 per 100,000 persons and 9.94% of total deaths. The present article deals with a diagnosed case of ischemic stroke presenting with left sided hemiplegia Acute infarct in the right temporo-parieto-frontal lobe and right ganglio-capsular region with haemorrhagic transformation. The Ayurvedic diagnosis of vama Pakshaghata was made and managed with shamana aushadhi and agnilepa (bahirparimarjana chikitsa). Two assessments were made before and after treatment using the National Institute of Health Stroke Scale (NIH-SS) and CT scan. Maximum improvement was noticed in the symptoms of Stambha, Ruja, Supti, Shotha, Sparsha hani. Even there was also improvement in left upper and lower extremity functions. At the end of the treatment the patient could be able to walk without support. After treatment CT scan showed considerable recovery. Agnilepa plays a major role in the management of Margavaranajanya pakshaghata (acute ischemic stroke) if associated with saama condition, in acute condition. The drugs used for Agnilepa are having Katu Rasa Pradhana, ruksha, teekshna, lekhana guna, ushna veerya, katu vipaka and kaphavataghna, vedanasthapaka, Shothahara, Stambhahara, Suptihara and helpful in regaining of Sparshana. Agnilepa can be practiced as bahirparimarjana chikitsa in pakshaghata, as many Salvana upanaha are mentioned in the chikitsa.

Abstract WMP16: Eloquence-Weighted Imaging Improves Clinical Outcomes Prediction in Endovascular Stroke Therapy

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Sunil A Sheth ◽  
David S Liebeskind ◽  
Conrad W Liang ◽  
Albert J Yoo ◽  
Reza Jahan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Ct Scan ◽  
Acute Ischemic Stroke ◽  
Left Hemisphere ◽  
Right Hemisphere ◽  
Infarct Volume ◽  
Good Outcome ◽  
Relative Contribution ◽  
C Statistic ◽  
The Right

Background: Larger infarct size at presentation as determined by ASPECTS is associated with reduced likelihood of good outcome in acute ischemic stroke. However, infarct volume alone explains only a modest fraction (∼30%) of the variation in stroke outcome. Incorporating the relative eloquence of each ASPECTS region may improve the predictive power. Methods: In the combined database of the SWIFT and STAR trials, we identified patients treated with the Solitaire stent retriever. Using the 24hr CT scan, a multivariate linear regression was used to determine the relative contribution of each ASPECTS region, separately in each hemisphere, to freedom from disability (mRS 0-2) at 90 days. The coefficients from the regression were used to create an Eloquence-weighted ASPECTS score (EL-ASPECTS), which was compared against the original in predicting outcome based on the presentation CT scan. Results: Among 254 patients treated with ET, average age was 68, 64% were female, and NIHSS was mean 16 (SD +/- 5). Mean ASPECTS at presentation was 8.2 and 6.4 at 24 hrs. The most commonly involved ASPECTS regions were the lentiform nuclei (70%), insula (55%), and caudate (52%). In multivariate analysis, for the right hemisphere on 24hr CT, preservation of M1 (OR 1.6) and M4 (OR 1.2) regions were most strongly predictive of good outcome. For the left hemisphere on 24 hr CT, preservation of M3 (OR 2.6), and M5 (OR 2.5) and involvement of M2 (OR -1.9) were most predictive. Eloquence weights were assigned to all 20 R/L ASPECTS regions to create EL-ASPECTS. EL-ASPECTS, compared with original ASPECTS, demonstrated improved discrimination for independent functional outcome for right hemisphere (C-statistic 0.78 vs. 0.69), left hemisphere (0.78 vs. 0.72), and all stroke patients (0.76 vs. 0.70). On presentation CTs, multivariate analyses including age and presentation NIHSS demonstrated EL-ASPECTS but not original ASPECTS was predictive of good clinical outcome (OR 1.65, p<.01). Higher C-statistic values were seen with EL-ASPECTS in analysis of presentation CT scans. Conclusions: Incorporation of regional weighting into ASPECTS improves the ability to predict who will achieve independent functional outcomes with endovascular therapy in acute ischemic stroke.

scholarly journals Diagnostic of psychoemotional and cognitive impairments in acute ischemic stroke

2021 ◽  
Author(s):  
Anastasya . M. Tynterova
Keyword(s):  
Ischemic Stroke ◽  
Coping Strategies ◽  
Acute Ischemic Stroke ◽  
Left Hemisphere ◽  
Right Hemisphere ◽  
Cognitive Impairments ◽  
Self Control ◽  
Cerebral Hemispheres ◽  
Adaptive Coping ◽  
The Right

Aims: to assess the severity of cognitive, psychoemotional, behavioral disorders, the level of self-control and prevalence of certain coping strategies in patients with lesions of the right and left cerebral hemispheres after acute ischemic stroke. Materials and methods: The study included 60 patients with a diagnosis of ischemic stroke. Depending on the location of the stroke, patients were divided into two groups: Group 1 - 30 patients with lesions of the right hemisphere, Group 2 - 30 patients with lesions of the left hemisphere. The study was conducted on the 7th day of treatment and included: assessment of the cognitive status according to the Montreal scale (with additional scales for assessing the functions of the right hemisphere); assessment of the level of distress, depression, anxiety and somatization using the Four DimensionalSymptomQuestionnaire; assessment of mental and physical asthenia according to the MFI-20 scale, level of self-control using the Rotter'sLocus of Control Scale and coping strategies modality using E. Heim coping questionnaire. Results: The study established the prevalence of depression, a tendency towards non-adaptive coping strategies, ideational praxis related disorders understanding of metaphors and low level of self-control in relation to health in patients with lesions of the right hemisphere. Patients with ischemic stroke localized in the left hemisphere are characterized by a high level of mental asthenia, a choice of adaptive and relatively adaptive coping strategies, and a low level of self-control in respect to interpersonal relationships. Conclusions: The results of the study show that in the acute period of stroke there are qualitative and quantitative differences in neuropsychiatric symptoms of patients with lesions of the right and left cerebral hemispheres. The predominance of depression, cognitive impairments, and non-adaptive coping strategies in patients with lesions of the right hemisphere even with minimal or moderate motor deficits justifies early examination of the patient's behavioral, neuropsychiatric, and cognitive syndromes. The results of the study indicate the need to develop individual psychological rehabilitation programs for patients with lesions of the right and left cerebral hemispheres during the acute period of stroke.

scholarly journals HUBUNGAN LETAK LESI HEMISFER SEREBRAL DAN DERAJAT KLINIS KECEMASAN PADA PENDERITA STROKE ISKEMIK

2018 ◽  
Vol 36 (1) ◽  
Author(s):  
Yelly Marliana Patu ◽  
Audry Devisanty Wuysang ◽  
Nadra Maricar
Keyword(s):  
Ischemic Stroke ◽  
Rating Scale ◽  
Right Hemisphere ◽  
P Value ◽  
Chi Square ◽  
Hemisphere Lesion ◽  
Hamilton Anxiety Rating Scale ◽  
The Right ◽  
The Relationship ◽  
Hamilton Anxiety

   RELATIONSHIP BETWEEN LOCATION OF CEREBRAL HEMISPHERE LESION AND CLINICAL DEGREES OF ANXIETY IN ISCHEMIC STROKE PATIENTSABSTRACTIntroduction: Stroke is the leading cause of disability and the third cause of death in the world. The lesion in the right hemisphere is most often associated with anxiety.Aim: Knowing the relationship between the location of the lesion and the degree of anxiety in patients with acute ischemic post-stroke.Method: Cross-sectional study of 40 ischemic post-stroke patients at Wahidin Sudirohusodo Hospital and network- ing hospitals in January-April 2018.  The degree of anxiety was measured by the Hamilton Anxiety Rating Scale (HARS). Chi-square and Mann-Whitney tests were used to analyze the relationship between variables with a p value <0.05 consid- ered significant.Result: There was a significant relationship between the location of the lesion in the hemisphere and the HARS score (p=0.01); and between the location of infarction lesions (cortical and subcortical) with the degree of anxiety in patients with ischemic stroke (p=0.012).Discussion: Moderate-severe anxiety levels occur higher in the lesions in the right hemisphere. The clinical instru- ments used cannot eliminate the element of subjectivity.Keywords: Anxiety in stroke, ischemic stroke, left hemisphere, lesion location, right hemisphereABSTRAKPendahuluan: Stroke merupakan penyebab utama kecacatan dan kematian ketiga terbanyak di dunia. Lokasi lesi di hemisfer kanan merupakan lokasi lesi yang paling sering dikaitkan dengan timbulnya kecemasan.Tujuan: Mengetahui hubungan antara lokasi lesi dan derajat kecemasan pada penderita pascastroke iskemik akut.Metode: Desain potong lintang pada 40 sampel penderita pascastroke iskemik di RS Wahidin Sudirohusodo dan rumah sakit jejaring pada bulan Januari-April 2018. Derajat kecemasan diukur dengan Hamilton Anxiety Rating Scale (HARS). Uji Chi-square dan Mann-Whitney digunakan untuk menganalisis hubungan antar variabel dengan nilai p<0,05 dianggap bermakna.Hasil: Terdapat hubungan yang signifikan antara lokasi lesi di hemisfer dengan skor HARS (p=0,01); dan antara lokasi lesi infark (kortikal dan subkortikal) dengan derajat kecemasan pada penderita stroke iskemik (p=0,012).Diskusi: Derajat kecemasan sedang-berat lebih tinggi terjadi pada lesi di hemisfer kanan.  Instrumen klinis yang digunakan tidak dapat menghilangkan unsur subjektifitas.Kata kunci: Cemas pada stroke, hemisfer kanan, hemisfer kiri, letak lesi, stroke iskemik

scholarly journals First report of coenurosis in sheep in the State of Mato Grosso do Sul, Brazil

2010 ◽  
Vol 19 (4) ◽  
pp. 265-267 ◽  
Author(s):  
Fernando Arévalo Batista ◽  
Dietrich Pizzigatti ◽  
Charles Ferreira Martins ◽  
Marcelo Monteiro Nunes ◽  
Tábata Torres Megda ◽  
...  
Keyword(s):  
Right Hemisphere ◽  
Pathological Condition ◽  
Brain Lesion ◽  
The State ◽  
Mato Grosso ◽  
Taenia Multiceps ◽  
First Case ◽  
Coenurus Cerebralis ◽  
The Right ◽  
Mato Grosso Do Sul

This paper reports the first case of coenurosis in the State of Mato Grosso do Sul, Brazil. This disease is caused by the larval stage of the tapeworm Taenia multiceps (Leske, 1780). The animal in which the disease was diagnosed was an 18-month-old ewe from an endemic area of Southern Brazil as an imported animal among a group of 30 sheep. The clinic-pathological condition was that commonly found in herbivores affected by the disease, especially sheep. Apathy, nystagmus, intermittent blindness, circling and pressing head against obstacles were the neurological signs reported. The necropsy showed that a brain lesion in the subcortex of the right hemisphere was a bladder-like cyst measuring 4 cm in diameter filled with a translucent fluid with a large number of white spherules (protoscolices) floating. In addition to the identification of the Coenurus cerebralis protoscolices, the brain tissue lesion was histopathologically described.

Left Auditory Cortex and Amygdala, but Right Insula Dominance for Human Laughing and Crying

2005 ◽  
Vol 17 (10) ◽  
pp. 1519-1531 ◽  
Author(s):  
Kerstin Sander ◽  
Henning Scheich
Keyword(s):  
Auditory Cortex ◽  
Left Hemisphere ◽  
Auditory Processing ◽  
Right Hemisphere ◽  
Imaging Study ◽  
Self Awareness ◽  
Animal Vocalizations ◽  
Shift Detection ◽  
Species Specific ◽  
The Right

Evidence suggests that in animals their own species-specific communication sounds are processed predominantly in the left hemisphere. In contrast, processing linguistic aspects of human speech involves the left hemisphere, whereas processing some prosodic aspects of speech as well as other not yet well-defined attributes of human voices predominantly involves the right hemisphere. This leaves open the question of hemispheric processing of universal (species-specific) human vocalizations that are more directly comparable to animal vocalizations. The present functional magnetic resonance imaging study addresses this question. Twenty subjects listened to human laughing and crying presented either in an original or time-reversed version while performing a pitch-shift detection task to control attention. Time-reversed presentation of these sounds is a suitable auditory control because it does not change the overall spectral content. The auditory cortex, amygdala, and insula in the left hemisphere were more strongly activated by original than by time-reversed laughing and crying. Thus, similar to speech, these nonspeech vocalizations involve predominantly left-hemisphere auditory processing. Functional data suggest that this lateralization effect is more likely based on acoustical similarities between speech and laughing or crying than on similarities with respect to communicative functions. Both the original and time-reversed laughing and crying activated more strongly the right insula, which may be compatible with its assumed function in emotional self-awareness.

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