scholarly journals D-dimer level elevation can aid in detection of asymptomatic COVID-19 presenting with acute cerebral infarction

2020 ◽  
Author(s):  
Takeru Umemura ◽  
Hirohisa Kondo ◽  
Hirotsugu Ohta ◽  
Koichiro Futatsuya ◽  
Takamitsu Mizobe
Keyword(s):  
Cerebral Infarction ◽  
Venous Thrombosis ◽  
Acute Stroke ◽  
Female Patient ◽  
Respiratory Symptoms ◽  
Stroke Onset ◽  
Acute Cerebral Infarction ◽  
First Case ◽  
Level Elevation ◽  
D Dimer

Abstract Coronavirus disease 2019 (COVID-19) mainly manifests as a respiratory syndrome, besides causing other complications. Severe COVID-19 may also present with coagulopathy, leading to venous thrombosis and cerebral infarction. Stroke is one of the complications associated with severe COVID-19. Generally, acute stroke is the second complication in patients with respiratory syndrome. Here, we present a case of COVID-19 in an 84-year-old female patient who did not manifest any respiratory symptoms; however, she presented with acute stroke. The patient had no cough or fever before the stroke onset, but the COVID-19 PCR was positive. The patient also had markedly elevated D-dimer levels. Our findings suggest that coagulopathy can occur, even in a patient with asymptomatic COVID-19 infection. To our knowledge, this is the first case of asymptomatic COVID-19 in a patient presenting with cerebral infarction. We concluded that elevation of D-dimer levels is one of the tools to ascertain COVID-19 infection in such patients.

scholarly journals D-dimer level elevation can aid in detection of asymptomatic COVID-19 presenting with acute cerebral infarction

2021 ◽  
Vol 22 ◽  
pp. 100294
Author(s):  
Takeru Umemura ◽  
Hirohisa Kondo ◽  
Hirotsugu Ohta ◽  
Koichiro Futatsuya ◽  
Takamitsu Mizobe ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Acute Cerebral Infarction ◽  
Level Elevation ◽  
D Dimer

A rare case of cerebral proliferative angiopathy with acute cerebral infarction and facial capillary malformation

2021 ◽  
pp. 197140092110428
Author(s):  
Trilochan Srivastava ◽  
Ashok Gandhi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebral Infarction ◽  
Rare Case ◽  
Acute Cerebral Infarction ◽  
Resonance Imaging ◽  
Capillary Malformation ◽  
First Case ◽  
Cerebral Vascular Malformation ◽  
Detailed Evaluation ◽  
Weighted Magnetic Resonance Imaging

We are describing a case of a 14-year-old girl who developed acute cerebral infarction which was documented on diffusion-weighted magnetic resonance imaging (DWI). On detailed evaluation, diagnosis of cerebral proliferative angiopathy (CPA) was made. Incidentally, she had capillary malformation on the forehead contralateral to cerebral vascular malformation. To our knowledge, this is the first case of CPA in the literature where DWI abnormality was due to acute cerebral infarction.

Dynamical levels of plasma F1+2and D-dimer in patients with acute cerebral infarction during intravenous urokinase thrombolysis

2009 ◽  
Vol 31 (4) ◽  
pp. 367-370 ◽  
Author(s):  
Ran Meng ◽  
Xunming Ji ◽  
Baoyu Li ◽  
Jin Zhou ◽  
Wenbin Li ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Acute Cerebral Infarction ◽  
D Dimer

scholarly journals Diffusion kurtosis imaging and diffusion-weighted imaging-based classification of acute stroke lesions in the brain: A pilot study

2020 ◽  
Author(s):  
Xin Liu ◽  
Songsen Chen ◽  
Fang Chen ◽  
Lei Wang ◽  
Khan Afsar ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Acute Stroke ◽  
Diffusion Weighted Imaging ◽  
Tissue Injury ◽  
Acute Cerebral Infarction ◽  
Diffusion Kurtosis Imaging ◽  
Type I ◽  
Type Ii ◽  
Diffusion Kurtosis

Abstract Background: We postulated that diffusion kurtosis imaging (DKI) could classify heterogeneous stroke lesions on diffusion-weighted imaging (DWI) and improve our understanding of the characteristics of tissue injury. We aimed to retrospectively study different DKI parameters in patients with acute stroke reported in the literature. Methods: We collected the DWI and DKI data of 41 patients (26 men, 15 women), including 86 cases of acute cerebral infarction in different brain regions. Of them, 20 patients had single infarction, whereas others had multiple infarctions. Acute cerebral infarction lesions were classified into two categories based on DKI and DWI parameters: type I, matched DKI and DWI parameters and type II, mismatched DKI and DWI parameters. Regions of interest (ROIs) were outlined within the most severely infarcted areas of each lesion according to each independent parametric map. In the control groups, same-sized ROIs were located in the corresponding region of the normal contralateral hemisphere. In both categories, DKI and DWI parameters followed a normal Gaussian distribution. We used the independent sample t-test to compare the differences in each group. Results: In type I cases, fractional anisotropy, mean diffusivity, axial diffusivity, radial diffusivity, mean kurtosis (MK), and axial kurtosis (Ka) values were significantly different (P<0.05). In type II cases, only MK and Ka values were significantly different (P<0.05). Conclusions: DKI can provide more information on acute ischemic brain infarction and enrich our understanding of ischemic tissue injury. This DKI and DWI parameters-based classification of acute stroke lesions may confer a renewed understanding of infarction cores.

scholarly journals Cerebral venous thrombosis secondary to an occult maxillary sinusitis in a young male from sub-Saharan Africa

2019 ◽  
pp. 08-12
Author(s):  
Mazou N Temgoua ◽  
Mickael Essouma ◽  
Larry N Tangie ◽  
Cedric Tsinda ◽  
Drusille Feze Foko ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Acute Stroke ◽  
Cerebral Venous Thrombosis ◽  
Fungal Infections ◽  
Sinus Thrombosis ◽  
Maxillary Sinusitis ◽  
Case Reports ◽  
Sub Saharan Africa ◽  
First Case ◽  
Increased Risk

Cerebral venous thrombosis (CVT) also termed cerebral venous sinus thrombosis (CVST), is a special type of cerebrovascular disease characterized by cerebral venous infarction [1]. As from 1825 when the first case was described by Ribes[2], epidemiological descriptions are still restricted to case reports and small retrospective cross-sectional studies yielding low butincreasing incidence: <10 cases per million per year in 1995 to about 13.2 cases per million per year in 2012.CVT mainly occurs in women of child bearing age, probably owing to the use of oral contraceptive pills, and mostly has an acute or subacute course [1]. It can be categorized as primary/idiopathicand secondary. Secondary CVT can further be classified into infective (mainly due to bacterial or fungal infections) and non-infective CVT; the latterbeing due tocoagulation disorders, neoplasms, procoagulant hemodynamic states, vascularitis,homocystinuria, or head trauma [3].With the advent of antibiotics, the epidemiology of CVT has shifted from predominant infective CVT to predominant non-infective CVT, leading to increased risk of misdiagnosis and delayed treatment [3]. We report occult purulent maxillary sinusitis-related CVT in a male Cameroonian patient who presented with headaches, seizures and acute stroke syndrome. The aim of this paper is to reiterate CVT as the main cause of acute stroke syndrome in young adults irrespective of ethnic origin and sex, and suggest systematic screening of infections in those patients, especially in regions with high rates of infections likesub-Saharan Africa.We describe this case with regard to CARE guidelines.

Abstract TP414: Cerebral Infarction After Antithrombotics Withdrawal and Its Impact on Clinical Outcome

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Keonjoo Lee ◽  
Jeong Min Kim ◽  
Keun-Hwa Jung ◽  
Jee-young Han ◽  
Jae-Kyu Roh
Keyword(s):  
Cerebral Infarction ◽  
Acute Stroke ◽  
Clinical Characteristics ◽  
Antiplatelet Agent ◽  
Stroke Onset ◽  
Poor Compliance ◽  
Stroke Outcome ◽  
Stroke Patients ◽  
Common Cause ◽  
Regular Medication

Background: The cessation of antithrombotic agent is related with increased thromboembolic events. However, the clinical characteristics of stroke after antithrombotics withdrawal and its impact on stroke outcome have not been studied. In this study we tried to evaluate clinical significance of antithrombotics withdrawal in stroke occurrence and outcome. Methods: Between January 1 st 2009, and March 1 st 2012, the acute stroke patients who admitted in Seoul National University Hospital within seven days after symptom onset were eligible in the study. We defined stroke after antithrombotics withdrawal (SAW) as those stroke patients who had maintained antiplatelet agent or anticoagulant regularly but ceased their medication before stroke onset. We reviewed their clinical characteristics as well as the reason of medication cessation, type of medication, and duration between medication hold and stroke onset. To evaluate the effect of antithrombotics withdrawal in stroke outcome, we compared SAW with stroke patients which occurred on regular medication. Results: Among 1635 acute stroke patients, 84 patients (5.2%) were identified as SAW during the inclusion period, with a mean age of 68.0±13.2 years including 49 male patients. The most common cause of medication cessation is poor compliance in 32 patients (37.7%), followed by pre-operation/procedure hold in 24, antithrombotics complication in 16, and doctor’s decision in 13. The 42 patients with SAW who had stroke within one month after medication cessation were compared with 261 patients who experienced cerebral infarction during regular medication. Stroke progression defined as 3 or more NIHSS worsening during admission was more prevalent in SAW patients than in patients with regular medication (14.3% vs. 5.0%, p=0.042). The patients with poor functional outcome defined as mRS of 5 and 6 at discharge were more common in SAW than in patients with regular medication (16.7% vs. 6.5%, p=0.043). Conclusion: This study shows that 5.2% of total stroke is due to medication withdrawal, and poor compliance is the most common cause of antithrombotics hold. Stroke after antithrombotics hold is associated with higher rate of stroke progression and poor outcome, implying exacerbated thromboembolic state.

Red blood cell distribution width is associated with poor clinical outcome in acute cerebral infarction

2012 ◽  
Vol 108 (08) ◽  
pp. 349-356 ◽  
Author(s):  
Jinkwon Kim ◽  
Young Kim ◽  
Tae-Jin Song ◽  
Ji Park ◽  
Hye Lee ◽  
...  
Keyword(s):  
Blood Cell ◽  
Cerebral Infarction ◽  
Functional Outcome ◽  
Red Blood Cell ◽  
Stroke Onset ◽  
Acute Cerebral Infarction ◽  
Cell Distribution ◽  
Poor Functional Outcome ◽  
Distribution Width ◽  
Red Blood Cell Distribution

SummaryIncreased red blood cell distribution width (RDW), which is a marker of anisocytosis, is associated with mortality and cardiovascular events in the general population and in patients with heart failure or coronary heart disease. We investigated whether RDW in acute cerebral infarction is predictive of functional outcome and mortality. A total of 847 consecutive patients with first-ever acute cerebral infarction who presented to the emergency department within seven days of symptom onset were enrolled in this study. We investigated the association of RDW with poor functional outcome (modified Rankin Scale >2) and all-cause mortality at three months, as well as survival time for one year after stroke onset. Multivariate logistic regression revealed that higher RDW was independently associated with poor functional outcome (adjusted odds ratio [OR], 1.222 per 1% increment in RDW, 95% confidence interval [CI] 1.059–1.409, p=0.006) and all-cause death (adjusted OR, 1.395 per 1% increment in RDW, 95% CI 1.168–1.665, p<0.001) at three months after stroke onset. RDW was an independent predictor of survival in multivariate Cox-proportional regression model (adjusted hazard ratio, 1.328 per 1% increment in RDW, 95%CI 1.178–1.498, p<0.001). The addition of RDW to a survival model significantly increased predictability for survival across the entire follow-up period (weighted average of the area-under the curves, 0.858 vs. 0.841, p<0.05). In conclusion, higher RDW measured in cases of acute stage cerebral infarction was associated with poor functional outcome and mortality. RDW may be used as a biomarker for the prediction of long-term outcomes in patients with acute cerebral infarction.

scholarly journals Clinical Risk Factors of Asymptomatic Deep Venous Thrombosis in Patients With Acute Stroke

2019 ◽  
Vol 25 ◽  
pp. 107602961986853
Author(s):  
Yi Wang ◽  
Yu Shi ◽  
Yi Dong ◽  
Qiang Dong ◽  
Ting Ye ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Acute Stroke ◽  
Area Under The Curve ◽  
High Risk Population ◽  
Observation Study ◽  
Kaplan Meier ◽  
D Dimer

Background: Deep venous thrombosis (DVT) is a common complication after stroke. It is easy to identify the patients with symptomatic DVT; however, the tool for asymptomatic high-risk population needs to be further explored. Our aim was to explore the risk factors of acute stroke patients with asymptomatic DVT. Methods: We performed a prospective observation study among 452 patients with acute stroke who had a stroke within 14 days. Ultrasound examination of deep veins was repeatedly performed in each patient for DVT every 7 days during his admission. The dynamic rate of DVT in acute stroke was analyzed. Then risk factors were compared between DVT patients and non-DVT patients. The predictive model was explored based on thr cox proportion model. Results: Asymptomatic DVT was detected in 52 (11.5%) patients with stroke and 85.9% of thrombi were identified in their distal veins. Patients with longer length of stay ( P = .004), more severe stroke ( P = 0.001), higher level of D-dimer ( P = .003), and higher blood glucose level were associated with higher risk of DVT, while patients with higher triglyceride level ( P = .003) were less likely to have DVT, after adjusting age and sex. With the median of D-dimer (0.38 FEU mg/L) as cutoff value. Patients with higher level of D-dimer might have a higher risk of DVT with a significant statistical difference. Also, the severity of stroke differed DVT risk in Kaplan-Meier model. Using cox-proportion hazard regression model, asymptomatic DVT could be predicted (area under the curve 0.852). Conclusion: Our data showed that asymptomatic DVT was common in patients with acute stroke and most of thrombosis occurred in distal veins. Combination of clinical manifestation and laboratory results might be helpful predict DVT. DVT prophylaxis should be condisdered in high risk.

Sign in / Sign up

Export Citation Format

Share Document