scholarly journals Bilateral thalamus stroke due to percheron artery

2021 ◽  
Vol 32 (2) ◽  
pp. 193-195
Author(s):  
Zeferino Demartini Junior ◽  
Jennyfer Paulla Galdino Chaves ◽  
Roberto Lages ◽  
Diogo Cardoso ◽  
Luana Antunes Maranha Gatto ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Ischemic Stroke ◽  
Functional Recovery ◽  
Early Recognition ◽  
Rare Condition ◽  
Common Trunk ◽  
Significant Morbidity ◽  
Anatomical Variant ◽  
Cerebellar Artery ◽  
Bilateral Thalamus

Bilateral thalamus ischemic stroke is a rare condition that carries significant morbidity and mortality in comparison to other forms of stroke. It is usually associated with an anatomical variant with the thalamic paramedian arteries arising from a common trunk from the posterior cerebellar artery, known as Percheron artery. This infarct is difficult to be recognized and early recognition of this syndrome improves survival and functional recovery. We report a case of bilateral thalamic stroke after cardiac surgery.

scholarly journals Ischemic stroke in azygos anterior cerebral artery: a case report

2021 ◽  
Author(s):  
Pedro Henrique Souza Reis ◽  
Mozart Guanaes Gomes Neto ◽  
Mauro Eduardo Jurno ◽  
Renata Souza dos Santos
Keyword(s):  
Traumatic Brain Injury ◽  
Ischemic Stroke ◽  
Case Report ◽  
Brain Injury ◽  
Rare Variant ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Common Trunk ◽  
Anatomical Variant ◽  
Level Of Consciousness

Context: The azygos anterior cerebral artery (azygos-ACA) is a rare variant that involves a common trunk in segment A2 (above the anterior communicating artery). Its prevalence is 0.3–2%. Case report: Male patient, 59 years old, diabetic, smoker, with congenital heart disease (long congenital QT) was admitted to the hospital on 01/07/2020 with traumatic brain injury followed by a seizure crisis (1st episode). Upon admission, he had Glasgow 13 and a cranial tomography showing small left frontal hemorrhage, then conservative treatment with phenytoin 100mg every 8 hours was initiated. The following day, there was a decrease in the level of consciousness (Glasgow 7), with orotracheal intubation being performed and a new skull tomography was performed revealing a slightly enlarged left frontal contusion area, right subdural hematoma, bifrontal hypodensity and left caudate nucleus. Mannitol (100ml / 6h) was indicated and phenytoin (100mg/ 8h) was maintained. On 16/07/2020, the cranial angiotomography showed hypoflow of the anterior cerebral artery and an anatomical variant showing that such artery emerged from a single trunk. The next day, he was still intubated, with Glasgow 6 and no interaction with an examiner. Conclusions: It is concluded that the patient had a bifrontal ischemic stroke (evidenced by the 2nd tomography) and this, occurred due to an obstruction of the azygos-ACA (rare variant), explaining its bilaterality. This situation led to traumatic brain injury, syncope and a severe decrease in the level of consciousness. Given the possible repercussions, the anatomical recognition of this variant becomes important.

Role of S100β Glial Protein as a Serological Marker for Analysis of Acute Ischemic Stroke

2021 ◽  
pp. 251660852110112
Author(s):  
Kiran Buddharaju ◽  
Mahendra Javali ◽  
Anish Mehta ◽  
R Srinivasa ◽  
Purushottam Acharya
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Recovery ◽  
Protein Level ◽  
Serological Marker ◽  
Protein Levels ◽  
S100β Protein ◽  
Asymptomatic Volunteers ◽  
Scale Scores

Background: Stroke is a major cause of neurological disability, which can be often predicted with serological markers. Glial-derived S100β protein is a potential biomarker for cerebral ischemia and may be helpful in predicting the severity, outcome, and recovery of stroke. Aim: This study aimed to study the role of S100β glial protein as a serological marker in predicting the severity of acute ischemic stroke (AIS), outcome, and functional recovery after 1 month. Methods: A hospital-based prospective case control study included 43 consecutive patients, >18 years old, who were admitted with acute middle cerebral artery (MCA) territory infarcts within 72 h of onset of neurological deficits. Control group comprised of 43 age-matched asymptomatic volunteers. Independent t-test and chi square test were used to compare the means and evaluate the association between protein level and various parameters. P ≤ .05 was statistically significant. Results: S100β protein level in AIS patients was significantly higher compared to controls ( P < .05). Elevated serum S100β protein level was found to be associated with larger infarct volumes, higher National Institute Health Stroke Scale scores, and higher modified Rankin Scale scores at admission ( P < .05). Patients with higher S100β protein levels at admission had poor recovery at 1 month compared to patients having normal S100β protein levels. Conclusion: S100β protein levels at admission after an acute MCA territory infarct may be used as a reliable serological tool in predicting the severity, outcome, and functional recovery in stroke.

scholarly journals Impact of Post-Stroke Recanalization on General and Upper Limb Functioning: A Prospective, Observational Study

2021 ◽  
Vol 13 (1) ◽  
pp. 46-58
Author(s):  
João Paulo Branco ◽  
Filipa Rocha ◽  
João Sargento-Freitas ◽  
Gustavo C. Santo ◽  
António Freire ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Observational Study ◽  
Acute Ischemic Stroke ◽  
Upper Limb ◽  
Functional Recovery ◽  
Prospective Observational Study ◽  
Positive Impact ◽  
Rehabilitation Program ◽  
Patient Functioning ◽  
The Impact

The objective of this study is to assess the impact of recanalization (spontaneous and therapeutic) on upper limb functioning and general patient functioning after stroke. This is a prospective, observational study of patients hospitalized due to acute ischemic stroke in the territory of the middle cerebral artery (n = 98). Patients completed a comprehensive rehabilitation program and were followed-up for 24 weeks. The impact of recanalization on patient functioning was evaluated using the modified Rankin Scale (mRS) and Stroke Upper Limb Capacity Scale (SULCS). General and upper limb functioning improved markedly in the first three weeks after stroke. Age, gender, and National Institutes of Health Stroke Scale (NIHSS) score at admission were associated with general and upper limb functioning at 12 weeks. Successful recanalization was associated with better functioning. Among patients who underwent therapeutic recanalization, NIHSS scores ≥16.5 indicate lower general functioning at 12 weeks (sensibility = 72.4%; specificity = 78.6%) and NIHSS scores ≥13.5 indicate no hand functioning at 12 weeks (sensibility = 83.8%; specificity = 76.5%). Recanalization, either spontaneous or therapeutic, has a positive impact on patient functioning after acute ischemic stroke. Functional recovery occurs mostly within the first 12 weeks after stroke, with greater functional gains among patients with successful recanalization. Higher NIHSS scores at admission are associated with worse functional recovery.

scholarly journals Aspergillus aortitis in an immunocompetent patient presenting with acute endophthalmitis

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Joseph M. Rocco ◽  
Maggie K. Benson
Keyword(s):  
Cardiac Surgery ◽  
Early Recognition ◽  
Disease Process ◽  
Infectious Agent ◽  
Immunocompetent Patient ◽  
Endogenous Endophthalmitis ◽  
Laboratory Studies ◽  
Aortic Pseudoaneurysm ◽  
First Case ◽  
Ascending Aortic Pseudoaneurysm

Aspergillus is a common environmental mold most often recognized as an infectious agent in patients with severe immune compromise. We present a case of an immunocompetent patient presenting with endogenous endophthalmitis in the absence of other infectious symptoms. The search for a systemic source revealed an ascending aortic pseudoaneurysm. Surgical resection and pathology revealed angioinvasive aspergillus aortitis. Recent cardiac surgery has been noted to be a risk factor for angioinvasive aspergillosis. Diagnosis is difficult as symptoms are mild and laboratory studies are often normal. To our knowledge this is the first case of aspergillus aortitis presenting as endogenous endophthalmitis without systemic signs of inflammation. These patients have a high mortality rate therefore early recognition is essential. It is important to consider angioinvasive aspergillus infections in patients with prior cardiac surgery presenting with occult embolic phenomena. Only with early diagnosis and prompt treatment can we improve outcomes of this disease process.

Chemogenetic activation of glutamatergic neurons in the motor cortex promotes functional recovery after ischemic stroke in rats

2019 ◽  
Vol 359 ◽  
pp. 81-88 ◽  
Author(s):  
Ke-hui Hu ◽  
Yang-an Li ◽  
Wei Jia ◽  
Guang-yan Wu ◽  
Lin Sun ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Motor Cortex ◽  
Functional Recovery ◽  
Glutamatergic Neurons

scholarly journals A rare case of mobile ball-like mass in right atrium associated with dilated cardiomyopathy

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Jing Dong ◽  
◽  
Yiqun Gao ◽  
Shunji Liang ◽  
Guorong Deng ◽  
...  
Keyword(s):  
Anticoagulant Therapy ◽  
Right Atrium ◽  
Early Recognition ◽  
Therapeutic Option ◽  
Venous Pressure ◽  
Rare Condition ◽  
Good Clinical Condition ◽  
Mobile Mass ◽  
2D Echocardiogram ◽  
The Right

Mobile thrombus in the Right Atrium (RA) is a rare condition. Here, we described a case of a 59-year-old male who presented in emergency room with complaints of progressively worsening dyspnea for 7 years. He was normotensive, had elevated jugular venous pressure and clear lungs. ECG revealed ventricular tachycardia. After successfully electrical defibrillation, an urgent 2D echocardiogram was obtained and revealed the enlargement of all heart chambers and a ball-like, mobile mass in the right atrium. An emergent CT scan revealed no sign of pulmonary embolism. Based on morphological features on echocardiogram, we highly suspected it as RA thrombus. The patient was treated with anticoagulant therapy comprising of low molecular heparin and warfarin since he rejected surgical treatment. Repeat echocardiogram was performed 7 days after anticoagulant therapy and showed disappearance of the RA mass. He was subsequently maintained on warfarin (INR=2.4- 3.0) and other medications for heart failure. The patient was followed up as outpatient and kept in good clinical condition. We concluded that early recognition of this rare situation and prompt management can help in preventing life-threatening complications, and anticoagulant therapy was a therapeutic option for RA thrombus.

scholarly journals Case report: Diagnosis and emergency surgery on a young patient with extensive aortic dissection without any risk factors

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masoud Shafiee ◽  
Mohsen Shafiee ◽  
Noorollah Tahery ◽  
Omid Azadbakht ◽  
Zeinab Nassari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Aortic Dissection ◽  
Heart Surgery ◽  
Heart Diseases ◽  
Open Heart Surgery ◽  
Rare Condition ◽  
Underlying Disease ◽  
Case Presentation ◽  
History Of

Abstract Background Type A aortic dissection is a very dangerous, fatal, and emergency condition for surgery. Acute aortic dissection is a rare condition, such that many patients will not survive without reconstructive surgery. Case presentation We present a case 24-year-old male who came with symptoms of shortness of breath and cough. The patient underwent ECG, chest radiology, and ultrasound, where the patient was found to have right pleural effusion while his ECG was normal. In the history taken from the patient, he had no underlying disease, no history of heart diseases in his family. For a better diagnosis, ETT and aortic CT angiography was performed on the patient which confirmed the evidence of dissection. Immediately after the diagnosis, necessary arrangements were made for open heart surgery and the patient was prepared for surgery. The patient was admitted in the cardiac surgery ICU for 5 days and his medication was carefully administered. After the conditions were stabilized, the patient was transferred to the post-cardiac surgery ICU ward. The patient was discharged from the hospital one week after the surgery and returned to the office as an OPD one week after his discharge. Conclusion Various risk factors can play a role in creating aortic dissection. Therefore, it is necessary to pay attention to patients’ history for achieving a quick and definitive diagnosis. Therefore, to control the complications of placing the cannula as well as the duration of the surgery, it is very important to reduce the duration of pumping on the patient and to be very careful during the cannula placement.

scholarly journals Eagle syndrome as a rare cause of recurrent transient ischemic stroke in Senegal (West Africa)

2021 ◽  
Vol 7 (9) ◽  
pp. 1534
Author(s):  
Birame Loum ◽  
Cheikh Ahmedou Lame ◽  
Cheikhna B. Ndiaye ◽  
Kamadore Toure ◽  
Mouhamadou Mansour Ndiaye
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Rare Condition ◽  
Styloid Process ◽  
Neurological Impairment ◽  
Vascular Events ◽  
Eagle Syndrome

<p>Eagle syndrome is a rare condition, often characterized by nonspecific symptoms. It is due to an abnormally long or compressive styloid process on surrounding structures. Exceptionally, it can cause neuro-vascular manifestations. We report an observation of Eagle syndrome discovered incidentally in presence of recurrent transient ischemic stroke. A 74-year-old man with no cardiovascular risk factors, was admitted to our department following 4 episodes of transient ischemic stroke with right hemiplegia and aphasia, always rapidly resolving. Head and neck CT scan showed 2 long styloid processes with a marked impingement of the left one against the ipsilateral internal carotid artery. Intraoral styloidectomy was performed. The patient recovered fully and remained free of symptoms without neurological impairment, at 6 months. Eagle syndrome is a rare condition which may lead, exceptionally, to repetitive transient ischemic stroke. Surgical styloidectomy must be considered to reduce the risk of new vascular events and prevent serious complications such as dissection of the internal carotid artery.</p>

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