scholarly journals Non-atherosclerotic arteriopathy as the cause of ishemic stroke among young adults

2010 ◽  
Vol 63 (5-6) ◽  
pp. 324-332 ◽  
Author(s):  
Mirjana Jovicevic ◽  
Ivana Divjak ◽  
Petar Slankamenac ◽  
Aleksandar Jovanovic ◽  
Svetlana Ruzicka ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Systemic Vasculitis ◽  
Age Groups ◽  
Diagnostic Procedures ◽  
Carotid Artery Dissection ◽  
Doppler Imaging ◽  
Artery Dissection ◽  
Conventional Angiography ◽  
Clinical Center

The study comprised 100 ischemic stroke patients of both sexes aged 15-45 years who were treated at the Clinic of Neurology of the Clinical Center of Vojvodina in the period January 2001 - September 2004. All study subjects were divided into three age groups: 15-25, 26-35 and 36-45 years. Sex, age and risk factors for cerebrovascular disease were determined in all patients. Diagnostic procedures applied in all patients included brain computed tomography and/or magnetic resonance imaging, routine laboratory tests, Doppler imaging of extra and endocranial blood vessels and coagulation tests. Contrast and/or transesophageal echocardiography, immunological blood assays, magnetic resonance angiography and/or computed tomography angiography and/or conventional angiography, trombophilia markers, antiphospholipid antibodies and toxicological examination, etc. were performed in selected patients. Non-atherosclerotic arteriopathies were found in 8% of all study subjects, and were the most frequent cause of stroke in the age group 15-25. Carotid artery dissection was the most frequent diagnosis overall, found in 6% of all patients. Fibromuscular dysplasia and systemic vasculitis were diagnosed in one patient each. Moyamoya disease, Takayasu disease, infectious and isolated vasculitis of the CNS were not found in our patients.

scholarly journals The most frequent causes of ischemic stroke in young adults

2011 ◽  
Vol 64 (5-6) ◽  
pp. 331-335 ◽  
Author(s):  
Mirjana Jovicevic ◽  
Ivana Divjak ◽  
Petar Slankamenac ◽  
Ksenija Bozic ◽  
Tamara Rabi-Zikic ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Young Adults ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Diagnostic Procedures ◽  
Doppler Imaging ◽  
Conventional Angiography ◽  
Stroke Treatment ◽  
Stroke In Young Adults ◽  
Stroke In Young

Introduction. Pathogenesis of ischemic stroke in young adults is heterogeneous, thus making differential diagnosis very broad. Material and methods. The study comprised 60 ischemic stroke patients of both sexes aged 15-45 years who were treated at the Department of Neurology of the Clinical Centre of Vojvodina. Information about sex and age, detailed history, risk factors for ischemic stroke were obtained for all patients who underwent neurological examination as well. Diagnostic procedures applied in all patients included brain computed tomography and/or magnetic resonance imaging, routine laboratory tests, Doppler imaging of extra and endocranial blood vessels and coagulation tests. Contrast and/ or transesophageal echocardiography, immunological blood assays, magnetic resonance angiography and/or computed tomography angiography and/or conventional angiography, immunological tests, assessment of levels of natural coagulation inhibitors, toxicological examination, etc. were performed in selected patients. Results. Causes of ischemic stroke were determined according to the Trial of ORG 10172 in Acute Stroke Treatment criteria. The most frequent were the so called other causes of ischemic stroke, which were found in 26.7% patients. The second most frequent cause was cardiac embolisation, found in 25%. The cause of ischemic stroke remained undetermined in 21.7% of all patients. Conclusion. Aetiology of ischemic stroke in young adults is diverse and demands thorough diagnostic evaluation.

Space reconstruction of the aneurysms of the vertebrobasilary confluence based on conventional angiography: Our experience

2008 ◽  
Vol 55 (2) ◽  
pp. 75-78
Author(s):  
I.M. Nikolic ◽  
M.Lj. Rakic ◽  
E.E. Slavik ◽  
G.M. Tasic ◽  
B.M. Djurovic ◽  
...  
Keyword(s):  
Blood Vessels ◽  
Diagnostic Procedures ◽  
Conventional Angiography ◽  
Two Dimensional Image ◽  
Diagnostic Protocol ◽  
Clinical Center ◽  
Golden Standard ◽  
Preoperative Diagnostic ◽  
Third Dimension ◽  
Initial Results

Besides current development of the new diagnostic procedures conventional angiography still represents the golden standard in the diagnosing of intracranial aneurysms. Since it gives a two-dimensional image if the presentation of the third dimension is wanted it is necessary to apply appropriate algorithm structures and computers. In this study we show our experience in the application of space reconstruction of blood vessels and aneurysms of the vertebrobasilary confluence in 6 patients operated at the Institute for Neurosurgery, Clinical Center of Serbia. Intraoperative finding in all patients matched the finding that we got by space reconstruction of the blood vessels, which was possible to observe from different angles. Postoperative course in all patients was satisfying. Upon discharge the patients were without rough lateralization of the pyramidal system. Our initial results and their practical agreement with the interoperative finding give us right to recommend this method as the standard for the preoperative diagnostic protocol.

Carotid Artery Dissection-Related Intracranial Aneurysm Development

Neurosurgery ◽  
2011 ◽  
Vol 70 (2) ◽  
pp. E511-E515 ◽  
Author(s):  
Giuseppe Esposito ◽  
Giovanni Sabatino ◽  
Giorgio Lofrese ◽  
Alessio Albanese
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Ct Scan ◽  
Computed Tomography Angiography ◽  
Internal Carotid ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Neurological Conditions

Abstract BACKGROUND AND IMPORTANCE: We analyzed the physiopathology of the association between cervical artery dissections (CADs), intracranial aneurysms (IAs), and aneurysmal subarachnoid hemorrhage. CLINICAL PRESENTATION: A 43-year-old woman presented with diffuse subarachnoid hemorrhage (Fisher 3; Hunt-Hess 1). computed tomography angiography revealed a cervical internal carotid artery dissection and 2 IAs: right paraclinoid and right posterior communicating artery. The patient underwent surgical clipping of the 2 aneurysms. CAD was managed conservatively. Postoperative course was initially uneventful. After 24 hours, digital subtraction angiography (DSA) documented the exclusion of the aneurysms and an improvement of the CAD. After 3 days, the patient's neurological condition suddenly worsened; CT scan documented a subarachnoid rebleeding (Hunt-Hess 4) and DSA revealed the recurrence of CAD and a new right internal carotid artery aneurysm. The patient underwent clipping of the new aneurysm and decompressive craniectomy because of severe brain swelling. Postoperative neurological conditions remained poor. DSA showed the exclusion of the aneurysms and improvement of CAD. Three days later, CT scan performed after a sudden raise in intracranial pressure documented a wide intracerebral hematoma. Computed tomography angiography did not show new vascular malformations. Surgical removal of the hematoma was performed, but poor neurological conditions persisted. CONCLUSION: CAD-related hemodynamic changes may play a role in the development of IAs. The presence of IAs must be screened carefully in case of CAD, because the dynamic behavior of CAD definitively increases the risk of IA formation, enlargement, and rupture.

scholarly journals Unexpected Angiography Findings and Effects on Management

2016 ◽  
Vol 6 ◽  
pp. 33
Author(s):  
Matthew Neill ◽  
Hearns W Charles ◽  
Jonathan S Gross ◽  
Sean Farquharson ◽  
Amy R Deipolyi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Interventional Procedures ◽  
Diagnostic Workup ◽  
Resonance Imaging ◽  
Conventional Angiography ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Despite progress in noninvasive imaging with computed tomography and magnetic resonance imaging, conventional angiography still contributes to the diagnostic workup of oncologic and other diseases. Arteriography can reveal tumors not evident on cross-sectional imaging, in addition to defining aberrant or unexpected arterial supply to targeted lesions. This additional and potentially unanticipated information can alter management decisions during interventional procedures.

Magnetic Resonance Imaging and Computed Tomography Imaging Sedation

2018 ◽  
pp. 224-229
Author(s):  
Amber Rogers
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Diagnostic Procedures ◽  
Resonance Imaging ◽  
Neuroprotective Effects ◽  
Ventilation Monitoring ◽  
Recovery Times ◽  
Magnetic Resonance Imaging Mri ◽  
Airway Tone

Magnetic resonance imaging (MRI) and computed tomography (CT) are among the most common procedures to require some level of pediatric sedation. Although painless, they necessitate immobility for adequate imaging quality. Many children can complete these diagnostic procedures without sedation, and this should be encouraged. If sedation medications are needed, propofol is commonly used to administer deep sedation for these procedures given its fast induction and recovery times, but particularly careful ventilation monitoring with capnography is important for the sedation provider who is physically separated from the patient in the MRI suite. Dexmedetomidine use is increasing in both MRI and CT sedation; its advantages are maintenance of airway tone and possible neuroprotective effects, but its disadvantages are longer induction and recovery times. Safety, efficacy, and efficiency should be carefully considered when coordinating sedation care for MRI and CT procedures.

scholarly journals A case series of 22 patients with internal carotid artery dissection

2011 ◽  
Vol 64 (11-12) ◽  
pp. 575-578 ◽  
Author(s):  
Ivana Divjak ◽  
Petar Slankamenac ◽  
Mirjana Jovicevic ◽  
Tamara Rabi-Zikic ◽  
Aleksandra Lucic-Prokin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection ◽  
Resonance Imaging ◽  
Sensorimotor Deficit

The aim of this study was to analyze the spectrum of clinical presentations of internal carotid artery dissection. Twenty-two patients with internal carotid artery dissection, mean age 39.02, were evaluated over the past ten years. Magnetic resonance imaging and magnetic resonance angiography were used to establish the diagnosis. Facial and neck pain and Horner?s syndrome were the only presenting symptoms in 4 patients (without brain infarction); facial pain, Horner?s syndrome and contralateral sensorimotor deficit in 6; headache and contralateral sensorimotor deficit in 2; contralateral sensorimotor deficit with or without speech impairment in 10. Internal carotid artery dissection was triggered by a trauma in 7, whereas it was spontaneous in 15. Magnetic resonance imaging revealed infarction in 18 patients. A good outcome (modified Rankin score 0-2) was seen in 20 patients. The spectrum of clinical presentations of internal carotid artery dissection is variable. Internal carotid artery dissection is not necessarily accompanied by infarction on magnetic resonance imaging.

Jugular Foramen Syndrome with Miosis: A Sign of Internal Carotid Artery Dissection

1998 ◽  
Vol 11 (1) ◽  
pp. 99-102
Author(s):  
F.A. Lupo ◽  
S.C. Perfetto ◽  
G. Sticchi
Keyword(s):  
Magnetic Resonance ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Spontaneous Remission ◽  
Jugular Foramen ◽  
Carotid Artery Dissection ◽  
Clinical Aspects ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection

We describe a case of left extra and intracranial internal carotid artery dissection in a 59-year-old man who presented with the clinical features of left jugular foramen syndrome (dysphonia, dysphagia, ageusia, paralysis of the sternocleidomastoid muscle) and ipsilateral miosis with acute onset, worsening in the first 24 hours and spontaneous remission over the next thirty days. The patient was investigated by computed tomography magnetic resonance and digital angiography and received conservative treatment. The clinical aspects are discussed, emphasizing the major role of magnetic resonance in the diagnosis of the syndrome.

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