scholarly journals Psoriasis as the single risk factor for “Locked-in syndrome” after ischemic stroke in a young patient: case report and literature review

Author(s):  
Mahesh Krishnamurthy
2010 ◽  
Vol 18 (4) ◽  
pp. 432-436 ◽  
Author(s):  
Melissa Rodrigues de Araujo ◽  
Bruna Stuchi Centurion ◽  
Danielle Frota de Albuquerque ◽  
Luiz Henrique Marchesano ◽  
José Humberto Damante

Author(s):  
Aravind Reddy ◽  
Neil Suryadevara ◽  
Hesham Masoud ◽  
Palma Shaw ◽  
Karen Albright

Introduction : Case report: 63 year old African American woman with history of hypertension presented with acute onset of expressive aphasia. Her neurologic exam and NIHSS was significant for moderate aphasia with paraphasic errors and impairment of repetition. She was outside the treatment window for IV thrombolytic therapy. CT angiography of the head and neck in the ED showed moderate 60–70% stenosis of the left internal carotid artery secondary to a carotid web. She was admitted to the stroke service and started on DAPT with ASA and clopidogrel. MRI brain was obtained, which confirmed a small acute infarct in the posterior margin of the left sylvian fissure. Methods : Intervention and Follow‐up: Vascular surgery and interventional neurology were consulted to discuss the treatment options for the patient’s carotid web. Give the unique nature of the patient’s web with its triple lumen appearance, carotid endarterectomy (CEA) was favored over stenting, and the patient underwent left CEA. There were no immediate complications, and she was continued on DAPT for 21 days, then ASA monotherapy. One month follow‐up carotid dopplers of the left ICA showed patent flow without significant stenosis. On follow‐up evaluations at 3 and 12 months, the patient’s speech deficits had improved significantly and she reported no new stroke‐like symptoms. Results : Literature Review: Carotid webs (CaW) may be a potentially underrecognized cause of ischemic strokes. CaW are thin, fibrous tissue that extends from the wall of the carotid artery into the lumen in a shelf‐like projection. It is believed to be a variant of fibromuscular dysplasia. It is hypothesized that blood stasis on the downstream surface of the web may result in thrombus formation and thromboembolic stroke. The optimal treatment for CaW remains unclear, however there is some evidence to suggest that antiplatelet therapy alone may be insufficient to prevent recurrent stroke, with rates of recurrent stroke of 30–50% from a systematic literature review. Furthermore, there have been no reports of CaW positive remodeling over time, so patients likely remain at elevated risk for ischemic stroke without intervention. Conclusions : Discussion: Case series as well as systematic literature review have shown high rates of stroke recurrence in CaW patients treated with medical therapy alone. Data is still limited, however, CEA and carotid artery stenting (CAS) appear to be safe and effective revascularization procedures for CaW, with potentially significant reduction in recurrent stroke risk. CEA was preferred in our patient case due to the triple‐lumen appearance of the carotid web (Figure). CaW is a relatively underappreciated cause of ischemic strokes and the optimal management is not well‐established, however medical therapy alone appears to be sub‐optimal with high rates of stroke recurrence. Our patient case shows that carotid revascularization can be safe may be effective in preventing stroke recurrence.


Author(s):  
Erasmo Bernardo Marinho ◽  
Ana Paula Negreiros Nunes Alves ◽  
Francisco Januário Farias Pereira-Filho ◽  
Antonio Ernando Carlos Ferreira-Junior ◽  
Mário Rogério Lima Mota ◽  
...  

Author(s):  
Andrew Alalade ◽  
Christopher Millward ◽  
Piyali Pal ◽  
Catherine Gilkes

2021 ◽  
Vol 10 (2) ◽  
pp. e26610212430
Author(s):  
Gustavo Zanna Ferreira ◽  
Carolina Ferrairo Danieletto-Zanna ◽  
Liogi Iwaki Filho ◽  
Rômulo Maciel Lustosa ◽  
Willian Pecin Jacomacci ◽  
...  

The ameloblastic fibro-odontoma (AFO) is a mixed odontogenic tumor, with characteristics of ameloblastic fibroma, presenting enamel and dentin, which occurs more frequently in individuals aged 5 to 17 years. This paper reports na extensive case of ameloblastic fibro-odontoma in the mandible of a 3-year-old patient, discussed in comparison to cases selected from a brief literature review on the clinical characteristics, Evolution and therapeutic options for this lesion. In the last years, there was no consensus in the literature concerning its etiopathogenesis and classification, yet recently the AFO was classified as a developing odontoma. This case is in accordance with the 7 cases reported in the literature of AFO in the mandible of children aged 10 years or younger, especially concerning the lesion pattern and evolution and treatment adopted. The patient did not present relapse and exhibited local bone regeneration at the 3-year follow-up.


2017 ◽  
Vol 23 (6) ◽  
pp. 908-912 ◽  
Author(s):  
Elda Righi ◽  
Alessia Carnelutti ◽  
Daniele Muser ◽  
Francesco Zaja ◽  
Elisa Lucchini ◽  
...  

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