Stroke Mimics in the Acute Setting: Role of Multimodal CT Protocol

Abstract ADAMTS13 (a disintegrin and metalloproteinase with thrombospondin type 1 motif, 13) is a metalloprotease responsible for cleavage of ultra-large von Willebrand factor (VWF) multimers. Severely deficient activity of the protease can trigger an acute episode of thrombotic thrombocytopenic purpura (TTP). Our understanding of the pathophysiology of TTP has allowed us to grasp the important role of ADAMTS13 in other thrombotic microangiopathies (TMAs) and thrombotic disorders, such as ischemic stroke and coronary artery disease. Through its action on VWF, ADAMTS13 can have prothrombotic and proinflammatory properties, not only when its activity is severely deficient, but also when it is only moderately low. Here, we will discuss the biology of ADAMTS13 and the different assays developed to evaluate its function in the context of TTP, in the acute setting and during follow-up. We will also discuss the latest evidence regarding the role of ADAMTS13 in other TMAs, stroke, and cardiovascular disease. This information will be useful for clinicians not only when evaluating patients who present with microangiopathic hemolytic anemia and thrombocytopenia, but also when making clinical decisions regarding the follow-up of patients with TTP.

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Role of the Neurosurgeon in Acute Ischemic Stroke Treatment From Triage to Intensive Care Unit

Neurosurgery ◽

10.1093/neuros/nyz013 ◽

2019 ◽

Vol 85 (suppl_1) ◽

pp. S47-S51

Author(s):

Kimberly P Kicielinski ◽

Christopher S Ogilvy

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Mechanical Thrombectomy ◽

Stroke Care ◽

Stroke Patients ◽

Acute Setting ◽

Stroke Treatment

Abstract As ischemic stroke care advances with more patients eligible for mechanical thrombectomy, so too does the role of the neurosurgeon in these patients. Neurosurgeons are an important member of the team from triage through the intensive care unit. This paper explores current research and insights on the contributions of neurosurgeons in care of acute ischemic stroke patients in the acute setting.

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Intracranial complications of sinusitis: what is the role of endoscopic sinus surgery in the acute setting

American Journal of Otolaryngology ◽

10.1016/j.amjoto.2008.09.009 ◽

2010 ◽

Vol 31 (1) ◽

pp. 25-28 ◽

Cited By ~ 34

Author(s):

John M. DelGaudio ◽

Seth H. Evans ◽

Steven E. Sobol ◽

Shatul L. Parikh

Keyword(s):

Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Acute Setting ◽

Intracranial Complications

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Faecoliths in Appendicitis: Does It Influence the Course and Treatment of the Disease in the Acute Setting?

10.5772/intechopen.97338 ◽

2021 ◽

Author(s):

Rossi Adu-Gyamfi

Keyword(s):

Acute Appendicitis ◽

Treatment Failure ◽

Operative Treatment ◽

Predictive Factor ◽

Complicated Appendicitis ◽

Current Evidence ◽

Failure Rates ◽

Independent Factor ◽

Acute Setting

Luminal obstruction has been widely considered as one of the major causes of appendicitis. Faecolith, in this case called appendicolith, is a hardened lump of faeces in varying sizes, have over the years been closely associated with appendicitis as a potential cause of luminal obstruction. There are varying opinions with regards to role of appendicolith in both uncomplicated and complicated acute appendicitis. While some authors have reported that the presence of appendicolith is a predictive factor for high failure rates, others are of the opinion that appendicolith does not necessarily predict non-operative treatment failure, and even if so, not as an independent factor. Opinions also seem to be divided on the correlation between complicated appendicitis and the presence of appendicolith. This chapter seeks to discuss the evidence available and attempt to clarify the controversies surrounding the role of appendicolith in acute appendicitis using current evidence available.

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Masquerade

10.1093/med/9780190495541.003.0003 ◽

2016 ◽

Author(s):

Ji Y. Chong ◽

Michael P. Lerario

Keyword(s):

Intracranial Hemorrhage ◽

Acute Treatment ◽

Minimal Risk ◽

Acute Setting ◽

Stroke Mimics ◽

Stroke Mimic

The diagnosis of a stroke mimic is typically made after the acute setting when the window for acute treatment has closed. Patients with stroke mimics who are eligible for tPA may safely be treated with a minimal risk of intracranial hemorrhage.

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Multimodal CT to Differentiate Acute Ischemic Stroke From Stroke Mimics

The Neurohospitalist ◽

10.1177/1941874412439582 ◽

2012 ◽

Vol 2 (2) ◽

pp. 60-61

Author(s):

Warren Vincent Carrigan ◽

Kevin Barrett ◽

William David Freeman ◽

Nicole Avalon

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Stroke Mimics ◽

Multimodal Ct

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Nasal Fractures: The Role of Primary Reduction and Secondary Revision

Facial Plastic Surgery ◽

10.1055/s-0039-1700801 ◽

2019 ◽

Vol 35 (06) ◽

pp. 590-601 ◽

Cited By ~ 2

Author(s):

Weitao Wang ◽

Thomas Lee ◽

Scott Kohlert ◽

Sameep Kadakia ◽

Yadranko Ducic

Keyword(s):

Rigid Fixation ◽

Open Rhinoplasty ◽

Facial Skeleton ◽

Acute Setting ◽

Nasal Bones ◽

Secondary Deformity ◽

Primary Reduction ◽

Nasal Trauma ◽

Nasal Fractures

AbstractThe nasal bones are among the most commonly fractured bones in the facial skeleton. Proper management of nasal trauma acutely is important in minimizing secondary deformities and impaired function with nasal airway obstruction. Septal hematoma, if present, should be drained right away. Acutely closed nasal reduction and limited septoplasty can be performed. Unrecognized septal fracture may play a role in the failure of closed nasal reduction of fractured nasal bones. Complex nasoorbitoethmoid fractures are approached openly and treated with rigid fixation. Primary use of open rhinoplasty in an acute setting is debated, and there are no clearly accepted indications for timing, patient selection, and surgical technique. However, open septorhinoplasty is more commonly used in a delayed fashion to provide definitive correction of any residual cosmetic or functional problems. Recent algorithms provide a systematic approach to nasal trauma and may improve secondary deformity rates following closed reduction.

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Seizure Mimicking Stroke: Role of CT Perfusion

Journal of Clinical Imaging Science ◽

10.4103/2156-7514.97728 ◽

2012 ◽

Vol 2 ◽

pp. 32 ◽

Cited By ~ 9

Author(s):

Vishnumurthy Shushrutha Hedna ◽

Prerak P. Shukla ◽

Michael F. Waters

Keyword(s):

Emergency Department ◽

Computerized Tomography ◽

Ct Perfusion ◽

Initial Presentation ◽

Stroke Mimics

Stroke mimics constitute 15--20% of all cases presenting to the emergency department, prominent among them being seizures, hypoglycemia, tumors, migraines, and posterior reversible leucoencephalopathy. They have also abnormal computerized tomography perfusion (CTP) findings. We report a case where CTP helped us to diagnose and treat a seizure when initial presentation was that of a stroke.

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