scholarly journals Endovascular Recanalization by Mechanical Thrombectomy in Tandem Extracranial and Intracranial Occlusive Lesion in Acute Ischemic Stroke is Still a Therapeutic Challenge: A Case Report

2019 ◽  
Vol 5 (1) ◽  
pp. 90-94
Author(s):  
Sirajee Shafiqul Islam ◽  
Kazi Mohibur Rahman ◽  
Sharif Uddin Khan ◽  
Dewan Md Elyas ◽  
Khairul Kabir Patwary ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ischemic Stroke ◽  
Case Report ◽  
Mechanical Thrombectomy ◽  
Intravenous Thrombolysis ◽  
The Body ◽  
National Institutes Of Health ◽  
Endovascular Recanalization ◽  
Occlusive Lesion ◽  
The Right

A 55-year-old male presented with complete left-sided weakness of the body with a National Institutes of Health Stroke Scale (NIHSS) 15 and Alberta Stroke Program Early Computed Tomography (ASPECT) score 8 and occlusion of the right middle cerebral artery (MCA) in the M1 segment on Computed Tomography Angiography (CTA). Intravenous thrombolysis (IVT) was not performed as symptoms developed at sleep. Mechanical Thrombectomy was performed after 4.5 hours of the symptom onset with recanalization of Thrombolysis in Cerebral Infarction (TICI classification 2b). Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 90-94

scholarly journals Case Report: Corpus callosal apraxia following acute ischemic stroke

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 731
Author(s):  
Santhosh Narayanan ◽  
Gomathy Subramaniam
Keyword(s):  
Computed Tomography ◽  
Ischemic Stroke ◽  
Case Report ◽  
Corpus Callosum ◽  
The Body ◽  
Cerebral Hemispheres ◽  
Diagnostic Challenge ◽  
Compact Structure ◽  
Ischemic Infarct ◽  
The Right

The corpus callosum is a compact structure that connects the right and left cerebral hemispheres. Here we report the case of a 50 year old woman who presented with features of corpus callosum apraxia, initially mistaken as psychiatric symptom by her relatives. Computed tomography and magnetic resonance of brain confirmed the diagnosis of acute ischemic infarct in the body of the corpus callosum. Isolated stroke involving the corpus callosum is rarely reported in literature and is a diagnostic challenge due to atypical clinical features.

Enhancing performance of a computed tomography perfusion software for improved prediction of final infarct volume in acute ischemic stroke patients

2021 ◽  
pp. 197140092098866
Author(s):  
Ryan A Rava ◽  
Kenneth V Snyder ◽  
Maxim Mokin ◽  
Muhammad Waqas ◽  
Alexander R Podgorsak ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ischemic Stroke ◽  
Conservative Treatment ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Infarct Volume ◽  
Correlation Coefficients ◽  
Intravenous Thrombolysis ◽  
Vessel Occlusion ◽  
Computed Tomography Perfusion

Computed tomography perfusion (CTP) is crucial for acute ischemic stroke (AIS) patient diagnosis. To improve infarct prediction, enhanced image processing and automated parameter selection have been implemented in Vital Images’ new CTP+ software. We compared CTP+ with its previous version, commercially available software (RAPID and Sphere), and follow-up diffusion-weighted imaging (DWI). Data from 191 AIS patients between March 2019 and January 2020 was retrospectively collected and allocated into endovascular intervention ( n = 81) and conservative treatment ( n = 110) cohorts. Intervention patients were treated for large vessel occlusion, underwent mechanical thrombectomy, and achieved successful reperfusion of thrombolysis in cerebral infarction 2b/2c/3. Conservative treatment patients suffered large or small vessel occlusion and did not receive intravenous thrombolysis or mechanical thrombectomy. Infarct and penumbra were assessed using intervention and conservative treatment patients, respectively. Infarct and penumbra volumes were segmented from CTP+ and compared with 24-h DWI along with RAPID, Sphere, and Vitrea. Mean infarct differences (95% confidence intervals) and Spearman correlation coefficients (SCCs) between DWI and each CTP software product for intervention patients are: CTP+  = (5.8 ± 5.9 ml, 0.62), RAPID = (10.0  ± 5.2 ml, 0.73), Sphere = (3.0 ± 6.0 ml, 0.56), Vitrea = (7.2 ± 4.9 ml, 0.66). For conservative treatment patients, mean infarct differences and SCCs are: CTP+ = (–8.0 ± 5.4 ml, 0.64), RAPID = (–25.6 ± 11.5 ml, 0.60), Sphere = (–25.6 ± 8.0 ml, 0.66), Vitrea = (1.3 ± 4.0 ml, 0.72). CTP+ performed similarly to RAPID and Sphere in addition to its semi-automated predecessor, Vitrea, when assessing intervention patient infarct volumes. For conservative treatment patients, CTP+ outperformed RAPID and Sphere in assessing penumbra. Semi-automated Vitrea remains the most accurate in assessing penumbra, but CTP+ provides an improved workflow from its predecessor.

Mechanical thrombectomy using a Solitaire stent retriever in the treatment of pediatric acute ischemic stroke

2019 ◽  
Vol 23 (3) ◽  
pp. 363-368 ◽  
Author(s):  
Bing Zhou ◽  
Xiao-Chuan Wang ◽  
Jun-Yi Xiang ◽  
Ming-Zhao Zhang ◽  
Bo Li ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Balloon Dilation ◽  
Stent Retriever ◽  
National Institutes Of Health ◽  
Clinical Prognosis ◽  
Nihss Score ◽  
Grade 3

OBJECTIVEMechanical thrombectomy using a Solitaire stent retriever has been widely applied as a safe and effective method in adult acute ischemic stroke (AIS). However, due to the lack of data, the safety and effectiveness of mechanical thrombectomy using a Solitaire stent in pediatric AIS has not yet been verified. The purpose of this study was to explore the safety and effectiveness of mechanical thrombectomy using a Solitaire stent retriever for pediatric AIS.METHODSBetween January 2012 and December 2017, 7 cases of pediatric AIS were treated via mechanical thrombectomy using a Solitaire stent retriever. The clinical practice, imaging, and follow-up results were reviewed, and the data were summarized and analyzed.RESULTSThe ages of the 7 patients ranged from 7 to 14 years with an average age of 11.1 years. The preoperative National Institutes of Health Stroke Scale (NIHSS) scores ranged from 9 to 22 with an average of 15.4 points. A Solitaire stent retriever was used in all patients, averaging 1.7 applications of thrombectomy and combined balloon dilation in 2 cases. Grade 3 on the modified Thrombolysis In Cerebral Infarction scale of recanalization was achieved in 5 cases and grade 2b in 2 cases. Six patients improved and 1 patient died after thrombectomy. The average NIHSS score of the 6 cases was 3.67 at discharge. The average modified Rankin Scale score was 1 at the 3-month follow-up. Subarachnoid hemorrhage after thrombectomy occurred in 1 case and that patient died 3 days postoperatively.CONCLUSIONSThis study shows that mechanical thrombectomy using a Solitaire stent retriever has a high recanalization rate and excellent clinical prognosis in pediatric AIS. The safety of mechanical thrombectomy in pediatric AIS requires more clinical trials for confirmation.

Mechanical thrombectomy beyond the circle of Willis: efficacy and safety of different techniques for M2 occlusions

2021 ◽  
pp. neurintsurg-2021-017425
Author(s):  
Leonardo Renieri ◽  
Iacopo Valente ◽  
Adam A Dmytriw ◽  
Ajit S Puri ◽  
Jasmeet Singh ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Mechanical Thrombectomy ◽  
Circle Of Willis ◽  
Stent Retriever ◽  
National Institutes Of Health ◽  
Neurological Deficits ◽  
Stent Retrievers ◽  
Subarachnoid Hemorrhages ◽  
Combined Technique

BackgroundM2 segment occlusions represent approximately one-third of non-lacunar ischemic stroke and can lead to permanent neurological deficits. Various techniques are available for mechanical thrombectomy beyond the circle of Willis, but data evaluating their effectiveness and safety are lacking.MethodsA retrospective review of patients with ischemic stroke undergoing mechanical thrombectomy for M2 occlusions from 13 centers in North American and Europe was performed. Tandem or multiple-territory occlusions were excluded. The primary outcome was 90-day modified Rankin Scale and reperfusion rates across stent-retriever, direct aspiration and combined techniques.ResultsThere were 465 patients (mean age 71.48±14.03 years, 53.1% female) with M2 occlusions who underwent mechanical thrombectomy. Stent-retriever alone was used in 133 (28.6%), direct aspiration alone in 93 (20.0%) and the combined technique in 239 (51.4%) patients. Successful reperfusion was achieved with the combined technique in 198 (82.2%; OR 2.6 (1.1–6.9)), with stent-retriever alone in 112 (84.2%; OR 9.2 (1.9–44.6)) and with direct aspiration alone in 62 (66.7%; referencecategory). Intraprocedural subarachnoid hemorrhages (iSAH) were 36 (7.7%) and were more likely to occur in patients treated with the stent-retrievers (OR 5.0 (1.1–24.3)) and combined technique (OR 4.6 (1.1–20.9)). Good clinical outcome was achieved in 260 (61.8%) patients, while 59 (14.0%) patients died. Older age, higher baseline NIHSS (National Institutes of Health Stroke Scale), parenchymal hemorrhage and iSAH were associated with poor outcome while successful recanalization and higher baseline ASPECTS (Alberta Stroke Program Early CT Score) were associated with good outcome. No differences were found among the three techniques in terms of clinical outcome.ConclusionStent-retrievers and a combined approach for M2 occlusions seem more effective than direct aspiration, but with higher rates of iSAH. This leads to no detectable difference in clinical outcome at 3 months.

scholarly journals Cerebral hemispheres – cerebellum – kidney interaction in patients with acute cerebral ischemia

2021 ◽  
Vol 26 (1) ◽  
pp. 90-98
Author(s):  
O.M. Kononets ◽  
O.V. Tkachenko ◽  
O.O. Kamenetska
Keyword(s):  
Nervous System ◽  
Ischemic Stroke ◽  
Brain Magnetic Resonance Imaging ◽  
Environmental Parameters ◽  
The Body ◽  
Electrolyte Balance ◽  
Vector Correlation ◽  
Vertebrobasilar System ◽  
Acute Cerebral Ischemia ◽  
The Right

The nervous system, in particular the autonomic one, is well known to constantly regulate the internal functioning of the body, adapting it to changeable external and internal environmental parameters. In particular, there is a close multiple-vector correlation between the nervous system and the kidneys. The aim of this study was to specify the mechanisms, clinical and paraclinical characteristics of the concomitant lesions of the nervous system and the kidneys in patients with acute stroke. This paper presents the case report of 215 patients, aged 70 ± 8.44, who suffered from ischemic stroke. Among them, we examined 144 women and 71 men. The patients underwent a comprehensive examination, including a detailed clinical and neurological check-up (evaluating the patients’ condition severity with the National Institutes of Health Stroke Scale (NIHSS) and the Barthel index on admission and on the 21st day of the disease), laboratory analysis (electrolyte balance, nitrogen metabolism (on admission and on the 21st day of the disease) and instrumental examination (CT scan of the brain, the follow-up brain magnetic resonance imaging). The statistical methods were used to analyze the data. In the 1st day of the disease, all the surveyed patients with right hemispheric carotid stroke and the overwhelming majority of the patients with left hemispheric carotid stroke and ischemic stroke in the vertebrobasilar system had cerebral renal syndrome, represented by renal concentration-filtration dysfunction, accompanied by the reduced glomerular filtration rate. A reliable relationship was found between the renal concentration and filtration function and the right hemispheric ischemic focus in patients with ischemic stroke, the characteristics are to be specified.

scholarly journals Laparoscopic approach in the treatment of echinococcal liver disease - case report and literature review

2020 ◽  
Vol 148 (7-8) ◽  
pp. 480-483
Author(s):  
Nikola Grubor ◽  
Boris Tadic ◽  
Vladimir Milosavljevic ◽  
Djordje Knezevic ◽  
Slavko Matic
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Open Surgery ◽  
Laparoscopic Approach ◽  
Parasitic Disease ◽  
Hydatid Cysts ◽  
Disease Case ◽  
Right Lobe ◽  
The Right ◽  
Hepatic Hydatid

Introduction. Cystic echinococcosis or hydatid disease is a parasitic disease, zoonosis, and is most commonly caused by Echinococcus granulosus larvae. It mainly occurs in endemic areas. The most common localization is the liver. Case outline. In this paper, we will present our experience with a 67-year-old female patient diagnosed with an echinococcal cyst in the right lobe of the liver, as confirmed by computed tomography examination of the abdomen. The patient underwent laparoscopic partial pericystectomy with omentoplasty. The operation went without complications, as well as the postoperative period. Conclusion. Laparoscopic partial pericystectomy is a safe and effective treatment of available hepatic hydatid cysts. Considering all the benefits of minimally invasive surgery, laparoscopic partial pericystectomy of hepatic hydatid cysts may be the treatment of choice, over the classical open surgery approach.

scholarly journals Endoscopic removal of metal foreign bodies by magnet: case report

2020 ◽  
Vol 10 (4) ◽  
pp. 467-472
Author(s):  
Vladimir I. Petlakh ◽  
Vladimir A. Borovitsky ◽  
Alexander K. Konovalov ◽  
Natalya N. Strogova
Keyword(s):  
Case Report ◽  
Conservative Therapy ◽  
Foreign Bodies ◽  
Intestinal Wall ◽  
The Body ◽  
Surgical Interventions ◽  
Number Of Children ◽  
The Past ◽  
A Chain ◽  
The Right

The number of children swallowing magnetic foreign bodies has been a significantly high for the past decades, increasingly needing endoscopic or surgical interventions. Case report. In our observation, a 12-year-old girl swallowed magnetic balls from childrens designer 10 days prior to hospital admission. Foreign bodies (5 balls) were found during X-ray examination in the projection of the cecum. Conservative therapy carried out for 4 days had no success, thus colonoscopy was performed to remove foreign bodies. Foreign bodies were fixed to the intestinal wall, and attempts to separate them were unsuccessful. When a medical magnet was placed outside the body in the right iliac region, a chain of magnetic balls detached from the intestinal wall and made it possible to be captured in a trap loop and be removed. The girl avoided a laparotomy with an opening of the colon. Conclusion. External use of a medical magnet is effective for navigation and assistance during colonoscopic extraction when magnetic foreign bodies are found in the colon.

scholarly journals Pernicious anemia-induced ischemic stroke associated with good outcomes after mechanical thrombectomy: A case report

Nosotchu ◽  
2021 ◽  
Author(s):  
Sho Murase ◽  
Yoshinori Maki ◽  
Masao Fukumura ◽  
Yuzo Kuroda ◽  
Yasufumi Gon ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Case Report ◽  
Pernicious Anemia ◽  
Mechanical Thrombectomy
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