Neurosyphilis causing stroke in young adult: a case report

Introduction: Up to 10% of strokes affect people under 45 years old. Syphilis is most common in adults. Fourteen percent of neurosyphilis cases have stroke its first manifestation. Objectives: To discuss neurosyphilis as an overlooked etiology for stroke. Design and setting: The case occurred in a public secondary care hospital located in São Paulo - Brazil. Methods: We present a case report of a 28-year-old woman brought to the emergency department due to acute ataxia. Previous history shows stroke at the age of 20 years old. Brain MRI showed ischemia in both cerebellar hemispheres, pons and midbrain. Arterial angiography showed segmental basilar artery stenosis. Serum laboratory tests showed Venereal Disease Research Laboratory (VDRL) of 1:128. Cerebrospinal fluid (CSF) analysis showed 117 cells (predominantly lymphomononuclear), protein 81 mg/ dl, normal glucose and VDRL of 1:8, confirming neurosyphilis. Treatment with intravenous penicillin led to partial improvement in ataxia before discharge. Discusion: A high percentage (up to 80%) of diagnostical errors is expected when stroke is caused by neurosyphilis. Misdiagnosis may compromise secondary prevention. It is possible that the first stroke was also caused by neurosyphilis in our patient. The involvement of the vertebrobasilar territory occurs in 25% of patients with meningovascular neurosyphilis. Basilar stenosis is typical for neurosyphilis. Conclusion: Stroke in young adults should include VDRL to screen for neurosyphilis. If positive, it should indicate a CSF exam.

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Risk Factors, Etiology, and Clinical Outcome of Ischemic Stroke in Young Adults Admitted in a Tertiary Care Hospital in India

Journal of Stroke Medicine ◽

10.1177/2516608519846034 ◽

2019 ◽

Vol 2 (1) ◽

pp. 32-39

Author(s):

Madhavi Karri ◽

Balakrishnan Ramasamy

Keyword(s):

Risk Factors ◽

Young Adults ◽

Ischemic Stroke ◽

Clinical Outcome ◽

Tertiary Care ◽

Care Hospital ◽

Diagnostic Challenge ◽

Stroke Treatment ◽

Stroke In Young Adults ◽

Stroke In Young

Background: Ischemic stroke in young adults is becoming a rising concern with the increase in vulnerability to traditional risk factors and changing lifestyles. Aim: An overview of risk factors, classification, and clinical outcome of ischemic stroke in young adults (19 to 45 years) has been presented. Methods: Data fulfilling the study criteria from the stroke registry between June 2014 and June 2017 were collected, and a detailed proforma was taken that included history, clinical examination, and routine investigations. Selective investigations such as prothrombotic workup and 24-hour Holter monitoring were performed. Stroke was subclassified using the Trial of Org 10172 in Acute Stroke Treatment criteria. National Institute of Health Stroke Scale (NIHSS) scores at baseline and the modified Rankin score (mRS) scoring after 3 months of patients’ admission were calculated. Results: Out of 223 identified cases of ischemic stroke in young adults, 186 (83.4%) were taken for analysis, constituting 7.3% of the total stroke population of 3,059. Among the cases taken for analysis, 137 were males and 49 were females. A total of 150 patients were among the age group of 36 to 45 years. Dyslipidemia, smoking, and alcohol consumption were prevalent in the study group. Atherosclerotic strokes were predominant in the study population. NIHSS scores at admission had a significant impact on mRS scores after 3 months. In this study, only 4% reported the recurrence of stroke, whereas mortality was about 0.02%. Conclusions: Workup required for ischemic stroke in young adults has always been a diagnostic challenge for physicians who treat the stroke patients, and this must be optimized in all health care centers. Despite extensive workup, 23.66% participants were found to be cryptogenic in this study. The clinical outcome was good in this study with less mortality observed.

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P0259 ACUTE ISCHEMCIC STROKE IN YOUNG ADULTS – CASE REPORT

European Journal of Internal Medicine ◽

10.1016/s0953-6205(09)60279-x ◽

2009 ◽

Vol 20 ◽

pp. S91

Author(s):

Catarina Graça Rodrigues ◽

Marinela Félix Major ◽

João Mascarenhas Araújo

Keyword(s):

Young Adults ◽

Case Report ◽

Stroke In Young Adults ◽

Stroke In Young

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Umbilical endometriosis in a 42 years old parous woman: A Case Report

TAJ Journal of Teachers Association ◽

10.3329/taj.v28i1.39070 ◽

2018 ◽

Vol 28 (1) ◽

pp. 48-51

Author(s):

Mosammat Nargis Shamima ◽

Mohd Alamgir Hossain ◽

Shahela Jesmin ◽

Nargis Jahan ◽

Arpita Das

Keyword(s):

Case Report ◽

Tertiary Care ◽

Previous History ◽

Needle Aspiration ◽

Care Hospital ◽

History Of ◽

Needle Aspiration Cytology ◽

High Resolution Ultrasonography ◽

Umbilical Endometriosis

Endometriosis is a common gynaecological condition and presents mainly with involvement of the pelvic organs. However umbilical endometriosis is uncommon. A correct differential diagnosis can be difficult and the use of epiluminescence and MRI is suggested for the accuracy of preoperative diagnosis. This case report was experienced at a tertiary care hospital at Rajshahi. The patient was 42 years old multigravid woman presented with umbilical swelling and pain during menstruation for last 6 years with cyclical bleeding from the umbilical region for same duration. The patient had regular menstrual bleeding since the time of menarche. The patient had no previous history of endometriosis, dysmenorrhea or dyspareunia. Physical examination showed a hyperpigmented tender paraumbilical swelling with bloody discharge through umbilicus. Clinical examination together with the use of high resolution ultrasonography and fine needle aspiration cytology led to an accurate pre-operative diagnosis of umbilical endometriosis. The surgical approach to umbilical endometriosis represented an important step in achieving a satisfying result. The lesion to be excised and adequate umbilical repositioning was done. The patient was asymptomatic at the follow-up visit (12 months after surgery). A natural-looking umbilicus was observed with minimal visible scars.TAJ 2015; 28(1): 48-51

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Pulmonary multifocal arteriovenous malformations lead to ischemic stroke in young adults: a case report and literature review

Annals of Palliative Medicine ◽

10.21037/apm-21-3034 ◽

2021 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Xuanfei Jiang ◽

Lifeng He ◽

Bin Shen ◽

Honggang Ma ◽

Bing Zhang

Keyword(s):

Young Adults ◽

Ischemic Stroke ◽

Case Report ◽

Literature Review ◽

Arteriovenous Malformations ◽

Stroke In Young Adults ◽

Stroke In Young

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Study of Risk Factors and Clinical Profile of Stroke in Young Adults

MVP Journal of Medical Sciences ◽

10.18311/mvpjms/2015/v2/i1/791 ◽

2015 ◽

Vol 2 (1) ◽

pp. 15

Author(s):

Yogesh L. Jadhav ◽

Shailesh A. Bondarde

Keyword(s):

Risk Factors ◽

Young Adults ◽

Clinical Profile ◽

Common Symptom ◽

Care Hospital ◽

Age Group ◽

Stroke Patients ◽

Stroke In Young Adults ◽

Younger Age ◽

Stroke In Young

Background: According to the Global Health Observatory, stroke is the second most common cause of death during last decade with a rising trend. Although stroke is considered to be the disease of older population, with the demographic shift the disease incidence is now shifting to younger age group. This shifting trend to younger age group pose a great concern to the world in terms of days lost to work and mortality. There is paucity of information on stroke in young individuals covering important types of stroke. Aims&Objectives: To study the clinical profile and risk factors associated with the stroke in young adults. Materials & Methods: The present descriptive study was carried out at tertiary care Hospital of Nasik from June 2011 to June 2013. A total of 40 consecutive cases between 15-45 years presenting with stroke were recruited for the study after taking prior informed consent. All cases underwent a detailed history taking, general and clinical examination along with all required Investigations. Data was analysed by SPSS software ver. 17 using appropriate statistical tests. Results: Ischemic stroke was the most common presentation and stroke prevalence was similar across both genders. Headache was the most common symptom followed by vomiting in all types of stroke patients. OC Pills and parity was found to significantly associated with CVST. Obesity, smoking and abnormal lipid profile was found to be significantly associated with thromboemblic stroke. Only 3 out of 40 stroke patients died during the course of study. Conclusion: OC Pills and parity were significantly associated with CVST while obesity, smoking and dyslipidemia were significantly associated with thromboemblic stroke. Outcome in young stroke patients was fairly good.

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Umbilical endometriosis in a 39 years old parous woman: A Case Report

Journal of Shaheed Suhrawardy Medical College ◽

10.3329/jssmc.v4i2.14423 ◽

2013 ◽

Vol 4 (2) ◽

pp. 65-67 ◽

Cited By ~ 1

Author(s):

Fatema Ashraf ◽

Nilofar Yasmin ◽

Jinnat Ara Islam ◽

Farzana Rabee Choudhury ◽

Kaberi Guha

Keyword(s):

Case Report ◽

Tertiary Care ◽

Previous History ◽

Needle Aspiration ◽

Care Hospital ◽

History Of ◽

Needle Aspiration Cytology ◽

High Resolution Ultrasonography ◽

Umbilical Endometriosis

Endometriosis is a common gynaecological condition and presents mainly with involvement of the pelvic organs. However umbilical endometriosis is uncommon. A correct differential diagnosis can be difficult and the use of epiluminescence and MRI is suggested for the accuracy of preoperative diagnosis. This case report was experienced at a tertiary care hospital at Dhaka city. The patient was 39 years old multigravid woman presented with umbilical swelling and pain during menstruation for last 1year with cyclical bleeding from the umbilical region for last 4 months. The patient had regular menstrual bleeding since the time of menarche. The patient had no previous history of endometriosis, dysmenorrhea or dyspareunia. Physical examination showed a hyperpigmented tender paraumbilical swelling with bloody discharge through umbilicus. An accurate anamnesis and clinical examination together with the use of high resolution ultrasonography and fine needle aspiration cytology led to an accurate pre-operative diagnosis of umbilical endometriosis. The surgical approach to umbilical endometriosis represented an important step in achieving a satisfying result. The lesion to be excised and adequate umbilical repositioning was done. The patient was asymptomatic at the follow-up visit (12 months after surgery), however, nevertheless warned of the risk of recurrence. A natural-looking umbilicus was observed in cases with minimal visible scars DOI: http://dx.doi.org/10.3329/jssmc.v4i2.14423 J Shaheed Suhrawardy Med Coll, 2012;4(2):65-67

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STUDY OF CAUSES OF STROKE IN YOUNG POPULATION VISITING A TERTIARY CARE HOSPITAL WITH EMPHASIS ON VASCULAR IMAGING.

10.36106/ijar/6914359 ◽

2021 ◽

pp. 54-58

Author(s):

Namrata Khandelwal ◽

Biman Kanti Ray ◽

Deep Das

Keyword(s):

Young Adults ◽

Tertiary Care ◽

Haemorrhagic Stroke ◽

Large Artery ◽

Care Hospital ◽

Imaging Features ◽

Stroke Patients ◽

Systematic Analysis ◽

Stroke In Young Adults ◽

Stroke In Young

The results of a systematic analysis of patients aged 15-49 years attending stroke clinic in eastern India were evaluated based on based on clinical and imaging features from January 2012– June 2013. Out of 98 patients of stroke, the mean age of ischaemic and haemorrhagic stroke patients was 34.26 years and 32.81 years respectively. Of the 66 patients of ischaemic stroke, 10.4% had large artery atherosclerosis followed by cardio embolic (14.5%) and lacunar (8.3%). Among 32 haemorrhagic stroke patients, aneurysmal bleed (30%) was the most common aetiology. The stroke of other determined aetiology was 52% and in 14.5% aetiology was undetermined. It is evident that the nature and cause of stroke in young adults is different and unique, and they need different diagnostic work. Attempts must be made to formulate specic guidelines aimed at stroke detection, management, prevention, and rehabilitation in the young adults' population.

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Popliteal artery thrombosis secondary to a tibial osteochondroma

VASA ◽

10.1024/0301-1526/a000101 ◽

2011 ◽

Vol 40 (3) ◽

pp. 251-255 ◽

Cited By ~ 4

Author(s):

Gruber-Szydlo ◽

Poreba ◽

Belowska-Bien ◽

Derkacz ◽

Badowski ◽

...

Keyword(s):

Case Report ◽

Magnetic Resonance Angiography ◽

Popliteal Artery ◽

Doppler Ultrasonography ◽

Histopathological Examination ◽

Previous History ◽

Plain Radiography ◽

Artery Thrombosis ◽

History Of ◽

The Right

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.

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