1/40. myxoma on anterior mitral leaflet presenting with symptoms of cerebellar artery infarction.This report describes a patient who had dizziness and loss of balance. During routine investigation, a mass located on the anterior mitral valve leaflet was detected on transthoracic echocardiography. The patient underwent surgery for a mass located on the mitral valve, and histopathologic examination determined the mass was a myxoma.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
2/40. Involuntary masturbation as a manifestation of stroke-related alien hand syndrome.alien hand syndrome is a perplexing and uncommon clinical diagnosis. We report an unusual manifestation of alien hand syndrome in a 73-yr-old man with a right anterior cerebral artery infarct affecting the right medial frontal cortex and the anterior portion of the corpus callosum. We conclude that alien hand syndrome should be considered in patients who present with a feeling of alienation of one or both upper limbs accompanied by complex purposeful involuntary movement.- - - - - - - - - - ranking = 0.25keywords = artery (Clic here for more details about this article) |
3/40. Antiphospholipid antibody syndrome manifested as a postoperative cerebrovascular event in a child.Perioperative cerebrovascular events are exceedingly uncommon in pediatric patients. The etiology of such problems includes emboli from intracardiac thrombi, sickle cell disease, vascular anomalies, vasculitis affecting the cerebral vasculature, and prothrombotic states. We describe a 6-year-old boy who had right-sided hemiparesis on the second postoperative day after an uneventful patch angioplasty for renal artery stenosis. Workup revealed a possible hypercoagulable state due to an anticardiolipin antibody. The pathogenesis of the anticardiolipin antibody syndrome, its clinical manifestations, diagnostic criteria, and potential treatment strategies are reviewed.- - - - - - - - - - ranking = 0.25keywords = artery (Clic here for more details about this article) |
4/40. Clinically unidentified dissection of vertebral artery as a cause of cerebellar infarction.BACKGROUND AND PURPOSE: dissection of vertebral arteries has been reported in association with minor neck movements without signs of trauma on the surface of the neck. In addition, injury of a vertebral artery can cause brain infarctions. However, few cases have been reported in which fatal brain infarction was due to nonocclusive, clinically undetected, traumatic thrombus formation in a vertebral artery. CASE DESCRIPTION: A 62-year-old man was hit by a car, and a right cerebellar infarction was found the day after the accident. The cause of the infarction could not be detected by angiography. Although the patient recovered favorably after surgical removal of the right lateral hemisphere of the cerebellum, he died suddenly 2 weeks after the accident. An autopsy and a microscopic study revealed pulmonary thromboembolism and organizing traumatic lesions of the right vertebral artery without occlusion or noteworthy stenosis of the artery. CONCLUSIONS: We concluded that the patient sustained traumatic lesions of the right vertebral artery during the traffic accident 2 weeks before death and that his cerebellar infarction was due to a thrombus resulting from these traumatic lesions.- - - - - - - - - - ranking = 2.25keywords = artery (Clic here for more details about this article) |
5/40. Bilateral sudden deafness as a prodrome of anterior inferior cerebellar artery infarction.BACKGROUND: Acute ischemic stroke in the distribution of the anterior inferior cerebellar artery is known to be associated with hearing loss, facial weakness, ataxia, nystagmus, and hypalgesia. There have been few reports on bilateral deafness and vertebrobasilar occlusive disease. Furthermore, previous reports have not emphasized the inner ear as a localization of bilateral deafness. OBJECTIVE: To describe the presentation of acute ischemic stroke in the distribution of the anterior inferior cerebellar artery as sudden bilateral hearing loss with minimal associated signs. DESIGN AND SETTING: Case report and tertiary care hospital. PATIENT: A 66-year-old man with diabetes mellitus developed sudden bilateral deafness, unilateral tinnitus, and vertigo 7 days before the onset of dysarthria, facial weakness, and ataxia. T2-weighted magnetic resonance imaging scans showed hyperintensities in the right lateral pons and right middle cerebral peduncle and a possible abnormality of the left middle cerebellar peduncle. A magnetic resonance angiogram showed moderately severe stenosis of the distal vertebral artery and middle third of the basilar artery. The patient's right limb coordination and gait improved steadily over several weeks, but there was no improvement in hearing in his right ear. CONCLUSIONS: The relatively isolated onset of deafness as well as the severity and persistence of the hearing loss led us to conclude that the hearing loss in this case was likely due to prominent hypoperfusion of the internal auditory artery, with labyrinthine infarction as the earliest event. Vertebrobasilar occlusive disease should be considered in the differential diagnosis of sudden bilateral deafness.- - - - - - - - - - ranking = 2.25keywords = artery (Clic here for more details about this article) |
6/40. Central retinal artery occlusion following cardiac catheterization.We describe a 66-year-old Japanese man in whom central retinal artery occlusion followed cardiac catheterization. After the procedure, blurred vision was noted in the right eye, and ophthalmological examination revealed an occlusion. Central retinal artery occlusion is a very rare but serious complication of cardiac catheterization. We should anticipate this potential risk to ensure prompt detection and treatment.- - - - - - - - - - ranking = 1.5keywords = artery (Clic here for more details about this article) |
7/40. Sudden deafness and anterior inferior cerebellar artery infarction.BACKGROUND AND PURPOSE: Acute ischemic stroke in the distribution of the anterior inferior cerebellar artery (AICA) is known to be associated with vertigo, nystagmus, facial weakness, and gait ataxia. Few reports have carefully examined the deafness associated with the AICA infarction. Furthermore, previous neurological reports have not emphasized the inner ear as a localization of sudden deafness. The aim of this study was to investigate the incidence of deafness associated with the AICA infarction and the sites predominantly involved in deafness. methods: Over 2 years, we prospectively identified 12 consecutive patients with unilateral AICA infarction diagnosed by brain MRI. Pure-tone audiogram, speech discrimination testing, stapedial reflex testing, and auditory brainstem response were performed to localize the site of lesion in the auditory pathways. electronystagmography was also performed to evaluate the function of the vestibular system. RESULTS: The most common affected site on brain MRI was the middle cerebellar peduncle (n=11). Four patients had vertigo and/or acute auditory symptoms such as hearing loss or tinnitus as an isolated manifestation from 1 day to 2 months before infarction. Audiological testings confirmed sensorineural hearing loss in 11 patients (92%), predominantly cochlear in 6 patients, retrocochlear in 1 patient, and combined on the affected side cochlear and retrocochlear in 4 patients. electronystagmography demonstrated no response to caloric stimulation in 10 patients (83%). CONCLUSIONS: In our series, sudden deafness was an important sign for the diagnosis of AICA infarction. Audiological examinations suggest that sudden deafness in AICA infarction is usually due to dysfunction of the cochlea resulting from ischemia to the inner ear.- - - - - - - - - - ranking = 1.25keywords = artery (Clic here for more details about this article) |
8/40. A rare sign of intracranial internal carotid artery dissection causing cerebral infarction: a case report and review of the literature.We describe a patient with CT-proven ischemic infarction of the left middle cerebral artery (MCA) territory. The emergency CT, on admission, was suggestive of intracranial internal carotid artery dissection by demonstrating gaseous gap defects in the arterial wall and a subsequent thromboembolic process in the MCA. To our knowledge, there is no previous report regarding radiologically detected gas within the vessel wall or lumen secondary to dissection. We discuss this uncommon radiologic sign and its possible pathogenesis with a review of the literature.- - - - - - - - - - ranking = 5.7847733004213keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
9/40. Trancranial Doppler monitoring of response to therapy for meningovascular syphilis.Meningovascular syphilis is now quite uncommon, but there have been increasing reports in patients immunocompromised with human immunodeficiency virus. The response of syphilis affecting the central nervous system to antibiotic therapy remains a challenge. This is an even greater challenge in patients who have underlying compromise of the immune system. The authors present a 46-year-old male with recurrent stroke who was found to have cerebrospinal fluid compatible with syphilitic involvement of the central nervous system and a cerebral arteriogram, which revealed focal narrowing of the right middle cerebral artery. The baseline transcranial Doppler study demonstrated increased mean and peak flow velocity within the right middle cerebral artery. Despite a 10-day course of intravenous penicillin, with substantial improvement in the cerebrospinal fluid results, this flow velocity elevation persisted, in a remarkably consistent pattern, over a 4-month follow-up period. Thus, the involved vessel remained patent following treatment, but no clear resolution of the stenotic lesion was observed.- - - - - - - - - - ranking = 0.5keywords = artery (Clic here for more details about this article) |
10/40. Transient aphasia and persistent amnesia after surgery for internal carotid artery--posterior communicating artery aneurysm.We report a case of transient aphasia and persistent amnesia after clipping of a ruptured cerebral aneurysm to treat a subarachnoid hemorrhage. Postoperatively, aphasia was identified and magnetic resonance imaging (MRI) showed an abnormal intensity area in the left anterior thalamus. Single photon emission computed tomography (SPECT) revealed a wider area of low perfusion surrounding the left thalamus and left frontotemporal lobe than that shown by the MRI. His aphasia resolved over the subsequent 12-week period. He was left with an isolated disturbance of memory; in the absence of any dementia, aphasia or disturbance of consciousness, his condition was classified as one of amnesia. SPECT 14 weeks after admission revealed an area of low perfusion limited to the left thalamus. These findings suggest that the persistence of amnesia in this case was caused by the infarction of the mammillothalamic tract, and the recovery from aphasia may have resulted from the disappearance of surrounding edema.- - - - - - - - - - ranking = 5.427818640337keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
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