1/33. Emergency department presentations of cerebrovascular disease in children.Five cases of children with cerebrovascular disease presentations to the emergency department (ED) were selected as a series to illustrate the variety of presentation of cerebrovascular disease in children. This series shows that although cerebrovascular disease in children is uncommon, it is likely that cases will occasionally present acutely to an ED. The emergency physician's role in the management of suspected acute strokes in children is that of immediate stabilization, imaging to rule out hemorrhage, other studies to rule out emergent acute disease, and timely consultation for further management. Computed tomography (CT) is useful to detect an acute hemorrhage or old ischemic lesion. magnetic resonance imaging has superior image resolution over CT, but CT may be more practical initially. magnetic resonance angiography is a useful part of the stroke workup in children.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
2/33. Correlation between the neural noise in the thalamus after cerebrovascular disease and computerized tomography. A case report.The case is presented of a 45-year-old man who suffered from a sudden attack of unconsciousness with right hemiplegia and later developed a spastic hemiparesis accompanied by involuntary movement of the right upper limb. CT scan revealed an old putaminal hemorrhage and almost intact thalamus, but neural noise recordings during the stereotactic thalamotomy of this case showed marked decrease of the neural activity in the thalamus suggesting some functional changes.- - - - - - - - - - ranking = 0.57142857142857keywords = vascular disease (Clic here for more details about this article) |
3/33. Possible acute hemorrhagic leukoencephalitis manifesting as intracerebral hemorrhage on computed tomography--case report.A 15-year-old girl presented with meningeal irritation and bilateral cerebral signs after contracting influenza. A lumbar puncture revealed bloody cerebrospinal fluid and polymorphonuclear predominant pleocytosis with an elevated protein level and normal glucose level. Computed tomography showed a hematoma in the right basal ganglia and lateral ventricles. Symmetrical low density areas were also noted in the bilateral white matter. The preliminary diagnosis was hemorrhagic cerebrovascular disease of unknown cause. However, her neurological condition deteriorated. Magnetic resonance (MR) imaging showed diffuse high intensity signals in the bilateral white matter and small spotty lesions, indicating hemorrhages in various stages. The final diagnosis was acute hemorrhagic leukoencephalitis (AHL). However, high-dose steroid administration and plasmapheresis failed to improve her condition. hypothermia could not control her intracranial pressure and she died 12 days after admission. The neuroimaging findings indicated the histological characteristics of AHL, but the hematoma formation is rare. AHL is a fulminant form of brain demyelination and can be fatal, so early diagnosis and aggressive treatment are important for successful recovery. Therefore, early investigation by MR imaging is necessary.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
4/33. Multiple stenting in takayasu arteritis.PURPOSE: To illustrate the possible peri- and postprocedural complications of stent treatment for takayasu arteritis and suggest ways of reducing these risks. CASE REPORT: A 69-year-old woman with takayasu arteritis had multiple stents implanted in the aortic arch (3 Memotherm) and main branches of the thoracic aorta (individual Corinthian stents in the subclavian and brachiocephalic arteries) following balloon dilation. She suffered reperfusion injury with cerebral hemorrhage following the procedure, preventing the use of anticoagulation or antiplatelet therapy. Further cerebral infarctions/hemorrhages over the ensuing months led to her death. CONCLUSIONS: Severe vascular disease of any cause confers a poor prognosis. Endovascular stenting may seem an attractive option for management of these patients, but there is often significant morbidity and mortality associated with the underlying disease as well as the stent.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
5/33. brain pathology in 6 fatal cases of post-transfusion hypertension, convulsion and cerebral hemorrhage syndrome.Six fatal cases of post-transfusion hypertension, convulsions and cerebral hemorrhage syndrome were found in a series of 76 autopsies of thalassemic patients. Five of these cases were hypertensive. At autopsy the brains were all markedly edematous and congested. Visible cerebral hemorrhages were found in 3 patients. Microscopically all cases showed small focal or perivascular hemorrhages and 1 patient had extensive arterial type hemorrhage. Microdissecting aneurysms characteristic of hypertensive cerebral hemorrhage were found in two. No underlying vascular disease was found in these 6 patients. A correlation was attempted between possible causes of post-transfusion hypertension and convulsions and anatomical findings.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
6/33. Thalamic hand: a late onset sequela of stroke and its influence on physical function after rehabilitation: two cases report.Thalamic hemorrhage or infarction is one of the common causes of stroke. People who suffer from this type of cerebrovascular disease may develop thalamic syndrome which includes sensory disturbance, motor deficit and psychological problems. In this report, we introduce two cases of thalamic hemorrhage followed up for more than a half year after stroke. Delayed rigidity and choreodystonic type of involuntary movement over their paretic hand developed gradually. The metacarpophalangeal joints of the affected hand were kept flexed and the proximal and distal interphalangeal joints became extended. Thalamic hand is demonstrated in the appended pictures. Once the patient develops a thalamic hand, activities of daily living will be affected due to poor hand performance despite of high motor recovery stage. Early recognition and proper rehabilitation program for the patients with thalamic hand are emphasized.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
7/33. Heraldic seizure.BACKGROUND: The term heraldic seizures indicates epileptic seizures caused by cerebrovascular disease, believed to be triggered by silent ischemia and occurring before a stroke. This fact widens the spectrum of possible interrelations between epilepsy and cerebrovascular disease outside the well known context of post-stroke epilepsy. methods: This is a case report of a healthy 67-year-old male who had a new onset epileptic seizure prior to a lobar intracerebral hemorrhage (ICH). This man began to suffer myoclonic jerks in his left arm which progressed to a generalized tonic-clonic seizure. At the emergency area the physical and neurological examination were unremarkable and a CT scan was normal. The next day the patient developed left hemiparesis, hemianopsia and confusion and a new CT scan showed right parietal-occipital ICH. CONCLUSIONS: This case report exemplifies the concept of heraldic seizures, showing a patient who had a focal seizure preceding an intracerebral hemorrhage. Our etiologic diagnostic work led us to a diagnosis of probable amyloid angiopathy. We suggest that cerebral amyloid angiopathy (CAA) may be the underlying cause, since it may be the origin of both the late event (ICH) and the heralding seizures, resulting from concurrent ischemia.- - - - - - - - - - ranking = 0.28571428571429keywords = vascular disease (Clic here for more details about this article) |
8/33. Successful treatment of tacrolimus (FK506)-related leukoencephalopathy with cerebral hemorrhage in a patient who underwent nonmyeloablative stem cell transplantation.A 46-year-old woman with Hodgkin's disease who underwent nonmyeloablative allogeneic stem cell transplantation developed cortical blindness, seizures, and left hemiparesis on day 100 while receiving tacrolimus (FK506) and prednisone for the treatment of graft-versus-host disease (GVHD). magnetic resonance imaging revealed multiple changes, mainly in the bilateral occipital lobes, suggesting FK506-related leukoencephalopathy. These abnormalities improved after discontinuation of FK506. However, 3 days after the episode, cerebral hemorrhage in the left occipital lobe with perforation to the left subdural space occurred. Although FK506-induced leukoencephalopathy with cerebral hemorrhage is considered the more severe form of such leukoencephalopathy, the patient's neurological symptoms almost completely resolved and radiographic findings improved after discontinuation of FK506, tapering of methylprednisolone, and initiation of mycophenolate mofetil. FK506-related leukoencephalopathy is a rare complication after allogeneic stem cell transplantation. Although the symptoms usually subside after discontinuation of FK506, therapeutic intervention in many cases may result in severe complications, including GVHD and vascular disease. We consider it important to use immunosuppressive agents without vascular endothelial toxicity for preventing the development of fatal GVHD after discontinuation of FK506.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
9/33. Cerebrovascular effects of selective serotonin reuptake inhibitors: a systematic review.OBJECTIVES: An understanding of cerebro-vascular effects of selective serotonin reuptake inhibitors (SSRIs) is essential, since SSRIs are a widely used antidepressant, serotonin is a vasoactive and thrombostatic amine, and there is a bidirectional relationship between depression and cerebrovascular disease. DATA SOURCES: A medline search was performed to identify published reports over the period of 1966 through 2003, using the terms SSRIs and antidepressants matched with the terms platelets, coagulation, anticoagulation, bleeding, fibrinolysis, thrombosis, embolism, cerebral ischemia, stroke, cerebrovascular accident, acute and chronic cerebrovascular disease, intracranial hemorrhage, cerebrovascular disorder, and cerebral circulation. Adverse event reports collected from the world health organization (WHO), manufacturers, and the physicians' Desk Reference (PDR) were also examined. DATA SYNTHESIS: Two case-control studies failed to show an association between SSRI use and intracranial hemorrhage, and of these, 1 showed no association with ischemic stroke. Sixteen studies of SSRI treatment in poststroke patients found no significant cerebrovascular adverse reactions. The WHO data have shown several hundred cases of SSRI-associated cerebrovascular disease, but definitive causal relationships remain undetermined. Four cases of vasoconstrictive stroke related to drug interactions between SSRIs and other serotonergic drugs have been reported. PDR and manufacturer reference sources categorized cerebrovascular reaction as an infrequent or rare adverse event related to SSRI use. CONCLUSIONS: Available evidence suggests that SSRI treatment has a very low rate of cerebrovascular adverse reaction. pharmacovigilance is required in the use of SSRIs in high-risk populations for bleeding and vasoconstrictive stroke. More research is warranted to examine the variability of pharmacologic and genetic factors, depressive illness, and stroke on the antiplatelet and vasospastic effects of SSRIs and their significance to cerebrovascular protection or adverse reactions.- - - - - - - - - - ranking = 0.42857142857143keywords = vascular disease (Clic here for more details about this article) |
10/33. ANCA-associated vasculitis (AAV) causing bilateral cerebral infarction and subsequent intracerebral hemorrhage without renal and respiratory dysfunction.A 56-year-old man complained of headache and the analgesia of the four extremities. Laboratory data presented signs of inflammation, but no other abnormality such as renal or respiratory dysfunction. Two months after the appearance of the primary symptoms, he developed cerebral infarction of the bilateral corona radiata. The patient did not have any of the risk factors for cerebrovascular disease. He was diagnosed with anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) because the systemic examinations revealed only that he tested positive for anti-neutrophil cytoplasmic autoantibody (ANCA). Moreover, the biopsy of the sural nerve displayed microscopic polyangitis (MPA). Despite undergoing steroid pulse therapy, the patient died from the fatal cerebral hemorrhage. The clinical course of AAV is rapid progressive. In cases of atypical cerebrovascular disease, the possibility of ANCA should be investigated.- - - - - - - - - - ranking = 0.28571428571429keywords = vascular disease (Clic here for more details about this article) |
| | Next -> |