1/75. Cerebrovascular disease in neonates. Evaluation of four cases.The clinical and neurological study in four neonates infants with cerebral infarction are reported. The purpose of this study is to call attention for the clinical course, cranial ultrasound, computed tomography and laboratories tests, in order to evaluate the neurological sequelae. A careful evaluation has be taken in order to determine the significance of clinical and laboratory tests for syndromic, topographic and etiologic diagnosis after one year ambulatorial follow-up.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
2/75. migraine with aura-like headache associated with moyamoya disease.A 49-year-old woman was admitted to our hospital because of severe headache. She had a 10-month history of migraine with aura-like headache that occurred every 7 to 10 days and was preceded by photopsia. brain CT showed cerebral infarction of the left occipital lobe. Bilateral carotid angiograms showed vascular occlusions in the supraclinoid portion of the bilateral internal carotid arteries with telangiectatic vessels acting as collateral channels to the occluded distal carotid arteries, which were consistent with the diagnosis of moyamoya disease. headache resolved gradually and has never developed again after the infarct of the left occipital lobe. Pathophysiological mechanisms of migraine-like headache were discussed. We conclude that borderline perfusion of occipital lobe cortex could be a trigger for the development of migraine with aura-like headache in susceptible patients. In the case of atypical attack of migraine detailed investigation should be done to detect underlying vascular diseases such as moyamoya disease.- - - - - - - - - - ranking = 0.25keywords = vascular disease (Clic here for more details about this article) |
3/75. Assessment of outcome by EC/IC bypass with 123I-iomazenil brain SPECT.We report two patients with occlusive cerebrovascular disease who were examined by means of benzodiazepine receptor SPECT(BZR-SPECT) with 123I-iomazenil (IMZ) before extracranial-intracranial bypass surgery (EC/IC bypass). Preoperative low perfusion areas detected by cerebral blood flow SPECT (CBF-SPECT) were divided into two parts on BZR-SPECT images. In the low perfusion areas where the BZR were preserved, regional cerebral blood flow (rCBF) increased on postoperative CBF-SPECT, but where the BZR were not preserved, rCBF did not increase on postoperative CBF-SPECT. On visual inspection, the SPECT images of postoperative CBF-SPECT appeared similar to those of preoperative BZR-SPECT. For evaluation of the ischemic brain condition itself, instead of the cerebral metabolism, the distribution and activity of cerebral neurons indicated by BZR-SPECT with IMZ might be utilized.- - - - - - - - - - ranking = 0.25keywords = vascular disease (Clic here for more details about this article) |
4/75. Moyamoya syndrome with protein s deficiency.moyamoya disease is a cerebrovascular disease with progressive occlusion of both internal carotid arteries and of their branches and formation of a new vascular network at the base of the brain. Because of the angiographic appearance, it is named as moyamoya. The clinical features are cerebral ischaemia, recurrent transient ischaemic attacks, sensorimotor paralysis, convulsions and migraine-like headaches. A 10-year-old child who acutely developed hemiparesis, weakness and aphasia was found to have moyamoya disease and heterozygous protein S deficiency. This case shows us that during the thromboembolic events the coexistence of protein s deficiency and moyamoya should be investigated.- - - - - - - - - - ranking = 0.25keywords = vascular disease (Clic here for more details about this article) |
5/75. Paradoxical embolization in an adult patient with cystic fibrosis.To our knowledge, we describe the first reported case of paradoxical embolization via a patent foramen ovale (PFO) in an adult with moderately severe cystic fibrosis (CF) and advanced lung disease. Fluctuating neurologic symptoms and signs suggestive of cerebrovascular disease in an adult patient with advanced CF may be due to paradoxical embolization via a PFO. The possibility of a PFO should be considered before placement of a totally implantable venous access device to avert unnecessary risk of stroke in CF patients. Further study is needed to determine whether the use of a totally implantable venous access device increases the risk of paradoxical embolization in adult CF patients with a PFO.- - - - - - - - - - ranking = 0.25keywords = vascular disease (Clic here for more details about this article) |
6/75. cerebral infarction in Menkes' disease.Menkes' disease is an X-linked disorder caused by impaired intracellular transport of copper. Currently, no therapy effectively arrests the relentless neurodegeneration of Menkes' disease. Previous neuroimaging reports of patients with Menkes' disease describe a range of abnormalities, including intracranial vessel tortuosity and cerebral white matter changes. We report two infants with Menkes' disease who developed ischemic cerebrovascular disease early in infancy. Magnetic resonance studies, including diffusion-weighted imaging and proton magnetic resonance spectroscopy, demonstrated bilateral infarctions of deep gray matter nuclei, a finding not previously described in Menkes' disease. Potential mechanisms for these cerebrovascular lesions in Menkes' disease include the susceptibility to free radical attack and inadequate energy supply from oxidative phosphorylation. These infarctions may play an unrecognized but important role in the neurodegeneration of children with Menkes' disease. The development of effective therapeutic agents against this disease will require a more detailed understanding of such underlying mechanisms.- - - - - - - - - - ranking = 0.25keywords = vascular disease (Clic here for more details about this article) |
7/75. Sudden cortical hearing loss for speech: a case report.A 35-yr-old male patient experienced a sudden loss of speech understanding due to a bilateral cerebrovascular disease. A detailed summary of audiological and neurological findings was presented. Findings indicated that the presence of Pa waves of the Middle Latency Response (MLR) may be a positive prognosis for improvement in hearing thresholds and speech understanding.- - - - - - - - - - ranking = 0.25keywords = vascular disease (Clic here for more details about this article) |
8/75. Retinal findings in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (cadasil).We describe a 45-year-old man with biopsy proven cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (cadasil). This patient demonstrated unique retinal findings, including arteriole narrowing and sheathing, irregular choroidal filling on fluorescein angiography, and patchy visual field loss. cadasil is a hereditary, nonamyloid, nonathersclerotic microangiopathy. This disorder has been mapped to chromosome 19 with mutations in the Notch 3 gene. Deposits of granular osmiophilic material in the basal lamina of the smooth muscle cells of small vessels are considered pathognomonic for cadasil and are typically seen only on electron microscopy. Although cadasil is a systemic vascular disease affecting the entire arteriole tree, we are unaware of other reports describing the retinal findings observed in our patient.- - - - - - - - - - ranking = 0.25keywords = vascular disease (Clic here for more details about this article) |
9/75. Progressive intracranial vascular disease with strokes and seizures in a boy with progeria.progeria, a rare genetic disorder, is characterized by severe growth failure, premature aging, and very early atherosclerosis with coronary artery and cerebrovascular disease. There has been no detailed description of progressive cerebrovascular changes in progeria or any attempted neurologic correlation of those changes. A 5-year-old boy developed signs of progeria at 4 months and hypertension at 4 years, treated with atenolol and dipyridamole. Left-sided seizures with a left hemiparesis occurred at 5 years. magnetic resonance imaging (MRI) showed bilateral acute, subacute, and chronic cerebral infarctions. magnetic resonance angiography disclosed severe stenosis of the left internal carotid artery. The child was also found to have an aortic valve vegetation and was anticoagulated. He subsequently developed right-sided seizures, and treatment with gabapentin was started. Later, severe stenosis also of the right internal carotid artery was found. MRI showed new left cerebral infarction. The child's neurologic symptoms almost certainly were caused by cerebral infarctions from progressive atherosclerosis of major intracranial vessels, but clinical-neuroradiologic correlations were imprecise. There were multiple cerebral infarctions of different ages, some asymptomatic, others ipsilateral to the child's neurologic findings. No therapy has halted progression of the child's cerebrovascular disease.- - - - - - - - - - ranking = 1.5keywords = vascular disease (Clic here for more details about this article) |
10/75. coronary artery bypass grafting in a patient with brainstem ischemia.We describe a 54-year-old male with severe coronary artery disease and cerebrovascular disease including right cerebellar infarction, total occlusion of the bilateral vertebral arteries, brainstem ischemia, and right cerebral infarction with significant right carotid artery disease. Repeated percutaneous transluminal coronary angioplasty had been performed, however, unstable angina was developed despite maximal medical treatment. coronary artery bypass grafting was successfully undergone with use of propofol, application of the intra-aortic balloon pumping perioperatively, and mild hypothermic cardiopulmonary bypass with alpha-stat blood gas management. The importance of preoperative evaluation of the intracranial circulation and management of cardiopulmonary bypass are discussed.- - - - - - - - - - ranking = 0.25keywords = vascular disease (Clic here for more details about this article) |
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