Neurocritical care
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Case Reports
The "cord sign" in cerebral venous thrombosis associated with high plasma levels of factor VIII.
Cerebral venous thrombosis (CVT) is a potentially life-threatening condition that requires acute recognition and treatment. Diagnosis of CVT is challenging and requires a high index of clinical suspicion. The finding of the "cord sign" in a non-contrast cranial CT is useful for the rapid recognition of CVT in the emergency setting. ⋯ We report the first case of CVT with the "cord sign" and concomitant elevated FVIII. Early recognition of the "cord sign" is warranted for the emergency diagnosis and treatment of CVT.
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Patients with stroke symptoms but negative diffusion-weighted imaging (DWI) might have transient ischemic attacks (TIA) or stroke mimics. Brain DWI is important for the diagnosis of cerebral infarction but it is not available before thrombolysis for most patients to avoid treatment delay. This study aimed to evaluate the safety of IV thrombolysis in patients with a negative post-treatment DWI for cerebral infarction. ⋯ Our results suggest that the administration of IV rt-PA within the first 4.5 h of symptom onset in patients with suspected ischemic stroke is safe even when post-treatment DWI does not demonstrate cerebral infarction.