Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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Cerebral fat embolism is an uncommon but serious complication of long-bone fracture. We report a young adult patient who sustained fat embolism after a femoral fracture. ⋯ His acute recovery was characterized by marked frontal dysfunction. A comprehensive neuropsychological evaluation 4 months later revealed overall normal cognitive function, except for mild residual frontal dysfunction and weakness of verbal memory.
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J Stroke Cerebrovasc Dis · Nov 2012
Case ReportsIntravenous recombinant tissue plasminogen activator thrombolysis in acute ischemic stroke due to middle cerebral artery dissection.
Beneficial effect of recombinant tissue plasminogen activator (rtPA) in cerebral arterial dissection is controversial. We experienced a 45-year-old man with acute ischemic stroke due to middle cerebral artery dissection, who was treated with rtPA. Characteristic vascular findings indicating dissection became evident only in subsequent angiographic examinations. Our case indicates that serial angiographic examinations should be essential after acute thrombolytic therapy, especially in young patients who are at a high risk of cerebral arterial dissection.
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Many patients with stroke-mimicking conditions receive treatment with intravenous fibrinolysis (IVF), a treatment associated with potentially serious complications. We sought to determine if any clinical or radiographic characteristics can help predict stroke mimics among IVF candidates. ⋯ IVF has low complication rates in stroke mimics. Certain clinical characteristics appear predictive of stroke mimics, particularly normal computed tomographic angiography. If confirmed, this may help prevent giving IVF to patients without stroke.
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J Stroke Cerebrovasc Dis · Nov 2012
Type of preadmission antidiabetic treatment and outcome among patients with ischemic stroke: a nationwide follow-up study.
We examined whether the preadmission use of sulfonylureas is associated with improved clinical outcome compared with other antidiabetic treatments after hospitalization with ischemic stroke. ⋯ Preadmission use of sulfonylureas appeared not to be associated with an overall improved clinical outcome among type 2 diabetic patients admitted with ischemic stroke.
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J Stroke Cerebrovasc Dis · Nov 2012
Case ReportsRotational vertigo associated with putaminal infarction.
A 57-year-old man was admitted because of left hemiparesis. A magnetic resonance imaging scan of the brain revealed a recent infarct from the dorsal side of the right putamen to the corona radiata. ⋯ Repeat magnetic resonance imaging scans on days 2 and 11 revealed no additional lesions. The present case indicates that rotational vertigo might result from a small, supratentorial, subcortical lesion.