Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Jan 2008
Case ReportsBilateral vertebral artery dissection possibly precipitated in delayed fashion as a result of roller coaster rides.
A 34-year-old woman presented with a 5-month history of persistent vertigo after multiple roller coaster rides, followed by neck pain for 1 month and then 2 weeks of blurred vision related to diplopia. She was ultimately found to have bilateral cervical vertebral artery dissection. The images are described and the literature is reviewed regarding late diagnosis of vertebral dissection and prior cases of roller coaster-associated dissection.
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J Stroke Cerebrovasc Dis · Sep 2007
Comparative StudyFunctional and cognitive capacity and health-related quality of life 2 years after day hospital rehabilitation for stroke: a prospective study.
This study prospectively evaluated long-term outcome 2 years after 6-8 weeks of day hospital rehabilitation (DHR) for stroke in younger patients. Assessment findings after discharge from DHR and at follow-up 2 years later using 3 instruments--the FIM (originally known as the Functional Independence Measure), SF-36, and EuroQol (now known as EQ-5D)--were compared. The study group comprised 50 consecutive patients age 18-60 years at the time of their initial stroke who had participated in a prospective study of the effects of DHR after stroke. ⋯ Women demonstrated less improvement in EuroQol scores than men. Our findings indicate that most stroke patients who sustained initial acute stroke at age 18-60 years and received 6-8 weeks of DHR poststroke maintained functional and cognitive capacity as well as HRQoL after 2 years. Some patients even may have improved their cognitive capacity and HRQoL.
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J Stroke Cerebrovasc Dis · May 2007
Case ReportsFibromuscular dysplasia with carotid artery dissection presenting as an isolated hemianopsia.
Internal carotid artery (ICA) dissection is a well-known cause of anterior circulation stroke, but its association with posterior circulation stroke has been less commonly reported. The latter situation can arise when there is persistent fetal circulation of the posterior cerebral artery and has, to our knowledge, never been reported in the setting of fibromuscular dysplasia (FMD) involving the ICA. ⋯ Although infrequently reported, carotid disease, including dissection, can be responsible for posterior circulation infarcts. Cervical artery dissection can be related to underlying arteriopathies such as FMD, which must be differentiated from vasculitis and vasospasm.
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J Stroke Cerebrovasc Dis · Mar 2007
Comparative StudyAcute ischemic stroke lesion measurement on diffusion-weighted imaging--important considerations in designing acute stroke trials with magnetic resonance imaging.
In acute ischemic stroke, magnetic resonance diffusion-weighted imaging (DWI) is increasingly used to select patients for inclusion or as a surrogate outcome marker in clinical trials, or in routine practice. Little is known of what factors might affect DWI lesion size measurement. We examined morphologic factors that might affect DWI lesion measurement. ⋯ DWI lesion characteristics influence lesion volume measurement. Large, multifocal, ill-defined DWI lesions obtained in less than 6 hours have the greatest variability. Trials using DWI should account for this in their study design.
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J Stroke Cerebrovasc Dis · Mar 2007
Case ReportsChanges in diffusion-weighted magnetic resonance imaging findings in the acute and subacute phases of anoxic encephalopathy.
We report serial magnetic resonance imaging findings in a case of anoxic encephalopathy (AE). Diffusion-weighted images clearly showed early development of lesions in the cerebellum, cerebral cortex, and caudate putamen, along with delayed manifestation of lesions in the hippocampus, corpus callosum, and white matter. The present case is the first to demonstrate delayed development of postischemic changes in the hippocampus and deep white matter after AE on neuroimaging.