Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Oct 2018
Observational StudyStroke Mimics Transported by Emergency Medical Services to a Comprehensive Stroke Center: The Magnitude of the Problem.
Despite the use of validated prehospital stroke scales, stroke mimics are frequent among patients transported by Emergency Medical Services to the Emergency Department. We aimed to describe the frequency and characteristics of neurological and non-neurological mimics transported to a comprehensive stroke center for acute stroke evaluation. ⋯ Stroke mimics are common among patients transported by Emergency Medical Services to a comprehensive stroke center for suspected stroke, with a considerable proportion being non-neurological in origin. Studies refining triage and transport of suspected acute stroke may be warranted to minimize the number of mimics transported by to a comprehensive stroke center for acute stroke evaluation.
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J Stroke Cerebrovasc Dis · Oct 2018
Case ReportsParoxysmal Sympathetic Hyperactivity after Surgery for Cerebral Hemorrhagic Arteriovenous Malformation: A Case Report.
Paroxysmal sympathetic hyperactivity is a condition involving a sudden increase in body temperature, heart rate, blood pressure, respiratory rate, sweating, and posturing followed by severe brain injury. Most of the reported preceding disorders involve head trauma, followed by anoxic brain injury, and stroke. Here, we report an extremely rare case of 17-year-old man diagnosed with hemorrhagic arteriovenous malformation, underwent emergent surgery, was on prolonged sedation due to postoperative complications, and subsequently developed paroxysmal sympathetic hyperactivity. We recommend monitoring for paroxysmal sympathetic hyperactivity occurrence with severe brain injury patients, even when sedating.
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J Stroke Cerebrovasc Dis · Oct 2018
Observational StudySpinal Cord Infarction: Clinical and Radiological Features.
Spinal cord infarction is an uncommon disease varying in its clinical presentation. This study describes the clinical and radiological presentation of spinal cord infarcts in 17 consecutive patients. ⋯ Spinal cord infarction is a rare but important cause of acute spinal syndrome. Typical distribution and appropriate imaging can help in timely diagnosis.
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J Stroke Cerebrovasc Dis · Sep 2018
Multicenter StudyEndovascular Treatment of Acute Basilar Artery Occlusion: Registro Endovascolare Lombardo Occlusione Basilar Artery (RELOBA) Study Group Experience.
Acute basilar artery occlusion (BAO) is considered among the most severe medical emergencies, with very high morbidity and mortality. The aims of this study are to present 5 years experience of 12 centers in Lombardy region on BAO endovascular treatment and to evaluate prognostic factors that may improve clinical outcomes and recanalization rates. ⋯ BAO treatment needs more efforts to assure patients better clinical outcomes. Mechanical thrombectomy is feasible and effective in patients with acute BAO. These results must be confirmed by further prospective studies within randomized controlled settings.
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J Stroke Cerebrovasc Dis · Sep 2018
Comparative StudyEvaluation of Intraplaque Neovascularization Using Superb Microvascular Imaging and Contrast-Enhanced Ultrasonography.
Several studies have shown a linkage between intraplaque neovascularization (IPN) and plaque instability. Although contrast-enhanced ultrasonography (CEUS) may help visualize IPN in the carotid artery, its benefits are limited in Japan, where there is no health insurance coverage for contrast agents in medical imaging. Superb microvascular imaging (SMI), however, enables the depiction of low-velocity blood flow. The current study compares the diagnostic accuracy of SMI and CEUS in the evaluation of IPN. ⋯ The results of this study show that patients with SMI-detected blood flow will tend to have plaque enhancement using CEUS. This suggests that SMI, as a simpler, safer, and noninvasive technique, can facilitate the visualization of carotid artery IPN without the use of a contrast agent, as well as in the clinical evaluation of plaque instability.