Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Nov 2014
Case ReportsCervical spinal epidural arteriovenous fistula with coexisting spinal anterior spinal artery aneurysm presenting as subarachnoid hemorrhage--case report.
Hemorrhagic presentation of spinal epidural arteriovenous fistulas (AVFs) is rare in patients with cervical spinal vascular lesions. The present report describes a patient with cervical spine epidural AVFs associated with anterior spinal artery aneurysm at the same vertebral level presenting with subarachnoid hemorrhage. A 54-year-old man presented with sudden onset of headache. ⋯ The aneurysm was noted to be reduced in size after the treatment and totally disappeared by 1 year later, according to follow-up angiography. Anterior spinal artery aneurysm from a separate vascular distribution may coexist with spinal epidural AVFs. In the setting of spinal subarachnoid hemorrhage, comprehensive imaging is indicated to rule out such lesions.
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J Stroke Cerebrovasc Dis · Nov 2014
Case ReportsUsefulness of laser speckle flowgraphy for the assessment of ocular blood flow in extracranial-intracranial bypass.
Laser speckle flowgraphy (LSFG) is a noninvasive technique that can measure relative blood flow velocity in the optic fundus. The authors present a case of symptomatic internal carotid artery occlusion treated with superficial temporal artery (STA)-middle cerebral artery (MCA) bypass in which an improvement of ocular circulation was confirmed by LSFG. A 47-year-old man presented with a 1-month history of repeated left blurred vision and motor weakness of the right leg. ⋯ Postoperative ophthalmologic examination revealed improvement of both ischemic changes of the left optic fundi. Moreover, LSFG revealed improvement of the blood flow around the left optic disc. LSFG can be a promising clinical tool for the assessment of ocular circulation before and after bypass surgery for occlusive cerebrovascular disease.
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J Stroke Cerebrovasc Dis · Nov 2014
Clinical outcomes after thrombectomy for acute ischemic stroke on weekends versus weekdays.
The objective of this study was to determine whether clinical outcomes differed in acute ischemic stroke (AIS) patients who underwent thrombectomy on weekends versus weekdays. ⋯ AIS patients undergoing thrombectomy who were admitted to nonteaching hospitals on weekends were more likely to be discharged with moderate-to-severe disability than those admitted on weekdays. No weekend effect on discharge clinical outcome was seen in teaching hospitals.
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J Stroke Cerebrovasc Dis · Nov 2014
Long-term magnetic resonance angiography follow-up for recanalized vessels after mechanical thrombectomy.
Mechanical thrombectomy is an effective revascularization therapy for acute intracranial large vessel occlusion. We retrospectively evaluated magnetic resonance angiography (MRA) follow-up data to assess the long-term patency of recanalized vessels after mechanical thrombectomy. ⋯ Reocclusion or late stenosis of successfully recanalized vessels was observed in 16.2% of patients. Long-term MRA follow-up of recanalized vessels will be useful, in particular, for the patient with middle cerebral artery occlusion who undergoes mechanical thrombectomy.
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J Stroke Cerebrovasc Dis · Nov 2014
Multicenter Study Observational StudyThe quality of prehospital ischemic stroke care: compliance with guidelines and impact on in-hospital stroke response.
A number of emergency medical services (EMSs) performance measures for stroke have been proposed to promote early stroke recognition and rapid transportation to definitive care. This study examined performance measure compliance among EMS-transported stroke patients and the relationship between compliance and in-hospital stroke response. ⋯ EMS transportation at highest priority and hospital prenotification were associated with faster in-hospital stroke response and represent logical targets for EMS quality improvement efforts.