Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Sep 2014
Effect of intravenous thrombolysis on stroke associated with atrial fibrillation.
Data based on randomized clinical trials regarding the efficacy and safety of intravenous thrombolysis (IVT) versus placebo or any other antithrombotic agent in the treatment of stroke associated with atrial fibrillation (AF) are unavailable. ⋯ These results should encourage the use of IVT in AF-associated strokes.
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J Stroke Cerebrovasc Dis · Sep 2014
Comparative StudyClinical characteristics of cardioembolic transient ischemic attack: comparison with noncardioembolic transient ischemic attack.
Previous studies show that 6%-31% of transient ischemic attacks (TIA) were caused by cardiogenic cerebral embolism (cardioembolic TIA). As prompt initiation of therapy is essential in TIA to prevent subsequent strokes, determining their cause is important. In this study, we aim to determine the features of cardioembolic TIA and to compare them with those of noncardioembolic etiology. ⋯ Clinical features are similar in tissue-defined TIA of cardioembolic and noncardioembolic etiologies. The CHADS2 score can be useful in assessing the probability of cardioembolic TIA.
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J Stroke Cerebrovasc Dis · Sep 2014
Case ReportsA case of bilateral giant internal carotid artery aneurysms at the cavernous portion managed by 2-stage extracranial-intracranial bypass with parent artery occlusion: consideration for bypass selection and timing of surgeries.
Bilateral giant internal carotid artery (ICA) aneurysms at the cavernous portion with bilateral cranial nerve symptoms are extremely rare. Extracranial-intracranial (EC-IC) bypass with parent artery occlusion (PAO) is one of the preferred procedures for giant ICA aneurysm at the cavernous portion with cranial nerve palsy; however, optimal bypass selection and the timing of surgery are controversial, particularly in bilateral cases. A 28-year-old woman developed left third nerve palsy with giant ICA aneurysms at the bilateral cavernous portion. ⋯ Cranial nerve palsy gradually improved postoperatively, and single-photon emission computed tomography confirmed static cerebral hemodynamics. In conclusion, high-flow EC-IC bypass with PAO is recommended in the first stage of surgery on a unilaterally symptomatic side to minimize postoperative hemodynamic stress to the contralateral aneurysm. Once the contralateral side becomes symptomatic, second stage EC-IC bypass with PAO, either low-flow or high-flow bypass, is recommended based on the results of balloon test occlusion.
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J Stroke Cerebrovasc Dis · Sep 2014
Case ReportsIsolated unilateral hypoglossal nerve paralysis caused by internal carotid artery dissection.
We here report the case of isolated hypoglossal nerve paralysis. Magnetic resonance imaging demonstrated characteristic findings of internal carotid artery dissection that should be considered as one of the differential diagnosis of ipsilateral pure hypoglossal nerve paralysis.
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J Stroke Cerebrovasc Dis · Aug 2014
Impact of aneurysm location on cardiopulmonary dysfunction after subarachnoid hemorrhage.
Cardiopulmonary dysfunction may occur after aneurysmal subarachnoid hemorrhage (SAH), but its characteristics have not been fully clarified. We investigated the impact of aneurysm location on systemic hemodynamics after SAH. ⋯ Aneurysm location affects cardiac output, vascular resistance, and pulmonary edema in biphasic fashion. Patient age and location of aneurysm in the ACA may be risk factors for cardiac failure after SAH.