1,721,032 research outputs found
Letter by Legge et al regarding article, "Safety of intravenous fibrinolysis in imaging-confirmed single penetrator artery infarcts"
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Intracranial dissection and extracranial hypoplasia of the internal carotid artery
No full textDissection of the intracranial portion of the internal carotid artery (ICA) is anuncommon cause of stroke or transient ischemic attack (TIA). Congenitalanomalies of the ICA have been rarely associated with cerebral ischemia.However, unilateral ICA hypoplasia can be frequently associated withintracranial arterial anomalies and altered hemodynamics.1We describe the case ofa woman who had sudden onset of right facial pain and transient left hemiparesis.Diffusion-weighted magnetic resonance imaging (MRI) findings were negative foracute ischemia. Magnetic resonance angiography (MRA) and sonography showedhypoplasia of the right extracranial ICA and vertebral artery (VA) and dissection ofthe intracranial portion of the right ICA and right middle cerebral artery (MCA), withinverted flow of the right anterior cerebral artery (ACA). At 12-month imaging stud-ies, the intracranial hemodynamics appeared normalized, whereas the extracranialfindings were unchanged. This case shows an association between hypoplasia, dis-section of the ICA, and cerebral ischemi
Ischemic stroke: From acute treatment to long-term recovery
No full textIschemic stroke (IS) is due to the sudden occlusion of a cerebral artery with the consequence of a critical reduction in cerebral blood flow in a localized region (rCBF) of the brain. It represents the second cause of death and the leading cause of neurological disability in developed countries. Primarily due to the resulting economic burden, IS is considered a world-wide challenge. Different strategies can be identified to face this challenge: acute treatment, primary and secondary prevention, rehabilitation. For several years acute IS treatment has been based on the use of the only current drug approved in the first 3 hours from symptom onset: recombinant tissue plasminogen activator (rtPA). However, mainly due to the short therapeutic window, a low percentage of patients can be actually treated by rtPA. Thus, with improving diffusion of more accurate diagnostic tools and of prognostic informations in different clinical scenarios, new treatment strategies in the acute phase have been developed such as intra-arterial and mechanical thrombolysis. Prevention plays a crucial role in counteracting the economic burden of IS through life-style changes, vascular risk factors control (with arterial hypertension being the main one for IS) and antiplatelet therapy. Moreover prevention therapy has been enriched by the introduction, in the last few years, of new drugs with pleiotropic effects such as statins and ACE-inhibitors. Also potential pleiotropic effects of antidiabetic drugs are currently under investigation. New insights in secondary prevention come from the use of phosphodiesterase inhibitors such as dipyridamole (in combination with aspirine) and cilostazol. The latter demonstrated to be more effective than aspirin in reducing the risk of recurrent stroke with the advantage of dramatically reducing the risk of haemorrhagic events as compared to aspirin. Rehabilitation strategies are weighted, together with acute IS treatment, by most of stroke physicians and patients expectations. Among them transcranial magnetic stimulation (TMS) is a new tool able to explore and affect critical aspects of neural plasticity, thus being of great importance in the understanding and treatment of those fundamental functional recovery mechanisms triggered after stroke. The present chapter will focus on standard, current and new potential treatments of acute phase, prevention and rehabilitation of IS. © 2013 Nova Scicence Publishers, Inc. All rights reserved
Letter by Diomedi et al regarding article "continuous stroke unit electrocardiographic monitoring versus 24-hour holter electrocardiography for detection of paroxysmal atrial fibrillation after stroke"
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Ultrasound evaluation of early changes in arterial dissection
No full textWe show magnetic resonance imaging, computed tomography-angiography, and ultrasound images of internal carotid artery dissection in a patient with acute ischemic stroke. Arterial changes occurring during the first few days were detected by serial ultrasound examinations. Neurologic and functional outcome are provided and therapeutic options discussed
Anticipation of onset age in hereditary essential tremor
No full textThe genetic anticipation phenomenon has been described in several neurological disorders, often associated with unstable trinucleotide repeats in the affected genes. The occurrence of this phenomenon in hereditary essential tremor is still debated. We describe a family in which three male members with essential tremor showed a progressive anticipation in onset age and an increased severity of clinical symptomatolog
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