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Query: UMLS:C0038454 (stroke)
147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Posterior circulation stroke, which includes basilar artery occlusion (BAO), accounts for approximately 20% of all ischemic strokes. Much is unclear concerning the early historical descriptions of basilar artery occlusion, and some modern authors cite the historical sources incorrectly and incompletely. The case described by the Scottish physician John Abercrombie in 1828 is probably the first description of this form of stroke. The progressive bulbar signs that Abercrombie described in his case were striking, i.e., dysphagia and speech difficulties. Many authors in the 19th century described a waxing and waning clinical course for several days before profound coma and death. They also noticed signs and symptoms such as hemiplegia without loss of sensitivity and bulbar symptoms such as swallowing and speech impairment, vertigo, and altered consciousness. After Virchow's epoch-making work on embolism and thrombosis, all authors correctly described BAO as resulting from emboli and thrombosis based on arteriosclerosis instead of ossification of the arterial walls or inflammation. Around 1880, the clinical symptoms of BAO were obviously well-known to the experienced clinician. In this article we offer a chronological description of historical sources.
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PMID:Historical sources of basilar artery occlusion. 2151 3

Epistaxis is a common disorder affecting equally both genders. Posterior origin of epistaxis in some instances requires endovascular treatment. Anastomoses between external carotid artery and internal carotid or ophthalmic arteries heighten the risk of stroke or blindness, if particles of polyvinyl alcohol are used for embolization. We report a case of 90-year-old man for whom successful embolization with N-Butyl Cyanoacrylate glue was performed as an alternative treatment for recurrent epistaxis.
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PMID:N-butyl cyanoacrylate proved beneficial to avoid a nontarget embolization of the ophthalmic artery in endovascular management of epistaxis. A neurointerventional report and literature review. 2156 54

PHACE syndrome is a neuro-cutaneous syndrome characterized by malformations of the Posterior fossa, facial Hemangiomas, Arterial anomalies, Cardiac anomalies, and abnormalities of the Eye. The arterial abnormalities usually involve the cervical and cerebral vasculature and include congenital abnormalities and progressive cerebral vasculopathy. The progressive cerebral vasculopathy leads to increased risk for arterial ischemic stroke (AIS) in patients with PHACE syndrome. Here we described the clinical neurological sequelae, the malformation of brain, the cervical and cerebral vasculopathy in a 23-year-old female of PHACE syndrome. Besides, she presented AIS with limb-shaking transient ischemic attack, a rare clinical presentation of AIS in patients of PHACE syndrome.
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PMID:Limb-shaking transient ischemic attacks in an adult PHACE syndrome: a case report and review of the literature. 2171 Jan 24

Posterior cerebral artery (PCA) dissection in children seldom is reported in the literature. This is the second report of acute PCA dissection with infarct occurring in a young child. A serial magnetic resonance angiography demonstrated a delayed and transient narrowing of the arterial caliber, which was consistent with a focal PCA dissection with delayed vascular recanalization. PCA dissection should be included in the causes of infarct in children and a thorough and serial neurovascular imaging should be considered if no cause of stroke is found.
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PMID:Posterior cerebral artery dissection on a serial magnetic resonance angiography. 2176 24

Certain Acute Clinical presentations are highly suggestive of stroke caused by specific mechanisms. One example of this would be the sudden onset of aphasia without hemiparesis often reflecting cerebral embolism, frequently from a cardiac source. Posterior reversible encephalopathy syndrome (PRES) describes a usually reversible neurologic syndrome with a variety of presenting symptoms from headache, altered mental status, seizures, vomiting, diminished spontaneity and speech, abnormalities of visual perception and visual loss. We report a patient presenting with elevated blood pressure, CT characteristics of PRES but a highly circumscribed neurologic syndrome (Wernicke's Aphasia without hemiparesis) suggestive of a cardioembolic stroke affecting the left MCA territory. That is, PRES mimicked a focal stroke syndrome. The importance of recognizing this possibility is that his deficits resolved with blood pressure control, while other treatments, such as intensifying his anticoagulation would have been inappropriate. In addition, allowing his blood pressure to remain elevated as is often done in the setting of an acute stroke might have perpetuated the underlying pathophysiology of PRES leading to a worse clinical outcome. For this reason PRES needs to be recognized quickly and treated appropriately.
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PMID:Posterior reversible encephalopathy syndrome mimicking a left middle cerebral artery stroke. 2237 21

Posterior reversible encephalopathy syndrome (PRES) can present with focal neurologic deficits, mimicking a stroke and can often represent a diagnostic challenge when presenting atypically. A high degree of suspicion is required in the clinical setting in order to yield the diagnosis. Cerebral CT perfusion (CTP) is utilized in many institutions as the first line in acute stroke imaging. CTP has proved to be a very sensitive measure of cerebral blood flow dynamics, most commonly employed to delineate the infarcted tissue from penumbra (at-risk tissue) in ischemic strokes. But abnormal CTP is also seen in stroke mimics such as seizures, hypoglycemia, tumors, migraines and PRES. In this article we describe a case of PRES in an elderly bone marrow transplant recipient who presented with focal neurological deficits concerning for a cerebrovascular accident. CTP played a pivotal role in the diagnosis and initiation of appropriate management. We also briefly discuss the pathophysiology of PRES.
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PMID:Posterior reversible encephalopathy syndrome (PRES) and CT perfusion changes. 2237 97

Posterior circulation stroke accounts for about 20% of all ischemic strokes in a variety of syndromic pictures ranging from lacunar and limited infarcts to more extensive involvement. Furthermore, infarcts in the vertebrobasilar (VB) region are frequently multiple and not univocally identifiable in one single clinical entity; the prognosis is sometimes unpredictable and very often is unfavorable having a high early mortality rate. The basilar artery (BA), which is the main vessel of the posterior circulation, supplies most of the brainstem and occipital lobes and part of the cerebellum and thalami, its occlusion (BAO) is the most severe occurrence in the posterior circulation infarct context. The optimum management of BAO is still under debate and in the absence of randomized studies the most appropriate approach is still unclear. In the previous chapters, single territory infarcts involving the posterior circulation have been discussed. The present chapter will discuss extended infarcts in the VB territory due to different degrees of VB involvement or to BAO.
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PMID:Extended infarcts in the vertebrobasilar territory. 2237 90

Posterior ischaemic stroke is relatively uncommon, and its occurrence should alert clinicians to possible uncommon underlying disease. We report a patient with occipital brain infarction. The combination of age, gender, general malaise and elevated erythrocyte sedimentation rate led to the clinical suspicion of giant cell arteritis. Vertebral artery vasculitis was confirmed by 18-FD G positron emission tomography, combined with CT angiography, and immediate immunosuppressive therapy was started. Symptoms of stroke should, in a particular clinical context, raise suspicion of giant cell arteritis.
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PMID:Vasculitis revealed by posterior stroke. 2241 54

Stent-grafting of thoracic aortic diseases has developed as an alternative therapeutic modality in thoracic aneurysm management. Postprocedural complications include mortality, endoleaks, paraplegia and stroke. Other complications that may arise in cases of overstenting the origin of the left subclavian arther include left upper limb ischemia, subclavian steal syndrome and stroke. Posterior circulation strokes due to vertebral artery insufficiency have been reported in the past. In the present case, a fatal stroke caused by a cerebellar infarct culminating in the death of a patient with a leaking thoracic aortic aneurysm is reported. Medical personnel as well as patients should be aware of this possible complication. Vigilance in assessing the contralateral cerebral circulation before the procedure is a prerequisite in less acute circumstances.
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PMID:Fatal cerebellar stroke following emergency endovascular stent grafting of a leaking thoracic aortic aneurysm: A case report. 2247 74

Posterior circulation stroke refers to the vascular occlusion or bleeding, arising from the vertebrobasilar vasculature of the brain. Clinical studies show that individuals who experience posterior circulation stroke will develop significant brain injury, neurologic dysfunction, or death. Yet the therapeutic needs of this patient subpopulation remain largely unknown. Thus understanding the causative factors and the pathogenesis of brain damage is important, if posterior circulation stroke is to be prevented or treated. Appropriate animal models are necessary to achieve this understanding. This paper critically integrates the neurovascular and pathophysiological features gleaned from posterior circulation stroke animal models into clinical correlations.
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PMID:Posterior circulation stroke: animal models and mechanism of disease. 2266 86


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