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

We report the case of a patient with completely painless chronic aortic dissection, who presented to another hospital with a left hemiparesia 3 months ago and received anticoagulation therapy with a diagnosis of ischemic stroke. Most of her symptoms had resolved when she presented to our outpatient clinic except for numbness of her left hand and dysphasia. Physical examination found a diastolic murmur at the left sternal border and a bruit over the right carotid artery. Transthoracic echocardiography and carotid sonography demonstrated aortic dissection with extension into the internal right carotid artery and severe aortic regurgitation. Surgery was performed successfully and the patient was discharged. This case emphasizes that the diagnosis of a completely painless aortic dissection with only neurologic symptoms at presentation can be extremely difficult and should always be considered as a cause of ischemic stroke to avoid catastrophic antithrombolytic or anticoagulation therapy.
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PMID:A survival case of painless chronic type A aortic dissection with a history of stroke and anticoagulant use. 2087 39

Evidence from healthy individuals and neuropsychological patients with deep dyslexia or semantic refractory access dysphasia suggests that abstract and concrete concepts have different dependencies upon associative and similarity-based representational frameworks. However, the importance of information about semantic similarity for concepts that lie across the full concreteness spectrum has not been investigated. Here we report the performance of healthy individuals on an odd-one-out task involving semantically related word triplets that showed continuous variation for the key variables of concreteness, similarity strength, and association strength. In addition, data from a stroke aphasic patient tested on a matching-to-sample task based on the same abstract, middle-concreteness, and concrete stimuli are also presented. The effects of similarity and association strength upon performance were both shown to interact significantly with concreteness, but in opposite directions. The effect of semantic similarity increased with concreteness but the effect of association decreased with concreteness. This research provides further evidence for the proposal that abstract and concrete words have different dependencies upon associative and similarity-based information. It also develops the proposal by providing data that are consistent with a graded and not binary or ungraded model of the relationship between concreteness and these two forms of semantic relationship.
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PMID:Contrasting graded effects of semantic similarity and association across the concreteness spectrum. 2133 84

We report three cases of stroke in association with peripheral venous interventions that each included foam ultrasound-guided sclerotherapy (UGS). All three female patients experienced a right middle cerebral artery (MCA) stroke causing dysphasia and left hemiparesis. A patent foramen ovale was found in each patient. The first incident occurred two days after foam UGS to treat small tributaries of a great saphenous vein (GSV). Paradoxical clot embolism was presumed in this case where concurrent deep vein thrombosis with non-occlusive thrombus in a medial gastrocnemius vein extending to the popliteal vein was detected on ultrasound. The second case occurred immediately at the completion of foam UGS and ambulatory phlebectomy to treat GSV tributaries. Paradoxical gas embolism was demonstrated in this patient confirmed by visualization of bubbles in the right MCA on CT angiography. The third case occurred one day after endovenous laser ablation (1470 nm) and foam UGS to treat both great and small saphenous veins. No specific cause could be confirmed in this patient. Sodium tetradecyl sulphate foam was used in all three cases (3%, 16 mL; 1.5%, 4 mL and 3%, 25 mL, respectively). All three patients recovered completely within a few days.
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PMID:Three cases of stroke following peripheral venous interventions. 2353 7

Childhood stroke is increasingly being recognized as an important burden not only for affected children and families, but also for socioeconomic reasons. A primary problem is delayed diagnosis, due to the many mimics of childhood stroke, and the variety of manifesting symptoms. The most important is hemiparesis (with/without dysphasia or facial palsy), but ataxia, seizures, and many more are also possible. Suspicion of stroke has to be ascertained by neuroimaging, gold standard being (diffusion weighted) magnetic resonance. Risk factors are multiple, but their presence might help to increase the suspicion of stroke. The most important factors are infectious/parainfectious etiologies, frequently possibly manifesting by transient focal cerebral arteriopathy (FCA). Cardiological underlying problems are the second most important. Arteriopathies can be detected in about half of the children, besides FCA and dissection and MoyaMoya disease are the most important. Hereditary coagulopathies increase the risk of stroke. There is still a controversy on best treatment in children: platelet antiaggregation and heparinization are used about equally. Thrombolysis is being discussed increasingly. Severity of symptoms at manifestation and on follow-up are not less significant in children than in young adults. About two-third of the children have significant residual neurological problems and a majority cognitive and behavior problems.
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PMID:A clinical approach to arterial ischemic childhood stroke: increasing knowledge over the last decade. 2243 Jan 54

The authors describe a case of L-asparaginase induced intracranial thrombosis and subsequent haemorrhage in a newly diagnosed 30-year-old man with acute lymphoblastic leukaemia who was successfully managed by surgical intervention. At presentation, he had a Glasgow Coma Score of 7/15, was aphasic and had dense right hemiplegia. Neuroimaging revealed an acute anterior left middle cerebral artery infarct with parenchymal haemorrhagic conversion, mass effect and subfalcine herniation. He subsequently underwent left frontal craniotomy and evacuation of large frontal haematoma and decompressive craniectomy for cerebral oedema. Six months postoperatively he underwent titanium cranioplasty. He had made good clinical recovery and is currently mobilising independently with mild occasional episodes of expressive dysphasia, difficulty with fine motor movement on the right side, and has remained seizure free. This is the first documented case of L-asparaginase induced haemorrhagic stroke managed by neurosurgical intervention. The authors emphasise the possible role of surgery in managing chemotherapy induced intracranial complications.
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PMID:Neurosurgical management of L-asparaginase induced haemorrhagic stroke. 2260 98

An 86-year-old lady presented to the accident and emergency department with a 90 min history of receptive and expressive dysphasia. There were no motor symptoms or visual symptoms reported. A partial anterior circulation stroke was diagnosed. On examination, she had a National Institutes of Health Stroke Scale of 6. CT angiography showed an occlusive thrombus within the left internal carotid artery extending into the left M1 segment of the middle cerebral artery and the proximal A1 segment of the anterior cerebral artery. Intra-arterial thrombectomy was preformed. Full recovery was achieved.
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PMID:Interventional treatment for acute ischaemic stroke in an 86-year-old. 2314 49

Dengzhanxixin injection is extracted from herbs of Erigeron breviscapusis. Its function includes activate blood, dispel stasis, unblock the collaterals and relieve pain. In clinical, it is widely used for static blood obstruction, wind-stroke and hemiplegia, numbness of limbs, deviated eyes and mouth, dysphasia, chest impediment, heart pain, ischemic stroke, coronary heart disease, and angina pectoris with the pattern mentioned above. In this paper, we planed to review the pharmacological and toxicological effects of Dengzhanxixin injection from relevant studies.
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PMID:[Progresses on pharmacological and toxicological effects of Dengzhanxixin injection]. 2328 44

Stroke is a major cause of death and disability. International and national guidelines are available to help clinicians provide evidence-based care for stroke prevention, acute treatment, and rehabilitation. Stroke is a medical emergency and rapid assessment is needed to establish the diagnosis, identify the underlying cause, provide acute treatment, and prevent complications. Although stroke is a clinical diagnosis based upon a history of sudden onset of neurological symptoms, which include unilateral weakness or sensory loss, dysphasia, hemianopia, inattention, and reduced coordination, brain imaging with CT or MRI scan is needed to distinguish cerebral infarction from primary intracerebral haemorrhage. Stroke units are the cornerstones of stroke care and should be available to all stroke patients throughout their inpatient stay. Multidisciplinary stroke care should address the physical, psychological, and social consequences of stroke and consider the needs of both patients and carers. Good communication with patients and carers and between members of the multidisciplinary team is fundamental to quality care. Ongoing assessment and treatment may be needed for: dysphagia; nutrition and hydration; continence and skin care; mobility and upper limb function; comprehension and communication; concentration and memory; spatial awareness and inattention; mood; pain and spasticity. Patients and carers should be fully informed about the diagnosis, prognosis, treatment and available care. Discharge requires careful planning and consultation. Early supported discharge can improve outcome for carefully selected patients. It is important to recognize and address the long-term needs in order to maximize choice, independence, and wellbeing. Targeted rehabilitation to address issues such as mobility and leisure may be effective.
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PMID:Stroke. 2331 61

It is well-known that sexual dysfunction can result from many classes of drugs including sedatives, anti-hypertensives and anti-depressants. Untreated sexual dysfunction can lead to patient distress.A 64-year-old man with a history of a left cerebrovascular accident participated in a qualitative research study on sex after stroke. He had been experiencing sexual dysfunction for four years.Discussions with the patient were difficult due to his expressive dysphasia. The researcher asked him to re-visit his general practitioner (GP) who reviewed his medications and changed the prescribed sleeping tablet. Sexual function returned within a week. This case report highlights the contribution of medication to sexual dysfunction and the need for doctors to initiate conversations about sexual concerns.
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PMID:Sex, drugs and the medical role: A case report of a man prescribed Alprazolam following stroke. 2338 75

We retrospectively reviewed clinical and imaging findings in 11 patients with stroke-like migraine attacks after radiation therapy (SMART) syndrome to better understand this disorder previously thought to be reversible. Six men and 5 women had complex bouts of neurologic impairment beginning, on average, 20 years after cerebral irradiation. All had characteristic, unilateral gyriform enhancement on MR imaging that developed within 2-7 days and typically resolved in 2-5 weeks. Unlike prior reports, 45% had incomplete neurologic recovery manifesting as dysphasia, cognitive impairment, or hemiparesis. The remaining 55% recovered completely over an average of 2 months. Three of 11 patients developed cortical laminar necrosis. Brain biopsies in 4 of 11 did not demonstrate a specific pathologic substrate. These additional 11 patients contribute to the understanding of variability in stroke-like migraine attacks after radiation therapy syndrome, which often but not uniformly manifests with headaches and seizures, demonstrates a typical evolution of imaging findings, and may result in permanent neurologic and imaging sequelae.
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PMID:Stroke-like migraine attacks after radiation therapy (SMART) syndrome is not always completely reversible: a case series. 2378 1


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