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

Eagle's syndrome is a disease without a clear lesion that is associated with repeated episodes of pharyngalgia, odynophagia, the sensation of a foreign body in the pharynx, tinnitus, and otalgia in which patients displaying these types of symptoms must be given a differential diagnosis. It is known to be characterized by styloid process elongation or increasing compression to adjacent anatomical structures through stylohyoid ligament calcification. In serious cases, continuous pressure to the carotid artery can lead to a stroke. Diagnosis is confirmed through clinical symptoms, radiological findings, and physical examinations. The most common type of treatment consists of a surgical excision of elongated styloid process. Nonetheless, this study presents a case of treating Eagle's syndrome with conservative management.
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PMID:Non Surgical Treatment of Eagle's Syndrome - A Case Report -. 2361 80

Eagle syndrome (symptoms associated with an elongated styloid process (SP)) is commonly divided into two presentations. First, the so-called classic Eagle syndrome where patients can present with unilateral sore throat, dysphagia, tinnitus, unilateral facial and neck pain and otalgia. Second, there is the vascular or stylocarotid form of Eagle syndrome in which the elongated SP is in contact with the extracranial internal carotid artery. We describe two cases of internal carotid artery dissection associated with an elongated SP. One is a patient with ischaemic stroke and another with transient ischaemic attacks caused by an elongated SP. A surgical resection of the SP was performed on the former patient. Both patients were treated with anticoagulation and recovered well. A literature search only revealed two prior descriptions of carotid dissection in the context of an elongated SP.
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PMID:Internal carotid dissection caused by an elongated styloid process (Eagle syndrome). 2376 67

Magnetic stimulation has called the attention of neuroscientists and the public due to the possibility to stimulate and "control" the nervous system in a non-invasive way. It has helped to make more accurate diagnosis, and apply more effective treatments and rehabilitation protocols in several diseases that affect the nervous system. Likewise, this novel tool has increased our knowledge about complex neural behavior, its connections as well as its plastic modulation. Magnetic stimulation applied in simple or paired-pulse protocols is a useful alternative in the diagnosis of diseases such as multiple sclerosis, Parkinson disease, epilepsy, dystonia, amyotrophic lateral sclerosis, cerebrovascular disease, and sleep disorders. From the therapeutic perspective, magnetic stimulation applied repetitively has been found useful, with different degrees of efficacy, in treating resistant depression, tinnitus, psychogenic dysphonia, Alzheimer disease, autism, Parkinson disease, dystonia, stroke, epilepsy, generalized anxiety as well as post traumatic stress disorder, auditory hallucinations, chronic pain, aphasias, obsessive-compulsive disorders, L-dopa induced dyskynesia, mania and Rasmussen syndrome, among others. The potential of magnetic stimulation in neurorehabilitation is outstanding, with excellent range of safety and, in practical terms, without side effects.
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PMID:[Present and future of the transcranial magnetic stimulation]. 2378 15

Cervical artery dissection (CeAD) occurs preferentially in the middle-aged, and its annual incidence rate is 2.6 to 3.0 per 100,000.(1) Manifestations of internal carotid artery dissection (ICAD) include ischemic stroke and TIA (>70% of patients), headache, neck pain, Horner syndrome, cranial nerve palsy, pulsatile tinnitus, and, rarely, subarachnoid hemorrhage.(2) Cerebral hyperperfusion syndrome is known to occur after carotid artery revascularization procedures and it is thought to result from the combination of several factors that impair cerebral vascular autoregulatory mechanisms.(3.)
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PMID:Cerebral hyperperfusion syndrome: a novel presentation of internal carotid artery dissection. 2382 78

Cortical stimulation, either transcranial or by means of electrodes implanted epidurally or subdurally, is used increasingly to treat neuropsychiatric diseases. In cases where transcranial stimulation gives only short-term success, implanted electrodes can yield results that are similar but long-term. Epidural stimulation is used widely to treat chronic neuropathic pain, whereas newer fields are in movement disorders, tinnitus, depression, and functional rehabilitation after stroke. For epidural stimulation, computational models explain the geometry of stimulation parameters (anodal, cathodal, and bifocal) and are used for targeting to yield the best clinical results. Nevertheless, the role of the cerebrospinal fluid layer also has to be taken into consideration. Subdural or intrasulcal stimulation allows a more focused stimulation with lower current intensities. This advantage, however, is counterbalanced by a higher complication rate with regard to epileptic seizures, subdural or intracerebral hemorrhages, and wound infections.
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PMID:Epidural and subdural stimulation. 2411 7

Hemifacial weakness, or palsy, results from disruption of communication between cortical motor centres and the facial musculature along the course of the facial nerve. Bell's palsy has a typical presentation of sudden onset, mild otalgia, altered facial sensation and/or taste, with no obvious prodrome. It represents over half of hemifacial weakness cases in primary care. However, as a diagnosis of exclusion, there are a number of key clinical features of more sinister diagnoses that must be considered. Acute hemifacial weakness secondary to isolated facial nerve palsy must be differentiated from acute cerebrovascular accident. The latter results in sparing of the brow musculature due to the bilateral innervation of the frontalis. Altered facial sensation and mild otalgia are common in Bell's palsy, however severe pain is suggestive of Ramsay Hunt syndrome. Recent facial or head trauma and surgery should also be excluded in causation. Patients with the following conditions should be referred: lagophthalmos if the weakness persists beyond a few days or ocular damage is suspected; Ramsay Hunt syndrome (immunocompromised patients, those with significant pain, and where intraoral vesicles prohibit oral intake); and palsy secondary to trauma or surgery. A parotid mass with facial palsy implies malignant change and must be referred within the two-week wait pathway. A history of progressive hearing loss and tinnitus with palsy also requires urgent referral to neuro-otology for assessment of cerebellopontine angle tumours. All cases of facial palsy associated with infective otological symptoms should be discussed with ENT.
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PMID:A case of persistent hemifacial weakness. 2419 32

Cortical blindness is a well described neuro-ophthalmologic complication of angiography due to neurotoxicity following contrast media exposure. A rarer association with retrograde amnesia has also been reported. Since ischemic stroke due to embolism remains the most common aetiology of neurological complications of diagnostic and therapeutic arterial catheterisation, prompt identification of the mechanism responsible for the clinical symptoms is essential for patient management. Although CT and conventional MRI findings have been reported in this condition, experience with diffusion weighted (DW) sequences is lacking especially in cases associated with memory impairment. A 65-year-old man with tinnitus underwent cerebral angiography for suspicion of a dural arteriovenous fistula. During the procedure the patient developed complete loss of vision and rapidly became confused. Brain CT showed bilateral cortical enhancement in the occipital lobes. MR with DWI was performed 3.5 hours after angiography. Early DWI showed no signal abnormalities thereby excluding an ischaemic complication. Gradual improvement of visual function occurred over the next 24 hours. After 48 hours the patient was alert and orientated but profound retrograde amnesia persisted with no memory for the events of the day of angiography. CT follow-up at one year was normal. DWI is invaluable in the evaluation of patients with cortical blindness with or without memory deficits precipitated by angiography and may advance understanding of the pathophysiology. Diffusion-weighted MRI is crucial in differentiating neuro-ophthalmologic complications precipitated by intracortical contrast leakage after angiography from an ischaemic stroke needing a prompt and often invasive treatment.
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PMID:Cortical Blindness and Retrograde Amnesia Following Cerebral Angiography Studied by Early Diffusion Weighted MR imaging. A Case Report. 2420 6

Pathological neural activity in a variety of neurological disorders could be treated by directing plasticity to specifically renormalize aberrant neural circuits, thereby restoring normal function. Brief bursts of acetylcholine and norepinephrine can enhance the neural plasticity associated with coincident events. Vagus nerve stimulation (VNS) represents a safe and effective means to trigger the release of these neuromodulators with a high degree of temporal control. VNS-event pairing can generate highly specific and long-lasting plasticity in sensory and motor cortex. Based on the capacity to drive specific changes in neural circuitry, VNS paired with experience has been successful in effectively ameliorating animal models of chronic tinnitus, stroke, and posttraumatic stress disorder. Targeted plasticity therapy utilizing VNS is currently being translated to humans to treat chronic tinnitus and improve motor recovery after stroke. This chapter will discuss the current progress of VNS paired with experience to drive specific plasticity to treat these neurological disorders and will evaluate additional future applications of targeted plasticity therapy.
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PMID:Targeting plasticity with vagus nerve stimulation to treat neurological disease. 2430 59

Acute hearing loss (AHL) has traditionally been considered to be a neglected and underestimated symptom of stroke. However, because the blood supply to the auditory system originates from the vertebrobasilar system, stroke in the distribution of the vertebrobasilar circulation can present with acute hearing loss (AHL) and/or tinnitus. Approximately one-tenth of vertebrobasilar ischemic stroke (VBIS) is accompanied by AHL. Sometimes, AHL is a warning symptom of impending VBIS (mainly in the anterior inferior cerebellar artery). In this case, the MRI is normal, and the clinician must rely on other clinical features to make the diagnosis. This review summarizes the current advances in the clinical syndromes and signs of AHL due to VBIS.
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PMID:Recent advances in acute hearing loss due to posterior circulation ischemic stroke. 2443 32

The medical management of patients requiring imaging of the head is often complex. This is confounded by growth and development of neuroimaging technology. Summarizing established guidelines and provided answers to commonly asked questions about neurovascular imaging may aid in providing efficient medical care. Noncontrast head computed tomography (CT) is usually the first line in imaging because of its speed and wide-spread availability. More advanced techniques are reserved for more specific questions or when the CT head is non-diagnostic. MRI is the modality of choice for indications that include chronic headache, pulsatile tinnitus, and cerebrovascular diseases including stroke in the subacute or chronic setting. The imaging of stroke is evolving and many advanced techniques including CT and magnetic resonance perfusion are playing an increasing role in diagnosis. Digital subtraction angiography is widely accepted as the gold standard for evaluation of vascular pathology including aneurysm, vascular malformations, Moyamoya syndrome, carotid stenosis and dissection; and offers treatment options. Alternatives such as MR angiography, MR venography, and CT angiography offer similar sensitivity and specificity to conventional digital subtraction angiography. Safety considerations are an important concern. When using iodinated and gadolinium contrast agents, there are potential complications including allergic reactions, lactic acidosis, and nephrogenic systemic fibrosis. Impaired renal function requires modification in the use of contrast during neuroimaging. Neuroimaging during pregnancy is also discussed.
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PMID:Commonly asked questions: imaging stroke and other types of neurovascular disorders. 2449 Nov 9


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