Pub Date : 2023-11-14DOI: 10.29011/2688-8734.100167
Telisha Tausinga, Mariam Asadian, Meenu Singh
Stroke is second leading cause of death and disability worldwide. Thus, it is critical to perform prompt workups when patients present with the concerning signs and symptoms. However, many other medical conditions mimic stroke and can account for hospitalizations where stroke and vascular workups are pursued, oftentimes being costly not only to the patient but to the medical system. One category of under recognized mimics is paraneoplastic neurologic syndromes, which are a variety of neurologic disorders associated with systemic malignancy. Kelch-like protein 11 antibody is a recently discovered antibody associated with paraneoplastic neurologic syndromes. Herein, we present a unique case of a patient presenting with recurrent and persistent cerebellar stroke-like symptoms found to have an underlying Kelch-like protein 11 antibody-associated paraneoplastic syndrome. We review the entirety of his presentation, review the current literature on this paraneoplastic syndrome, and discuss implications from this case that can be applied in future practice
{"title":"Paraneoplastic Syndrome Masquerading as Recurrent Cerebellar Vascular Injury: A Case Report","authors":"Telisha Tausinga, Mariam Asadian, Meenu Singh","doi":"10.29011/2688-8734.100167","DOIUrl":"https://doi.org/10.29011/2688-8734.100167","url":null,"abstract":"Stroke is second leading cause of death and disability worldwide. Thus, it is critical to perform prompt workups when patients present with the concerning signs and symptoms. However, many other medical conditions mimic stroke and can account for hospitalizations where stroke and vascular workups are pursued, oftentimes being costly not only to the patient but to the medical system. One category of under recognized mimics is paraneoplastic neurologic syndromes, which are a variety of neurologic disorders associated with systemic malignancy. Kelch-like protein 11 antibody is a recently discovered antibody associated with paraneoplastic neurologic syndromes. Herein, we present a unique case of a patient presenting with recurrent and persistent cerebellar stroke-like symptoms found to have an underlying Kelch-like protein 11 antibody-associated paraneoplastic syndrome. We review the entirety of his presentation, review the current literature on this paraneoplastic syndrome, and discuss implications from this case that can be applied in future practice","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"7 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139276165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30DOI: 10.29011/2688-8734.100165
Abstract Congenital heart disease patients would have an elevated stroke risk compared to the general population. The prevalence of adults living with this condition is increasing, and knowledge of their risks and management should be of common knowledge to adult clinicians. The mechanisms of stroke implicate right to left shunt allowing paradoxical embolization. Anticoagulation of patients with complex congenital heart disease is preferred with vitamin K antagonist. We describe a successful thrombolysis case of a patient with Tetralogy of Fallot who presented at the emergency room with an ischemic stroke in time for intravascular thrombolysis treatment and had favorable outcomes.
{"title":"Successful Intravenous Thrombolytic Therapy in a Patient with Tetralogy of Fallot Presenting with Stroke","authors":"","doi":"10.29011/2688-8734.100165","DOIUrl":"https://doi.org/10.29011/2688-8734.100165","url":null,"abstract":"Abstract Congenital heart disease patients would have an elevated stroke risk compared to the general population. The prevalence of adults living with this condition is increasing, and knowledge of their risks and management should be of common knowledge to adult clinicians. The mechanisms of stroke implicate right to left shunt allowing paradoxical embolization. Anticoagulation of patients with complex congenital heart disease is preferred with vitamin K antagonist. We describe a successful thrombolysis case of a patient with Tetralogy of Fallot who presented at the emergency room with an ischemic stroke in time for intravascular thrombolysis treatment and had favorable outcomes.","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"36 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-23DOI: 10.29011/2688-8734.100164
Abstract Pulsatile tinnitus is often the initial presentation of a dural arteriovenous fistula, so a high index of suspicion is needed to avoid misdiagnoses and possible fatal consequences. Although pulsatile tinnitus commonly originates from a vascular malformation and non-pulsatile tinnitus from a neurodegenerative one, pulsatile and non-pulsatile presentations can result from other underlying pathologies. If a vascular pathology causes a non-pulsatile complaint that cannot be heard by the examiner or detected clinically or radiologically, it is bound to be misdiagnosed as central tinnitus. Herein, we report a rare presentation of a dural arteriovenous fistulas contributing to subjective, non-pulsatile tinnitus. The 50-year-old male patient in this case presented with 2 years of tinnitus, refractory to several treatment approaches that eventually lead to suicidal ideation. Magnetic resonance imaging of the head, magnetic resonance angiography of the head and neck, and computerized tomography scan of the temporal bone did not reveal any acute pathology. Cerebral angiogram revealed a dural arterio-venous malformation in the left sigmoid and transverse sinus. The patient was treated with transarterial Onyx18 embolization of the dural arterio-venous malformation. His symptoms resolved by 50% following treatment and by 80% at 6-month reevaluation. Dural arteriovenous fistulas are rare vascular malformations that, if left untreated, have fatal complications. These vascular malformations may not be detected by physical examination or audiometric evaluation alone. In the absence of neurologic deficits and retrograde leptomeningeal or cortical venous drainage, selective angiographic embolization appears to be an efficient and low-risk modality for symptomatic treatment.
{"title":"Suicidal Ideation in a Severe Case of NonPulsatile Tinnitus Caused by a Dural Arteriovenous Fistula","authors":"","doi":"10.29011/2688-8734.100164","DOIUrl":"https://doi.org/10.29011/2688-8734.100164","url":null,"abstract":"Abstract Pulsatile tinnitus is often the initial presentation of a dural arteriovenous fistula, so a high index of suspicion is needed to avoid misdiagnoses and possible fatal consequences. Although pulsatile tinnitus commonly originates from a vascular malformation and non-pulsatile tinnitus from a neurodegenerative one, pulsatile and non-pulsatile presentations can result from other underlying pathologies. If a vascular pathology causes a non-pulsatile complaint that cannot be heard by the examiner or detected clinically or radiologically, it is bound to be misdiagnosed as central tinnitus. Herein, we report a rare presentation of a dural arteriovenous fistulas contributing to subjective, non-pulsatile tinnitus. The 50-year-old male patient in this case presented with 2 years of tinnitus, refractory to several treatment approaches that eventually lead to suicidal ideation. Magnetic resonance imaging of the head, magnetic resonance angiography of the head and neck, and computerized tomography scan of the temporal bone did not reveal any acute pathology. Cerebral angiogram revealed a dural arterio-venous malformation in the left sigmoid and transverse sinus. The patient was treated with transarterial Onyx18 embolization of the dural arterio-venous malformation. His symptoms resolved by 50% following treatment and by 80% at 6-month reevaluation. Dural arteriovenous fistulas are rare vascular malformations that, if left untreated, have fatal complications. These vascular malformations may not be detected by physical examination or audiometric evaluation alone. In the absence of neurologic deficits and retrograde leptomeningeal or cortical venous drainage, selective angiographic embolization appears to be an efficient and low-risk modality for symptomatic treatment.","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"5 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135460232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-05DOI: 10.29011/2688-8734.100163
Background: The objectives were to assess the validity and reliability of the Greek version of the Sickness Impact Profile (SIP-GR) questionnaire. Methods: SIP-GR was tested for test-retest reliability, internal consistency and validity in 90 participants (54.4% males and 45.6% females) with obesity, cardiac, pulmonary and musculoskeletal problems. The questionnaire was administrated twice by one examiner, within an interval of 1-week. During this period, participants with cardiac, pulmonary and musculoskeletal problems underwent 2-weekly physiotherapy sessions. Treatment related effects were considered in the analysis. Results: SIP-GR demonstrated an excellent internal consistency. The overall Cronbach’s alpha for SIP-Total score >0.9, for SIP-Psychological was >0.8 and for SIP-Physical >0.9. The categories scores were all >0.5 except for Communication and Work category. Test-retest reliability for the total score was ICC=0.691 for all subjects, 0.562 for those that reported a subjective change in their health status due to treatment and 0.999 for those that reported no change in health status. Similar results were found for the Physical and Psychological component. Strong negative correlation was found between SIP-Gr total score and Short Form Health Survey SF-36 (SF-36) total score (r=-0.66), physical component of SIP-GR and Physical Health of SF-36 (r=-0.62) and between psychological component of SIP-GR and Mental health of SF-36 (r=-0.61) at the initial assessment. At reassessment the same correlations were moderate due to different treatment effects in the scores of the two questionnaires. Finally, minimum detectable change (MDC) was 4.6-5.5 points for the overall score, 6.4-7 for Physical component and 3.5-4.9 for psychosocial component, at initial assessment and re-assessment respectively. Conclusion: SIP-GR has shown to be valid and reliable for the assessment of patients with cardiac, pulmonary, musculoskeletal diagnosis and obesity. Further studies should assess its ability to identify clinically meaningful changes.
{"title":"Reliability and Validity of the Greek Version of Sickness Impact Profile Questionnaire","authors":"","doi":"10.29011/2688-8734.100163","DOIUrl":"https://doi.org/10.29011/2688-8734.100163","url":null,"abstract":"Background: The objectives were to assess the validity and reliability of the Greek version of the Sickness Impact Profile (SIP-GR) questionnaire. Methods: SIP-GR was tested for test-retest reliability, internal consistency and validity in 90 participants (54.4% males and 45.6% females) with obesity, cardiac, pulmonary and musculoskeletal problems. The questionnaire was administrated twice by one examiner, within an interval of 1-week. During this period, participants with cardiac, pulmonary and musculoskeletal problems underwent 2-weekly physiotherapy sessions. Treatment related effects were considered in the analysis. Results: SIP-GR demonstrated an excellent internal consistency. The overall Cronbach’s alpha for SIP-Total score >0.9, for SIP-Psychological was >0.8 and for SIP-Physical >0.9. The categories scores were all >0.5 except for Communication and Work category. Test-retest reliability for the total score was ICC=0.691 for all subjects, 0.562 for those that reported a subjective change in their health status due to treatment and 0.999 for those that reported no change in health status. Similar results were found for the Physical and Psychological component. Strong negative correlation was found between SIP-Gr total score and Short Form Health Survey SF-36 (SF-36) total score (r=-0.66), physical component of SIP-GR and Physical Health of SF-36 (r=-0.62) and between psychological component of SIP-GR and Mental health of SF-36 (r=-0.61) at the initial assessment. At reassessment the same correlations were moderate due to different treatment effects in the scores of the two questionnaires. Finally, minimum detectable change (MDC) was 4.6-5.5 points for the overall score, 6.4-7 for Physical component and 3.5-4.9 for psychosocial component, at initial assessment and re-assessment respectively. Conclusion: SIP-GR has shown to be valid and reliable for the assessment of patients with cardiac, pulmonary, musculoskeletal diagnosis and obesity. Further studies should assess its ability to identify clinically meaningful changes.","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135483657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-11DOI: 10.29011/2688-8734.100162
to the
{"title":"PRES Secondary to the LenvatinibPembrolizumab Combination in a Patient with Serous Endometrial Adenocarcinoma","authors":"","doi":"10.29011/2688-8734.100162","DOIUrl":"https://doi.org/10.29011/2688-8734.100162","url":null,"abstract":"to the","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"365 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136025152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-02DOI: 10.29011/2688-8734.100160
Antoine Salambo Mabila, Donald Accrombessi, Patrick Lisasi, Job Osango, Elisé Kisioko, Robert Mutombo, Aurélien Darrigol, A. Woga, Martial Zossou, A. Landais, Annie Lannuzel
Revealing Peri-Partum Cardiomyopathy, an Unusual Presentation: About a Case
揭示围产期心肌病，一个不寻常的表现:关于一个病例
{"title":"Stroke and Multi-Organic Infarction Revealing Peri-Partum Cardiomyopathy, an Unusual Presentation: About a Case","authors":"Antoine Salambo Mabila, Donald Accrombessi, Patrick Lisasi, Job Osango, Elisé Kisioko, Robert Mutombo, Aurélien Darrigol, A. Woga, Martial Zossou, A. Landais, Annie Lannuzel","doi":"10.29011/2688-8734.100160","DOIUrl":"https://doi.org/10.29011/2688-8734.100160","url":null,"abstract":"Revealing Peri-Partum Cardiomyopathy, an Unusual Presentation: About a Case","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"289 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77771894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
. In are source-limited environment in which urgent revascularization therapies are not available, it seems wise to us to have urgent recourse to a brain scan without injection, which is much more available and which will effectively eliminate cerebral haemorrhageand initiate antithrombotic treatment.
{"title":"Normal MRI Stroke in a Resource-Limited Setting: About a Case","authors":"Salambo Mabila, Ntalaja Kabuayi, L. Patrick, Kongolo Wa, Nzambi Gérard, Kibokela Ndembe Dalida, Tshangala Kavunga, Okitundu Luwa","doi":"10.29011/2688-8734.100155","DOIUrl":"https://doi.org/10.29011/2688-8734.100155","url":null,"abstract":". In are source-limited environment in which urgent revascularization therapies are not available, it seems wise to us to have urgent recourse to a brain scan without injection, which is much more available and which will effectively eliminate cerebral haemorrhageand initiate antithrombotic treatment.","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72719591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-22DOI: 10.29011/2688-8734.100152
{"title":"Indirect Left Coraticocavernous Fistula","authors":"","doi":"10.29011/2688-8734.100152","DOIUrl":"https://doi.org/10.29011/2688-8734.100152","url":null,"abstract":"","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135429485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-08DOI: 10.29011/2688-8734.100150
Emily J Farina, G. Kelly, M. Sturgill, D. Dixit
Background: Tenecteplase offers several practical advantages over alteplase; recent comparative studies have demonstrated tenecteplase to be non-inferior to alteplase in terms of its safety and efficacy in acute ischemic stroke (AIS). We recently switched to Tenecteplase for AIS from alteplase and describe our real-world outcome data. Objectives: To compare the efficacy and safety of alteplase with tenecteplase for AIS. Methods: We conducted a retrospective study of patients’ thrombolysis with alteplase or Tenecteplase from January 1 st , 2021, to December 31 st , 2021. Patients were included if they had received alteplase or tenecteplase within 4.5 hours of symptom onset. Patients with wake-up stroke were excluded. The primary outcome was a composite of bleeding-related adverse events. Secondary outcomes included door-to-needle (DTN) time, median 24-hour National Institute of Health Stroke Scale (NIHSS) score, discharge NIHSS score
{"title":"Safety and Efficacy Outcomes of Off-Label Tenecteplase versus Alteplase for Acute Ischemic Stroke: Real-World Experience","authors":"Emily J Farina, G. Kelly, M. Sturgill, D. Dixit","doi":"10.29011/2688-8734.100150","DOIUrl":"https://doi.org/10.29011/2688-8734.100150","url":null,"abstract":"Background: Tenecteplase offers several practical advantages over alteplase; recent comparative studies have demonstrated tenecteplase to be non-inferior to alteplase in terms of its safety and efficacy in acute ischemic stroke (AIS). We recently switched to Tenecteplase for AIS from alteplase and describe our real-world outcome data. Objectives: To compare the efficacy and safety of alteplase with tenecteplase for AIS. Methods: We conducted a retrospective study of patients’ thrombolysis with alteplase or Tenecteplase from January 1 st , 2021, to December 31 st , 2021. Patients were included if they had received alteplase or tenecteplase within 4.5 hours of symptom onset. Patients with wake-up stroke were excluded. The primary outcome was a composite of bleeding-related adverse events. Secondary outcomes included door-to-needle (DTN) time, median 24-hour National Institute of Health Stroke Scale (NIHSS) score, discharge NIHSS score","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"135 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81742012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.29011/2688-8734.100049
{"title":"NG Tube Confirmation by Using the Chest X-ray","authors":"","doi":"10.29011/2688-8734.100049","DOIUrl":"https://doi.org/10.29011/2688-8734.100049","url":null,"abstract":"","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74815979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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