scholarly journals Internal carotid artery occlusion and cerebral infarction in a case of juvenile systemic lupus erythematosus and positive for phosphatidylserine dependent antiprothrombin antibody

2017 ◽  
Vol 5 (2) ◽  
pp. 68-70 ◽  
Author(s):  
Tameto Naoi ◽  
Tomoaki Kameda ◽  
Kenji Oku ◽  
Ayako Ando ◽  
Yuka Hayashi ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cerebral Infarction ◽  
Lupus Erythematosus ◽  
Internal Carotid ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Systemic Lupus ◽  
Juvenile Systemic Lupus Erythematosus

scholarly journals Internal Carotid Artery Occlusion in Systemic Lupus Erythematosus as a Potential Mimicker of Multiple Sclerosis

2017 ◽  
Vol 9 (1) ◽  
pp. 86-90 ◽  
Author(s):  
Kenichiro Sato ◽  
Mami Kanzaki ◽  
Yoshifumi Ubara ◽  
Yoshikazu Uesaka
Keyword(s):  
Multiple Sclerosis ◽  
Systemic Lupus Erythematosus ◽  
White Matter ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Lupus Erythematosus ◽  
Internal Carotid ◽  
White Matter Lesions ◽  
Systemic Lupus ◽  
Neuropsychiatric Sle

The diagnosis of neurological symptoms in patients with systemic lupus erythematosus (SLE) is often challenging, in part because they sometimes mimic features of multiple sclerosis (MS). Herein we report a case of a young female who presented with relapsing-remitting symptoms of unilateral visual loss and motor aphasia. Additionally, radiological findings revealed multiple white matter lesions on her brain that led to an initial diagnosis of MS based on the established diagnostic criteria. However, she was eventually diagnosed with neuropsychiatric SLE (NPSLE) presenting with extracranial internal carotid artery (ICA) occlusion. Her ICA occlusion had not been detected for 2 months until she underwent magnetic resonance angiography. Although exact underlying pathological mechanisms are unclear, both the ICA occlusion and MS-like brain white matter lesions could be attributed to SLE. This case demonstrated that both of these lesions can coexist in the same patient, suggesting that NPSLE with ICA occlusion can be a potential mimicker of MS, and vice versa. Care must be paid to avoid delay in the diagnosis.

scholarly journals Successful Bridging Therapy in a 103-Year-Old Woman with Acute Terminal Internal Carotid Artery Occlusion

2020 ◽  
Vol 12 (Suppl. 1) ◽  
pp. 9-14
Author(s):  
Trung Quoc Nguyen ◽  
Hoang Thi Phan ◽  
Tinh Quang Dang ◽  
Vu Thanh Tran ◽  
Thang Huy Nguyen
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Intravenous Thrombolysis ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Left Internal Carotid Artery ◽  
Bridging Therapy ◽  
Nihss Score ◽  
Current Guidelines

The efficacy of intravenous thrombolysis and endovascular therapy and their favorable treatment outcomes have been established in clinical trials irrespective of age. Current guidelines do not recommend an age limit in selecting eligible patients for reperfusion treatment as long as other criteria are satisfied. A 103-year-old woman was admitted at our hospital within 1 h of stroke onset secondary to a left internal carotid artery terminus occlusion. On admission, her National Institutes of Health Stroke Scale (NIHSS) score was 30, with a small left thalamic diffusion restriction lesion on MRI. Her medical history included paroxysmal atrial fibrillation, prior myocardial infarction, hypertension, chronic kidney disease, and diabetes mellitus. Her pre-stroke modified Rankin Scale score was 0, and she was fully independent before stroke. Once intravenous thrombolysis was started, the patient successfully underwent mechanical thrombectomy, and thrombolysis in cerebral infarction-3 recanalization was achieved 225 min after symptom onset. She showed dramatic recovery (NIHSS score of 5 after 48 h) and was discharged on day 7 with a modified Rankin Score of 1. To our knowledge, our patient is the second oldest documented patient who successfully underwent bridging therapy for stroke.

scholarly journals Brain Temperature Measured by Magnetic Resonance Spectroscopy to Predict Clinical Outcome in Patients with Infarction

Sensors ◽  
2021 ◽  
Vol 21 (2) ◽  
pp. 490
Author(s):  
Tomohisa Ishida ◽  
Takashi Inoue ◽  
Tomoo Inoue ◽  
Toshiki Endo ◽  
Miki Fujimura ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Mr Spectroscopy ◽  
Internal Carotid ◽  
Brain Temperature ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Clinical Settings ◽  
Brain Swelling

Acute ischemic stroke is characterized by dynamic changes in metabolism and hemodynamics, which can affect brain temperature. We used proton magnetic resonance (MR) spectroscopy under everyday clinical settings to measure brain temperature in seven patients with internal carotid artery occlusion to explore the relationship between lesion temperature and clinical course. Regions of interest were selected in the infarct area and the corresponding contralateral region. Single-voxel MR spectroscopy was performed using the following parameters: 2000-ms repetition time, 144-ms echo time, and 128 excitations. Brain temperature was calculated from the chemical shift between water and N-acetyl aspartate, choline-containing compounds, or creatine phosphate. Within 48 h of onset, compared with the contralateral region temperature, brain temperature in the ischemic lesion was lower in five patients and higher in two patients. Severe brain swelling occurred subsequently in three of the five patients with lower lesion temperatures, but in neither of the two patients with higher lesion temperatures. The use of proton MR spectroscopy to measure brain temperature in patients with internal carotid artery occlusion may predict brain swelling and subsequent motor deficits, allowing for more effective early surgical intervention. Moreover, our methodology allows for MR spectroscopy to be used in everyday clinical settings.

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