The Lesion Patterns and Mechanisms of Ischemic Stroke Contralateral to the Internal Carotid Artery Occlusive Disease

2008 ◽  
Vol 60 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Seung-Jae Lee ◽  
Kwang-Soo Lee ◽  
Jae-Young An ◽  
Woo-Jun Kim ◽  
Yeong-In Kim ◽  
...  
PLoS ONE ◽  
2013 ◽  
Vol 8 (1) ◽  
pp. e55318 ◽  
Author(s):  
Raimund Pechlaner ◽  
Michael Knoflach ◽  
Benjamin Matosevic ◽  
Michael Ruecker ◽  
Christoph Schmidauer ◽  
...  

2020 ◽  
Vol 4 (9) ◽  
pp. 539-543
Author(s):  
D.T. Chipova ◽  
◽  
L.V. Santikova ◽  
A.Ch. Zhemukhov ◽  
◽  
...  

Aim: to study the stroke-associated pneumonia (SAP) effect on the outcome of ischemic stroke (IS) in the internal carotid artery system. Patients and Methods: 87 patients with IS underwent the follow-up study, of which 75 had no inflammatory bronchopulmonary complications (group 1), and 12 had pneumonia manifestation (group 2). The study was performed on days 1, 5, and 9 after IS, and 6 months and 12 months after discharge from the hospital. Neurological deficit severity (NIHSS, Barthel index) and inflammatory markers (peripheral blood leukocyte composition, C-reactive protein (CRP), ESR) were studied. Results: it was found that the presence of SAP was associated with increased mortality during the acute IS period (4 (33.1%) patients died in group 1 and 10 (13.3%) — in group 2, p<0.05), greater severity of neurological deficits (63.3±5.3 and 71.5±4.0 points on the NIHSS scale, respectively, p<0.05) and incapacitation (Barthel index — 63.3±5.3 and 71.5±4.0 points, respectively, p<0.05) at the end of the inpatient treatment period. In group 2, signs of an inflammatory response were detected on day 5, and the values of the white blood cell shift index, ESR and CRP significantly (p<0.05) differed from the initial values. During examination at 6 months and 12 months, there were no significant differences in these indicators between the groups. An association was established between the probability of SAP occurrence and the presence of swallowing disorders (r=0.672; p<0.05), the age of patients (r=0.572; p<0.05) and the presence of diabetes mellitus (r=0.522; p<0.05). The studied laboratory inflammatory markers allow us to timely assume the occurrence of pulmonary pathology. Conclusion: timely diagnosis and prevention of SAP can reduce the risk of fatal outcome, facilitate rehabilitation measures, and improve early IS outcomes. KEYWORDS: ischemic stroke, cardioembolic stroke, atherothrombotic stroke, complications, acute period, inflammatory markers, strokeassociated pneumonia, long-term outcomes. FOR CITATION: Chipova D.T., Santikova L.V., Zhemukhov A.Ch. Impact of stroke-associated pneumonia on the outcome of acute ischemic stroke in internal carotid artery system. Russian Medical Inquiry. 2020;4(9):539–543. DOI: 10.32364/2587-6821-2020-4-9-539-543.


Author(s):  
Birame Loum ◽  
Cheikh Ahmedou Lame ◽  
Cheikhna B. Ndiaye ◽  
Kamadore Toure ◽  
Mouhamadou Mansour Ndiaye

<p>Eagle syndrome is a rare condition, often characterized by nonspecific symptoms. It is due to an abnormally long or compressive styloid process on surrounding structures. Exceptionally, it can cause neuro-vascular manifestations. We report an observation of Eagle syndrome discovered incidentally in presence of recurrent transient ischemic stroke. A 74-year-old man with no cardiovascular risk factors, was admitted to our department following 4 episodes of transient ischemic stroke with right hemiplegia and aphasia, always rapidly resolving. Head and neck CT scan showed 2 long styloid processes with a marked impingement of the left one against the ipsilateral internal carotid artery. Intraoral styloidectomy was performed. The patient recovered fully and remained free of symptoms without neurological impairment, at 6 months. Eagle syndrome is a rare condition which may lead, exceptionally, to repetitive transient ischemic stroke. Surgical styloidectomy must be considered to reduce the risk of new vascular events and prevent serious complications such as dissection of the internal carotid artery.</p>


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Ethem M Arsava ◽  
Dogan Dinc Oge ◽  
Ozge Berna Gultekin-Zaim ◽  
Ekim Gumeler ◽  
Jeong-Min Kim ◽  
...  

Background: Intracranial internal carotid artery calcifications (IICAC), considered a phenomenon within the spectrum of atherosclerosis and vascular aging, are frequently encountered in ischemic stroke patients. While intimal IICAC directly contributes to ischemic stroke pathophysiology, the medial counterpart is generally deemed as a risk factor for vascular end-points. Apart from aging and cardiovascular risk factors, the underlying pathophysiology that contributes to development of IICAC is not well understood; herein we studied the interplay between mineral and skeletal metabolism biomarkers, and IICAC presence and pattern. Methods: In a prospective series of 194 ischemic stroke patients (mean±SD age: 69±14 yr), blood samples were collected to determine calcium, phosphorus, magnesium, osteocalcin, parathyroid hormone, and vitamin D levels within 72 hours of symptom onset. IICAC presence and type was determined on admission CT-angiography source images; a medial or intimal type of IICAC category was assigned according to Kockelkoren criteria. Results: A total of 45 (23%) patients had no calcifications, while 95 (49%) had an intimal pattern and 54 (28%) had non-intimal (or medial) pattern. Apart from the well-known factors related with IICAC, such as age, lower glomerular filtration rate (GFR), history of hypertension, diabetes mellitus, coronary artery disease and atrial fibrillation, we identified admission magnesium levels to be associated with IICAC presence and pattern (no calcification: 1.96±0.18 mEq/L, intimal calcification 1.93±0.19 mEq/L, medial calcification: 1.81±0.28 mEq/L; p=0.006). None of the other biomarkers had any significant relationship to IICAC. In multivariate models, a lower magnesium level was significantly associated with medial calcification (each 0.1 mEq/L drop increased the odds by 1.2 (95% CI 1.0-1.4; p=0.046)), in addition to older age, history of diabetes mellitus and lower GFR. Conclusion: Hypomagnesemia is one of the factors well-known to be associated with vascular calcifications in the body. Our findings, extend this relationship to the intracranial vascular bed. No similar association was observed for other biomarkers related to mineral and skeletal metabolism. (Funding: TUBITAK grant 218S753)


Stroke ◽  
2021 ◽  
Author(s):  
Ashutosh P. Jadhav ◽  
Shashvat M. Desai ◽  
Osama O. Zaidat ◽  
Raul G. Nogueira ◽  
Tudor G. Jovin ◽  
...  

Background and Purpose: Achieving complete revascularization after a single pass of a mechanical thrombectomy device (first pass effect [FPE]) is associated with good clinical outcomes in patients with acute ischemic stroke due to large vessel occlusion. We assessed patient characteristics, outcomes, and predictors of FPE among a large real-world cohort of patients (Systematic Evaluation of Patients Treated with Stroke Devices for Acute Ischemic Stroke registry). Methods: Demographics, clinical outcomes, and procedural characteristics were analyzed among patients in whom FPE (modified Thrombolysis in Cerebral Infarction 2c/3 after first pass) was achieved versus those requiring multiple passes (MP). Modified FPE and modified MP included patients achieving modified Thrombolysis in Cerebral Infarction 2B-3. Primary outcomes included 90-day modified Rankin Scale (mRS) score and mortality. Results: Among 984 Systematic Evaluation of Patients Treated with Stroke Devices for Acute Ischemic Stroke patients, 930 had complete 90-day follow-up. FPE was achieved in 40.5% (377/930) of patients and MP in 20.0% (186/930). Baseline characteristics were similar across all groups. The FPE group had fewer internal carotid artery occlusions compared with MP ( P =0.029). The FPE group had faster puncture to recanalization time ( P ≤0.001), higher rates of 90-day mRS score of 0 to 1 (52.6% versus 38.6%, P =0.003), mRS score of 0 to 2 (65.4% versus 52.0%, P =0.003), and lower 90-day mortality compared with the MP group (12.0% versus 18.7%, P =0.038). Similarly, compared with modified MP patients, the modified FPE group had fewer internal carotid artery occlusions ( P =0.004), faster puncture to recanalization time ( P ≤0.001), and higher rates of 90-day mRS score of 0 to 1 ( P =0.002) and mRS score of 0 to 2 ( P =0.003). Conclusions: Our findings demonstrate that FPE and modified FPE are associated with superior clinical outcomes.


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