scholarly journals Delayed Endovascular Thrombectomy for Ischemic Stroke in a Young Woman with No Known Risk Factors: A Case Report

2021 ◽  
Vol 22 ◽  
Author(s):  
Bryce D. Beutler ◽  
Rajesh Rangaswamy ◽  
Richard D. King ◽  
Burton J. Tabaac
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Case Report ◽  
Young Woman ◽  
Endovascular Thrombectomy

scholarly journals Early pregnancy‐associated ischemic stroke during first trimester in a young woman: A case report

2021 ◽  
Vol 9 (9) ◽  
Author(s):  
Asma Ouerdiene ◽  
Mariem Messelmani ◽  
Malek Mansour ◽  
Jamel Zaouali ◽  
Ridha Mrissa
Keyword(s):  
Ischemic Stroke ◽  
Case Report ◽  
Young Woman ◽  
Early Pregnancy ◽  
First Trimester

scholarly journals Case Report: Migrainous Infarct without Aura

2017 ◽  
Vol 9 (3) ◽  
pp. 241-251
Author(s):  
Kamesh Gupta ◽  
Anurag  Rohatgi ◽  
Shivani Handa
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Case Report ◽  
Rare Case ◽  
Case Presentation ◽  
The Past ◽  
Need To Evaluate ◽  
History Of ◽  
Complicated Migraine ◽  
Full Investigation

Background: Stroke in a migraine with aura has been documented in several cases, even deserving the merit of a classification as complicated migraine. Herein, we present a rare case of migrainous infarct without aura. The diagnosis was challenging due to lack of risk factors. The patient was unique in not having any other comorbidities. Case Presentation: The case is of a 21-year-old female presenting with right-sided hemiplegia and facial drooping. She had had an index presentation of throbbing headaches for the past 2 years, typical of a migraine but not preceded by any aura symptoms. However, in the current episode, the pain became excessively severe and accompanied by right-sided hemiplegia and facial drooping. A full investigation workup using MRI revealed evidence of infarct in the left temporoparietal and basal ganglion region. Conclusion: Our case highlights the need to evaluate silent ischemic stroke in case of prolonged headache with a history of migraine as well as the need for precaution to avoid the use of triptans or opioids in such a case. It also highlights the conditions that need to be excluded before labeling it as a migrainous infarct.

Risk factors and outcomes of intravenous tissue plasminogen activator and endovascular thrombectomy utilization amongst pediatrics acute ischemic stroke

2020 ◽  
pp. 174749302090491
Author(s):  
Preeti Malik ◽  
Urvish K Patel ◽  
Surabhi Kaul ◽  
Ramit Singla ◽  
Tapan Kavi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Recombinant Tissue Plasminogen Activator ◽  
Pediatric Stroke ◽  
Endovascular Thrombectomy ◽  
Intravenous Tissue Plasminogen Activator ◽  
Tissue Plasminogen

Background Pediatric stroke is a debilitating disease. There are several risk factors predisposing children to this life-threatening disease. Although, published literature estimates a relatively high incidence of pediatric stroke, treatment guidelines on intravenous tissue plasminogen activator and endovascular thrombectomy utilization remain a dilemma. There is a lack of large population-based studies and clinical trials evaluating the efficacy and safety outcomes associated with these treatments in this unique population. Aim We sought to determine the prevalence of risk factors, concurrent utilization of intravenous tissue plasminogen activator and endovascular thrombectomy, and associated outcomes in pediatric stroke hospitalizations. Methods We performed a retrospective analysis of the Nationwide Inpatient Sample data (2003–2014) in pediatric (1–21 years of age) acute ischemic stroke hospitalizations using ICD-9-CM codes. The multivariable survey logistic regression model was weighted to account for sampling strategy, evaluate predictors of hemorrhagic conversion, and treatment outcomes (mortality, morbidity, and discharge disposition) amongst pediatric stroke hospitalizations. Results In this analysis, 9109 patients between 1 and 21 years of age were admitted during 2003–2014 for acute ischemic stroke. Of these 9109 patients, 119 (1.30%) received endovascular thrombectomy alone, 256 (2.82%) intravenous recombinant tissue plasminogen activator, and 69 (0.75%) both endovascular thrombectomy and intravenous recombinant tissue plasminogen activator. We found overall high prevalence of conditions like epilepsy (19.59%), atrial septal defect (11.76%), sickle cell disease (8.63%), and moyamoya disease (5.41%) in pediatric acute ischemic stroke patients. Unadjusted analysis showed high prevalence of all-cause in-hospital mortality in combined endovascular thrombectomy and intravenous recombinant tissue plasminogen activator utilization group, and higher prevalence of hemorrhagic conversion and morbidity in endovascular thrombectomy utilization group compared to other groups ( p < 0.0001). Multivariate adjusted analysis showed that children with endovascular thrombectomy utilization (aOR: 19.19; 95% CI: 2.50–147.29, p = 0.005), intravenous recombinant tissue plasminogen activator utilization (aOR: 8.85; 95% CI: 1.92–40.76, p = 0.005), and both (endovascular thrombectomy and intravenous recombinant tissue plasminogen activator) utilization (aOR: 7.55; 95% CI: 1.16–49.31, p = 0.035) had higher odds of hemorrhagic conversion compared to no-treatment group. Conclusion We found various risk factors associated with pediatric stroke. The early identification can be useful to formulate preventive strategies and influence the incidence of pediatric stroke. Our study results showed that use of intravenous recombinant tissue plasminogen activator and endovascular thrombectomy increase risk of mortality and hemorrhagic conversion, but we suggest to have more clinical studies to evaluate the idea candidates for utilization of intravenous recombinant tissue plasminogen activator and endovascular thrombectomy based on risk: benefit ratio.

scholarly journals Angioedema Secondary to tPA Use in Acute Ischemic Stroke Patient with Hypertension: A Case Report

2021 ◽  
Vol 2 (5) ◽  
pp. 159-162
Author(s):  
Chris Kim ◽  
Andrea Hladik
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Case Report ◽  
Acute Ischemic Stroke ◽  
Ace Inhibitor ◽  
Sudden Onset ◽  
Acute Ischemic Stroke Patient ◽  
Factors Associated ◽  
Tissue Plasminogen ◽  
Life Threatening

Introduction: A well-documented complication of administering tissue plasminogen activator (tPA) in stroke patients is acute intracranial bleeding. A lesser known but still significant complication is angioedema secondary to tPA administration, which can develop in certain individuals with risk factors such as angiotensin converting enzyme (ACE) inhibitor use and location of the stroke. Knowing the potential for this life-threatening complication and being prepared for its proper management is vital for emergency physicians. Case Report: We report a 53-year-old Black female who presented to the emergency department with sudden onset of slurred speech and a facial droop. She was found to have an acute ischemic stroke and tPA was administered. She subsequently developed angioedema. Retrospectively, the patient was found to have risk factors that are thought to predispose patients to tPA-induced angioedema. Conclusion: Risk factors associated with angioedema secondary to tPA administration have been documented in patients taking ACE inhibitors, as well as patients who develop strokes in the frontal lobe. While many cases may be mild, some patients may develop life-threatening angioedema. Although this complication does not necessarily contraindicate tPA use, it is prudent for the emergency physician to be vigilant for its development, prepared for its treatment, and to be diligent in assessing the need for control of the patient’s airway.

Ischemic stroke in a young woman with anti-phosphatidylserine/prothrombin (aPS/PT) complex antibody: a case report

2019 ◽  
Vol 397 ◽  
pp. 77-79
Author(s):  
Kenichi Todo ◽  
Masaya Togo ◽  
Yasutaka Murakami ◽  
Tomoyuki Kono ◽  
Hajime Yoshimura ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Case Report ◽  
Young Woman ◽  
Pt Complex

scholarly journals Contrast-Induced Encephalopathy After Endovascular Thrombectomy for Acute Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (12) ◽  
pp. 3756-3759
Author(s):  
Yung-Tsai Chu ◽  
Kang-Po Lee ◽  
Chih-Hao Chen ◽  
Pi-Shan Sung ◽  
Yen-Heng Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Renal Dysfunction ◽  
Odds Ratio ◽  
Kidney Injury ◽  
Infarct Core ◽  
Endovascular Thrombectomy ◽  
Clinical Criteria ◽  
History Of

Background and Purpose: Contrast-induced encephalopathy (CIE) is a rare and underrecognized complication after endovascular thrombectomy (EVT) for acute ischemic stroke. This study investigated the incidence and risk factors of CIE in patients who underwent EVT. Methods: Consecutive patients with acute ischemic stroke who received EVT between September 2014 and December 2019 at 2 medical centers were included. CIE was diagnosed on clinical criteria of neurological deterioration or delayed improvement within 24 hours after the procedure that was unexplained by the infarct or hemorrhagic transformation and radiological criterion of edematous change extending beyond the infarct core accompanied by contrast staining. Results: Of 421 patients with acute ischemic stroke who received EVT, 7 (1.7%) developed CIE. The manifestations included worsening of focal neurological signs, coma, and seizure. Patients with CIE were more likely to experience contrast-induced acute kidney injury than were those without CIE, but the volume of contrast medium was comparable between the two groups. The independent risk factors for CIE included renal dysfunction (defined as an estimated glomerular filtration rate <45 mL/min per 1.73 m 2 ; odds ratio, 5.77 [95% CI, 1.37–24.3]; P =0.02) and history of stroke (odds ratio, 4.96 [95% CI, 1.15–21.3]; P =0.03). Patients with CIE were less likely to achieve favorable functional outcomes (odds ratio, 0.09 [95% CI, 0.01–0.87]; P =0.04). Conclusions: CIE should be suspected in patients with clinical worsening after EVT accompanied by imaging evidence of contrast staining and edematous changes, especially in patients with renal dysfunction or history of stroke.

scholarly journals Risk factors for young ischemic stroke and the enigma of trombophilic polymorphisms: a case report

2011 ◽  
Vol 5 (4) ◽  
pp. 135-143
Author(s):  
Linda Iurato ◽  
Marialuisa Ventruto ◽  
Maria Adalgisa Police ◽  
Alessandro Morella ◽  
Alfonso Fortunato ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Case Report ◽  
Cardiovascular Risk ◽  
Migraine Patient ◽  
Diagnostic Process ◽  
Arterial Ischemic Stroke ◽  
Inherited Thrombophilia ◽  
Stroke Diagnosis ◽  
Toast Criteria

We report the case of a 48-year-old female patient with stroke family history that was admitted in our ward with suspected ischemic stroke diagnosis. The diagnostic process is described in detail, paying attention in particular to anamnestic data and to genetic polymorphisms related to higher risk for inherited thrombophilia. At the end, the diagnosis indicates red infarct in a migraine patient with cerebrovascular and cardiovascular risk factors of undetermined aetiology according to TOAST criteria. Some of the known thrombophilic polymorphisms were found in the patient: however not all the mentioned thrombophilic markers are universally recognized as predisposing factors for arterial ischemic stroke.

A Case Report of the Occurrence of a Rare Middle Mediastinal Thymoma in a Young Woman

2008 ◽  
Vol 58 (6) ◽  
pp. 583
Author(s):  
Jae Myeong Lee ◽  
Ghi Jai Lee ◽  
Jae Chan Shim ◽  
Ho Kyun Kim ◽  
Jung Ho Suh ◽  
...  
Keyword(s):  
Case Report ◽  
Young Woman
Sign in / Sign up

Export Citation Format

Share Document