{"title":"Response to Letter to the Editor.","authors":"Deema Fattal, Gregory Schmidt","doi":"10.1016/j.jstrokecerebrovasdis.2020.105361","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105361","url":null,"abstract":"","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"105361"},"PeriodicalIF":2.5,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38482642","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}
{"title":"Acute Spinal Cord Infarction with Preferential Involvement of Ventral Gray Matter: An Autopsy Report.","authors":"Shuta Toru, Tetsuo Yamada, Masako Suzuki, Akira Takemoto, Tomonari Amano, Masanobu Kitagawa, Takayoshi Kobayashi, Toshiki Uchihara","doi":"10.1016/j.jstrokecerebrovasdis.2020.105348","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105348","url":null,"abstract":"<p><p>Herein, we report abdominal aortic thrombosis as a rare cause of acute spinal cord infarction. A 78-year-old man with multiple vascular risk factors developed acute paraplegia with sensory and urinary disturbances and signs of ischemia in both lower limbs. The post-mortem study done 3 days after the onset of symptoms revealed a large coagulum in the abdominal aorta, distal to the renal arteries and extending to bilateral common iliac arteries; in addition, marked atherosclerosis was present in most large blood vessels. Premature incomplete necrotic foci were seen in the ventral gray matter of the spinal cord from T6 through S5; the surrounding white matter and dorsal gray matter were spared. Considering our autopsy case, spinal cord gray matter may be more vulnerable to ischemia than the white matter.</p>","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"105348"},"PeriodicalIF":2.5,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jstrokecerebrovasdis.2020.105348","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38501288","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}
Katarina Dakay, Gurmeen Kaur, Stephan A Mayer, Justin Santarelli, Chirag Gandhi, Fawaz Al-Mufti
{"title":"Cerebral Herniation Secondary to Stroke-Associated Hemorrhagic Transformation, Fulminant Cerebral Edema in Setting of COVID-19 Associated ARDS and Active Malignancy.","authors":"Katarina Dakay, Gurmeen Kaur, Stephan A Mayer, Justin Santarelli, Chirag Gandhi, Fawaz Al-Mufti","doi":"10.1016/j.jstrokecerebrovasdis.2020.105397","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105397","url":null,"abstract":"<p><p>SARS-CoV-2 infection has been associated with ischemic stroke as well as systemic complications such as acute respiratory failure; cytotoxic edema is a well-known sequelae of acute ischemic stroke and can be worsened by the presence of hypercarbia induced by respiratory failure. We present the case of a very rapid neurologic and radiographic decline of a patient with an acute ischemic stroke who developed rapid fulminant cerebral edema leading to herniation in the setting of hypercarbic respiratory failure attributed to SARS-CoV-2 infection. Given the elevated incidence of cerebrovascular complications in patients with COVID-19, it is imperative for clinicians to be aware of the risk of rapidly progressive cerebral edema in patients who develop COVID-19 associated acute respiratory distress syndrome.</p>","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"105397"},"PeriodicalIF":2.5,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jstrokecerebrovasdis.2020.105397","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38523837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ocular movements preclude brain death determination: Response to Fattal et al.","authors":"Ariane Lewis, David Greer","doi":"10.1016/j.jstrokecerebrovasdis.2020.105354","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105354","url":null,"abstract":"","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"105354"},"PeriodicalIF":2.5,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jstrokecerebrovasdis.2020.105354","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38460420","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}
{"title":"Ignoring Subtle Retained Brain(stem) Functions in the Clinical Diagnosis of Brain Death.","authors":"Mohamed Y Rady","doi":"10.1016/j.jstrokecerebrovasdis.2020.105345","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105345","url":null,"abstract":"","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"105345"},"PeriodicalIF":2.5,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jstrokecerebrovasdis.2020.105345","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38461731","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}
Chia Siang Kow, Abdullah Faiz Zaihan, Syed Shahzad Hasan
{"title":"Anticoagulant approach in COVID-19 patients with cerebral venous thrombosis.","authors":"Chia Siang Kow, Abdullah Faiz Zaihan, Syed Shahzad Hasan","doi":"10.1016/j.jstrokecerebrovasdis.2020.105222","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105222","url":null,"abstract":"","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"105222"},"PeriodicalIF":2.5,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jstrokecerebrovasdis.2020.105222","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38444868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Postpartum Atypical Posterior Reversible Encephalopathy Syndrome in a COVID-19 Patient - An Obstetric Emergency.","authors":"Sripadma P V, Ashish Rai, Chetan Wadhwa","doi":"10.1016/j.jstrokecerebrovasdis.2020.105357","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105357","url":null,"abstract":"<p><p>Encephalopathy in COVID-19 has been widely reported with several reports of posterior reversible encephalopathy syndrome (PRES) speculated to be due to an abrupt surge in blood pressure caused by coronavirus disease. Though peripartum posterior reversible encephalopathy syndrome is well recognized, its atypical variant with hemorrhage is uncommon. Peripartum atypical posterior reversible encephalopathy syndrome with COVID-19 requires early recognition and warrants dedicated inter-disciplinary management. We present a case of postpartum atypical posterior reversible encephalopathy syndrome with good maternal and fetal outcome. Our clinical and treatment approach with differential diagnosis are discussed in this hitherto unreported obstetric emergency with COVID-19.</p>","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"105357"},"PeriodicalIF":2.5,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jstrokecerebrovasdis.2020.105357","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38474066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Tumor Embolism Through Right-to-Left Shunt Due to Venous Invasion of Esophageal Carcinoma.","authors":"Suguru Araki, Kota Maekawa, Kazuto Kobayashi, Takanori Sano, Tadashi Yabana, Masunari Shibata, Fumitaka Miya","doi":"10.1016/j.jstrokecerebrovasdis.2020.105352","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105352","url":null,"abstract":"<p><p>A 69-year-old man was admitted to the hospital with right hemiparesis and global aphasia. Perfusion computed tomography imaging revealed ischemic penumbra in the middle cerebral artery territory. Angiography showed left middle cerebral artery occlusion. Mechanical thrombectomy with one pass was performed, and successful recanalization was obtained. Embolic material was retrieved; it contained tumor fragments with atypical keratinizing squamous cell carcinoma. Contrast computed tomography imaging indicated tumor invasion into the superior vena cava, and contrast transcranial Doppler indicated the presence of a right-to-left shunt after the Valsalva maneuver. We diagnosed the patient with acute ischemic stroke of large vessel occlusion due to venous invasion of esophageal carcinoma via a right-to-left shunt. To the best of our knowledge, this is the first case of embolic occlusion resulting from an extracardiac tumor via a right-to-left shunt. Contrast transcranial Doppler potentially detects right-to-left shunts in patients who cannot undergo transesophageal echocardiography.</p>","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"105352"},"PeriodicalIF":2.5,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38450348","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}
{"title":"A Novel Mutation Outside of the EGFr Encoding Exons of NOTCH3 Gene in a Chinese with CADASIL.","authors":"Wan Wang, Zhixia Ren, Yingying Shi, Jiewen Zhang","doi":"10.1016/j.jstrokecerebrovasdis.2020.105410","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105410","url":null,"abstract":"<p><strong>Background: </strong>Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary cerebral small vascular disease caused by the mutations of the NOTCH3 gene. The NOTCH3 gene consists of 33 exons. The pathogenic mutations of the NOTCH3 gene in CADASIL are located in 2-24 exons coding for the 34 EGFr (epidermal growth factor-like repeat) domains. The classical clinical manifestations are recurrent TIA or ischaemic stroke, migraine, cognitive disorder and affective disorder. The deposition of granular osmiophilic material (GOM) in the vascular wall is considered as a hallmark of the disease.</p><p><strong>Methods: </strong>Here, we report a rare pathogenic mutation on exon 29 of the NOTCH3 gene in a Chinese family. Clinical data for the proband and available relatives is collected. Mutation analysis of the NOTCH3 gene was performed by screening the entire 33 exons in this family and 200 normal controls. A complete imaging evaluation and skin biopsy were performed on the proband.</p><p><strong>Results: </strong>We identified a novel R1761H (c.5282G>A) mutation. The same mutation was not founded in 200 normal controls. The proband had recurrent stroke, depression, cognitive decline and cerebral lobe hemorrhage. Cranial MRI showed white matter lesions and multiple infarction. Susceptibility weighted imaging revealed numerous microbleeds.Most importantly, the deposition of GOM was found in the proband.</p><p><strong>Conclusion: </strong>33 exons of NOTCH3 gene should be performed for individuals with a convincing CADASIL phenotype and positive family history.</p>","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"105410"},"PeriodicalIF":2.5,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jstrokecerebrovasdis.2020.105410","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38666081","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}
{"title":"Bilateral Internal Carotid Artery Agenesis and Posterior Circulation Stroke: A Rare Association.","authors":"Suresh Giragani, Komal Kumar Rn, Ashok Reddy Kasireddy, Surender Alwala","doi":"10.1016/j.jstrokecerebrovasdis.2020.105342","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105342","url":null,"abstract":"<p><p>Bilateral ICA agenesis is a rare developmental anomaly of the anterior circulation. It can be accompanied by various posterior circulation abnormalities including aneurysms, dolichoectatic vessels. We report the clinical presentation, imaging findings and management of a unique case of a 25 year old man having bilateral internal carotid agenesis with cerebellar ischemic lesions secondary to thrombus formation in dolichoectatic basilar artery.</p>","PeriodicalId":520692,"journal":{"name":"Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association","volume":" ","pages":"105342"},"PeriodicalIF":2.5,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jstrokecerebrovasdis.2020.105342","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38474068","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}