Database : MEDLINE
Search on : Intracranial and Arterial and Diseases [Words]
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[PMID]: 29419394
[Au] Autor:Morley RL; Sharma A; Horsch AD; Hinchliffe RJ
[Ad] Address:North Bristol NHS Trust, Bristol, Bristol, UK.
[Ti] Title:Peripheral artery disease.
[So] Source:BMJ;360:j5842, 2018 02 01.
[Is] ISSN:1756-1833
[Cp] Country of publication:England
[La] Language:eng
[Mh] MeSH terms primary: Atherosclerosis/complications
Cerebrovascular Disorders/complications
Myocardial Ischemia/complications
Peripheral Arterial Disease/diagnosis
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
Atherosclerosis/pathology
Cerebrovascular Disorders/epidemiology
Diabetes Complications
Diagnosis, Differential
England/epidemiology
Humans
Middle Aged
Myocardial Ischemia/epidemiology
Peripheral Arterial Disease/complications
Peripheral Arterial Disease/epidemiology
Peripheral Arterial Disease/physiopathology
Practice Guidelines as Topic
Primary Health Care/standards
Risk Assessment
Risk Factors
Smoking/adverse effects
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180209
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5842

  2 / 20264 MEDLINE  
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[PMID]: 29386181
[Au] Autor:Adelborg K; Szépligeti SK; Holland-Bill L; Ehrenstein V; Horváth-Puhó E; Henderson VW; Sørensen HT
[Ad] Address:Department of Clinical Epidemiology, Aarhus University Hospital, Denmark kade@clin.au.dk.
[Ti] Title:Migraine and risk of cardiovascular diseases: Danish population based matched cohort study.
[So] Source:BMJ;360:k96, 2018 01 31.
[Is] ISSN:1756-1833
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To examine the risks of myocardial infarction, stroke (ischaemic and haemorrhagic), peripheral artery disease, venous thromboembolism, atrial fibrillation or atrial flutter, and heart failure in patients with migraine and in a general population comparison cohort. DESIGN: Nationwide, population based cohort study. SETTING: All Danish hospitals and hospital outpatient clinics from 1995 to 2013. PARTICIPANTS: 51 032 patients with migraine and 510 320 people from the general population matched on age, sex, and calendar year. MAIN OUTCOME MEASURES: Comorbidity adjusted hazard ratios of cardiovascular outcomes based on Cox regression analysis. RESULTS: Higher absolute risks were observed among patients with incident migraine than in the general population across most outcomes and follow-up periods. After 19 years of follow-up, the cumulative incidences per 1000 people for the migraine cohort compared with the general population were 25 17 for myocardial infarction, 45 25 for ischaemic stroke, 11 6 for haemorrhagic stroke, 13 11 for peripheral artery disease, 27 18 for venous thromboembolism, 47 34 for atrial fibrillation or atrial flutter, and 19 18 for heart failure. Correspondingly, migraine was positively associated with myocardial infarction (adjusted hazard ratio 1.49, 95% confidence interval 1.36 to 1.64), ischaemic stroke (2.26, 2.11 to 2.41), and haemorrhagic stroke (1.94, 1.68 to 2.23), as well as venous thromboembolism (1.59, 1.45 to 1.74) and atrial fibrillation or atrial flutter (1.25, 1.16 to 1.36). No meaningful association was found with peripheral artery disease (adjusted hazard ratio 1.12, 0.96 to 1.30) or heart failure (1.04, 0.93 to 1.16). The associations, particularly for stroke outcomes, were stronger during the short term (0-1 years) after diagnosis than the long term (up to 19 years), in patients with aura than in those without aura, and in women than in men. In a subcohort of patients, the associations persisted after additional multivariable adjustment for body mass index and smoking. CONCLUSIONS: Migraine was associated with increased risks of myocardial infarction, ischaemic stroke, haemorrhagic stroke, venous thromboembolism, and atrial fibrillation or atrial flutter. Migraine may be an important risk factor for most cardiovascular diseases.
[Mh] MeSH terms primary: Cardiovascular Diseases/etiology
Migraine Disorders/complications
Myocardial Infarction/etiology
Stroke/etiology
[Mh] MeSH terms secundary: Adult
Atrial Fibrillation/epidemiology
Atrial Fibrillation/etiology
Body Mass Index
Cardiovascular Diseases/epidemiology
Cohort Studies
Comorbidity
Denmark/epidemiology
Female
Heart Failure/epidemiology
Heart Failure/etiology
Humans
Incidence
Intracranial Hemorrhages/epidemiology
Intracranial Hemorrhages/etiology
Male
Middle Aged
Migraine Disorders/diagnosis
Migraine Disorders/epidemiology
Myocardial Infarction/epidemiology
Outcome Assessment (Health Care)
Peripheral Arterial Disease/epidemiology
Peripheral Arterial Disease/etiology
Prospective Studies
Risk Factors
Smoking/epidemiology
Stroke/epidemiology
Venous Thromboembolism/epidemiology
Venous Thromboembolism/etiology
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180202
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k96

  3 / 20264 MEDLINE  
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[PMID]: 28455321
[Au] Autor:Derdeyn CP; Fiorella D; Lynn MJ; Turan TN; Cotsonis GA; Lane BF; Montgomery J; Janis LS; Chimowitz MI; SAMMPRIS Investigators
[Ad] Address:From the Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, State University of New York, Stony Brook (D.F.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta,
[Ti] Title:Nonprocedural Symptomatic Infarction and In-Stent Restenosis After Intracranial Angioplasty and Stenting in the SAMMPRIS Trial (Stenting and Aggressive Medical Management for the Prevention of Recurrent Stroke in Intracranial Stenosis).
[So] Source:Stroke;48(6):1501-1506, 2017 06.
[Is] ISSN:1524-4628
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND AND PURPOSE: The purpose of this study was to investigate the frequency of symptomatic in-stent restenosis (ISR) and its contribution to nonprocedural symptomatic infarction in the SAMMPRIS trial (Stenting and Aggressive Medical Management for the Prevention of Recurrent Stroke in Intracranial Stenosis). METHODS: Patients without a periprocedural primary end point were followed up to determine the occurrence of any of the following events: ischemic stroke, cerebral infarct with temporary signs, or transient ischemic attack in the territory of the stented artery. Vascular imaging performed after these events was reviewed for ISR. Annual rates for symptomatic ISR were calculated using Kaplan-Meier estimates. RESULTS: Of 183 patients in the stenting group without a periprocedural primary end point, 27 (14.8%) had a symptomatic infarction (stroke or cerebral infarct with temporary signs) and 16 (8.7%) had transient ischemic attack alone in the territory during a median follow-up of 35.0 months. Of the 27 patients with infarctions, 17 (9.3%) had an ischemic stroke and 10 (5.5%) had a cerebral infarct with temporary signs alone. Adequate vascular imaging to evaluate ISR was available in 24 patients with infarctions (showing ISR in 16 [66.7%]) and in 10 patients with transient ischemic attack alone (showing ISR in 8 [80%]). The 1-, 2-, and 3-year rates (with 95% confidence limits) for symptomatic ISR in the SAMMPRIS stent cohort were 9.6% (6.1%-14.9%), 11.3% (7.5%-17.0%), and 14.0% (9.6%-20.2%), respectively. CONCLUSIONS: Symptomatic ISR occurred in at least 1 of 7 patients in SAMMPRIS by 3 years of follow-up and was likely responsible for the majority of nonprocedural cerebral infarctions. CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov. Unique identifier: NCT00576693.
[Mh] MeSH terms primary: Angioplasty, Balloon/statistics & numerical data
Brain Ischemia/epidemiology
Constriction, Pathologic/epidemiology
Intracranial Arterial Diseases/epidemiology
Intracranial Arterial Diseases/therapy
Postoperative Complications/epidemiology
Stents/statistics & numerical data
Stroke/epidemiology
[Mh] MeSH terms secundary: Aftercare
Aged
Angioplasty, Balloon/adverse effects
Brain Ischemia/diagnosis
Cerebral Angiography
Cerebral Infarction/diagnostic imaging
Cerebral Infarction/epidemiology
Constriction, Pathologic/diagnostic imaging
Female
Humans
Intracranial Arterial Diseases/diagnostic imaging
Ischemic Attack, Transient/diagnostic imaging
Ischemic Attack, Transient/epidemiology
Kaplan-Meier Estimate
Male
Middle Aged
Postoperative Complications/diagnostic imaging
Recurrence
Risk
Stents/adverse effects
Stroke/diagnosis
[Pt] Publication type:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Entry month:1707
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[Js] Journal subset:IM
[Da] Date of entry for processing:170430
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.116.014537

  4 / 20264 MEDLINE  
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[PMID]: 29492549
[Au] Autor:Smielewski P; Steiner L; Puppo C; Budohoski K; Varsos GV; Czosnyka M
[Ad] Address:Brain Physics Lab, Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge University, Cambridge, UK. ps10011@cam.ac.uk.
[Ti] Title:Effect of Mild Hypocapnia on Critical Closing Pressure and Other Mechanoelastic Parameters of the Cerebrospinal System.
[So] Source:Acta Neurochir Suppl;126:139-142, 2018.
[Is] ISSN:0065-1419
[Cp] Country of publication:Austria
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Brain arterial critical closing pressure (CrCP) has been studied in several diseases such as traumatic brain injury (TBI), subarachnoid haemorrhage, hydrocephalus, and in various physiological scenarios: intracranial hypertension, decreased cerebral perfusion pressure, hypercapnia, etc. Little or nothing so far has been demonstrated to characterise change in CrCP during mild hypocapnia. METHOD: We retrospectively analysed recordings of intracranial pressure (ICP), arterial blood pressure (ABP) and blood flow velocity from 27 severe TBI patients (mean 39.5 ± 3.4 years, 6 women) in whom a ventilation increase (20% increase in respiratory minute volume) was performed over 50 min as part of a standard clinical CO reactivity test. CrCP was calculated using the Windkessel model of cerebral arterial flow. Arteriolar wall tension (WT) was calculated as a difference between CrCP and ICP. The compartmental compliances arterial (C ) and cerebrospinal fluid space (C ) were also evaluated. RESULTS: During hypocapnia, ICP decreased from 17±6.8 to 13.2±6.6 mmHg (p < 0.000001). Wall tension increased from 14.5 ± 9.9 to 21.7±9.1 mmHg (p < 0.0002). CrCP, being a sum of WT + ICP, changed significantly from 31.5 ± 11.9 mmHg to 34.9±11.1 mmHg (p < 0.002), and the closing margin (ABP-CrCP) remained constant at an average value of 60 mmHg. C decreased significantly during hypocapnia by 30% (p < 0.00001) and C increased by 26% (p < 0.003). CONCLUSION: During hypocapnia in TBI patients, ICP decreases and WT increases. CrCP increases slightly as the rise in wall tension outweighs the decrease in ICP. The closing margin remained unchanged, suggesting that the risk of hypocapnia-induced ischemia might not be increased.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:In-Data-Review
[do] DOI:10.1007/978-3-319-65798-1_29

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[PMID]: 29492530
[Au] Autor:Donnelly J; Czosnyka M; Harland S; Varsos GV; Cardim D; Robba C; Liu X; Ainslie PN; Smielewski P
[Ad] Address:Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge Biomedical Campus, University of Cambridge, Cambridge, CB2 0QQ, UK. jd634@cam.ac.uk.
[Ti] Title:Increased ICP and Its Cerebral Haemodynamic Sequelae.
[So] Source:Acta Neurochir Suppl;126:47-50, 2018.
[Is] ISSN:0065-1419
[Cp] Country of publication:Austria
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Increased intracranial pressure (ICP) is a pathological feature of many neurological diseases; however, the local and systemic sequelae of raised ICP are incompletely understood. Using an experimental paradigm, we aimed to describe the cerebrovascular consequences of acute increases in ICP. MATERIALS AND METHODS: We assessed cerebral haemodynamics [mean arterial blood pressure (MAP), ICP, laser Doppler flowmetry (LDF), basilar artery Doppler flow velocity (Fv) and estimated vascular wall tension (WT)] in 27 basilar artery-dependent rabbits during experimental (artificial lumbar CSF infusion) intracranial hypertension. WT was estimated as the difference between critical closing pressure and ICP. RESULTS: From baseline (~9 mmHg) to moderate increases in ICP (~41 mmHg), cortical LDF decreased (from 100 to 39.1%, p < 0.001), while mean global Fv was unchanged (from 47 to 45 cm/s, p = 0.38). In addition, MAP increased (from 88.8 to 94.2 mmHg, p < 0.01 and WT decreased (from 19.3 to 9.8 mmHg, p < 0.001). From moderate to high ICP (~75 mmHg), both global Fv and cortical LDF decreased (Fv, from 45 to 31.3 cm/s, p < 0.001; LDF, from 39.1 to 13.3%, p < 0.001) while MAP increased further (94.2 to 114.5 mmHg, p < 0.001) and estimated WT was unchanged (from 9.7 to 9.6 mmHg, p = 0.35). CONCLUSION: In this analysis, we demonstrate a cortical vulnerability to increases in ICP and two ICP-dependent cerebro-protective mechanisms: with moderate increases in ICP, WT decreases and MAP increases to buffer cerebral perfusion, while with severe increases of ICP, an increased MAP predominates.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:In-Data-Review
[do] DOI:10.1007/978-3-319-65798-1_10

  6 / 20264 MEDLINE  
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[PMID]: 29390277
[Au] Autor:Fan L; Ma W; Zhang H; Cai J
[Ad] Address:State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
[Ti] Title:A rare case report of bilateral common and internal iliac arterial fibromuscular dysplasia: Coexisted dissection, aneurysm, and stenosis.
[So] Source:Medicine (Baltimore);96(50):e8896, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Iliac arterial fibromuscular dysplasia (FMD) was rarely reported and its demographic, clinical, and imaging features have not been precisely described resulting in uncertain therapeutic methods. PATIENT CONCERNS: A 31-year-old man was referred because of 3-month-ago onset hypertension, low serum potassium, and a small-sized right kidney with normal renal artery under ultrasound examination. This patient was suspected of primary aldosteronism, whereas spirolactone was poorly effective. DIAGNOSIS: Contrast-enhanced computed tomographic angiography (CTA) and three-dimensional reconstruction of the whole aorta discovered an aneurysm from the right common iliac artery (CIA) to the internal iliac artery, consistent with a left CIA dissection and a remarkable right renal artery aneurysm before a stenosis. Iliac and renal arteries FMD were then confirmed through digital subtraction angiography (DSA). INTERVENTION: Percutaneous transluminal angioplasty (PTA) of right renal artery was operated and a stent was deployed in left CIA. OUTCOMES: This patient was normotensive, asymptomatic, and free from recurrence without any antihypertensive agents at an 8-month follow-up. LESSONS: To our knowledge, this is the first bilateral common and internal iliac arterial FMD case in China, with unique asymptomatic dissection, aneurysm, and renovascular hypertension. Screening for secondary hypertension in young population and for iliac or renal arterial FMD is therefore suggested with CTA and reconstruction from neck to pelvis and MRA in those with intracranial disorders. Among youth FMD, the potential of PTRA in renovascular hypertension out of antihypertensive drugs and stent in dissection is novelly indicated.
[Mh] MeSH terms primary: Aneurysm/diagnosis
Arterial Occlusive Diseases/diagnosis
Fibromuscular Dysplasia/diagnosis
Iliac Artery
[Mh] MeSH terms secundary: Adult
Aneurysm/surgery
Angiography, Digital Subtraction
China
Comorbidity
Computed Tomography Angiography
Diagnosis, Differential
Fibromuscular Dysplasia/surgery
Humans
Imaging, Three-Dimensional
Male
Stents
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008896

  7 / 20264 MEDLINE  
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[PMID]: 29475584
[Au] Autor:Liu JC; Zhang Q
[Ad] Address:Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, China; National Clinical Research Center for Neurological, 6 Tiantanxili, DongCheng District, Beijing, China.
[Ti] Title:Comments on "RNF213 p.R4810k Variant and Intracranial Arterial Stenosis or Occlusion in Relatives of Patients with Moyamoya Disease".
[So] Source:J Stroke Cerebrovasc Dis;, 2018 Feb 20.
[Is] ISSN:1532-8511
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:LETTER
[Em] Entry month:1802
[Cu] Class update date: 180224
[Lr] Last revision date:180224
[St] Status:Publisher

  8 / 20264 MEDLINE  
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[PMID]: 28454636
[Au] Autor:Udesh R; Mehta A; Gleason T; Thirumala PD
[Ad] Address:Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
[Ti] Title:Carotid artery disease and perioperative stroke risk after surgical aortic valve replacement: A nationwide inpatient sample analysis.
[So] Source:J Clin Neurosci;42:91-96, 2017 Aug.
[Is] ISSN:1532-2653
[Cp] Country of publication:Scotland
[La] Language:eng
[Ab] Abstract:To study the role of carotid stenosis (CS) and cerebrovascular disease as independent risk factors for perioperative stroke following surgical aortic valve replacement (SAVR). The National Inpatient Sample (NIS) database was used for our study. All patients who underwent SAVR from 1999 to 2011 were identified using ICD-9 codes. Univariate and multivariate analysis of baseline characteristics, Elixhauser comorbidities and other covariates were examined to identify independent predictors of perioperative strokes following SAVR. Data on 50,979 patients who underwent SAVR from 1999 to 2011 was obtained. The mean age of the study cohort was 60.5. The study patients were predominantly Caucasian (79.3%) and males (60.01%). The incidence of perioperative stroke was 2.48%. CS (OR 1.8, 95%CI 1.1-2.8, p=0.009) and cerebral arterial occlusion (OR 3.4, 95% CI 1.3-8.9) significantly increased perioperative stroke risk following SAVR. Infective endocarditis (OR 4.6, 95%CI 3.8-5.6, p=0.00) and neurological disorders (OR 4.8, 95% CI 4-5.8, p=0.00) appeared to be the strongest risk factors for strokes. Other risk factors found to be significant predictors of perioperative strokes (p<0.05) were - age, higher VWR scores, CS, cerebral arterial occlusion, infective endocarditis, DM, HTN, renal failure, neurological disorders, coagulopathy and hypothyroidsm. In conclusion, perioperative stroke risk has remained more or less constant despite advancements in surgical techniques with risk having gone up in patients <65years of age. CS and cerebral arterial occlusion significantly increase stroke risk following SAVR. Improved patient selection with pre-operative risk stratification and institution of preventive strategies are necessary to improve operative outcomes following SAVR.
[Mh] MeSH terms primary: Aortic Valve Stenosis/epidemiology
Aortic Valve/surgery
Carotid Stenosis/epidemiology
Cerebrovascular Disorders/epidemiology
Intraoperative Complications/epidemiology
Stroke/epidemiology
[Mh] MeSH terms secundary: Aged
Comorbidity
Female
Heart Valve Prosthesis
Humans
Incidence
Inpatients
Male
Middle Aged
Risk Factors
United States/epidemiology
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180219
[Lr] Last revision date:180219
[Js] Journal subset:IM
[Da] Date of entry for processing:170430
[St] Status:MEDLINE

  9 / 20264 MEDLINE  
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[PMID]: 29394920
[Au] Autor:Vanikieti K; Poonyathalang A; Jindahra P; Cheecharoen P; Chokthaweesak W
[Ad] Address:Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Bangkok, 10400, Thailand.
[Ti] Title:Occipital lobe infarction: a rare presentation of bilateral giant cavernous carotid aneurysms: a case report.
[So] Source:BMC Ophthalmol;18(1):25, 2018 Feb 02.
[Is] ISSN:1471-2415
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Cavernous carotid aneurysm (CCA) represents 2-9% of all intracranial aneurysms and 15% of internal carotid artery (ICA) aneurysms; additionally, giant aneurysms are those aneurysms that are > 25 mm in size. Bilateral CCAs account for 11-29% of patients and are commonly associated with structural weaknesses in the ICA wall, secondary to systemic hypertension. CCAs are considered benign lesions, given the low risk for developing major neurologic morbidities (i.e., subarachnoid hemorrhage, cerebral infarction, or carotid cavernous fistula). Moreover, concurrent presentation with posterior circulation cerebral infarction is even rarer, given different circulation territory from CCA. Here, we report on a patient with bilateral giant CCAs who presented with both typical and atypical symptoms. CASE PRESENTATION: An 88-year-old hypertensive woman presented with acute vertical oblique binocular diplopia, followed by complete ptosis of the right eye. Ophthalmic examination showed dysfunction of the right third, fourth, and sixth cranial nerves. Further examination revealed hypesthesia of the areas supplied by the ophthalmic (V1) and maxillary (V2) branches of the right trigeminal nerve. Bilateral giant cavernous carotid aneurysms, with a concurrent subacute right occipital lobe infarction, were discovered on brain imaging and angiogram. Additionally, a prominent right posterior communicating artery (PCOM) was revealed. Seven months later, clinical improvement with stable radiographic findings was documented without any intervention. CONCLUSIONS: Dysfunction of the third, fourth, and sixth cranial nerves, and the ophthalmic (V ) and maxillary (V ) branches of the trigeminal nerves, should necessitate brain imaging, with special attention given to the cavernous sinus. Despite unilateral symptomatic presentation, bilateral lesions cannot be excluded solely on the basis of clinical findings. CCA should be included in the differential diagnosis of cavernous sinus lesions. Although rare, ipsilateral posterior circulation cerebral infarction (i.e., occipital lobe infarction) can occur in CCA patients, presumably as a result of distal embolization through an ipsilateral, prominent PCOM. Spontaneous clinical improvement with stable radiographic support may occur.
[Mh] MeSH terms primary: Brain Infarction/diagnostic imaging
Carotid Artery Diseases/diagnostic imaging
Carotid Artery, Internal/diagnostic imaging
Cavernous Sinus Thrombosis/diagnostic imaging
Intracranial Aneurysm/diagnostic imaging
Occipital Lobe/diagnostic imaging
[Mh] MeSH terms secundary: Aged, 80 and over
Blepharoptosis/diagnosis
Carotid Artery, Internal/pathology
Diplopia/diagnosis
Female
Humans
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Occipital Lobe/pathology
Visual Fields
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180216
[Lr] Last revision date:180216
[Js] Journal subset:IM
[Da] Date of entry for processing:180204
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0687-4

  10 / 20264 MEDLINE  
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[PMID]: 28743241
[Au] Autor:Herath HMMTB; Pahalagamage SP; Withana D; Senanayake S
[Ad] Address:National Hospital, Colombo, Sri Lanka. tharukaherath11@gmail.com.
[Ti] Title:Complete ophthalmoplegia, complete ptosis and dilated pupil due to internal carotid artery dissection: as the first manifestation of Takayasu arteritis.
[So] Source:BMC Cardiovasc Disord;17(1):201, 2017 07 25.
[Is] ISSN:1471-2261
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Takayasu arteritis is a rare, chronic large vessel vasculitis involving the aorta and its primary branches. As the disease progresses, the active inflammation of large vessels leads to dilation, narrowing and occlusion of the arteries. Arterial dissection is due to separation of the layers of the arterial wall resulting in a false lumen, where blood seeps into the vessel wall. Neurological sequelae of intracranial arterial dissection results from cerebral ischemia due to thromboembolism and hypo perfusion. Internal carotid artery dissection in Takayasu arteritis is very rare and complete ophthalmoplegia due to internal carotid artery dissection is also rare. This is the first case report of Takayasu arteritis presenting as complete ophthalmoplegia due to internal carotid artery dissection. CASE PRESENTATION: A 38-year-old Sri Lankan female presented with sudden onset severe headache, fixed dilated pupil, complete ptosis and ophthalmoplegia on the right side. On imaging, dissection and dilatation was evident in the right internal carotid artery from the origin up to the cavernous segment. She also had stenosis and aneurysmal dilatation of right subclavian artery. Takayasu arteritis was diagnosed subsequently. She was started on aspirin and high dose steroids. CONCLUSIONS: Internal carotid artery dissection within the cavernous sinus can lead to third, fourth and sixth nerve palsy due to compression, stretching and ischemia from occlusion of the nutritional arteries. This case report illustrates that internal carotid artery dissection should be a differential diagnosis in palsies of the third, fourth, or sixth cranial nerves, especially when associated with headache. In cases of internal carotid artery dissection, vasculitis such as Takayasu arteritis should also be considered.
[Mh] MeSH terms primary: Aneurysm, Dissecting/etiology
Blepharoptosis/etiology
Carotid Artery Diseases/etiology
Carotid Artery, Internal
Intracranial Aneurysm/etiology
Ophthalmoplegia/etiology
Pupil
Takayasu Arteritis/complications
[Mh] MeSH terms secundary: Adult
Aneurysm, Dissecting/diagnostic imaging
Angiography, Digital Subtraction
Aspirin/administration & dosage
Blepharoptosis/diagnosis
Blepharoptosis/physiopathology
Carotid Artery Diseases/diagnostic imaging
Carotid Artery, Internal/diagnostic imaging
Cerebral Angiography/methods
Computed Tomography Angiography
Female
Humans
Intracranial Aneurysm/diagnostic imaging
Magnetic Resonance Imaging
Ophthalmoplegia/diagnosis
Ophthalmoplegia/physiopathology
Steroids/administration & dosage
Takayasu Arteritis/diagnosis
Takayasu Arteritis/drug therapy
Treatment Outcome
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Name of substance:0 (Steroids); R16CO5Y76E (Aspirin)
[Em] Entry month:1801
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[Js] Journal subset:IM
[Da] Date of entry for processing:170727
[St] Status:MEDLINE
[do] DOI:10.1186/s12872-017-0638-7


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BIREME/PAHO/WHO - Latin American and Caribbean Center on Health Sciences Information