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[PMID]:28754833
[Au] Autor:Thijs V; Grittner U; Fazekas F; McCabe DJH; Giese AK; Kessler C; Martus P; Norrving B; Ringelstein EB; Schmidt R; Tanislav C; Putaala J; Tatlisumak T; von Sarnowski B; Rolfs A; Enzinger C; Stroke in Fabry (SIFAP1) Investigators
[Ad] Endereço:From the Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia (V.T.); Department of Neurology, Austin Health, Heidelberg, Victoria, Australia (V.T.); Center for Stroke Research and Department of Biostatistics and Clinical Epide
[Ti] Título:Dolichoectasia and Small Vessel Disease in Young Patients With Transient Ischemic Attack and Stroke.
[So] Source:Stroke;48(9):2361-2367, 2017 Sep.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: We evaluated whether basilar dolichoectasia is associated with markers of cerebral small vessel disease in younger transient ischemic attack and ischemic stroke patients. METHODS: We used data from the SIFAP1 study (Stroke in Young Fabry Patients), a large prospective, hospital-based, screening study for Fabry disease in young (<55 years) transient ischemic attack/stroke patients in whom detailed clinical data and brain MRI were obtained, and stroke subtyping with TOAST classification (Trial of ORG 10172 in Acute Stroke Treatment) was performed. RESULTS: Dolichoectasia was found in 508 of 3850 (13.2%) of patients. Dolichoectasia was associated with older age (odds ratio per decade, 1.26; 95% confidence interval, 1.09-1.44), male sex (odds ratio, 1.96; 95% confidence interval, 1.59-2.42), and hypertension (odds ratio, 1.39; 95% confidence interval, 1.13-1.70). Dolichoectasia was more common in patients with small infarctions (33.9% versus 29.8% for acute lesions, =0.065; 29.1% versus 16.5% for old lesions, <0.001), infarct location in the brain stem (12.4% versus 6.9%, <0.001), and in white matter (27.8% versus 21.1%, =0.001). Microbleeds (16.3% versus 4.7%, =0.001), higher grades of white matter hyperintensities ( <0.001), and small vessel disease subtype (18.1% versus 12.4%, overall for differences in TOAST ( =0.018) were more often present in patients with dolichoectasia. CONCLUSIONS: Dolichoectasia is associated with imaging markers of small vessel disease and brain stem localization of acute and old infarcts in younger patients with transient ischemic attack and ischemic stroke. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00414583.
[Mh] Termos MeSH primário: Doenças de Pequenos Vasos Cerebrais/epidemiologia
Ataque Isquêmico Transitório/epidemiologia
Acidente Vascular Cerebral/epidemiologia
Insuficiência Vertebrobasilar/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Infartos do Tronco Encefálico/epidemiologia
Hemorragia Cerebral/epidemiologia
Doenças de Pequenos Vasos Cerebrais/diagnóstico por imagem
Feminino
Seres Humanos
Hipertensão/epidemiologia
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Razão de Chances
Fatores de Risco
Fatores Sexuais
Insuficiência Vertebrobasilar/diagnóstico por imagem
Substância Branca/irrigação sanguínea
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170730
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.017406


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[PMID]:28413710
[Au] Autor:Felfeli P; Wenz H; Al-Zghloul M; Groden C; Förster A
[Ad] Endereço:Department of NeuroradiologyUniversitätsmedizin MannheimUniversity of HeidelbergMannheimGermany.
[Ti] Título:Combination of standard axial and thin-section coronal diffusion-weighted imaging facilitates the diagnosis of brainstem infarction.
[So] Source:Brain Behav;7(4):e00666, 2017 Apr.
[Is] ISSN:2162-3279
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Although diffusion-weighted imaging (DWI) is a very sensitive technique for the detection of small ischemic lesions in the human brain, in particular in the brainstem it may fail to demonstrate acute ischemic infarction. In this study, we sought to evaluate the value of additional thin-section coronal DWI for the detection of brainstem infarction. METHODS: In 155 consecutive patients (median age 69 [interquartile range, IQR 57-78] years, 95 [61.3%] males) with isolated brainstem infarction, MRI findings were analyzed, with emphasis on ischemic lesions on standard axial (5 mm) and thin-section coronal (3 mm) DWI. RESULTS: On DWI, we identified ischemic lesions in the mesencephalon in 12 (7.7%), pons in 115 (74.2%), and medulla oblongata in 31 (20%) patients. In 3 (1.9%) cases-all of these with medulla oblongata infarction-the ischemic lesion was detected only on thin-section coronal DWI. Overall, in 35 (22.6%) patients the ischemic lesion was more easily identified on thin-section coronal DWI in comparison to standard axial DWI. In these, the ischemic lesions were significantly smaller (0.06 [IQR 0.05-0.11] cm vs. 0.25 [IQR 0.13-0.47] cm ;  < .001) in comparison to those patients whose ischemic lesion was more easily (6 [3.9%]) or at least similarly well identified (114 [73.5%]) on standard axial DWI. CONCLUSIONS: Since thin-section coronal DWI may facilitate the diagnosis of brainstem infarction, we suggest its inclusion in standard stroke MRI protocols.
[Mh] Termos MeSH primário: Infartos do Tronco Encefálico/diagnóstico por imagem
Tronco Encefálico/diagnóstico por imagem
Imagem de Difusão por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
[Pt] Tipo de publicação:CLINICAL STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170424
[Lr] Data última revisão:
170424
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170418
[St] Status:MEDLINE
[do] DOI:10.1002/brb3.666


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[PMID]:28400488
[Au] Autor:Lapa S; Luger S; Pfeilschifter W; Henke C; Wagner M; Foerch C
[Ad] Endereço:From the Department of Neurology (S. Lapa, S. Luger, W.P., C.H., C.F.) and Institute of Neuroradiology (M.W.), Goethe University Frankfurt, Germany. sriramya.lapa@kgu.de.
[Ti] Título:Predictors of Dysphagia in Acute Pontine Infarction.
[So] Source:Stroke;48(5):1397-1399, 2017 May.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Little is known about the frequency and the clinical characteristics of neurogenic dysphagia in pontine strokes. In this study, we sought to identify predictors for dysphagia in a cohort of patients with isolated pontine infarctions. METHODS: We included all patients admitted to our department between 2008 and 2014 having an acute (<48 hours after symptom onset) ischemic stroke in the pons, as documented by means of diffusion-weighted magnetic resonance imaging. Precise infarct localization was stratified according to established vascular territories. The presence of dysphagia was the primary end point of the study and was assessed by a Speech-Language Pathologist according to defined criteria. RESULTS: The study recruited 59 patients, 14 with and 45 without dysphagia. Median (interquartile range) stroke severity (in terms of National Institutes of Health Stroke Scale values) was higher in the dysphagic group as compared with patients without dysphagia (8.5 [6-12] versus 2 [1-5]; <0.001). Infarct localization in the upper part of the pons (78.6% versus 33.3%; =0.004) and in the anterolateral vascular territory (78.6% versus 31.1%; =0.002) occurred more often in the dysphagic group. In a multivariate model, age, infarct volume, and National Institutes of Health Stroke Scale value were independent predictors of dysphagia. CONCLUSIONS: Dysphagia occurs frequently in patients with isolated pontine infarctions. Clinical and imaging predictors of dysphagia may help to provide optimal screening, to prevent complications and to improve long-term prognosis.
[Mh] Termos MeSH primário: Infartos do Tronco Encefálico/complicações
Infartos do Tronco Encefálico/diagnóstico por imagem
Transtornos de Deglutição/etiologia
Ponte/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Transtornos de Deglutição/diagnóstico
Imagem de Difusão por Ressonância Magnética
Feminino
Seres Humanos
Masculino
Meia-Idade
Prognóstico
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170630
[Lr] Data última revisão:
170630
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170413
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.116.015045


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[PMID]:28250306
[Au] Autor:Hosaka A; Tsunoda R; Yamaguchi T; Shibagaki Y
[Ad] Endereço:Department of Neurology, Hitachinaka Medical Education and Research Center, University of Tsukuba Hospital, Japan.
[Ti] Título:Body Lateropulsion and Cerebellar Tremor in a Patient with Pontine Infarction.
[So] Source:Intern Med;56(5):563-565, 2017.
[Is] ISSN:1349-7235
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:Body lateropulsion is known to be caused commonly by lateral medullary lesions but rarely by pontine lesions. It is also known to be associated with lesions of the dorsal spinothalamic tract or ascending graviceptive pathways. We herein report the case of a 75-year-old woman presenting with contralateral lateropulsion and cerebellar tremor caused by pons infarction. To our knowledge, this is the first case report of pontine infarction causing both lateropulsion and cerebellar tremor. Our case may be helpful in anatomical studies of ascending graviceptive pathways.
[Mh] Termos MeSH primário: Infartos do Tronco Encefálico/complicações
Ponte/diagnóstico por imagem
Equilíbrio Postural/fisiologia
Transtornos das Sensações/etiologia
Tremor/etiologia
[Mh] Termos MeSH secundário: Idoso
Infartos do Tronco Encefálico/diagnóstico por imagem
Infartos do Tronco Encefálico/fisiopatologia
Imagem de Difusão por Ressonância Magnética/métodos
Feminino
Seres Humanos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170425
[Lr] Data última revisão:
170425
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170303
[St] Status:MEDLINE
[do] DOI:10.2169/internalmedicine.56.6923


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[PMID]:28137897
[Au] Autor:Rostron E; Dickerson MP; Heath G
[Ad] Endereço:Ophthalmology Department, St James Hospital, Leeds, UK.
[Ti] Título:Blood, brain and binocular vision.
[So] Source:BMJ Case Rep;2017, 2017 Jan 30.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:A man aged 51 years presented with sudden onset, horizontal, binocular, double vision and right facial weakness. Ocular motility examination demonstrated a right horizontal gaze palsy pattern in keeping with a one-and-a-half syndrome. Since this was associated with a concomitant, ipsilateral, lower motor neuron (LMN) facial (VIIth) cranial nerve palsy, he had acquired an eight-and-a-half syndrome. Diffusion-weighted MRI confirmed a small infarcted area in the pons of the brainstem which correlated with anatomical location of the horizontal gaze centre and VIIth cranial nerve fasciculus. As a result of this presentation, further investigations uncovered a hitherto undiagnosed blood dyscrasia-namely polycythaemia vera. Regular venesection was started which resulted in complete resolution of his ocular motility dysfunction and an improvement of his LMN facial nerve palsy.
[Mh] Termos MeSH primário: Infartos do Tronco Encefálico/etiologia
Diplopia/etiologia
Paralisia Facial/etiologia
Transtornos da Motilidade Ocular/etiologia
Policitemia Vera/complicações
Ponte/diagnóstico por imagem
[Mh] Termos MeSH secundário: Infartos do Tronco Encefálico/diagnóstico por imagem
Imagem de Difusão por Ressonância Magnética
Paralisia Facial/diagnóstico
Seres Humanos
Masculino
Meia-Idade
Transtornos da Motilidade Ocular/diagnóstico
Policitemia Vera/diagnóstico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170306
[Lr] Data última revisão:
170306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170201
[St] Status:MEDLINE


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[PMID]:28131224
[Au] Autor:Kim HA; You S
[Ad] Endereço:Department of Neurology, Keimyung University School of Medicine, South Korea; Brain Research Institute, Keimyung University School of Medicine, South Korea.
[Ti] Título:Akinetic mutism in a patient with acute infarcts in the bilateral substantia nigra.
[So] Source:J Neurol Sci;373:46-47, 2017 Feb 15.
[Is] ISSN:1878-5883
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Afasia Acinética/diagnóstico por imagem
Afasia Acinética/etiologia
Infartos do Tronco Encefálico/complicações
Infartos do Tronco Encefálico/diagnóstico por imagem
Substância Negra/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Afasia Acinética/tratamento farmacológico
Afasia Acinética/fisiopatologia
Infartos do Tronco Encefálico/tratamento farmacológico
Infartos do Tronco Encefálico/fisiopatologia
Diagnóstico Diferencial
Feminino
Seres Humanos
Substância Negra/fisiopatologia
[Pt] Tipo de publicação:CASE REPORTS; LETTER
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170130
[St] Status:MEDLINE


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[PMID]:28127514
[Au] Autor:Valdés Hernández MD; Qiu X; Wang X; Wiseman S; Sakka E; Maconick LC; Doubal F; Sudlow CL; Wardlaw JM
[Ad] Endereço:Department of Neuroimaging Sciences Centre for Clinical Brain Sciences University of Edinburgh Edinburgh UK.
[Ti] Título:Interhemispheric characterization of small vessel disease imaging markers after subcortical infarct.
[So] Source:Brain Behav;7(1):e00595, 2017 Jan.
[Is] ISSN:2162-3279
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In structural Magnetic Resonance Imaging (MRI) of patients with a recent small subcortical infarct (RSSI) and small vessel disease (SVD) imaging markers coexist. However, their spatial distribution and prevalence with respect to the hemisphere of the RSSI remain unknown. MATERIALS AND METHODS: From brain MRI in 187 patients with an acute lacunar ischemic stroke clinical syndrome and a relevant diffusion weighted imaging (DWI)-positive lesion, we semiautomatically extracted the RSSI, microbleeds, lacunes, old cortical infarcts, and white matter hyperintensities (WMH) using optimized thresholding in the relevant sequences, and rated the load of perivascular spaces. We registered all images to an age-relevant brain template and calculated the probability distribution of all SVD markers mentioned for patients who had the RSSI in each hemisphere separately. We used the Wilcoxon and chi-squared tests to compare the volumes and frequencies of occurrence, respectively, of the SVD markers between hemispheres throughout the sample. RESULTS: Fifty-two percent patients ( = 97) had the RSSI in the left hemisphere, 42% ( = 78) in the right, 2.7% ( = 5) in both, and 3.7% ( = 7) in the cerebellum or brainstem. There was no significant difference in RSSI frequency between left and right hemispheres ( = .10) in the sample. The median volume of the RSSI (expressed as a percentage of the total intracranial volume) was 0.05% (IQR = 0.06). There was no difference in median percent volume of the right RSSIs versus left ( = .16). Neither was there a significant interhemispheric difference in the volume of any of the SVD markers regardless of the location of the RSSI and they were equally distributed in both hemispheres. CONCLUSION: Assessment of SVD imaging markers in the contralateral hemisphere could be used as a proxy for the SVD load in the whole brain to avoid contamination by the RSSI of the measurements, especially of WMH.
[Mh] Termos MeSH primário: Infarto Encefálico/patologia
Córtex Cerebral/patologia
Hemorragia Cerebral/patologia
Imagem por Ressonância Magnética/métodos
Acidente Vascular Cerebral Lacunar/patologia
Substância Branca/patologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Biomarcadores
Infarto Encefálico/diagnóstico por imagem
Infartos do Tronco Encefálico/diagnóstico por imagem
Infartos do Tronco Encefálico/patologia
Córtex Cerebral/diagnóstico por imagem
Hemorragia Cerebral/diagnóstico por imagem
Infarto Cerebral/diagnóstico por imagem
Infarto Cerebral/patologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Acidente Vascular Cerebral Lacunar/diagnóstico por imagem
Substância Branca/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170128
[St] Status:MEDLINE
[do] DOI:10.1002/brb3.595


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[PMID]:28089423
[Au] Autor:Chen WH; Yang TP; Yin HL
[Ad] Endereço:Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Kaohsiung City, Taiwan.
[Ti] Título:Crossed cheiro-oral syndrome: A warning sign for medullary involvement and neurological deterioration.
[So] Source:J Clin Neurosci;39:130-132, 2017 May.
[Is] ISSN:1532-2653
[Cp] País de publicação:Scotland
[La] Idioma:eng
[Ab] Resumo:Crossed cheiro-oral syndrome (CCOS) is characterized by crossed sensory disturbance confined to the unilateral perioral area and contralateral hand/finger(s). Although a few classical crossed sensory syndromes accurately predict brainstem or spinal involvement, the clinical significance of CCOS remains unclear. In this study, we analyzed the etiology, localization and outcome of CCOS patients. The results showed that ischemic stroke is the exclusive cause of CCOS. The location of responsible stroke is pertinent to the middle or upper level of the lateral medulla oblongata medial to the lateral sulcus. The vascular supply is from the vertebral artery or the posterior inferior cerebellar artery. Half of the CCOS patients progressed to Wallenberg's syndrome and complicated with disabled daily living. However, no patient died during the follow-up period. A larger size and dorsal extension of the infarction correlated with neurological deterioration. Therefore, CCOS is an independent clinical sign of medullary involvement. It strongly predicts involvement at the lateral medulla oblongata, especially the ischemic stroke, and neurological deterioration. A rapid evaluation of the infarction location and vascular status is suggested in cases of CCOS.
[Mh] Termos MeSH primário: Infartos do Tronco Encefálico/patologia
Síndrome Medular Lateral/fisiopatologia
Bulbo/patologia
Distúrbios Somatossensoriais/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Infartos do Tronco Encefálico/complicações
Progressão da Doença
Feminino
Seres Humanos
Masculino
Meia-Idade
Distúrbios Somatossensoriais/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170529
[Lr] Data última revisão:
170529
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170117
[St] Status:MEDLINE


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[PMID]:27927777
[Au] Autor:Virgo JD; Plant GT
[Ad] Endereço:Moorfields Eye Hospital, London, UK.
[Ti] Título:Internuclear ophthalmoplegia.
[So] Source:Pract Neurol;17(2):149-153, 2017 Apr.
[Is] ISSN:1474-7766
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:A brainstem lesion of any type that involves the medial longitudinal fasciculus (MLF) can cause internuclear ophthalmoplegia (INO). This primarily affects conjugate horizontal gaze and classically manifests as impaired adduction ipsilateral to the lesion and abduction nystagmus contralateral to the lesion. Here, we describe the anatomy of the MLF and review the clinical features of INO. We also describe conjugate horizontal gaze palsy and some of the 'INO-plus' syndromes.
[Mh] Termos MeSH primário: Infartos do Tronco Encefálico/complicações
Transtornos da Motilidade Ocular/diagnóstico
Transtornos da Motilidade Ocular/etiologia
[Mh] Termos MeSH secundário: Vias Aferentes/patologia
Vias Aferentes/fisiopatologia
Infartos do Tronco Encefálico/diagnóstico por imagem
Movimentos Oculares
Feminino
Lateralidade Funcional
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Nistagmo Patológico/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170327
[Lr] Data última revisão:
170327
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161209
[St] Status:MEDLINE
[do] DOI:10.1136/practneurol-2016-001428


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[PMID]:27663557
[Au] Autor:Kliesch S; Bauknecht C; Bohner G; Liebig T; Siebert E
[Ad] Endereço:Department of Neuroradiology, Charite Universitatsmedizin Berlin, Berlin, Germany.
[Ti] Título:Traumatic basilar artery entrapment with patency of pontine perforators and absence of significant brainstem infarction: report of an unusual case.
[So] Source:J Neurointerv Surg;9(5):e17, 2017 May.
[Is] ISSN:1759-8486
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:We report a rare case of entrapment of the basilar artery into the sphenoid bone caused by a longitudinal fracture of the clivus. Using high resolution three-dimensional flat panel angiography, we show preservation of the basilar artery perforators in spite of severe stenosis of the entrapped segment of the basilar artery. There were no obvious signs and symptoms of posterior fossa stroke clinically or radiographically as far as could be assessed under given clinical circumstances.
[Mh] Termos MeSH primário: Artéria Basilar/diagnóstico por imagem
Infartos do Tronco Encefálico/diagnóstico por imagem
Ponte/irrigação sanguínea
Fraturas Cranianas/diagnóstico por imagem
Insuficiência Vertebrobasilar/diagnóstico por imagem
[Mh] Termos MeSH secundário: Infartos do Tronco Encefálico/etiologia
Fossa Craniana Posterior/diagnóstico por imagem
Fossa Craniana Posterior/lesões
Seres Humanos
Masculino
Fraturas Cranianas/complicações
Insuficiência Vertebrobasilar/etiologia
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170526
[Lr] Data última revisão:
170526
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160925
[St] Status:MEDLINE
[do] DOI:10.1136/neurintsurg-2016-012558.rep



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