1.Parenchymal Hemorrhage, Subdural Hematoma, and Subarachnoid Hemorrhage in a Patient with Cerebral Venous Sinus Thrombosis.
Korean Journal of Stroke 2012;14(3):173-176
Cerebral venous sinus thrombosis (CVST) may be complicated with various intracranial hemorrhage such as petechial hemorrhage, hemorrhagic infarction, parenchymal hemorrhage, subarachnoid hemorrhage (SAH), and subdural hematoma (SDH). However, combination of these types of intracranial hemorrhages supervening on CVST is seldom reported. A 55-year-old female with rectal cancer presented with severe headache, nausea, vomiting and diplopia. She was diagnosed as having CVST in the superior sagittal sinus with left frontal parenchymal hemorrhage and was treated with anticoagulants. The CVST were extended to inferior sagittal and straight sinuses. Moreover, SDH along the left cerebral convexity and SAH in the left sylvian fissure were simultaneously observed. Our present case shows that combination of various types of hemorrhages is rare but may occur in advanced CVST.
Anticoagulants
;
Diplopia
;
Female
;
Headache
;
Hematoma
;
Hematoma, Subdural
;
Hemorrhage
;
Humans
;
Infarction
;
Intracranial Hemorrhages
;
Nausea
;
Rectal Neoplasms
;
Sinus Thrombosis, Intracranial
;
Subarachnoid Hemorrhage
;
Superior Sagittal Sinus
;
Vomiting
2.Spontaneous Spinal Epidural Hematoma in a Patient on Cilostazol.
Shin Hye BAEK ; Hyung Suk LEE ; Jin Hwi KANG ; Jaewon SHIN ; Hyelim LEE ; Inha KIM ; Se Jin YANG ; Ji Seon KIM ; Dong Ick SHIN ; Sung Hyun LEE ; Sang Soo LEE
Korean Journal of Stroke 2012;14(3):170-172
Cilostazol is a phosphodiesterase inhibitor that has been shown to have similar efficacy in stroke prevention but fewer hemorrhagic events compared with aspirin. We report a case of spontaneous spinal epidural hematoma (SSEH) in a 67-year-old woman who has been treated with cilostazol for cerebral infarction. The patient was presented with sudden neck pain and right hemiparesis. Thirteen days after the onset, she recovered completely. Even cilostazol, which is a relatively safer drug in terms of bleeding risk compared to other antiplatelet agents, may cause SSEH. Therefore, physicians should keep in mind rare, but potentially fatal, bleeding complications such as SSEH when prescribing antiplatelet agents.
Aspirin
;
Cerebral Infarction
;
Female
;
Hematoma, Epidural, Spinal
;
Hemorrhage
;
Humans
;
Neck Pain
;
Paresis
;
Platelet Aggregation Inhibitors
;
Stroke
;
Tetrazoles
3.Hypertensive Brainstem Encephalopathy with Atypical Supratentorial Involvement.
Jung Gon LEE ; Hakjae ROH ; Il Mi JANG ; Kyung Bok LEE ; Moo Young AHN
Korean Journal of Stroke 2012;14(3):166-169
Hypertensive brainstem encephalopathy (HBE) is a variant of hypertensive encephalopathy characterized by brainstem and cerebellar involvement. Simultaneous supratentorial involvement in HBE is rarely reported as a vasogenic edema in subcortex and/or periventricular white matter. A 36-year-old woman visited hospital due to headache lasting 7 days before admission. Initial blood pressure was 270/170mmHg. T2-weighted and fluid-attenuated inversion recovery magnetic resonance imaging revealed multifocal high signal intensity lesions in upper medulla, pons, midbrain and cerebellar hemisphere. Especially, atypical periventricular lesions were shown as perpendicular fingers to the lateral ventricle like multiple sclerosis. Her clinical symptoms and radiological lesions were subsided with lowering blood pressure. We herein report a HBE with unusual supratentorial involvement mimicking multiple sclerosis.
Blood Pressure
;
Brain Stem
;
Edema
;
Female
;
Fingers
;
Headache
;
Humans
;
Hypertensive Encephalopathy
;
Lateral Ventricles
;
Magnetic Resonance Imaging
;
Mesencephalon
;
Multiple Sclerosis
;
Pons
;
Posterior Leukoencephalopathy Syndrome
4.A Case of Atypical Isolated Nodular Infarction: Nystagmus with a Reverse Direction.
Kang Min PARK ; Kyong Jin SHIN ; Sam Yeol HA ; Jin Se PARK ; Sung Eun KIM
Korean Journal of Stroke 2012;14(3):163-165
A cerebral infarction involving the nodulus usually produce contralateral lateropulsion and ipsilateral spontaneous nystagmus to the lesion. Here, we report a case of atypical isolated nodular infarction showed ipsilateral lateropulsion and contralateral spontaneous nystagmus to the lesion with a normal head impulse test. A right-handed 70-year-old man developed sudden vertigo with an unsteady gait. Neurologic examination revealed spontaneous left-beating nystagmus with a torsional component. He also displayed imbalance of walking and axial lateropulsion to the right side. Head impulse test was normal. Magnetic resonance imaging indicated acute infarction in the right nodulus on diffusion-weighted images.
Cerebral Infarction
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Gait Disorders, Neurologic
;
Head
;
Infarction
;
Magnetic Resonance Imaging
;
Neurologic Examination
;
Vertigo
;
Vestibular Neuronitis
;
Walking
5.Lacunar Infarction Following Recurrent Transient Ischemic Attack During Consecutive Hemodialysis.
Sang Don HAN ; Yoon Sik JO ; Ick Hee KIM ; Jin Yong CHOI
Korean Journal of Stroke 2012;14(3):160-162
The link between hemodialysis and cerebrovascular disease has become more apparent. Several reports have suggested that the incidence of ischemic stroke on hemodialysis patients is greater than that on the general populations. We report a case with lacunar infarction following recurrent transient ischemic attack during consecutive hemodialysis.
Aluminum Hydroxide
;
Carbonates
;
Hemodiafiltration
;
Humans
;
Incidence
;
Ischemic Attack, Transient
;
Renal Dialysis
;
Stroke
;
Stroke, Lacunar
6.A Unique Ultrasonographic Finding of Carotid Thrombus in a Patient with Acute Cardiogenic Cerebral Infarction.
Young Hyun LEE ; Ji Hye YANG ; Young Min SHON ; Beum Saeng KIM ; A Hyun CHO
Korean Journal of Stroke 2012;14(3):156-159
In patients with acute ischemic stroke, carotid duplex ultrasonography has been used to assess atherosclerotic lesions at the extracranial carotid artery. We reported a unique sonographic finding of carotid artery thrombus in a patient with acute cardioembolic stroke and atrial fibrillation. An 81-year-old woman with atrial fibrillation was presented with dysarthria and left side hemiparesis. She had undergone surgical thrombectomy and angioplasty for her right brachial artery occlusion four days before the stroke onset. Diffusion-weighted MRI revealed multiple territorial infarctions suggestive of acute cardio-embolic stroke. CT angiography showed an occlusion of the right common carotid artery. On B-mode ultrasonography, longitudinal intraluminal tortuous cylinderic oscillating thrombus was observed on the right distal common carotid artery to the proximal internal carotid artery. This case illustrates a unique ultrasonographic finding of acute cardiogenic thrombus in the extracranial carotid artery.
Angiography
;
Angioplasty
;
Atrial Fibrillation
;
Brachial Artery
;
Carotid Arteries
;
Carotid Artery, Common
;
Carotid Artery, Internal
;
Cerebral Infarction
;
Dysarthria
;
Female
;
Humans
;
Infarction
;
Paresis
;
Stroke
;
Thrombectomy
;
Thrombosis
7.Two Cases of Cerebral Infarctions from Vertebral Artery Dissection Induced by Severe Coughing.
Korean Journal of Stroke 2012;14(3):152-155
Vertebral artery dissection (VAD) is a rare cause of young age stroke. This risky condition can be caused by even minor head or neck trauma. None of the previous studies has reported cough-related intracranial vertebral arterial dissection in Korea. We present two cases of cerebral infarctions from VAD induced by severe coughing. We should be alert to clinical manifestations of VAD to make proper diagnosis and to recognize coughing as a potential cause of VAD.
Cerebral Infarction
;
Cough
;
Head
;
Korea
;
Neck
;
Stroke
;
Vertebral Artery
;
Vertebral Artery Dissection
8.Critical Appraisal of SAMMPRIS Study.
Korean Journal of Stroke 2012;14(1):55-56
No abstract available.
9.Critical Appraisal of SCAST Study.
Korean Journal of Stroke 2012;14(1):52-54
No abstract available.
Benzimidazoles
;
Blood Pressure
;
Stroke
;
Tetrazoles
10.Multiple Cerebral Infarctions after Intravenous Vitamin K Injection in a Patient with Trauma.
Se Hoon LEE ; Jiyoun KIM ; Hye Eun SHIN ; Kyusik KANG ; Jungju LEE ; Ohyun KWON ; Byung Kun KIM ; Jong Moo PARK
Korean Journal of Stroke 2012;14(1):49-51
Vitamin K, a cofactor of coagulation cascade, is used for hemostasis in patients with abnormal coagulation status. However, it is uncertain whether administration of vitamin K elevates the risk of thrombotic events. We present a patient with trauma who developed acute multiple cerebral infarctions after receiving intravenous vitamin K for several days. We presume that vitamin K can be a contributing factor for embolism in a patient with trauma.
Cerebral Infarction
;
Embolism
;
Hemostasis
;
Humans
;
Vitamin K
;
Vitamins