Recurrent cryptogenic strokes in a young female as a novel presentation of Parry Romberg syndrome: a case report and review.

Introduction: Parry Romberg Syndrome (PRS) is a less common genetic condition presenting with progressive hemifacial atrophy involving skin, underlying connective tissue, muscle and facial bone. Neurological manifestations include seizures, headaches, deafness and trigeminal neuralgia refractory to medications, while stroke is a less common presentation.

Materials And Methods: A 43-year-old right-handed female with previous history of Lower Motor Neuron (LMN) type facial palsy, seizure disorder and linear scleroderma, presented to our clinic with recurrent cryptogenic strokes.

Motor Band Sign in Primary Lateral Sclerosis: A Case Report Proposing the Need for an Imaging Biomarker.

Motor neuron disease is a degenerative condition involving both upper motor neurons (UMN) and lower motor neurons (LMN). While amyotrophic lateral sclerosis (ALS) is an overlap of upper and lower motor neuron involvement, primary lateral sclerosis (PLS) is predominantly an upper motor neuron involvement with lower motor involvement seen in the later stages of illness. Diagnostic criteria rely on clinical features and electrodiagnostic tests such as electromyography (EMG).

Subclavian steal phenomena in right-sided aortic arch with isolated left subclavian artery as demonstrated by quantitative-MRA.

Right-sided aortic arch with an isolated left subclavian artery is a very rare congenital anatomical variant that can lead to subclavian steal syndrome. We present a case of an asymptomatic patient who was incidentally found to have this variant on CT angiography with QMRA evidence of retrograde flow in the left vertebral artery consistent with subclavian steal phenomena. Since patients often remain asymptomatic until their compensatory mechanisms become compromised later in life, serial monitoring using non-invasive hemodynamic studies such as QMRA may guide treatment.

Negative Impact of Vestibular Suppressant Drugs on Provocative Positional Tests of BPPV: A Study from the Western Part of India.

Aims: To study the impact of vestibular suppressant drugs (VSD) on provocative positional tests (PPT) in patients with benign paroxysmal positional vertigo (BPPV).

Settings And Design: A prospective case-control observational study.

Materials And Methods: Patients with a history suggestive of BPPV were tested for PPT.

Reversible Cerebral Vasoconstriction Syndrome Following Exposure to Oleoresin Capsicum "Pepper Spray".

Objectives: To report a case associating the use of Oleoresin Capsicum Pepper Spray (OCPS) during law enforcement training with development of Reversible Cerebral Vasoconstriction Syndrome (RCVS).

Materials And Methods: RCVS is radiographically characterized by multifocal smooth narrowing of cerebral arteries heralded by clinical manifestations of recurrent thunderclap headaches. 70% of cases with RCVS have a clear precipitating factor and agents commonly implicated were cannabis, selective serotonin reuptake inhibitors, nasal decongestants, cocaine, postpartum state, eclampsia and strenuous physical/sexual activity.

Occult paroxysmal atrial fibrillation in non-cryptogenic ischemic stroke.

Objective: To determine the prevalence and risk factors for paroxysmal atrial fibrillation (PAF) diagnosis in non- cryptogenic ischemic stroke (CIS) patients.

Methods: In this pilot-prospective cohort study of non-CIS patients from September 2014 to September 2017, 53 patients were enrolled. 51/53 patients were implanted within 10 days of stroke onset with the Reveal LINQ insertable cardiac monitor and monitored until PAF detection or a minimum of 12 months.

Improving Regional Stroke Systems of Care.

Purpose Of Review: Acute ischemic stroke (AIS) care is rapidly evolving. This review discusses current diagnostic, therapeutic, and process models that can expedite stroke treatment to achieve best outcomes.

Recent Findings: Use of stent retrievers after selection via advanced imaging is safe and effective, and is an important option for AIS patients with large vessel occlusion (LVO).

Bilateral Vein of Trolard Thrombosis.

Isolated cortical vein thrombosis without dural sinus involvement is not common. The vein of Trolard is an important cortical vein as it drains eloquent cortex. We report 2 cases of bilateral vein of Trolard thrombosis; one with and the other without dural sinus involvement.

Catastrophic Intracranial Hemorrhages after IV tPA in a Patient with Insidious Onset of Fever and Back Pain.

Infective endocarditis is associated with unstable infective vegetations, which have a propensity to embolize and cause embolic events, such as stroke. Many cases present with an embolic event as the first sign of infective endocarditis. We present a patient who had a history of recent and persistent fever, an acute ischemic stroke treated with intravenous tissue plasminogen activator (IV tPA), and severe, multifocal intracerebral hemorrhage as a complication of tPA treatment.