Femoral Neuropathy Following Transfemoral Neuroendovascular Procedures. An Analysis of a Prospective Registry.

Background And Purpose: Although femoral neuropathy is recognized as an adverse consequence following transfemoral neuroendovascular procedures, no reliable estimates are available. We analyzed data from a prospective registry to ascertain the frequency and characteristics of femoral neuropathy following transfemoral neuroendovascular procedures.

Methods: Consecutive patients who underwent neuroendovascular procedures through the transfemoral route were included.

Migraine and Non-Migraine Headaches Following Diagnostic Catheter-Based Cerebral Angiography.

Background And Objective: No reliable estimates of headaches following catheter-based cerebral angiography are available. We performed an observational cohort study to ascertain the frequency and type of headaches following catheter-based cerebral angiography.

Materials And Methods: Consecutive patients who underwent cerebral angiography through the transfemoral (or infrequently radial) route were included.

Effect of epidural blood injection on upright posture intolerance in patients with headaches due to intracranial hypotension: A prospective study.

Background: We performed a prospective study to quantify changes in various aspects of upright posture intolerance in patients with intracranial hypotension.

Methods: Six patients were provided a standard questionnaire before, immediately after epidural blood patch injection and at follow-up visit within 1 month after epidural blood injection inquiring: (a) How long can they stand straight without any support? (b) Do they feel any sense of sickness when they sit or lie down after standing? (c) How long do they have to wait before they are comfortable standing again after they have stood straight? (d) How effectively and fast can they get up from sitting or lying position to stand straight? and (e) Rate their activities in upright posture without support on a standard vertical visual analogue scale between 100 (can do everything) and 0 (cannot do anything).

Results: All patients responded that they could not stand straight for ≥30 min (four responding <5 min) on pretreatment evaluation.

Chest Pain as a Manifestation of Intracranial Hypotension: Report of Four Cases.

Background: Chest pain has not been recognized as a manifestation of intracranial hypotension secondary to cerebrospinal fluid leakage.

Case Report: We report on 4 patients with intracranial hypotension diagnosed by the pattern of headaches, temporal proximity to dural puncture, magnetic resonance imaging findings, and resolution of symptoms after epidural blood patch who presented with chest pain. The chest pain was episodic, located in the sternal and interscapular region for the first 3 patients, with no radiation to any other region and no clear relationship to exertion.

Intra-arterial Modulation of the Trigeminal Nerve Ganglion in Patients with Refractory Trigeminal Neuralgia.

Background And Purpose: Nerves and nerve ganglions are supplied by segmental arteries and the vasa nervorum, but the intra-arterial route has not been used for diagnostic or therapeutic purposes. We present the results of intra-arterial delivery of medication for modulating trigeminal nerve ganglion function in patients with refractory trigeminal neuralgia.

Methods: We administered intra-arterial lidocaine in doses up to 50 mg in the middle meningeal artery territory adjacent to the arterial branch that supplies the trigeminal nerve ganglion.

Imaging of the Vasa Nervorum Using Contrast-Enhanced Ultrasound.

Introduction: We describe the use of intravenous contrast-enhanced ultrasonography to study vasa nervorum using contrast-enhanced ultrasound.

Methods: We imaged the median, femoral, or sciatic nerves in 4 patients in longitudinal plane using high-resolution ultrasound after intravenous bolus of activated Perflutren lipid microspheres. The images were acquired as photopic images (in brown color) in real time using 2-dimensional B-Flow mode scan within a selected region of interest.

Structural myocardial involvement in adult patients with type 1 myotonic dystrophy.

Myotonic dystrophy type 1 (DM1) is the commonest muscular dystrophy in adults, affecting multiple organs in addition to skeletal muscles. Cardiac conduction system abnormalities are well recognized as an important component of DM1 phenotype; however, primary structural myocardial abnormalities, which may predispose these patients to congestive heart failure, are not as well characterized. We reviewed the retrospective analysis of the clinical and echocardiographic findings in adult patients with DM1.

Type A aortic dissection presenting as superior vena cava syndrome.

A 51-year-old man presented with a 5-day history of progressive facial swelling, sensation of head fullness, increasing shortness of breath and paroxysmal nocturnal dyspnea. He denied chest pain, syncope or presyncope. Past medical history included mechanical aortic valve replacement 7 years prior and atrial fibrillation treated with warfarin.

The restless legs syndrome: diagnosis and treatment.

Restless leg syndrome (RLS) is a common neurological disorder which can be accompanied with PLMS and can result in sleep disturbance. Greater understanding of pathophysiology of RLS in recent years has led to increased treatment options for this condition. A comprehensive clinical evaluation and appropriate management using combined nonpharmacologic and pharmacologic strategies can result in significant improvement in treatment outcomes in patients with RLS.

Risk factors, hospital management and outcomes after acute myocardial infarction in South Asian Canadians and matched control subjects.

Background: Coronary artery disease affects a significantly larger proportion of Canadians of South Asian origin than Canadians of other ethnic origins. We compared differences in presentation, risk factors and management of myocardial infarction (MI) between South Asian Canadians and matched control subjects.

Methods: We reviewed the charts of 553 South Asian patients and 553 non-South Asian matched control subjects presenting with acute MI (International Classification of Diseases code 410) to 2 hospitals in Canada from January 1994 to April 1999.