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Syncope Induced by Dynamic Head and Shoulder Motion in the Setting of Left Subclavian Stenosis.
Neurologist
January 2025
Department of Neurology.
Introduction: Dynamic vertebral artery insufficiency is a rare vascular phenomenon characterized by insufficient flow of the posterior cerebral circulation induced by dynamic motion of the head. Prior case reports have been limited to vertebral artery occlusion by cervical osteophytes or other structural impingements.
Case Report: In this case report, we discuss the unusual case of a 61-year-old female with a history of vertigo, diplopia, nystagmus, and left subclavian stenosis admitted to the hospital for syncope elicited by a left head turn and left shoulder raise.
Ipsilateral Hemiparesis in Lateral Medullary Syndrome: A Case Report on Opalski's Syndrome.
Cureus
December 2024
Neurology, Mahatma Gandhi Medical College and Hospital, Jaipur, Jaipur, IND.
Lateral medullary syndrome (LMS) is a neurological disorder usually presenting as loss of pain and thermal sensation over the ipsilateral face and contralateral half of the body, ipsilateral limb ataxia, Horner's syndrome, dysphagia, nystagmus, hiccups among other symptoms but never with limb weakness. In the present case, the patient presented with ipsilateral hemiparesis, which can be attributed to the extension of the infarct caudally beyond the pyramidal decussation, affecting the corticospinal fibers in the upper cervical cord, a variant of LMS, known as Opalski syndrome (OS).
View Article and Find Full Text PDFSafety and Outcomes of Intravenous Thrombolysis in Acute Ischemic Stroke with Intracranial Artery Dissection.
Int J Stroke
January 2025
Department of Health Security System, Center for Health Security, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
background: : Intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) related to underlying intracranial artery dissection (IAD) poses potential risks, including the exacerbation of intramural hematoma and the rupture of the dissected arterial wall. However, the safety of IVT in this specific population remains uncertain.
aims:: This study aimed to assess whether IAD is associated with an increased risk of intracranial hemorrhage (ICH) following IVT and to evaluate its impact on functional outcomes.
Intentional staged embolization via the "highway bypass" using a radial artery graft for a large posterior circulation aneurysm: illustrative case.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Kanto Rosai Hospital, Kanagawa, Japan.
Background: The presence of significant tortuosity in access routes to aneurysms can interfere with catheter guidance and manipulation and significantly impact treatment strategies.
Observations: In this report, the authors combined intentional staged aneurysm embolization with the construction of a new direct access route, which they call a "highway bypass," for a symptomatic posterior circulation cerebral aneurysm that was difficult to access with a catheter. Notably, the highway bypass is used for catheter passage, and technical tips should be considered.
Retrograde thrombosis of the superficial sylvian vein following liquid adhesive hemostat use during craniotomy: illustrative case.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, University of California, Irvine, Orange, California.
Background: Intravascular injection of liquid adhesive hemostats is a rare but serious complication that can result in cerebral thromboembolism.
Observations: A 64-year-old female underwent orbitozygomatic craniotomy for posterior communicating artery aneurysm clipping with the routine use of a flowable hemostatic agent during extradural dissection. After placement of the aneurysm clip, flow was confirmed through the parent vessel and nearby branches.
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