Objective: To study acute cerebrovascular ischemia in young persons in our environment.
Patients And Methods: A retrospective study was made of 68 patients, aged between 15 and 45, with transient ischemic accidents (TIA) or cerebral infarcts. Etiological factors, clinical features, diagnostic groups according to the TOAST classification and prognosis were analyzed.
Results: In our series there was a ratio of 1.26 in favor of the women. TIAs made up 29.4% of the cases. The most commonly affected territory was that of the carotid artery. In persons over the age of 30 there was greater prevalence of this pathology and of the risk factors diabetes, arterial hypertension and dyslipaemia. There was a significant association with migraine in those aged under 30. The biggest diagnostic group was that of infarct of unknown origin (39.7%), probably because of the specificity of the classification. The functional condition on follow-up was good: only 4.4% of the patients had a score greater than 3 on the Rankin scale. There were no deaths either during the acute phase or subsequently. Recurrences were seen in 10.2% of the patients.
Conclusions: The results obtained in our series are similar to those published in the literature. In acute cerebrovascular ischaemia in young persons, full diagnostic investigations should be carried out in order to give suitable treatment.
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Int J Emerg Med
January 2025
Emergency Department, Shanghai United Family Hospital, 699 Pingtang Road, Changning District, Shanghai, 200335, China.
Background: Adenomyosis, typically associated with heavy menstrual bleeding and pelvic pain, is rarely linked to neurological complications. This case presents a rare instance of ischemic stroke in a young patient with adenomyosis and vascular abnormalities, underscoring the role of anemia, hypercoagulability, and vascular factors as potential contributors to cerebral infarction.
Case Presentation: We describe a 41-year-old female with a history of adenomyosis who presented with right-sided hemianopia and dizziness following severe menstrual bleeding.
J Neuroimaging
January 2025
Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA.
Background And Purpose: Prolonged venous transit (PVT), derived from computed tomography perfusion (CTP) time-to-maximum (T) maps, reflects compromised venous outflow (VO) in acute ischemic stroke due to large vessel occlusion (AIS-LVO). Poor VO is associated with worse clinical outcomes, but pre-treatment markers predictive of PVT are not well described.
Methods: We conducted a retrospective analysis of 189 patients with anterior circulation AIS-LVO who underwent baseline CT evaluation, including non-contrast CT, CT angiography, and CTP.
PLoS One
January 2025
Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.
Background: Aeromedical transfer of patients with ischemic stroke to access hyperacute stroke treatment is becoming increasingly common. Little is known about how rapid changes of altitude and atmospheric pressure can impact cerebral perfusion and ischemic burden. In patients with ischemic stroke, there is a theoretical possibility that this physiologic response of hypoxia-driven hyperventilation at higher altitude can lead to a relative drop in PaCO2.
View Article and Find Full Text PDFJ Clin Invest
January 2025
Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden.
Ischemic stroke is a major cause of adult disability. Early treatment with thrombolytics and/or thrombectomy can significantly improve outcomes; however, following these acute interventions, treatment is limited to rehabilitation therapies. Thus, the identification of therapeutic strategies that can help restore brain function in the post-acute phase remains a major challenge.
View Article and Find Full Text PDFEur J Trauma Emerg Surg
January 2025
Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Purpose: This study aims to identify predictors of discharge to post-acute care in geriatric emergency general surgery (EGS) patients.
Methods: This is a retrospective study of geriatric emergency general surgery (EGS) patients at a tertiary care facility between 2017 and 2018. Inclusion criteria were ≥ 65 years old and presented directly from home.
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