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ABSTRACT: The patient, a 32-year-old man, presented with sudden onset of occipital headache, vertigo, dysarthria, gait ataxia, right Horner syndrome, numbness of the right hand, and mild right hemiparesis. On magnetic resonance imaging, an acute small infarction was located on the right side of the caudal medulla extending dorsomedially. Magnetic resonance angiography showed severe right vertebral artery stenosis. Lateral medullary infarction associated with ipsilateral sensorimotor deficits in the limb is very rare, and the lesion probably involved the ipsilateral dorsal column or decussating lemniscal fibers and corticospinal fibers caudal to the pyramidal decussation or compression of the decussation.
Journal of stroke and cerebrovascular diseases: the official journal of National Stroke Association 12/2012;
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ABSTRACT: Surgical treatment for acute type A aortic dissection (AAD) complicated by cerebral malperfusion (CM) remains debatable. Worsening of neurologic symptoms and poor quality of life after immediate surgery continue to be cause for concern. We performed immediate aortic repair followed by early rehabilitation in 10 patients with AAD complicated by CM. The early and midterm neurologic statuses were satisfactory. The immediate aortic repair did not have a negative impact on early and midterm neurologic condition in patients with AAD complicated by CM.
The Annals of thoracic surgery 07/2011; 92(1):336-8. · 3.74 Impact Factor
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ABSTRACT: An 85-year-old woman presented with a dural arteriovenous fistula of the superior petrosal sinus manifesting as venous infarction of the cerebellum. Magnetic resonance imaging and angiography revealed right cerebellar swelling, venous engorgement, and an arteriovenous fistula in the superior petrosal sinus. Our initial attempt to obliterate the lesion through a transvenous endovascular approach failed, so we successfully treated the fistula via surgical interruption of the superior petrosal vein through a small suboccipital craniotomy. Careful examination of the pattern of venous drainage is important to determine surgical indications. This case indicates that minimally invasive open surgery can be effective even in an elderly patient.
Neurologia medico-chirurgica 10/2009; 49(10):465-7. · 0.61 Impact Factor