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Article ; Online: Cervico-shoulder dystonia following lateral medullary infarction: a case report and review of the literature.

Ogawa, Takashi / Shojima, Yuri / Kuroki, Takuma / Eguchi, Hiroto / Hattori, Nobutaka / Miwa, Hideto

2018 Volume 12, Issue 1, Page(s) 34

Abstract: Background: Secondary cervical dystonia is induced by organic brain lesions involving the basal ganglia, thalamus, cerebellum, and brain stem. It is extremely rare to see cervical dystonia induced by a medullary lesion.: Case presentation: We report ... ...

Abstract	Background: Secondary cervical dystonia is induced by organic brain lesions involving the basal ganglia, thalamus, cerebellum, and brain stem. It is extremely rare to see cervical dystonia induced by a medullary lesion. Case presentation: We report a case of an 86-year-old Japanese woman who developed cervical dystonia following lateral medullary infarction. She developed sudden-onset left upper and lower extremity weakness, right-side numbness, and dysarthria. Brain magnetic resonance imaging revealed an acute ischemic lesion involving the left lateral and dorsal medullae. A few days after her stroke, she complained of a taut sensation in her left neck and body, and cervico-shoulder dystonia toward the contralateral side subsequently appeared. Within a few weeks, it disappeared spontaneously, but her hemiplegia remained residual. Conclusions: To date, to the best of our knowledge, there has been only one reported case of cervical dystonia associated with a single medullary lesion. It is interesting to note the similarities in the clinical characteristics of the previously reported case and our patient: the involvement of the dorsal and caudal parts of the medullary and associated ipsilateral hemiplegia. The present case may support the speculation that the lateral and caudal regions of the medulla may be the anatomical sites responsible for inducing cervical dystonia.
MeSH term(s)	Aged, 80 and over ; Computed Tomography Angiography ; Dystonia/diagnostic imaging ; Dystonia/etiology ; Dystonia/physiopathology ; Female ; Hemiplegia/etiology ; Hemiplegia/therapy ; Humans ; Lateral Medullary Syndrome/complications ; Lateral Medullary Syndrome/diagnostic imaging ; Lateral Medullary Syndrome/physiopathology ; Shoulder Joint/diagnostic imaging ; Shoulder Joint/physiopathology ; Treatment Outcome
Language	English
Publishing date	2018-02-10
Publishing country	England
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2269805-X
ISSN	1752-1947 ; 1752-1947
ISSN (online)	1752-1947
ISSN	1752-1947
DOI	10.1186/s13256-018-1561-y
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Mucosal-Associated Invariant T Cells Are Involved in Acute Ischemic Stroke by Regulating Neuroinflammation.

Nakajima, Sho / Tanaka, Ryota / Yamashiro, Kazuo / Chiba, Asako / Noto, Daisuke / Inaba, Toshiki / Kurita, Naohide / Miyamoto, Nobukazu / Kuroki, Takuma / Shimura, Hideki / Ueno, Yuji / Urabe, Takao / Miyake, Sachiko / Hattori, Nobutaka

Journal of the American Heart Association

2021 Volume 10, Issue 7, Page(s) e018803

Abstract: Background Mucosal-associated invariant T (MAIT) cells have been associated with inflammation in several autoimmune diseases. However, their relation to ischemic stroke remains unclear. This study attempted to elucidate the role of MAIT cells in acute ... ...

Abstract	Background Mucosal-associated invariant T (MAIT) cells have been associated with inflammation in several autoimmune diseases. However, their relation to ischemic stroke remains unclear. This study attempted to elucidate the role of MAIT cells in acute ischemic stroke in mice. Methods and Results We used MR1 knockout C57BL/6 (MR1
MeSH term(s)	Acute Disease ; Animals ; Disease Models, Animal ; Immunity, Cellular ; Inflammation/immunology ; Ischemic Stroke/immunology ; Ischemic Stroke/metabolism ; Mice, Inbred C57BL ; Mice, Knockout ; Mucosal-Associated Invariant T Cells/immunology ; Mice
Language	English
Publishing date	2021-03-18
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.120.018803
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Article ; Online: Deep cerebral venous thrombosis mimicking influenza-associated acute necrotizing encephalopathy: a case report.

Taniguchi, Daisuke / Nakajima, Sho / Hayashida, Arisa / Kuroki, Takuma / Eguchi, Hiroto / Machida, Yutaka / Hattori, Nobutaka / Miwa, Hideto

Journal of medical case reports

2017 Volume 11, Issue 1, Page(s) 281

Abstract: Background: Acute necrotizing encephalopathy is one of the most devastating neurological complications of influenza virus infection. Acute necrotizing encephalopathy preferentially affects the thalamus bilaterally, as does deep cerebral venous ... ...

Abstract	Background: Acute necrotizing encephalopathy is one of the most devastating neurological complications of influenza virus infection. Acute necrotizing encephalopathy preferentially affects the thalamus bilaterally, as does deep cerebral venous thrombosis, which can lead to misdiagnosis. Case presentation: A 52-year-old Japanese woman infected with seasonal influenza B virus presented to the emergency care unit in our hospital with progressive alteration of her level of consciousness. Bilateral thalamic lesions were demonstrated by magnetic resonance imaging, leading to a tentative diagnosis of acute necrotizing encephalopathy. However, she had deep cerebral venous thrombosis, and the presence of diminished signal and enlargement of deep cerebral veins on T2-weighted imaging contributed to a revised diagnosis of deep cerebral venous thrombosis. Anticoagulant therapy was initiated, leading to her gradual recovery, with recanalization of the deep venous system and straight sinus. Conclusions:* To the best of our knowledge, these results represent the first report of deep cerebral venous thrombosis associated with influenza infection. It is clinically important to recognize that deep cerebral venous thrombosis, although rare, might be one of the neurological complications of influenza infection. In the presence of bilateral thalamic lesions in patients with influenza infection, deep cerebral venous thrombosis should be considered in addition to acute necrotizing encephalopathy. Delays in diagnosis and commencement of anticoagulant therapy can lead to unfavorable outcomes.
Language	English
Publishing date	2017-09-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2269805-X
ISSN	1752-1947 ; 1752-1947
ISSN (online)	1752-1947
ISSN	1752-1947
DOI	10.1186/s13256-017-1444-7
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Article ; Online: Vertebral artery dissection in patients with autosomal dominant polycystic kidney disease.

Kuroki, Takuma / Yamashiro, Kazuo / Tanaka, Ryota / Hirano, Kazuoki / Shimada, Yoshiaki / Hattori, Nobutaka

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

2014 Volume 23, Issue 10, Page(s) e441–e443

Abstract: Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited renal cystic disease, and it is associated with various extrarenal manifestations, including vascular complications, such as intracranial aneurysms, and aortic root ... ...

Abstract	Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited renal cystic disease, and it is associated with various extrarenal manifestations, including vascular complications, such as intracranial aneurysms, and aortic root dilatation and aneurysms. However, intracranial arterial dissection has rarely been reported. We herein report the cases of 2 patients with ADPKD who developed a vertebral artery (VA) dissection. Dissection was also observed on the other side of the VA and in the internal carotid artery in the first and second patient, respectively. Both patients also had a history of hypertension, which is frequently accompanied by ADPKD, and their serum creatinine levels were normal. Our report supports the importance of considering ADPKD as one of the possible pathogenic factors in arterial dissection.
MeSH term(s)	Adult ; Biomarkers/blood ; Carotid Artery, Internal, Dissection/diagnosis ; Carotid Artery, Internal, Dissection/etiology ; Cerebral Angiography/methods ; Creatinine/blood ; Humans ; Hypertension/complications ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Polycystic Kidney, Autosomal Dominant/blood ; Polycystic Kidney, Autosomal Dominant/complications ; Polycystic Kidney, Autosomal Dominant/diagnosis ; Risk Factors ; Tomography, X-Ray Computed ; Vertebral Artery Dissection/diagnosis ; Vertebral Artery Dissection/etiology
Chemical Substances	Biomarkers ; Creatinine (AYI8EX34EU)
Language	English
Publishing date	2014-09-26
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1131675-5
ISSN	1532-8511 ; 1052-3057
ISSN (online)	1532-8511
ISSN	1052-3057
DOI	10.1016/j.jstrokecerebrovasdis.2014.05.028
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Article ; Online: Metabolic endotoxemia promotes neuroinflammation after focal cerebral ischemia.

Kurita, Naohide / Yamashiro, Kazuo / Kuroki, Takuma / Tanaka, Ryota / Urabe, Takao / Ueno, Yuji / Miyamoto, Nobukazu / Takanashi, Masashi / Shimura, Hideki / Inaba, Toshiki / Yamashiro, Yuichiro / Nomoto, Koji / Matsumoto, Satoshi / Takahashi, Takuya / Tsuji, Hirokazu / Asahara, Takashi / Hattori, Nobutaka

Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism

2020 Volume 40, Issue 12, Page(s) 2505–2520

Abstract: Lipopolysaccharide (LPS) is a major component of the outer membrane of Gram-negative bacteria and a potent inflammatory stimulus for the innate immune response via toll-like receptor (TLR) 4 activation. Type 2 diabetes is associated with changes in gut ... ...

Abstract	Lipopolysaccharide (LPS) is a major component of the outer membrane of Gram-negative bacteria and a potent inflammatory stimulus for the innate immune response via toll-like receptor (TLR) 4 activation. Type 2 diabetes is associated with changes in gut microbiota and impaired intestinal barrier functions, leading to translocation of microbiota-derived LPS into the circulatory system, a condition referred to as metabolic endotoxemia. We investigated the effects of metabolic endotoxemia after experimental stroke with transient middle cerebral artery occlusion (MCAO) in a murine model of type 2 diabetes (
MeSH term(s)	Administration, Oral ; Animals ; Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/therapeutic use ; Brain Ischemia/metabolism ; Brain Ischemia/pathology ; Case-Control Studies ; Cytokines/metabolism ; Diabetes Mellitus, Type 2/complications ; Endotoxemia/drug therapy ; Endotoxemia/metabolism ; Endotoxemia/physiopathology ; Gastrointestinal Microbiome/drug effects ; Gastrointestinal Microbiome/physiology ; Gram-Negative Bacteria/metabolism ; Immunity, Innate/drug effects ; Infarction, Middle Cerebral Artery/complications ; Infarction, Middle Cerebral Artery/pathology ; Infarction, Middle Cerebral Artery/veterinary ; Lipopolysaccharides/blood ; Lipopolysaccharides/metabolism ; Lipopolysaccharides/pharmacology ; Male ; Mice ; Models, Animal ; Neurogenic Inflammation/drug therapy ; Neurogenic Inflammation/metabolism ; Neurogenic Inflammation/physiopathology ; Polymyxin B/administration & dosage ; Polymyxin B/therapeutic use ; Stroke/metabolism ; Survival Rate ; Toll-Like Receptor 4/drug effects ; Toll-Like Receptor 4/metabolism
Chemical Substances	Anti-Bacterial Agents ; Cytokines ; Lipopolysaccharides ; TLR4 protein, human ; Toll-Like Receptor 4 ; Polymyxin B (J2VZ07J96K)
Language	English
Publishing date	2020-01-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	604628-9
ISSN	1559-7016 ; 0271-678X
ISSN (online)	1559-7016
ISSN	0271-678X
DOI	10.1177/0271678X19899577
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Zs.A 1663: Show issues

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Article ; Online: Exendin-4 Inhibits Matrix Metalloproteinase-9 Activation and Reduces Infarct Growth After Focal Cerebral Ischemia in Hyperglycemic Mice.

Kuroki, Takuma / Tanaka, Ryota / Shimada, Yoshiaki / Yamashiro, Kazuo / Ueno, Yuji / Shimura, Hideki / Urabe, Takao / Hattori, Nobutaka

Stroke

2016 Volume 47, Issue 5, Page(s) 1328–1335

Abstract: Background and purpose: Admission hyperglycemia is an independent risk factor for poor outcome of ischemic stroke. Amelioration of hyperglycemia by insulin has not been shown to improve the poststroke outcome. Glucagon-like peptide 1 receptor agonists, ... ...

Abstract	Background and purpose: Admission hyperglycemia is an independent risk factor for poor outcome of ischemic stroke. Amelioration of hyperglycemia by insulin has not been shown to improve the poststroke outcome. Glucagon-like peptide 1 receptor agonists, which modulate glucose levels by stimulating insulin secretion, have been shown to exert cytoprotective effects by inhibiting inflammation and oxidative stress. This study aimed to evaluate whether the glucagon-like peptide 1 receptor agonist exendin-4 could reduce glucose levels and exert protective effects after acute focal ischemia in hyperglycemic mice. Methods: Hyperglycemia was induced by intraperitoneal injection of dextrose 15 minutes before transient middle cerebral artery occlusion was performed for 60 minutes using an intraluminal thread. We assessed 4 groups: (1) normal glucose (vehicle control), (2) induced hyperglycemia, (3) induced hyperglycemia with insulin treatment, and (4) induced hyperglycemia with exendin-4 treatment. Neurovascular injuries in brains from each group were evaluated 24 hours and 7 days post ischemia. Results: Hyperglycemia significantly increased infarct volume (36.3±1.20 versus 26.9±1.28; P<0.001), brain edema (P<0.05), and hemorrhagic transformation compared with control (P<0.001). This increase in infarct volume was associated with increased blood-brain barrier disruption and matrix metalloproteinase-9 activation. Exendin-4, but not insulin, attenuated matrix metalloproteinase-9 activation, proinflammatory cytokine (tumor necrosis factor-α) release, and biomarkers of oxidative stress and showed significant inhibition of infarct growth at 24 hours (23.6±0.97 versus 36.3±1.20; P<0.001) and at 7 days after ischemia (21.0±0.92 versus 29.3±1.41; P<0.001). Conclusions: Treatment with exendin-4 could be a potentially useful therapeutic option for treatment of acute ischemic stroke with transient hyperglycemia.
MeSH term(s)	Animals ; Blood-Brain Barrier/drug effects ; Brain Ischemia/drug therapy ; Brain Ischemia/pathology ; Disease Models, Animal ; Hyperglycemia/drug therapy ; Hypoglycemic Agents/administration & dosage ; Hypoglycemic Agents/pharmacology ; Infarction, Middle Cerebral Artery/drug therapy ; Infarction, Middle Cerebral Artery/pathology ; Male ; Matrix Metalloproteinase 9/drug effects ; Mice, Inbred C57BL ; Peptides/administration & dosage ; Peptides/pharmacology ; Venoms/administration & dosage ; Venoms/pharmacology
Chemical Substances	Hypoglycemic Agents ; Peptides ; Venoms ; exenatide (9P1872D4OL) ; Matrix Metalloproteinase 9 (EC 3.4.24.35)
Language	English
Publishing date	2016-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.116.012934
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Zs.A 448: Show issues

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Article ; Online: Emerging Risk Factors for Recurrent Vascular Events in Patients With Embolic Stroke of Undetermined Source.

Ueno, Yuji / Yamashiro, Kazuo / Tanaka, Ryota / Kuroki, Takuma / Hira, Kenichiro / Kurita, Naohide / Urabe, Takao / Hattori, Nobutaka

Stroke

2016 Volume 47, Issue 11, Page(s) 2714–2721

Abstract: Background and purpose: Underlying embolic causes diagnosed by transesophageal echocardiography could be implicated in mechanisms of embolic stroke of undetermined source. We aimed to explore factors, including underlying embolic causes, related to ... ...

Abstract	Background and purpose: Underlying embolic causes diagnosed by transesophageal echocardiography could be implicated in mechanisms of embolic stroke of undetermined source. We aimed to explore factors, including underlying embolic causes, related to recurrent vascular events in embolic stroke of undetermined source. Methods: Patients who fulfilled the diagnostic criteria for embolic stroke of undetermined source and whose potential embolic sources were examined by transesophageal echocardiography were included. Recurrent vascular events, including ischemic stroke, cardiovascular and peripheral artery diseases, and vascular death, were retrospectively analyzed. Cox proportional hazards regression analysis was used to explore factors, including clinical characteristics, embolic causes on transesophageal echocardiography, and the Calcification in the Aortic Arch, Age, Multiple Infarction score (CAM), based on the degree of aortic arch calcification on chest radiograph (0-3 points), age (≥70 years; 1 point), and multiple infarctions on magnetic resonance imaging (multiple infarcts in 1, 2, or ≥3 territories of large intracranial arteries, 1, 2, or 3 points) associated with recurrent vascular events. Results: A total of 177 patients (age, 64.1±14.2 years; 127 men) were enrolled. Thirty-one patients had recurrent vascular events (follow-up, 3.5±2.7 years; annualized rate, 5.0% per person-year). Among embolic causes on transesophageal echocardiography, incidence of recurrent vascular events was high in patients with large aortic arch plaques (7.5% per person-year). Diabetes mellitus (hazard ratio, 2.56; 95% confidence interval, 1.23-5.32; P=0.012) and CAM score grade (hazard ratio, 2.29; 95% confidence interval, 1.11-4.72; P=0.026) predicted recurrent vascular events. Conclusions: History of diabetes mellitus and the CAM score could be novel risk factors for recurrent vascular events in embolic stroke of undetermined source.
MeSH term(s)	Aged ; Aged, 80 and over ; Aortic Diseases/epidemiology ; Brain Ischemia/epidemiology ; Diabetes Mellitus/epidemiology ; Echocardiography, Transesophageal ; Embolism/complications ; Embolism/epidemiology ; Female ; Humans ; Japan/epidemiology ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Stroke/epidemiology ; Stroke/etiology ; Vascular Diseases/epidemiology ; Vascular Diseases/etiology
Language	English
Publishing date	2016-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.116.013878
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Zs.A 448: Show issues

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Article ; Online: Impact of BNP on cryptogenic stroke without potential embolic sources on transesophageal echocardiography.

Ueno, Yuji / Tanaka, Ryota / Yamashiro, Kazuo / Shimada, Yoshiaki / Kuroki, Takuma / Hira, Kenichiro / Urabe, Takao / Hattori, Nobutaka

Journal of the neurological sciences

2015 Volume 359, Issue 1-2, Page(s) 287–292

Abstract: Background: Clinical characteristics are important for determining the etiologies of embolic stroke, including patent foramen ovale and complex aortic plaques demonstrated on transesophageal echocardiography (TEE). This study sought to analyze the ... ...

Abstract	Background: Clinical characteristics are important for determining the etiologies of embolic stroke, including patent foramen ovale and complex aortic plaques demonstrated on transesophageal echocardiography (TEE). This study sought to analyze the clinical signs of cryptogenic stroke (CS) without such embolic etiologies and to examine the association between CS and brain natriuretic peptide (BNP), which is currently unknown. Methods: Patients with CS after routine examinations who underwent TEE were included in this single-center observational study. Patients were classified into the potential embolic sources (PES) group (patients having PES on TEE) and the no potential embolic source (NPES) group. Patients were also categorized according to the tertile of BNP. Results: A total of 158 patients (age, 64.0 ± 13.9 years; 119 males) with CS were enrolled. The PES group had 108 (68%) patients, and the NPES group had 50 (32%). Hypertension was more common, and glucose, D-dimer, and BNP were higher in the NPES than in the PES group (p<0.05). NPES was independently associated with high-BNP tertile (OR: 5.61; 95% CI: 1.91 to 16.44; p=0.002). Conclusions: BNP, an indicator of cardioembolism, was closely associated with NPES. Cardiogenic mechanisms may be implicated in the etiology of CS without potential embolic etiologies on TEE.
MeSH term(s)	Aged ; Echocardiography, Transesophageal ; Embolism/etiology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Natriuretic Peptide, Brain/blood ; Risk Factors ; Statistics, Nonparametric ; Stroke/blood ; Stroke/diagnostic imaging
Chemical Substances	Natriuretic Peptide, Brain (114471-18-0)
Language	English
Publishing date	2015-12-15
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80160-4
ISSN	1878-5883 ; 0022-510X ; 0374-8642
ISSN (online)	1878-5883
ISSN	0022-510X ; 0374-8642
DOI	10.1016/j.jns.2015.11.014
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Zs.A 308: Show issues

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Article ; Online: Analysis of the Usefulness of the WORSEN Score for Predicting the Deterioration of Acute Ischemic Stroke.

Miyamoto, Nobukazu / Tanaka, Ryota / Ueno, Yuji / Watanabe, Masao / Kurita, Naohide / Hira, Kenichiro / Shimada, Yoshiaki / Kuroki, Takuma / Yamashiro, Kazuo / Urabe, Takao / Hattori, Nobutaka

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

2017 Volume 26, Issue 12, Page(s) 2834–2839

Abstract: Background: Early neurological worsening is associated with increased mortality and long-term functional disability. We developed the WORSEN score for predicting whether patients with stroke will deteriorate during the week after stroke onset and ... ...

Abstract	Background: Early neurological worsening is associated with increased mortality and long-term functional disability. We developed the WORSEN score for predicting whether patients with stroke will deteriorate during the week after stroke onset and investigated its usefulness. Patients and methods: We retrospectively investigated the cases of 478 patients who were admitted to Juntendo University Hospital between April 2007 and March 2009. Neurological deterioration was defined as a worsening of 4 points or higher on the National Institute of Health Stroke Scale score within 1 week of admission. Based on a previous study, we developed the WORSEN score, which was derived from the following factors: wrong (poor) blood sugar control (W), old myocardial infarction (O), radiological findings (R), infarct size (S), elevated low-density lipoprotein cholesterol (E), and neurological findings (N). Next, we investigated the utility of this scoring system in 456 other patients who were admitted to Juntendo University Hospital and Juntendo Urayasu Hospital between October 2013 and December 2014. Results: First, we checked the utility of the WORSEN score for detecting worsening in cases of stroke. In the first patient group, deterioration was noted in 32.5% of the patients with scores higher than 3 points (sensitivity: .704 and specificity: .744). For checking reproductivity on using the second group, deterioration was detected in 36.1% of the patients with WORSEN scores higher than 3 points (sensitivity: .740 and specificity: .835). Conclusions: Careful attention should be paid to patients with acute stroke with high WORSEN scores. The WORSEN score might become a valuable tool for detecting the neurological deterioration of ischemic stroke.
MeSH term(s)	Aged ; Aged, 80 and over ; Biomarkers/blood ; Blood Glucose/metabolism ; Brain Ischemia/blood ; Brain Ischemia/diagnosis ; Brain Ischemia/physiopathology ; Cholesterol, LDL/blood ; Decision Support Techniques ; Disability Evaluation ; Disease Progression ; Female ; Hospitals, University ; Humans ; Japan ; Male ; Middle Aged ; Myocardial Infarction/diagnosis ; Nerve Degeneration ; Predictive Value of Tests ; Prognosis ; Reproducibility of Results ; Retrospective Studies ; Risk Factors ; Stroke/blood ; Stroke/diagnosis ; Stroke/physiopathology ; Time Factors
Chemical Substances	Biomarkers ; Blood Glucose ; Cholesterol, LDL
Language	English
Publishing date	2017-08-04
Publishing country	United States
Document type	Evaluation Studies ; Journal Article
ZDB-ID	1131675-5
ISSN	1532-8511 ; 1052-3057
ISSN (online)	1532-8511
ISSN	1052-3057
DOI	10.1016/j.jstrokecerebrovasdis.2017.07.005
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Article ; Online: Recurrent embolic strokes associated with vertical atlantoaxial subluxation in a patient with rheumatoid arthritis: a case report and review of literature.

Kuroki, Takuma / Ueno, Yuji / Takeda, Ikuko / Kambe, Taiki / Nishioka, Kenya / Shimura, Hideki / Itoh, Masanori / Hattori, Nobutaka / Urabe, Takao

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

2013 Volume 22, Issue 8, Page(s) e676–81

Abstract: We report a 78-year-old woman with rheumatoid arthritis who developed recurrent embolic cerebellar strokes associated with vertical atlantoaxial subluxation (AAS). On contrast angiography, the bilateral vertebral arteries (VAs) were occluded between the ... ...

Abstract	We report a 78-year-old woman with rheumatoid arthritis who developed recurrent embolic cerebellar strokes associated with vertical atlantoaxial subluxation (AAS). On contrast angiography, the bilateral vertebral arteries (VAs) were occluded between the C1 and C2 levels, and the distal parts of bilateral VA were supplied by the collateral circulations. Dynamic cerebral angiography and carotid duplex ultrasonography showed that blood flow was substantially decreased in the left VA and left posterior inferior cerebellar artery on cervical anteflexion. It is suggested that vertical AAS reduced the blood flow of collateral circulation in the left VA with cervical anteflexion and might be a cause of recurrent ischemic stroke.
MeSH term(s)	Aged ; Arthritis, Rheumatoid/complications ; Arthritis, Rheumatoid/diagnosis ; Atlanto-Axial Joint ; Carotid Arteries/diagnostic imaging ; Carotid Arteries/physiopathology ; Cerebral Angiography/methods ; Cerebrovascular Circulation ; Collateral Circulation ; Diffusion Magnetic Resonance Imaging ; Female ; Head Movements ; Hemodynamics ; Humans ; Intracranial Embolism/diagnosis ; Intracranial Embolism/etiology ; Intracranial Embolism/physiopathology ; Joint Dislocations/diagnosis ; Joint Dislocations/etiology ; Magnetic Resonance Angiography ; Recurrence ; Stroke/diagnosis ; Stroke/etiology ; Stroke/physiopathology ; Tomography, X-Ray Computed ; Ultrasonography, Doppler, Duplex ; Vertebrobasilar Insufficiency/complications ; Vertebrobasilar Insufficiency/physiopathology
Language	English
Publishing date	2013-11
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	1131675-5
ISSN	1532-8511 ; 1052-3057
ISSN (online)	1532-8511
ISSN	1052-3057
DOI	10.1016/j.jstrokecerebrovasdis.2013.07.010
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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

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Full text online

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Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito