ABSTRACT
We report the rare presentation of lacunar stroke syndrome secondary to single perforator mouth occlusion from radiation-induced middle cerebral artery (MCA) stem arteriopathy. A 30-year-old female had acute-onset right-sided ataxic hemiparesis and dysarthria. As a child, she had a medulloblastoma of the posterior fossa and had surgery followed by cranial radiotherapy. She had no significant vascular risk factors. Acute CT showed extensive bilateral basal ganglia and left thalamic calcification; DWI showed a left internal capsule lacunar infarct; and MRA and CTA showed a 50% stenosis of the proximal left MCA.
Subject(s)
Brain Infarction/etiology , Infarction, Middle Cerebral Artery/etiology , Middle Cerebral Artery/radiation effects , Radiotherapy/adverse effects , Adult , Basal Ganglia/pathology , Basal Ganglia/radiation effects , Brain Infarction/pathology , Brain Infarction/physiopathology , Calcinosis/etiology , Calcinosis/pathology , Calcinosis/physiopathology , Diffusion Magnetic Resonance Imaging , Female , Humans , Infarction, Middle Cerebral Artery/pathology , Infarction, Middle Cerebral Artery/physiopathology , Internal Capsule/blood supply , Internal Capsule/pathology , Internal Capsule/physiopathology , Medulloblastoma/radiotherapy , Middle Cerebral Artery/pathology , Middle Cerebral Artery/physiopathology , Thalamus/pathology , Thalamus/radiation effects , Tomography, X-Ray ComputedABSTRACT
We compared the effects of single doses of thioridazine and mesoridazine on the heart rate-corrected QT (QTc) interval in healthy adult volunteers. QTc intervals and plasma concentrations of thioridazine, mesoridazine, and metabolites were measured after single oral doses of thioridazine hydrochloride 50 mg, mesoridazine besylate 50 mg, or placebo in a double-blind, crossover study. Mean maximum increases in the QTc interval following thioridazine (37.3+/-4.1 ms, P=0.023) and mesoridazine (46.6+/-7.4 ms, P=0.021) were similar and significantly greater than following placebo (12.9+/-8.1 ms). The area under the effect-time curve over 8 h following drug administration was similar between the two drugs (129.3+/-22.1 vs 148.3+/-43.0 ms h). In conclusion, thioridazine and mesoridazine are associated with similar effects on the QTc interval.
