ABSTRACT
INTRODUCTION: Carotid webs are shelf-like projections of the carotid bulb lumen associated with ipsilateral ischemic stroke in young patients. Given its rarity, a limited number of studies have evaluated the optimal management of symptomatic carotid webs to prevent further ischemic stroke. CASE REPORT: A 40-year-old Caucasian man presented with a sudden onset of left-sided facial droop, hemiparesis, and dysarthria. Computed tomography angiography revealed occlusion of the distal M1 and proximal M2 segments of the right middle cerebral artery and a small intimal flap at the right internal carotid artery origin. Intravenous alteplase was administered without clinical improvement. The patient underwent successful mechanical thrombectomy with complete revascularization of the middle cerebral artery and no residual neurologic deficits. Magnetic resonance angiography confirmed a curvilinear, shelf-like projection from the right carotid bulb posterior wall, consistent with a carotid web. The patient underwent carotid endarterectomy with no complications and was discharged home with no residual deficits or recurrence of stroke. CONCLUSION: No randomized, controlled prospective studies have compared the efficacy of endarterectomy to carotid artery stenting in patients with symptomatic carotid web. This case emphasizes the importance of considering carotid web as an embolic source of stroke in the young and provides support for revascularization as a safe and effective mean of secondary stroke prevention.
Subject(s)
Carotid Stenosis , Ischemic Stroke , Stroke , Male , Humans , Adult , Ischemic Stroke/complications , Carotid Stenosis/surgery , Prospective Studies , Stents/adverse effects , Stroke/complications , Stroke/diagnostic imaging , Carotid Artery, Internal/surgery , Treatment OutcomeABSTRACT
OBJECTIVE: To identify the mediating role of self-confidence in family cohesion and depression in adolescents. METHODS: The cross-sectional study was conducted at five mainstream government boys and girls schools in Lahore, Pakistan, from March 1 to November 30, 2019, and comprised adolescents aged 12-19 years. Data was collected using Family Cohesion Scale, Self-confidence Scale and Depression Scale for Adolescents. Data was analysed using SPSS 25. RESULTS: Of the 394 subjects, 214(54%) were boys and 180(46%) were girls. The overall mean age was 14.76±1.39 years. A significant positive association between family cohesion and self-confidence (p<0.001), and a significant negative association of family cohesion (p<0.001) and self-confidence (p<0.01) with depression was found. Self-confidence partially mediated the relationship between family cohesion and depression (p < 0.05). CONCLUSIONS: Early and timely identification of risk factors can prevent serious consequences of depression in adolescents.
Subject(s)
Depression , Family Relations , Adolescent , Adult , Child , Cross-Sectional Studies , Depression/epidemiology , Female , Humans , Male , Pakistan/epidemiology , Self Concept , Young AdultABSTRACT
This research aims to determine the mediating role of social deficits in self-criticism and aggression using a sample of 695 adolescents (girls = 49%, boys = 51%), aged 12 to 19 years (M = 14.97, SD = 1.30) from an urbanized city of Pakistan. Interpersonal Difficulties Scale, Self-Criticism Scale, and Aggressive Behavior Scale were used in the present study. Results indicated a significant positive association of social deficits with self-criticism and aggression (p < .001). Furthermore, findings also suggested a significant positive association between self-criticism and aggression. Mediation analysis revealed that self-criticism partially mediated the relationship between social deficits and aggression. Findings are discussed in terms of the expression and manifestation of self-criticism, social deficits, and aggression in adolescents in collectivistic cultures.
