Acute recurrent cerebral infarction caused by moyamoya disease complicated with adenomyosis: A case report.

BACKGROUND: Moyamoya disease is essentially an ischemic cerebrovascular disease. Here, we describe a case of acute recurrent cerebral infarction caused by moyamoya disease with concurrent adenomyosis which, to our knowledge, is the first in the literature. A literature review is also presented. CASE SUMMARY: A 38-year-old female presented to the Research and Treatment Center of Moyamoya Disease in our hospital with "left limb weakness" as the main symptom. She was diagnosed with acute cerebral infarction and moyamoya disease through magnetic resonance imaging and digital subtraction angiography. Prior to this, she had experienced a prolonged menstrual period of one-month duration. This was investigated and adenomyosis was diagnosed. After passing the acute cerebral infarction phase, the patient underwent surgery for adenomyosis followed by combined cerebral revascularization. During the postoperative follow-up, improvements of the perfusion imaging stage and modified Rankin Scale were observed. A review of the literature showed only 16 reported cases of gynecological diseases complicated with stroke. The clinical characteristics, pathogenesis, therapeutic effects, and long-term prognosis of these cases have been studied and discussed. CONCLUSION: In patients with moyamoya disease, early management of gynecological-related bleeding disorders is essential to prevent the complications of cerebral events.

Association of aspirin resistance with 4-hydroxynonenal and its impact on recurrent cerebral infarction in patients with acute cerebral infarction.

OBJECTIVES: To investigate the association of aspirin resistance (AR) with the plasma 4-hydroxynonenal (4-HNE) level and its impact on recurrent cerebral infarction (CI) in patients with acute cerebral infarction (ACI) who were receiving aspirin therapy. METHODS: One hundred and fifty-four ACI patients who previously received aspirin therapy (100 mg/day) were enrolled. Whole urine (for measuring 11dhTXB2 and creatinine) along with blood (for measuring the plasma 4-HNE level) were collected at least 7 days after the patients received aspirin. A cutoff of 1500 pg/mg of 11dhTXB2/ creatinine was used to determine AR. A follow-up period to monitor recurrence CI events was 1 year. In addition, blood testing was performed when the patients were first admitted to hospital. RESULTS: Forty-six of the 154 enrolled patients (29.9%) were found to be AR. No statistical difference in age, sex, hypertension, diabetes mellitus, coronary disease, smoking status, NIHSS score, TOAST classification, platelet count, thrombocytocrit, LDL-C, HDL-C, TG, and TC was found between the AR and aspirin-sensitive (AS) patients, but the plasma 4-HNE level was found to be higher in the AR patients than AS patients (p < .05). Multiple logistic regression analysis showed that the 4-HNE level was associated with a higher risk of AR (OR = 1.034; 95% CI = 1.011-1.058; p < .05). Moreover, 1-year follow-up showed that AR was more prevalent in patients with recurrent CI (26 (56.6%)) than those without (20/(43.5%)) (p < .001). CONCLUSIONS: The plasma 4-HNE level is strongly associated with AR and thus may be a factor contributing to AR. Patients with AR have a greater risk of recurrence CI.

Associations of blood pressure variability and internal diameter of left atrium with recurrent cerebral infarction / 中国现代医生

Objective To investigate the associations of blood pressure variability(BPV) and internal diameter of left atrium with primary hypertension accompanied with recurrent cerebral infarction(CI). Methods Patient with primary hypertension accompanied with recurrent CIin the first affiliated hospital of the medical college, Shihezi university from October 2016 to October 2017 were collected. Patients were divided into group A (first attack group, 78 patients) and group B(recurrence group, 71 patients) according to whether the CIattacked for the first time. Statistical tests were performed to test the average values of blood pressure of 24 h, daytime and nighttime and BPV. Setting BPVand LADIas independent variables, logistic regression analysis was used to analyze the influential factors of the CIrecurrence. Results SBPof 24 h and daytime as well as DBPof 24 h, daytime and nighttime in group Bwere statistically higher than those in group A (P＜0. 05). SBPVof 24 h, SBPVof daytime, DBPVof 24 h and LADIin group Bwere statistically higher than those in group A(P＜0. 05). The results of Logistic regression analysis showed BMI, LADI, DBPVof 24 h, SBPVof daytime and DBPVof daytime were the risk factors of the recurrence of CI. Conclusion Increase in average blood pressure was associated with the recurrence of CI, BMI, LADI, DBPVof 24 h, SBPVof daytime and DBPVof daytime were the risk factors of the recurrence of CI.

Factores de riesgo asociados en recurrencias de un infarto cerebral en pacientes del Hospital Carlos Andrade Marín / Risk factors associated to recurring cerebral infarction in Carlos Andrade Marin Hospital patients

Introducción: al paciente que ha sufrido un infarto cerebral no solo le preocupan las secuelas de este, tanto a él, sus familiares como a su médico le preocupa la posibilidad de que dicha enfermedad se repita. La relación entre algunos factores de riesgo y recurrencia de infarto cerebral no es completamente clara. El objetivo de este trabajo es establecer la tasa de recurrencia de un infarto cerebral durante el primer año posterior al primer evento isquémico en los pacientes hospitalizados en el servicio de Neurología del Hospital Carlos Andrade Marín, la tasa de mortalidad y los factores de riesgo relacionados con estas. Materiales y métodos: se realizó un estudio observacional, donde se analizaron los expedientes clínicos electrónicos (Sistema Informático AS 400) de 80 pacientes que sufrieron un Infarto Cerebral comprobado por estudios de imagen entre los meses de enero a diciembre del año 2011 y que fueron evaluados posteriormente durante 1 año en forma periódica en la consulta externa. Todos los pacientes estaban recibiendo medicación para prevención de un segundo infarto. Resultados: en la muestra se observó que 9 pacientes (11%) tuvieron recurrencia y de estos 4 fallecieron. Los pacientes que fallecieron tuvieron todos como etiología de su primer infarto cerebral al cardioembolismo por Fibrilación Auricular. Conclusión: la recurrencia tiene una relación directa con la edad de los pacientes y con la presencia de hipertensión arterial como factor de riesgo.

Introduction: patients who have suffered a Cerebral Infarction (stroke) are not only concerned about the consequences of it; the patient, family and doctors are concerned about the possibility that the disease will recur. The correlation between risk factors and recurrence of cerebral infarction is not entirely clear. The objective of this work is to establish the rate of recurrence of cerebral infarction during the first year after the first ischemic event in patients hospitalized in the Neurology Ward of the Carlos Andrade Marín Hospital, the mortality rate and risk factors related to it. Materials and methods: an observational study was performed, where electronic medical records (Information System AS 400) of 80 patients who suffered a Cerebral infarction, verified by imaging studies between january and december 2011 and who were subsequently periodically evaluated within 1 year, were analyzed. All patients were receiving medication for stroke prevention. Results: the study showed that 9 patients (11%) had recurrence and among these 4 died. All patients who died had Atrial Fibrillation Cardio Embolism as a cause of their first cerebral infarction. Conclusion: recurrence is directly related to patient age and the presence of hypertension as a risk factor.

A Case of Recurrent Cerebral Infarction due to Carotid Compression by a Neurogenic Tumor in the Neck / 대한뇌졸중학회지

A 62-year-old man with a neurogenic tumor in the neck was admitted to our hospital for recurrent ischemic stroke due to carotid occlusion. The magnetic resonance (MR) angiograms revealed the occlusion of the right internal carotid artery (ICA). Arterial compression by the tumor could be considered as the cause of ICA occlusion. Since neurogenic tumors of the neck have significant surgical risks, the patient underwent extracranial-intracranial arterial bypass (EC-IC bypass) surgery. We report a case with recurrent ischemic stroke due to carotid compression by a neurogenic tumor of the neck.

Neuro-Behcet Disease with Recurrent Cerebral Infarction: A case report

Behcet disease defined as multisystemic vasculitis of unknown origin in which musculoskeletal, cardiovascular, gastrointestinal, pulmonary and/or central nervous system were involved. Neurological involvement is one of the most devastating manifestation of Behcet disease. We experienced a patient who was a 42-year-old female, admitted for right hemiplegia and dysarthria with high fever and she had been diagnosed as tuberculous meningitis at first. The physical examination revealed recurrent oral and genital ulcerated lesion. The brain MRI showed multifocal infarctions in medulla, pons, midbrain, both posterior limb of internal capsule and left periventricular white matter. After 6 months, she was aggravated right hemiplegia with erythematous skin lesion. The follow-up brain MRI showed the inactivated non-enhanced multifocal lesions compared with previous findings. So we confirmed neuro-Betchet disease and started immunosuppressive therapy with steroid, but despite of intensive care she was bedridden state at discharge and expired with septic pneumonia 8 months later. We report the neuro-Behcet disease with recurrent cerebral infarction showing poor prognosis.