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Ischemic Infarction (ischemic + infarction)
Selected AbstractsRhabdomyolysis and brain ischemic stroke in a heroin-dependent male under methadone maintenance therapyACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2009W.-Y. Hsu Objective:, There are several complications associated with heroin abuse, some of which are life-threatening. Methadone may aggravate this problem. Method:, A clinical case description. Results:, A 33-year-old man presented with rhabdomyolysis and cerebral ischemic stroke after intravenous heroin. He had used heroin since age 20, and had used 150 mg methadone daily for 6 months. He was found unconsciousness at home and was sent to our hospital. In the ER, his opiate level was 4497 ng/ml. In the ICU, we found rhabdomyolysis, acute renal failure and acute respiratory failure. After transfer to an internal ward, we noted aphasia and weakness of his left limbs. After MRI, we found cerebral ischemic infarction. Conclusion:, Those using methadone and heroin simultaneously may increase risk of rhabdomyolysis and ischemic stroke. Patients under methadone maintenance therapy should be warned regarding these serious adverse events. Hypotheses of heroin-related rhabdomyolysis and stroke in heroin abusers are discussed. [source] Association Between Migraine and Headache Attributed to Stroke: A Case,Control StudyHEADACHE, Issue 10 2008Katiuscia Nardi MD Background., Several studies were carried out to investigate the occurrence of headache attributed to acute stroke in patients with a lifetime history of migraine. Methods., In a case,control series of 96 acute stroke patients with a lifetime history of migraine (M+) and 96 stroke patients without (M,), ischemic stroke patients only, without secondary infarction, were selected. The headache attributed to acute ischemic stroke was then analyzed. Results., (M+) patients complained of headache more often than (M,) patients (P < .0001), mainly in the 24 hours before stroke onset (P < .0001). Migraine-like features of headache were recognized in a greater proportion of cases in the (M+) patient group with ischemic stroke (P < .018). A preferential brainstem location of ischemic stroke in (M+) patients emerged compared with (M,) patients (P = .014). Discussion., The high prevalence of headache attributed to stroke in (M+) patients, in a relevant proportion of cases presenting as a sentinel headache, suggests that cerebral ischemia lowers the threshold for head pain more easily in these "susceptible" patients. The most frequent involvement of the brainstem in (M+) patients with ischemic infarction concurs with recent reports that emphasized a greater headache frequency when cerebral infarctions are localized in this structure or deep brain gray matter. [source] MRI Changes in Thrombotic Microangiopathy Secondary to Malignant HypertensionJOURNAL OF NEUROIMAGING, Issue 2 2007Mandeep Garewal MD ABSTRACT Thrombotic microangiopathy with thrombocytopenia and intravascular hemolysis are characteristic of three disorders: malignant hypertension (MH), disseminated intravascular coagulation (DIC), and thrombocytopenic thrombotic purpura (TTP). We describe a patient with thrombotic microangiopathy secondary to malignant hypertension that caused extensive bilateral cortical ischemic infarction. [source] Placental Anomalies in Children with Infantile HemangiomaPEDIATRIC DERMATOLOGY, Issue 4 2007Juan Carlos López Gutiérrez M.D., Ph.D. We investigated the pathogenic significance of placental features and their relationship to the development of infantile hemangioma in order to obtain a better understanding of its cause. Placental specimens were reviewed from 26 singleton pregnancies of women whose offspring weighed less than 1500 g. A group of 13 neonates who developed infantile hemangioma in the immediate neonate period were compared with 13 healthy preterm infants of comparable postconception age who had no infantile hemangioma. Pathologic placental changes were analyzed in both groups. Gross lesions with disturbance of the utero-placental circulation were found in all placentas from children who developed infantile hemangioma, including massive retroplacental hematoma in two infants, extensive ischemic infarction in seven, and large dilatated vascular communications, severe vasculitis, chorioamnionitis and funiculitis in four. Placental features included percentages greater than 25% of avascular villi, platelet and fibrin aggregates, and multifocal disease involving more than one histologic section. Examination of 13 placentas of low-birth-weight infants without infantile hemangioma only showed abnormal placentation in one and isolated villous dismaturity in two. The higher ratio of placental pathologic findings in patients with infantile hemangioma suggests that reduced placental oxygen diffusive conductance contributes to fetal hypoxic stress and that hypoxic/ischemic changes in the placenta could be related to infantile hemangioma development via vascular endothelial growth factor and placental growth factor expression, among others, within the villious vessels and throphoblasts. [source] |