Ali Noureddine; Kavian Ghandehari; Mohammad Taghi Shakeri
Volume 13, Issue 3 , September 2014, , Pages 127-130
Abstract
Background: Previous literatures have shown a transient ischemic attack (TIA) mimic rate of 9-31%. We aimed to ascertain the proportion of stroke mimics amongst suspected TIA patients. Methods: A prospective observational study was performed in Ghaem Hospital, Mashhad, Iran ...
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Background: Previous literatures have shown a transient ischemic attack (TIA) mimic rate of 9-31%. We aimed to ascertain the proportion of stroke mimics amongst suspected TIA patients. Methods: A prospective observational study was performed in Ghaem Hospital, Mashhad, Iran during 2012-2013. Consecutive TIA patients were identified in a stroke center. The initial diagnosis of TIA was made by the resident of neurology and final diagnosis of true TIA versus TIA mimics was made after 3 months follow-up by stroke subspecialist. Results: A total of 310 patients were assessed during a 3- month period of which 182 (58.7%) subjects were male and 128 (41.3%) were female. Ten percent of the patients was categorized as a TIA mimic. The presence of hypertension, aphasia, duration of symptoms, and increased age was the strongest predictor of a true TIA. Migraine was the most common etiology of stroke mimic in our study. Conclusion: It seems that many signs and symptoms have low diagno tic usefulness for discrimination of true TIA from non-cerebrovascular events and predictive usefulness of any sign or symptom should be interpreted by a stroke neurologist.
Humain Baharvahdat; Hamid Etemadrezaie; Samira Zabyhian; Zahra Valipour; Babak Ganjeifar; Seyed Mohammad Mousavi Mirzaye; Payam Sasannejad; Kavian Ghandehari
Volume 13, Issue 2 , June 2014, , Pages 101-104
Abstract
Background: Intravenous recombinant tissue plasminogen activator (rt-PA) is an approved treatment for acute ischemic stroke within 4.5 h of symptoms onset. Decompressive craniectomy (DC) has been shown as an effective therapeutic modality in malignant middle cerebral artery (MCA) ...
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Background: Intravenous recombinant tissue plasminogen activator (rt-PA) is an approved treatment for acute ischemic stroke within 4.5 h of symptoms onset. Decompressive craniectomy (DC) has been shown as an effective therapeutic modality in malignant middle cerebral artery (MCA) infarction. As rt-PA could result in hemorrhagic complication during or after any surgery DC may be associated with severe bleeding after intravenous thrombolysis.Case Description: A 57-year-old woman was presented 90 min after the sudden onset of left hemiplegia. Despite intravenous thrombolytic therapy, she lost consciousness within 48 h and brain CT scan showed a right malignant MCA infarction associated with a small bleeding. DC was performed without any complication. The patient improved dramatically.Conclusion: DC could be done safety for malignant MCA infarction after unsuccessful intravenous thrombolytic therapy even the later was complicated with intra- infarction hemorrhage.
