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Cerebral Embolism


Presentation

  • Four days after chemotherapy initiation, he presented with left hemiplegia, and brain magnetic resonance imaging and magnetic resonance angiography revealed a right MCA occlusion.[ncbi.nlm.nih.gov]
  • We are reporting two cases of distal subclavian artery disease presenting with cerebral embolization, an unusual manifestation.[ncbi.nlm.nih.gov]
  • This mitral valvular strand was the only explanation for an episode of cerebral embolism, presenting with a transient right sided hemiparesis.[ncbi.nlm.nih.gov]
  • Atrial myxoma should be considered in the differential diagnosis when children present with neurologic symptoms or with signs of embolization, because surgical removal of the tumor is critical and may be curative.[ncbi.nlm.nih.gov]
  • Isolated aortic valve endocarditis was present in 165 patients (44%), 132 patients (36%) had isolated AIE of the mitral valve, and 64 (17%) patients had left-sided double valve endocarditis.[ncbi.nlm.nih.gov]
Cardiac Signs and Symptoms
  • The tumor is usually benign, and the cardiac signs and symptoms produced are related to the size and location of the tumor. Primary cardiac tumors in children are rare. Myxomas are the third most common tissue type behind rhabdomyomas and fibromas.[pediatrics.aappublications.org]
Diastolic Murmur
  • A diastolic murmur was heard best over the third left intercostal space. Results of duplex ultrasound investigation of the cerebral vessels, chest x-ray, and electrocardiography and biochemical and hematological variables were normal.[ncbi.nlm.nih.gov]
Transient Blindness
  • He had suffered dizziness and transient blindness 6 months ago and had also been found lying in the bathroom on another occasion. Multiple cerebral infarctions were confirmed by brain CT scan and MRI.[ncbi.nlm.nih.gov]
Facial Numbness
  • A cerebral embolism that induces a stroke can also cause facial numbness, vision loss in one or both eyes, and difficulty speaking or understanding words.[reference.com]
Stroke
  • Over 27 months 188 cryptogenic stroke/TIA patients 55 years were entered by 15 Austrian stroke units.[ncbi.nlm.nih.gov]
  • To report and comment on therapeutic options for 2 patients with acute ischemic strokes, PFO, and venous access related thrombosis, sources of paradoxical embolism, from Boston Medical Center stroke database. Case 1.[ncbi.nlm.nih.gov]
  • Because cardioembolic stroke is associated with poor prognosis compared to other stroke subtypes, in patients with asymptomatic severe aortic stenosis and spontaneous calcific embolic stroke valve replacement appears to offer the best hope of avoiding[ncbi.nlm.nih.gov]
  • All were extensively investigated and no other causes for stroke were found.[ncbi.nlm.nih.gov]
  • Copyright 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved. KEYWORDS: Stroke; echocardiogram; paradoxical embolism; transcranial Doppler[ncbi.nlm.nih.gov]
Confusion
  • A cerebral embolism increases the risk for an embolic stroke and causes symptoms such as sudden confusion and severe headache, according to the University of Washington Medicine.[reference.com]
  • Example 3: When the posterior circulation is affected, our physician may document complaints like gait imbalance, problems in hand-eye coordination, bumping into objects, repeated falls due to hitting obstacles, acute loss of vision, confusion, posterior[supercoder.com]
  • […] weakness or numbness in one part of the body Some people may experience more-serious neurological signs and symptoms, depending on the location of the AVM, including: -Severe headache -Weakness, numbness or paralysis -Vision loss -Difficulty speaking -Confusion[hospals.com]
  • Consequence of surgery on the heart may be of particular neurological syndrome: the patient wakes up slowly, in the waking state he has slowed thinking, confusion, there may be excitement, pugnacity, memory deteriorates, there are often visual hallucinations[minclinic.ru]
  • Following the cardiac arrest, the patient was noted to be confused, with a decreased level of consciousness. No focal neurologic signs were elicited on clinical examination.[ajnr.org]
Focal Neurologic Deficit
  • The patient came to the emergency department due to left-hemisphere focal neurological deficits with unknown time of onset. He was last seen to be asymptomatic at 9.30.[elsevier.es]
  • neurological deficit in the area of distribution of the cerebral arteries.[icd10data.com]
Stupor
  • Cerebral manifestations of fat embolism syndrome can be highly variable and non-specific: the symptoms spectrum includes headache, lethargy, irritability, delirium, stupor, convulsions, or coma. Most cases can occur as subclinical events.[radiopaedia.org]
Nystagmus
  • There was no gaze preference or nystagmus. Corneal reflexes were intact. The right nasolabial fold was flattened, and right eye closure was decreased. There was no movement of the right upper extremity.[pediatrics.aappublications.org]

Workup

  • Workup failed to detect causes of the embolism other than dissemination from the placental hemangioma. The fetal heart rate tracing was reassuring a few days after the cerebral embolism.[ncbi.nlm.nih.gov]
  • In the workup of a patient with a known murmur and stroke symptoms, paradoxical cerebral embolism should be included in the differential.[ncbi.nlm.nih.gov]

Treatment

  • We discuss the utility of intraoperative EEG monitoring in the detection and treatment of cerebral embolism.[ncbi.nlm.nih.gov]
  • Most patients with this condition are given life-long anticoagulation, a treatment that may have serious complications. As an alternative treatment with possible lower risk, we removed the aneurysm surgically.[ncbi.nlm.nih.gov]
  • Interventional treatment of a cardiac RLS may offer a small benefit, but has to be weighed against possible complications and the problem of establishing causality.[ncbi.nlm.nih.gov]
  • The findings of a mass in the aneurysm, suggestive of thrombus, may justify anticoagulation treatment or even surgical intervention.[ncbi.nlm.nih.gov]
  • The importance of early echocardiography is stressed, especially in view of the recent tendency of early and aggressive stroke treatment.[ncbi.nlm.nih.gov]

Prognosis

  • Because cardioembolic stroke is associated with poor prognosis compared to other stroke subtypes, in patients with asymptomatic severe aortic stenosis and spontaneous calcific embolic stroke valve replacement appears to offer the best hope of avoiding[ncbi.nlm.nih.gov]
  • Prognosis of cerebral embolism. Lancets 2:514. 1965. 33. Szekely P. Systemic embolism and anticoagulant prophylaxis in rheumatic heart disease. Br Med J 1:1209. 1964. 34. Adams GF, Merrett JD, Hutchinson WM, Pollock AM.[kjim.org]
  • Prognosis Of patients hospitalized with an arterial embolism, 25-30% die, and 5-25% require amputation of a limb. About 10% of patients with a pulmonary embolism die suddenly within the first hour of onset of the condition.[encyclopedia.com]
  • These four entities predict the extent of the stroke, the area of the brain affected, the underlying cause, and the prognosis. [2] [3] The TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification is based on clinical symptoms as well as results[en.wikipedia.org]

Etiology

  • Neither was the type of embolism found to be influenced by the etiologic factor. Nine patients died. In three patients, the cause of death was hemorrhage from a cerebral apoplectic focus.[ncbi.nlm.nih.gov]
  • In most cases, however, it is difficult to establish a firm etiological association and the debate about management is ongoing.[ncbi.nlm.nih.gov]
  • ICD-10-CM Codes › I00-I99 Diseases of the circulatory system › I60-I69 Cerebrovascular diseases › Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology[icd10data.com]
  • Influence of etiology of atrial fibrillation on incidence of systemic embolism. Am J Cardiol 40:509. 1977. 20. Wolf PA, Dawber TR, Thomas HE Jr, Kannel WB.[kjim.org]

Epidemiology

  • Epidemiology and natural history of venous thromboembolism.[scla.org.sy]
  • Epidemiologic assessment of chronic atrial fibrillation and risk of stroke: The framingham study. Neurology 28:973. 1978. 21. Hoenkesema TD, Wallace RB, Kirklin JW. Closed mitral commissurotomy. Recent results in 291 cases.[kjim.org]
  • Epidemiologic aspects of infective endocarditis in an urban population: a 5-year prospective study. Medicine 1995;74:324-339. 12.[dhm.mhn.de]
Sex distribution
Age distribution

Pathophysiology

  • Abstract Polycythemia rubra vera (PRV) is a rare haematological disorder that has a high risk of stroke, although the pathophysiological origin of the cerebral ischaemia in this disease is not well known.[ncbi.nlm.nih.gov]
  • They presented with a focal hemispheric stroke where the probable pathophysiology is embolism to the distal internal carotid artery from thrombus formed at the proximal FMD site.[ncbi.nlm.nih.gov]
  • Pathophysiology, Diagnosis, and Management. New York: Churchill Livingstone, 1992:271]. A small clot may break off from a larger thrombus and be carried to other places in the bloodstream.[strokecenter.org]
  • "You'll need to ensure your clinician clearly documents which territory in the central circulation was affected by embolism," said Stacey Chevious, BA, CPC, AHI, CDIP , ICD-10-CM/PCS Trainer and Ambassador, in the webinar on "Anatomy and pathophysiology[supercoder.com]
  • During the 19th century, advances were made in understanding the pathophysiology of cerebral embolism and thrombosis.[medlink.com]

Prevention

  • In our case, anticoagulation therapy was not continued to prevent recurrence, and antiplatelet therapy was performed instead, which might be associated with the thrombus reformation.[ncbi.nlm.nih.gov]
  • The risk of cerebral embolism in those on HRT should be emphasized, along with the beneficial effects in terms of postmenopausal symptoms and prevention of breast cancer recurrence.[ncbi.nlm.nih.gov]
  • Surgical closure of the aneurysm prevents rupture and recurrent embolism and possibly corrects aortic regurgitation.[ncbi.nlm.nih.gov]
  • We report 2 cases of paradoxic cerebral embolism after cemented total knee arthroplasty and propose a novel treatment plan to prevent recurrent stroke during subsequent surgery.[ncbi.nlm.nih.gov]
  • In addition to reporting an extremely rare case, this paper confirms that the opportune identification of endocarditis caused by S. agalactiae and the selection of appropriate antibiotics can prevent the necessity of cardiac surgery, usually required[ncbi.nlm.nih.gov]

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