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Strömbäck, Ulrica, Åsa Engström, Robert Lundqvist, Dan Lundblad e Irene Vikman. "The second myocardial infarction: Is there any difference in symptoms and prehospital delay compared to the first myocardial infarction?" European Journal of Cardiovascular Nursing 17, n.º 7 (11 de maio de 2018): 652–59. http://dx.doi.org/10.1177/1474515118777391.
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Background: Knowledge is limited concerning the type of symptoms and the time from onset of symptoms to first medical contact at first and second myocardial infarction in the same patient. Aim: This study aimed to describe the type of symptoms and the time from onset of symptoms to first medical contact in first and second myocardial infarctions in men and women affected by two myocardial infarctions. Furthermore, the aim was to identify factors associated with prehospital delays ≥2 h at second myocardial infarction. Methods: A retrospective cohort study with 820 patients aged 31–74 years with a first and a second myocardial infarction from 1986 through 2009 registered in the Northern Sweden MONICA registry. Results: The most common symptoms reported among patients affected by two myocardial infarctions are typical symptoms at both myocardial infarction events. Significantly more women reported atypical symptoms at the second myocardial infarction compared to the first. Ten per cent of the men did not report the same type of symptoms at the first and second myocardial infarctions; the corresponding figure for women was 16.2%. The time from onset of symptoms to first medical contact was shorter at the second myocardial infarction compared to the first myocardial infarction. Patients with prehospital delay ≥2 h at the first myocardial infarction were more likely to have a prehospital delay ≥2 h at the second myocardial infarction. Conclusions: Symptoms of second myocardial infarctions are not necessarily the same as those of first myocardial infarctions. A patient’s behaviour at the first myocardial infarction could predict how he or she would behave at a second myocardial infarction.
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Prokopiv, Mariia. "Evaluation of functional outcomes of vertebrobasilar infarction depending on the aff ected intracranial vascular territory of the posterior circulation". Ukrains'kyi Visnyk Psykhonevrolohii 27, n.º 3 (5 de setembro de 2019): 26–33. http://dx.doi.org/10.36927/2079-0325-v27-is3-2019-4.
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The aim of the work is to examine the features of recovery of lost neurological functions and the quali ty of life of patients with acute vertebrobasilar infarction, to evaluate and compare the short-term and long-term outcome of a stroke depending on the aff ected intracranial anatomical areas of the posterior circulation basin. 120 patients with acute vertebrobasilar infarction were examined, among them 22 (18.3 %) patients had a cerebral infarction, 38 (31.7 %) — pontine infarction, 13 (10.8 %) — midbrain infarction, 22 (18.3 %) — thalamic infarction and 25 (20.8 %) patients — cerebellar infarction. Strokes were distributed into three intracranial anatomical territories of the posterior circular basin: proximal, medial, distal. The diagnosis was established on the basis of data from the neurological clinic and magnetic resonance imaging in standard and DV modes. Clinical and neurological comparisons and a comparative statistical analysis of the functional outcomes of infarctions on the 21st and 90th day of a prospective observation. Despite the fact that there is no clear functional boundary between the proximal, medial and distal intracranial anatomical territories of the posterior circulation basin, which once again confi rms their functional unity, the potential for resuming lost neurological functions, a short-term and long-term outcome after infarction of diff erent anatomical and topographic areas of posterior circulation basin do not always match. Statistical analysis pointed that the short-term and long-term functional outcome after a infarction in diff erent intracranial vascular territories of the posterior circulation basin had certain features of the evolution of functional and neurological recovery. In particular, cerebellar infarctions had a signifi cantly better functional outcome compared to infarctions of the medulla oblongata in the short and long term perspective and midbrain infarctions — on the 90th day of the prospective observation (p <0.05). Paired comparisons of functional consequences between cere bellar, pontine and thalamic infarction did not reveal a statistically signifi cant (p > 0.05) correlation between factorial and eff ective signs during short-term and longterm follow-up.
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Kim, Hyun Gi, Seung-Koo Lee e Jung-Dong Lee. "Characteristics of infarction after encephaloduroarteriosynangiosis in young patients with moyamoya disease". Journal of Neurosurgery: Pediatrics 19, n.º 1 (janeiro de 2017): 1–7. http://dx.doi.org/10.3171/2016.7.peds16218.
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OBJECTIVE Young patients with moyamoya disease can exhibit infarction after revascularization surgery. This analysis of the characteristics of infarction after encephaloduroarteriosynangiosis (EDAS) in young patients with moyamoya disease was undertaken in an effort to elucidate the infarction mechanism. METHODS The authors retrospectively collected clinical information and reviewed pre- and postoperative MRI studies from cases involving patients younger than 18 years who underwent EDAS for the treatment of moyamoya disease between January 2012 and February 2015. Infarction patterns were categorized into watershed, territorial, or mixed pattern. The Wilcoxon rank sum test, chi-square test, and Fisher exact test were used to compare the clinical and imaging variables between patient groups. The characteristics of patients with and without postoperative infarction were compared using univariate and multivariate analysis. The cumulative proportion of patients without postoperative infarction according to operation stage was calculated using the Kaplan-Meier method and the resulting curves were compared using the log-rank test. RESULTS In 100 patients, 171 EDAS procedures had been performed. There were 38 cases of preoperative infarction in 35 patients and 20 cases of postoperative infarction in 13 patients. Territorial infarction was more frequent in the postoperative infarction group than in the preoperative infarction group (55.0% vs 37.8%, p = 0.037). Infarction was more common on the bilateral or contralateral side of the operation after first-stage EDAS (9 [75.0%] of 12 infarctions) than in the second-stage operation (2 [25.0%] of 8 infarctions), but the difference was not statistically significant (p = 0.068). The frequency of postoperative infarction was not significantly different depending on the stage of the operation (p = 0.694). CONCLUSIONS An acute infarction pattern after EDAS was more frequently territorial, suggesting an underlying occlusive mechanism. Operation stage did not affect the rate of postoperative infarction occurrence.
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Alemu, Rahel, Eileen E. Fuller, John F. Harper e Mark Feldman. "Influence of Smoking on the Location of Acute Myocardial Infarctions". ISRN Cardiology 2011 (17 de abril de 2011): 1–3. http://dx.doi.org/10.5402/2011/174358.
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Objective. To determine whether there is an association between smoking and the location of acute myocardial infarctions. Methods. Using a cohort from our hospital and published cohorts from Ireland, Uruguay, and Israel, we calculated odds of having an inferior wall as opposed to an anterior wall acute myocardial infarction among smokers and nonsmokers. Results. In our cohort, there was a higher proportion of smokers than nonsmokers in patients with inferior acute myocardial infarctions than in patients with anterior infarctions. This difference was also present in each of the other cohorts. Odds ratios for an inferior versus an anterior acute myocardial infarction among smokers ranged from 1.15 to 2.00 (median odds ratio, 1.32). When the cohorts were combined (), the pooled odds ratio for an inferior as opposed to an anterior acute myocardial infarction among smokers was 1.38 ( confidence interval, 1.20 to 1.58) (). Conclusions. Cigarette smoking increases the risk of inferior wall acute myocardial infarction more than the risk of anterior wall infarction. Smoking thus appears to adversely affect the right coronary arterial circulation to a greater extent than the left coronary arterial circulation by a mechanism not yet understood.
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Stosic-Opincal, Tatjana, Katarina Kacar, Srboljub Stosic, Slobodan Lavrnic, Vesna Peric e Mihail Gavrilov. "The use of magnetic resonance and MR angiography in the detection of cerebral infarction: A complication of pediatric bacterial meningitis". Vojnosanitetski pregled 62, n.º 9 (2005): 645–48. http://dx.doi.org/10.2298/vsp0509645s.
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Bacground. Association of both cerebral infarction and acute bacterial meningitis is more common in younger patients than in the elderly. The rate of mortality and the frequency of sequel are very high inspite of the use of modern antibiotic therapy. In more than 30% of the cases of childhood bacterial meningitis, both arterial and venous infarctions can occur. The aim of this study was to present the role of the use of magnetic resonance (MRI), and MR angiography (MRA) in the detection of bacterial meningitis in children complicated with cerebral infarctions. Method. In the Centre for MR, the Clinical Centre of Serbia, 25 patients with the diagnosis of bacterial meningitis, of which 9 children with cerebral infarction whose clinical conditon deteriorated acutely, despite the antibiotic therapy, underwent MRI and MR angiography examination on a 1T scanner. Examination included the conventional spin-echo techniques with T1-weighted saggital and coronal, and T2- weighted axial and coronal images. Coronal fluid attenuated inversion recovery (FLAIR) and the postcontrast T1-weighted images in three orthogonal planes were also used. The use MR angiography was accomplished by the three-dimensional time-of-flight (3D TOF) technique. Results. The findings included: multiple hemorrhagic infarction in 4 patients, multiple infarctions in 3 patients, focal infarction in 1 patient and diffuse infarction (1 patient). Common sites of involvement were: the frontal lobes, temporal lobes and basal ganglia. The majority of infarctions were bilateral. In 3 of the patients empyema was found, and in 1 patient bitemporal abscess was detected. In 8 of the patients MR angiography confirmed inflammatory vasculitis. Conclusion. Infarction is the most common sequel of severe meningitis in children. Since the complication of cerebral infarction influences the prognosis of meningitis, repetitive MRI examinations are very significant for the evaluation of the time course of vascular involvement. The use of MRI, especially FLAIR imaging, confirmed its value in the detection and determination of the site and the extent of cerebral infarction. Non-invasive technique of examination, 3D TOF MR angiography clearly should show the presence of inflammatory vasculitis.
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Srikanth, S. G., H. S. Chandrashekhar, J. J. S. Shankar, S. Ravishankar e S. K. Shankar. "Vertebral Body Signal Changes in Spinal Cord Infarction: Histopathological Confirmation". Neuroradiology Journal 20, n.º 5 (outubro de 2007): 580–85. http://dx.doi.org/10.1177/197140090702000518.
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Spinal cord infarctions are rare. They are difficult to diagnose clinically and remain undiagnosed even after extensive investigations. Magnetic Resonance (MR) features include hyperintensity of the cord on T2W images. Few cases of spinal cord infarction associated with vertebral body infarction are reported in the literature. We describe another five cases of spinal cord infarction with histopathological confirmation of the vertebral body signal changes. MR examinations of five patients who presented with acute spontaneous spinal cord syndrome were reviewed. Abnormal MR features of the spinal cord included signal changes within the parenchyma, best demonstrated on T2W images. These cord changes were associated with vertebral body T2 hyperintensity in all the patients and in one patient, the computed tomography guided biopsy of vertebral body lesion reported infarction. MR is sensitive to detect spinal cord infarctions and associated vascular and bony changes. The associated signal abnormalities in the bone marrow are a corroborative sign in the diagnosis of spinal cord infarction which was proved by histopathology.
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Feng, Chao, Yu Xu, Ting Hua, Xue-Yuan Liu e Min Fang. "Irregularly shaped lacunar infarction: risk factors and clinical significance". Arquivos de Neuro-Psiquiatria 71, n.º 10 (outubro de 2013): 769–73. http://dx.doi.org/10.1590/0004-282x20130119.
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Objective Our study focused on acute lacunar infarct shapes to explore the risk factors and clinical significance of irregularly shaped lacunar infarctions. Methods Based on the shape of their acute lacunar infarct, patients (n=204) were classified into the “regular” group or “irregular” group. The characteristics of the lacunar infarction were compared between the regular and irregular groups, between patients with and without neurological deterioration, and between patients with different modified Rankin scale (mRS) scores. The risk factors for irregularly shaped lacunar infarctions, neurological deterioration, and high mRS scores were identified. Results Blood pressure variability (BPV) was an independent risk factor for irregularly shaped lacunar infarction. Infarction size, prevalence of advanced leukoaraiosis, and irregularly shaped lacunar infarcts were independent risk factors for higher mRS scores. Conclusions The irregularly shaped lacunar infarcts were correlated with BPV. Irregularly shaped lacunar infarctions and leukoaraiosis may be associated with unfavorable clinical outcomes.
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Özkaçmaz, Sercan. "Imaging quiz: A child with multiple trauma". Hong Kong Journal of Emergency Medicine 26, n.º 1 (7 de setembro de 2018): 67–69. http://dx.doi.org/10.1177/1024907918799952.
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Splenic and renal infarctions are embolic conditions which usually occur secondary to cardiac problems, thromboembolic systemic diseases, and infectious conditions such as sepsis. Trauma is a relatively rare cause of visceral infarctions. Traumatic segmental renal infarction associated with total splenic infarction is extremely rare. For detecting these visceral infarctions, contrast-enhanced computed tomography is essential, and a very careful examination is required for detecting very small infarctions and excluding total visceral infarctions. In isolated splenic or renal infarctions secondary to trauma, the common contrast-enhanced computed tomography findings are wedge-shaped or segmental hypodense areas in kidneys or spleen and rarely total visceral infarctions. Usually, intraperitoneal or retroperitoneal fluid collection which corresponds to bleeding from kidney or spleen is not seen in such cases. Also, the lack of evidence of active extravasation from renal/splenic arteries and pseudoaneurysm or dissection is an important finding of isolated traumatic splenic or renal infarctions. Because total infarctions can be misinterpreted in some cases, differences in density between intra-abdominal organs allowed by computed tomography must be carefully examined. Intestinal infarctions, the other abdominal injuries, pulmonary injuries, and pelvic or thoracic bone fractures usually accompany traumatic renal or splenic infarctions. In this report, we present contrast-enhanced computed tomography findings of a multitrauma pediatric case of traumatic total splenic and bilateral segmental renal infarction by reviewing the literature.
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Almushayti, Ziyad. "Corpus callosum infarction: a case report". International Journal of Advances in Medicine 7, n.º 11 (21 de outubro de 2020): 1751. http://dx.doi.org/10.18203/2349-3933.ijam20204442.
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Infarctions of corpus callosal are rare due to an abundant collateral blood supply. Few case reports published in the literature regarding the corpus callosum infarction. We present a case of corpus callosum infarction in a 66-year-old man with a history of diabetes mellitus, hypertension, and coronary artery disease who presented to the emergency room with left lower limb weakness. Diagnosed was made based on magnetic resonance imaging and treated conservatively.
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Lim, Jia Xu, Srujana Venkata Vedicherla, Shu Kiat Sukit Chan, Nishal Kishinchand Primalani, Audrey J. L. Tan, Seyed Ehsan Saffari e Lester Lee. "Decompressive craniectomy for internal carotid artery and middle carotid artery infarctions: a long-term comparative outcome study". Neurosurgical Focus 51, n.º 1 (julho de 2021): E10. http://dx.doi.org/10.3171/2021.4.focus21123.
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OBJECTIVE Malignant internal carotid artery (ICA) infarction is an entirely different disease entity when compared with middle cerebral artery (MCA) infarction. Because of an increased area of infarction, it is assumed to have a poorer prognosis; however, this has never been adequately investigated. Decompressive craniectomy (DC) for malignant MCA infarction has been shown to improve mortality rates in several randomized controlled trials. Conversely, aggressive surgical decompression for ICA infarction has not been recommended. The authors sought to compare the functional outcomes and survival between patients with ICA infarctions and those with MCA infarctions after DC in the largest series to date to investigate this assumption. METHODS A multicenter retrospective review of 154 consecutive DCs for large territory cerebral infarctions performed from 2005 to 2020 were analyzed. Patients were divided into ICA and MCA groups depending on the territory of infarction. Variables, including age, sex, medical comorbidities, laterality of the infarction, preoperative neurological status, primary stroke treatment, and the time from stroke onset to DC, were recorded. Univariable and multivariable analyses were performed for the clinical exposures for functional outcomes (modified Rankin Scale [mRS] score) on discharge and at the 1- and 6-month follow-ups, and for mortality, both inpatient and at the 1-year follow-up. A favorable mRS score was defined as 0–2. RESULTS There were 67 patients (43.5%) and 87 patients (56.5%) in the ICA and MCA groups, respectively. Univariable analysis showed that the ICA group had a comparably favorable mRS (OR 0.15 [95% CI 0.18–1.21], p = 0.077). Inpatient mortality (OR 1.79 [95% CI 0.79–4.03], p = 0.16) and 1-year mortality (OR 2.07 [95% CI 0.98–4.37], p = 0.054) were comparable between the groups. After adjustment, a favorable mRS score at 6 months (OR 0.17 [95% CI 0.018–1.59], p = 0.12), inpatient mortality (OR 1.02 [95% CI 0.29–3.57], p = 0.97), and 1-year mortality (OR 0.94 [95% CI 0.41–2.69], p = 0.88) were similar in both groups. The overall survival, plotted using the Cox proportional hazard regression, did not show a significant difference between the ICA and MCA groups (HR 0.581). CONCLUSIONS Unlike previous smaller studies, this study found that patients with malignant ICA infarction had a functional outcome and survival that was similar to those with MCA infarction after DC. Therefore, DC can be offered for malignant ICA infarction for life-saving purposes with limited functional recovery.
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Klein, Sarit Hochberg, Eyal David Klein, Zvi Ackerman e Nurit Hiller. "Liver infarction: To treat or not to treat?" Case Reports in Internal Medicine 5, n.º 2 (10 de maio de 2018): 28. http://dx.doi.org/10.5430/crim.v5n2p28.
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Liver infarctions are a very rare occurrence due to the multiple-source blood supply of the liver. The cause of hepatic infarction is unclear. When diagnosed, appropriate treatment of these infarctions is unknown. Herein we describe a case of acute liver infarctions, with no obvious cause, in a young woman. Work-up did not shed light on the underlying etiology. Treatment with anticoagulation was commenced in this case, with rapid improvement and a good clinical outcome. We suggest that anticoagulation can be administered to treat hepatic infarctions even in the absence of clear-cut thrombosis.
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Lee, Chun Lin, Regunath Kandasamy e Mohammed Azman Bin Mohammad Raffiq. "Computed tomography perfusion in detecting malignant middle cerebral artery infarct". Surgical Neurology International 10 (9 de agosto de 2019): 159. http://dx.doi.org/10.25259/sni_64_2019.
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Background: Computed tomography perfusion (CTP) is an emerging modality which produces maps of time-to- peak (TTP), cerebral blood flow (CBF), and cerebral blood volume (CBV), with a computerized automated map of the infarct and penumbra. This modality provides a better evaluation of the extent of infarction, making it a potential method for assessing patients suffering from large middle cerebral artery (MCA) infarctions. Methods: A prospective cohort study of all patients in Hospital Kuala Lumpur, Malaysia, who presented with the clinical diagnosis of a large MCA infarction within 48 h of onset were subjected to CT brain, and CTP scans on admission and were followed up to determine the development of malignant infarction requiring surgical decompression. Results: CTP parameters were generally lower in patients with malignant brain infarct (MBI) group compared to the nonMBI group. The largest mean difference between the group was noted in the TTP values (P = 0.005). CTP parameters had a comparable positive predictive value (83%–90%) and high net present value (88–93). CBF with cutoff value of >32.85 of the hemisphere could accurately predict malignant infarctions in 81.4% of cases. The National Institutes of Health Stroke Scale score of more than 13.5 was also found to be able to accurately determine malignant infarct (97.6%). Functional outcome of patients based on Glasgow outcome scale was similar on discharge, however, showed improvement at 6 months during reviewed base on modified Rankin scale (P < 0.001). Conclusion: CTP parameters should be included in the initial evaluation of patients to predict malignant brain infarction and facilitate surgical treatment of large MCA infarctions. Key messages: CT perfusion parameters have an important role in predicting malignant brain infarction and should be included in the initial evaluation of patients to facilitate the early identification and surgical treatment of large middle cerebral artery infarctions, to improve patient’s prognosis.
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Huda, MN, MZ Sayeed, MK Rahman, MMR Khan e ARMS Ekram. "Right Ventricular Myocardial Infarction : Presentation and Acute Outcomes". TAJ: Journal of Teachers Association 25 (28 de novembro de 2018): 42–46. http://dx.doi.org/10.3329/taj.v25i0.37557.
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Right Ventricular Infarction (RVI) complicating inferior wall myocardial infarction (MI) is common and associated with significant morbidity and mortality. We try to systematically assess the incidence, clinical presentation and in hospital outcomes of right ventricular myocardial infarction in a tertiary-care set up. This study was a descriptive, cross sectional observational series of consecutive patients with RVMI. All patients with acute inferior myocardial infarction (n=100) were enlisted. RVMI was diagnosed by ≥1mm ST elevation in lead V4R in right sided electrocardiogram. RVI occurred in 31% (n=31) of patients of acute inferior infarctions. Patients with isolated inferior myocardial infarction served as controls (n=69). Echocardiography was performed within 24 hours of admission. From both groups, 51% were qualified for thrombolysis. The incidence of hypotension (96.7%), cardiogenic shock (64.5%), bradycardia and heart block were much higher in RVI than in inferior myocardial infarction. Clinically manifest RV dysfunction (raised jugular venous pulse, hypotension and tricuspid regurgitation) and right ventricular dilatation detected by echocardiography was seen in a variable number of patients. In hospital mortality rate was significantly higher (n=13, 41.9%) in right ventricular infarction group than in inferior myocardial infarction group (n=2, 2.9%)TAJ 2012; 25: 42-46
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Zhu, Jinmao, Youfu Li, Yanxia Wang, Shuanggen Zhu e Yongjun Jiang. "Higher Prevalence of Diabetes in Pontine Infarction than in Other Posterior Circulation Strokes". Journal of Diabetes Research 2022 (27 de janeiro de 2022): 1–8. http://dx.doi.org/10.1155/2022/4819412.
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Background. Pontine infarction is the major subtype of posterior circulation stroke, and diabetes is more common in pontine infarction patients than in anterior circulation stroke patients. Whether the prevalence of diabetes remains homogenous within the posterior circulation stroke population is unclear. The present study is aimed at investigating the prevalence of diabetes in pontine infarction and comparing it to other subtypes of posterior circulation stroke. Methods. We conducted a multicenter case-control study. Patients with posterior circulation stroke were screened. The subjects were divided into pontine infarction and nonpontine infarction groups. Results. From November 1, 2018, to February 28, 2021, a total of 6145 stroke patients were screened and 2627 patients had posterior circulation strokes. After excluding cardioembolic stroke, as well as its other determined and undetermined causes, 1549 patients with 754 pontine infarctions were included in the analysis. The prevalence of diabetes in the pontine infarction group was higher than that in the nonpontine infarction group (42.7% vs. 31.4%, P < 0.05 ). After adjusting for confounding factors, diabetes was an independent risk factor for pontine infarction (OR 1.63, 95% CI 1.27-2.09, P < 0.05 ). For small vessel occlusion, diabetes was also more common in the pontine infarction group (43.2% vs. 30.0%, P < 0.05 ). Multivariate analysis also showed that diabetes was an independent risk factor for pontine infarction (OR 1.80, 95% CI 1.32-2.46, P < 0.05 ). Conclusion. In comparison with the nonpontine infarction subtype of posterior circulation stroke, patients with pontine infarction had a higher prevalence of diabetes, and diabetes was an independent risk factor for pontine infarction.
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Kurhaluk, Natalia, Krzysztof Tota, Małgorzata Dubik-Tota e Halyna Tkachenko. "LEVEL OF ALDEHYDIC AND KETONIC DERIVATIVES OF OXIDATIVELY MODIFIED PROTEINS IN THE BLOOD OF MEN AND WOMEN WITH MYOCARDIAL INFARCTIONS AND HYPOTHYROIDISM". Biota. Human. Technology, n.º 2 (29 de dezembro de 2022): 79–91. http://dx.doi.org/10.58407/bht.2.22.6.
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Oxidative stress and excessive reactive oxygen species production play considerable roles in infarction-induced injury impairing cardiac functions, as well as thyroid diseases. Purpose: assessment of the oxidative stress markers, including oxidation of proteins [concentrations of aldehydic and ketonic derivatives of oxidatively modified proteins (OMB)] in the blood of individuals with hypothyroidism and/or myocardial infarction living in the Central Pomerania. Methodology. The level of oxidative stress markers was assessed among 225 individuals, i.e. 132 males (58.67%) and 93 females (41.33%) aged 35-71 years residing in Central Pomerania. In the obtained plasma, an assessment of levels of aldehydic and ketonic derivatives of oxidatively modified protein analyses was carried out. Scientific novelty. The highest level of aldehydic and ketonic derivatives of oxidatively modified proteins was found in the group of males with myocardium infarctions and hypothyroidism compared to other groups. In females, an increase in aldehydic and ketonic derivatives was observed in the group with myocardial infarctions and in the group with hypothyroidism compared to the control group, while a decrease in aldehydic and ketonic derivatives was observed in subjects with myocardial infarction compared to individuals both with myocardial infarctions and hypothyroidism. In males, an increase in aldehydic and ketonic derivatives in both groups with myocardial infarctions and with hypothyroidism compared to the control group was observed, while in relation to the individuals with myocardial infarctions and hypothyroidism there was a decrease in aldehydic and ketonic derivatives in the group with myocardial infarctions and a decrease in ketonic derivatives in individuals with hypothyroidism. In addition, a decrease in the level of ketonic derivatives in the males with myocardial infarction and hypothyroidism compared to the group of females was observed. Conclusions. In the course of myocardial infarction, gender affects the level of the aldehydic derivatives of oxidative modification of proteins. Among individuals with hypothyroidism, the increase of ketonic derivatives of oxidatively modified proteins is also affected by sex. Analysis of oxidative stress markers depending on the sex may provide a biochemical basis for epidemiological differences in susceptibility to disease between sexes and suggest different strategies for risk assessment, diagnosis, and treatment specifically targeted at groups of males and females of different ages.
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MacKenzie, Ross. "Infarction or Pseudo-infarction?" Journal of Insurance Medicine 47, n.º 1 (1 de janeiro de 2017): 50–54. http://dx.doi.org/10.17849/insm-47-01-50-54.1.
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An applicant with a history of paroxysmal atrial fibrillation is found to have QS waves in leads III and AVF suggestive of a prior inferior wall myocardial infarction. Using the relationship between Q wave and T wave vectors in the inferior leads, an alternative explanation is explored.
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Libova, L., P. Minarik, A. Solgajova, T. Sollar, D. Zrubcova, J. Turzakova e G. Vorosova. "Gender, Age, previous Myocardial Infarction, and Personality as Predictors of Anxiety in Patients after Myocardial Infarction". Clinical Social Work and Health Intervention 12, n.º 3 (30 de setembro de 2021): 97–103. http://dx.doi.org/10.22359/cswhi_12_3_17.
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Objectives: The first research objective was to study the prevalence of anxiety in patients after myocardial infarction; next objective was to investigate demographic and personality predictors of anxiety. Methods: 100 hospitalized patients after myocardial infarction were studied. The Mini IPIP tool was used for the evaluation of personality characteristics and HADS-A scale was used for the evaluation of anxiety. Multiple regression was used as an analytical framework. Results: The prevalence of significant anxiety among patients after myocardial infarction was high, almost one half of patients reported abnormal anxiety symptoms. Female gender, higher age, higher neuroticism and lower conscientiousness explain 66% of the variability of anxiety. Personality traits of extraversion, openness, agreeableness and previous myocardial infarctions do not show as significant predictors. Conclusion: The prevalence of anxiety in the group of patients after myocardial infarction is high. Knowing predictors of anxiety is important for better provision of care.
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Prokopiv, M. M. "Clinical and neuroimaging analysis of carotid infarction in the acute ischemic stroke". INTERNATIONAL NEUROLOGICAL JOURNAL 17, n.º 5 (13 de outubro de 2021): 36–46. http://dx.doi.org/10.22141/2224-0713.17.5.2021.238521.
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Background. The assessment of clinical manifestations in patients with acute pre-circular infarction is important for verification of the lesion, the choice of the treatment program, prediction of the stroke consequences. The purpose is to investigate the clinical, neurological, and neuroimaging features of lacunar and non-lacunar carotid infarctions in acute ischemic stroke and to assess their short-term consequences. Materials and methods. There was performed a clinical and radiological analysis of carotid infarction in 540 patients with acute ischemic stroke, which were divided into two groups: 155 patients were verified for infarcts in the cortex and white matter of the brain in the vasculature of the anterior and middle cerebral artery; in 385 patients, infarct foci were found in the area of the deep hemispheres of the brain (subcortical-capsular infarcts). Results. Clinical neuroimaging analysis of patients with ischemic stroke in the vasculature of the cortical branches of the anterior and middle cerebral arteries of the anterior circulatory basin showed that acute cerebral circulatory disorders caused the development of small cortical infarctions in 89 (57.4 %) patients and 65 (41 %) — lacunar infarction, in one patient (0.7 %) with occlusion of the proximal anterior cerebral artery — total infarction. The neurological clinical picture of infarcts of varying localization, which was determined by the location and size of the lesion, was described. Conclusions. The obtained results showed that the consequences of anterior circular infarctions depended on the localization of the lesion of the arterial area, the caliber of the infarction of the dependent artery, the size of the infarct locus. For the most part, these factors determined the background severity of neurological deficit after the development of acute ischemic stroke.
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Sulo, Gerhard, Jannicke Igland, Stein Emil Vollset, Marta Ebbing, Grace M. Egeland, Inger Ariansen e Grethe S. Tell. "Trends in incident acute myocardial infarction in Norway: An updated analysis to 2014 using national data from the CVDNOR project". European Journal of Preventive Cardiology 25, n.º 10 (29 de maio de 2018): 1031–39. http://dx.doi.org/10.1177/2047487318780033.
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Background We updated the information on trends of incident acute myocardial infarction in Norway, focusing on whether the observed trends during 2001–2009 continued throughout 2014. Methods All incident (first) acute myocardial infarctions in Norwegian residents age 25 years and older were identified in the Cardiovascular Disease in Norway 1994–2014 project. We analysed overall and age group-specific (25–64 years, 65–84 years and 85 + years) trends by gender using Poisson regression analyses and report the average annual changes in rates with their 95% confidence intervals. Results During 2001–2014, 221,684 incident acute myocardial infarctions (59.4% men) were identified. Hospitalised cases accounted for 79.9% of all incident acute myocardial infarctions. Overall, incident acute myocardial infarction rates declined on average 2.6% per year (incidence rate ratio 0.974, 95% confidence interval 0.972–0.977) in men and 2.8% per year (incidence rate ratio 0.972, 95% confidence interval 0.971–0.974) in women, contributed by declining rates of hospitalisations (1.8% and 1.9% per year in men and women, respectively) and deaths (6.0% and 5.8% per year in men and women, respectively). Declining rates were observed in all three age groups. The overall acute myocardial infarction incidence rates continued to decline from 2009 onwards, with a steeper decline compared to 2001–2009. During 2009–2014, gender-adjusted acute myocardial infarction incidence among adults age 25–44 years declined 5.3% per year, contributed mostly by declines in hospitalisation rates (5.1% per year). Conclusion Acute myocardial infarction incidence rates continued to decline after 2009 in Norway in both men and women. The decline started to involve individuals aged 25–44 years, marking a turning point in the previously reported stagnation of rates during 2001–2009.
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Klatka, Lisa A., Mark H. Depper e Ann M. Marini. "Infarction in the territory of the anterior cerebral artery". Neurology 51, n.º 2 (agosto de 1998): 620–22. http://dx.doi.org/10.1212/wnl.51.2.620.
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Infarction in the anterior cerebral artery (ACA) territory is an uncommon cause of stroke. The clinical findings of ACA infarctions are not fully characterized but include contralateral hemiparesis, urinary incontinence, transcortical aphasia, agraphia, apraxia, and executive dysfunction. We report a patient with a large right ACA infarction, who in addition to previously reported findings also had a complete hemiplegia, profound sensory neglect, and micrographia.
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Bergui, M., G. Ventilii, F. M. Ferrio, D. R. Daniele e G. B. Bradač. "Spinal Cord Ischemia due to Vertebral Artery Dissection". Rivista di Neuroradiologia 18, n.º 3 (junho de 2005): 390–94. http://dx.doi.org/10.1177/197140090501800318.
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We reviewed clinical and neuroradiological findings in 37 consecutive patients with cervical cord infarction due to vertebral artery dissection diagnosed at our institution from 1996 to 2004. Four patients had clinical and neuroradiological findings consistent with spinal cord ischemia. Three patients had “pencil-like” infarction at C3-C5 level; one patient had an infarction of the anterior horns of the spinal grey matter at C3-C4 level. Symptoms were crural sensory deficit with mild tetraparesis and proximal strength deficit of the arms, respectively. Spinal cord infarction complicated vertebral artery dissection in about 10% of patients of our series. Infarctions involved the most central regions of the spinal cord, with relative sparing of the peripheral white matter tracts. Clinical and MRI pictures were almost typical, and consistent with a hemodynamic mechanism for the lesions. Vertebral artery dissection must be considered in the differential diagnosis in patients with cervical cord infarction.
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Li, Jie-Yuan, Ping-Hong Lai e Robert Chen. "Transcallosal inhibition in patients with callosal infarction". Journal of Neurophysiology 109, n.º 3 (1 de fevereiro de 2013): 659–65. http://dx.doi.org/10.1152/jn.01044.2011.
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Recent studies in normal subjects suggested that callosal motor fibers pass through the posterior body of the corpus callosum (CC), but this has not been tested in patients with callosal infarction. The objective of this study is to define the pathways involved in transcallosal inhibition by examining patients with infarctions in different subregions of the CC. We hypothesized that patients with lesions in the posterior one-half of the CC would have greater reduction in transcallosal inhibition between the motor cortices. Twenty-six patients with callosal infarction and 14 healthy subjects were studied. The callosal lesions were localized on sagittal MRI and were attributed to one of five segments of the CC. Transcranial magnetic stimulation was used to assess ipsilateral silent period (iSP) and short- and long-latency interhemispheric inhibition (SIHI and LIHI, respectively) originating from both motor cortices. The results showed that the iSP areas and durations were markedly reduced bilaterally in patients with callosal infarction compared with normal subjects. Patients with callosal infarctions also had less IHI bidirectionally compared with normal subjects. iSP areas and durations were lower in patients with lesions than in patients without lesions in segment 3 (posterior midbody) of the CC. Lesion burden in the posterior one-half of the CC negatively correlated transcallosal inhibition measured with iSP and SIHI. Our study suggests that callosal infarction led to reduced transcallosal inhibition, as measured by iSP, SIHI, and LIHI. Fibers mediating transcallosal inhibition cross the CC mainly in the posterior one-half.
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Janga, Chaitra, Kimberley Okoyeze e Vincent Chan. "Isolated Splenic Infarction: An Initial Manifestation of Postoperative Atrial Fibrillation". Journal of Investigative Medicine High Impact Case Reports 10 (janeiro de 2022): 232470962211033. http://dx.doi.org/10.1177/23247096221103384.
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Splenic infarction is an uncommon cause of abdominal pain. In this article, we present a case of isolated splenic infarction presenting with severe abdominal pain, nausea, and with associated generalized weakness. Computed tomography (CT) abdomen and pelvis with contrast revealed multiple splenic infarctions of the entire lower pole with occlusion of the branch splenic arteries, while CT abdomen without contrast was unremarkable. Etiology was later revealed to be thromboembolism secondary to atrial fibrillation. It was managed with anticoagulation. To our knowledge, this is the second case of splenic infarction presenting as an initial manifestation of atrial fibrillation (AF), reported in the literature.
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Kovalchuk, E. Yu, e A. V. Rysev. "POST-INFARCTION CARDIAC RUPTURE". HERALD of North-Western State Medical University named after I.I. Mechnikov 7, n.º 3 (15 de setembro de 2015): 97–101. http://dx.doi.org/10.17816/mechnikov20157397-101.
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The field of post-infarction myocardial ruptures is still a nearly blind spot of cardiology; there are many facts about it which are ambiguous and simply too vague. For example, the dispersion in frequency rate is quite self-explanatory: from 0 to 30 or even 35 per cent. A number of clinical studies concerning the 30 days mortality due to acute myocardial infarctions just ignores myocardial ruptures as being the cause of death. This probably comes from a certain confusion as the post-infarction myocardial ruptures and the cardiogenic shock have almost similar manifestations. However pathologists participating in those not so numerous clinical studies concerning the 30 days mortality due to acute MIs presume that the real frequency rate of myocardial ruptures is much higher and stands at 20 to 36 per cent among all cases.
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Graff-Radford, Neill R., Harold P. Adams, Wendy R. K. Smoker, José Biller e David J. Boarini. "Unruptured Fusiform Aneurysms of the Posterior Circulation with Thalamic Infarction". Neurosurgery 17, n.º 3 (1 de setembro de 1985): 495–99. http://dx.doi.org/10.1227/00006123-198509000-00018.
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Abstract Three patients with unruptured fusiform aneurysms of the posterior circulation presented with nonhemorrhagic thalamic infarctions. All of the aneurysms were seen on enhanced computed tomographic (CT) scans preangiographically. Although unruptured fusiform aneurysms are probably a rare cause of nonhemorrhagic thalamic infarction, their importance lies in the therapeutic implications of this diagnosis. In patients with nonhemorrhagic thalamic infarction, we suggest careful scrutiny of the blood vessels on enhanced CT scans.
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Menzel, Linda K. "The Electrocardiogram during Myocardial Infarction". AACN Advanced Critical Care 3, n.º 1 (1 de fevereiro de 1992): 190–202. http://dx.doi.org/10.4037/15597768-1992-1024.
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The electrocardiogram during myocardial ischemia, injury, and infarction produces classic changes in the QRS complex, ST segment, and T wave. These changes arc easily recognized and, with results of serum isoenzymes, physical assessment, and the patient’s history, aid in diagnosis. This article reviews the changes that occur on the electrocardiogram beginning with a brief review of normal depolarization and repolarization and ending with changes seen in various types of myocardial infarctions
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Huda, Nazmul, Zahidus Sayeed, ARMS Ekram, MMR Khan e MK Rahman. "Right Ventricular Myocardial Infarction as an Independent Predictor of Prognosis in Acute Inferior Myocardial Infarction". TAJ: Journal of Teachers Association 26 (28 de novembro de 2018): 8–13. http://dx.doi.org/10.3329/taj.v26i0.37578.
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Background: Acute inferior myocardial Infarction frequently involves the right ventricle and associated with significant morbidity and mortality. We hypothesized that right ventricular involvement may affect the prognosis of patients with inferior myocardial infarctions.Methodology: In 100 consecutive patients admitted to the hospital with acute inferior myocardial infarction, we assessed the incidence and prognostic factors for in-hospital outcome. RVMI (Right ventricular myocardial infarction) was diagnosed by ≥1mm ST elevation in lead V4R in right sided electrocardiogram.Result: RVMI was found in 31(31%) of patients of acute inferior myocardial infarctions. Major complications as hypotension and cardiogenic shock occurred in 96.7% and 64.5% patients respectively and in-hospital mortality was 41.9%. Whereas major complications as hypotension and cardiogenic shock occurred in 10.1% and 2.8% patients respectively and in hospital mortality was 2.8% of patients without right ventricular infarction among the inferior myocardial infarction. Multiple logistic regression analysis showed right ventricular infarction to be independent of and superior to all other clinical variables available on admission for the prediction of in hospital mortality (relative risk 88.37 percent, 95% confidence interval 7.33 to 1064.80; p=0.000) and major complications as hypotension (relative risk 394.22, 95% confidence interval 32.04 to 4849.07; p=0.000) and cardiogenic shock (relative risk 272.36, 95% confidence interval, 16.38 to 4526.35; p=0.000).Conclusion: RVMI commonly occurs in inferior myocardial infarction. It is a strong and independent predictor of major complications and in-hospital mortality. Early detection and appropriate monitoring can reduce its high mortality rate.TAJ 2013; 26: 8-13
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Matsubara, Noriaki, Shigeru Miyachi, Takeshi Okamaoto, Takashi Izumi, Takumi Asai, Takashi Yamanouchi, Keisuke Ota, Keiko Oda e Toshihiko Wakabayashi. "Spinal Cord Infarction is an Unusual Complication of Intracranial Neuroendovascular Intervention". Interventional Neuroradiology 19, n.º 4 (dezembro de 2013): 500–505. http://dx.doi.org/10.1177/159101991301900416.
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Spinal cord infarction is an unusual complication of intracranial neuroendovascular intervention. The authors report on two cases involving spinal cord infarction after endovascular coil embolization for large basilar-tip aneurysms. Each aneurysm was sufficiently embolized by the stent/balloon combination-assisted technique or double catheter technique. However, postoperatively, patients presented neurological symptoms without cranial nerve manifestation. MRI revealed multiple infarctions at the cervical spinal cord. In both cases, larger-sized guiding catheters were used for an adjunctive technique. Therefore, guiding catheters had been wedged in the vertebral artery (VA). The wedge of the VA and flow restriction may have caused thromboemboli and/or hemodynamic insufficiency of the spinal branches from the VA (radiculomedullary artery), resulting in spinal cord infarction. Spinal cord infarction should be taken into consideration as a complication of endovascular intervention for lesions of the posterior circulation.
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Dabby, Ron, Nathan Watemberg, Yair Lampl, Anda Eilam, Abraham Rapaport e Menachem Sadeh. "Pathological Laughter as a Symptom of Midbrain Infarction". Behavioural Neurology 15, n.º 3-4 (2004): 73–76. http://dx.doi.org/10.1155/2004/409248.
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Pathological laughter is an uncommon symptom usually caused by bilateral, diffuse cerebral lesions. It has rarely been reported in association with isolated cerebral lesions. Midbrain involvement causing pathological laughter is extremely unusual. We describe three patients who developed pathological laughter after midbrain and pontine-midbrain infarction. In two patients a small infarction in the left paramedian midbrain was detected, whereas the third one sustained a massive bilateral pontine infarction extending to the midbrain. Laughter heralded stroke by one day in one patient and occurred as a delayed phenomenon three months after stroke in another. Pathological laughter ceased within a few days in two patients and was still present at a two year follow-up in the patient with delayed-onset laughter. Pathological laughter can herald midbrain infarction or follow stroke either shortly after onset of symptoms or as a delayed phenomenon. Furthermore, small unilateral midbrain infarctions can cause this rare complication.
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Yang, Lei, Wei Qin, Yue Li, Shuna Yang, Hua Gu e Wenli Hu. "Differentiation of pontine infarction by size". Open Medicine 15, n.º 1 (8 de março de 2020): 160–66. http://dx.doi.org/10.1515/med-2020-0025.
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AbstractPurposeWe hypothesized that the current criteria may be unsuitable for lacunar pontine infarctions (LPI) diagnosis and that size criteria may indicate different stroke mechanisms.MethodsA total of 102 patients with isolated pontine infarctions were divided into a parent artery disease (PAD) and non-PAD groups according to stenosis of basilar artery. Further, 86 patients from the non-PAD group were divided into paramedian pontine infarction (PPI) and LPI groups. Data were collected from the three groups. The “golden” criterion for LPI was established based on the location of the infarction. A receiver operating characteristic (ROC) curve were used to evaluate the optimal cutoff value to use as an LPI diagnostic indicator.ResultsThere was a high prevalence of patients with PAD in both asymptomatic carotid atherosclerosis (ACAS) and PPI groups. Patients with PPI had a higher prevalence in diabetes and ACAS than those with LPI. Based upon the ROC curve, the optimal lesion size cutoff value for use as an LPI diagnostic indicator was 11.8 mm.ConclusionsDiffusion weighted imaging (DWI) cutoff points for predicting LPI may differ from that of the middle cerebral artery territory. The diameter of LPI may also indicate different stroke mechanisms.
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Содномова, Лариса, Larisa Sodnomova, Наталья Булутова e Natalya Bulutova. "GENDER DIFFERENCES FOR MYOCARDIAL INFARCTION AS OUTCOME OF ST ELEVATION ACS IN THE REPUBLIC OF BURYATIA". Acta biomedica scientifica 2, n.º 5 (18 de janeiro de 2018): 49–54. http://dx.doi.org/10.12737/article_5a3a0dbc1a5221.80743076.
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Evidential base for diagnosis and treatment of myocardial infarction is based on the results of randomized clinical
studies that included mostly male patients.
Objective: to determine gender specifics in development, progression, methods of treatment, diagnostics, outcomes of
myocardial infarction for defining customized approaches to its treatment.
Study material and methods: 84 medical records of patients with myocardial infarction – 50 male and 54 female patients
admitted in the emergency cardiac care department. Statistical data is processed in Microsoft Excel and Statistica v. 10.0.
Results. Female patients suffer myocardial infarction late in life; they display higher obesity rate, renal dysfunction, type
2 diabetes as compared to male patients. At the time of admission to hospital the risk of hemorrhage is higher among
female patients, which is related to the higher rate of renal disfunction and age. Average CRUSADE score for female
patients is 39.14 ± 2.5, for male patients – 22.7 ± 1.4 points. Female patients demonstrate higher frequency of atypical
symptoms for myocardial infarction – 18 %, compared to 8 % for males (p = 0.05), that leads to prolongated period
of symptom-hospitalization. Thus, there are less women who are hospitalized within first 3 hours – 6 % against 28 %
men (p = 0.01). Women display tendency to a higher frequency of Q-negative and recurrent myocardial infarctions,
men – to first-time and Q-positive infarctions. As for the frequency of CAG, TLT and PCI, as well as mortality rate due
to MI there is no difference between the groups.
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Pan, Yuesong, Xia Meng, Jing Jing, Hao Li, Xingquan Zhao, Liping Liu, David Wang, S. Claiborne Johnston, Yilong Wang e Yongjun Wang. "Association of multiple infarctions and ICAS with outcomes of minor stroke and TIA". Neurology 88, n.º 11 (15 de fevereiro de 2017): 1081–88. http://dx.doi.org/10.1212/wnl.0000000000003719.
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Objective:To estimate the association of different patterns of infarction and intracranial arterial stenosis (ICAS) with the prognosis of acute minor ischemic stroke and TIA.Methods:We derived data from the Clopidogrel in High-risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial. A total of 1,089 patients from 45 of 114 participating sites of the trial undergoing baseline MRI/angiography were included in this subgroup analysis. Patterns of infarction and ICAS were recorded for each individual. The primary efficacy outcome was an ischemic stroke at the 90-day follow-up. We assessed the associations between imaging patterns and prognosis of patients using multivariable Cox regression models.Results:Among the 1,089 patients included in this subgroup analysis, 93 (8.5%) patients had a recurrent ischemic stroke at 90 days. Compared with those without infarction or ICAS, patients with single infarction with ICAS (11.9% vs 1.3%, hazard ratio [HR] 6.25, 95% confidence intervals [CIs] 1.40–27.86, p = 0.02) and single infarction without ICAS (6.8% vs 1.3%, HR 4.65, 95% CI 1.05–20.64, p = 0.04) were all associated with an increased risk of ischemic stroke at 90 days. Patients with both multiple infarctions and ICAS were associated with approximately 13-fold risk of ischemic stroke at 90 days (18.0% vs 1.3%, HR 13.14, 95% CI 2.96–58.36, p < 0.001).Conclusions:The presence of multiple infarctions and ICAS were both associated with an increased risk of 90-day ischemic stroke in patients with minor stroke or TIA, while the presence of both imaging features had a combined effect.ClinicalTrials.gov identifier:NCT00979589.
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Doggen, Carine J. M., Frits R. Rosendaal e Joost C. M. Meijers. "Levels of intrinsic coagulation factors and the risk of myocardial infarction among men: opposite and synergistic effects of factors XI and XII". Blood 108, n.º 13 (15 de dezembro de 2006): 4045–51. http://dx.doi.org/10.1182/blood-2005-12-023697.
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Abstract The role of the intrinsic coagulation system on the risk of myocardial infarction is unclear. In the Study of Myocardial Infarctions Leiden (SMILE) that included 560 men younger than age 70 with a first myocardial infarction and 646 control subjects, we investigated the risk of myocardial infarction for levels of factor XI (factor XIc) and factor XII (factor XIIc). Furthermore, the risks for factor VIII activity (factor VIIIc) and factor IX activity (factor IXc) were assessed. Factor XIc was 113.0% in patients compared with 109.8% in control subjects (difference, 3.2%; 95% CI, 1.1%-5.4%). The risk of myocardial infarction adjusted for age for men in the highest quintile compared with those in the lowest quintile was 1.8-fold increased (ORadj, 1.8; 95% CI, 1.2-2.7). In contrast, factor XIIc among patients with myocardial infarction was lower than in control subjects, respectively, 93.0% and 98.6% (difference, 5.6%; 95% CI, 3.3%-7.9%). The odds ratio of myocardial infarction for men in the highest quintile versus those in the lowest quintile was 0.4 (ORadj, 0.4; 95% CI, 0.2-0.5). The highest risk was found among men with both high factor XIc and low factor XIIc (analyses in tertiles: ORadj, 6.4; 95% CI, 2.2-18.0). Factor VIIIc increased the risk of myocardial infarction although not dose dependently. Factor IXc increased the risk; odds ratio of myocardial infarction for men in the highest quintile versus those in the lowest quintile was 3.2 (ORadj, 3.2; 95% CI, 2.0-5.1). Thus, factors XIc and XIIc have opposite and synergistic effects on the risk of myocardial infarction in men; factor VIIIc and factor IXc increase the risk.
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Endo, Hidenori, Yasushi Matsumoto, Ryushi Kondo, Kenichi Sato, Miki Fujimura, Takashi Inoue, Hiroaki Shimizu, Akira Takahashi e Teiji Tominaga. "Medullary infarction as a poor prognostic factor after internal coil trapping of a ruptured vertebral artery dissection". Journal of Neurosurgery 118, n.º 1 (janeiro de 2013): 131–39. http://dx.doi.org/10.3171/2012.9.jns12566.
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Object Internal coil trapping is a treatment method used to prevent rebleeding from a ruptured intracranial vertebral artery dissection (VAD). Postoperative medullary infarctions have been reported as a complication of this treatment strategy. The aim of this study was to determine the relationship between a postoperative medullary infarction and the clinical outcomes for patients with ruptured VADs treated with internal coil trapping during the acute stage of a subarachnoid hemorrhage (SAH). Methods A retrospective study identified 38 patients who presented between 2006 and 2011 with ruptured VADs and underwent internal coil trapping during the acute stage of SAH. The SAH was identified on CT scanning, and the diagnosis for VAD was rendered by cerebral angiography. Under general anesthesia, the dissection was packed with coils, beginning at the distal end and proceeding proximally. When VAD involved the origin of the posterior inferior cerebellar artery (PICA) with a large cerebellar territory, an occipital artery (OA)–PICA anastomosis was created prior to internal coil trapping. The pre- and postoperative radiological findings, clinical course, and outcomes were analyzed. Results The internal coil trapping was completed within 24 hours after admission. An OA-PICA anastomosis followed by internal coil trapping was performed in 5 patients. Postoperative rebleeding did not occur in any patient during a mean follow-up period of 16 months. The postoperative MRI studies showed medullary infarctions in 18 patients (47%). The mean length of the trapped VAD for the infarction group (15.7 ± 6.0 mm) was significantly longer than that of the noninfarction group (11.5 ± 4.3 mm) (p = 0.019). Three of the 5 patients treated with OA-PICA anastomosis had postoperative medullary infarction. The clinical outcomes at 6 months were favorable (modified Rankin Scale Scores 0–2) for 23 patients (60.5%) and unfavorable (modified Rankin Scale Scores 3–6) for 15 patients (39.5%). Of the 18 patients with postoperative medullary infarctions, the outcomes were favorable for 6 patients (33.3%) and unfavorable for 12 patients (66.7%). A logistic regression analysis predicted the following independent risk factors for unfavorable outcomes: postoperative medullary infarctions (OR 21.287 [95% CI 2.622–498.242], p = 0.003); preoperative rebleeding episodes (OR 7.450 [95% CI 1.140–71.138], p = 0.036); and a history of diabetes mellitus (OR 45.456 [95% CI 1.993–5287.595], p = 0.013). Conclusions A postoperative medullary infarction was associated with unfavorable outcomes after internal coil trapping for ruptured VADs. Coil occlusion of the long segment of the VA led to medullary infarction, and an OA-PICA bypass did not prevent medullary infarction. A VA-sparing procedure, such as flow diversion by stenting, is an alternative treatment in the future, if this approach is demonstrated to effectively prevent rebleeding.
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Nilsson, S., G. Wikström, A. Ericsson, M. Wikström, A. Waldenström e A. Hemmingsson. "MR Imaging of Gadolinium-DTPA-BMA-Enhanced Reperfused and Nonreperfused Porcine Myocardial Infarction". Acta Radiologica 36, n.º 4-6 (julho de 1995): 633–40. http://dx.doi.org/10.1177/028418519503600465.
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To investigate whether Gd-DTPA-BMA-enhanced MR imaging permits differentiation between reperfused and nonreperfused myocardial infarction, myocardial infarction was induced in 12 domestic pigs. In 6 pigs, Gd-DTPA-BMA, 0.3 mmol/kg b.w. was administered i.v. 60 min after the occlusion. In 6 other pigs, the infarctions were reperfused 80 min after the occlusion, followed by injection of Gd-DTPA-BMA after 20 min of reperfusion. Radiolabeled microspheres were used to confirm zero-flow during the occlusion period and reperfusion in the infarcted myocardium. All pigs were killed 20 min after injection of contrast medium, and the hearts were excised and imaged with MR. The Gd concentration was measured in infarcted and nonischemic myocardium by ICPAES. In the reperfused hearts, the infarctions were strongly highlighted, corresponding to a 5-fold higher Gd concentration in infarcted vis-à-vis nonischemic myocardium. In the hearts subjected to occlusion without reperfusion, there was only a rim of enhancement in the peripheral part of the infarctions.
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Polat, Büşra Sümeyye Arıca, Akçay Övünç Özen e Ömer Karadaş. "Hemispheric lateralization of depression and attention deficit". Medical Science and Discovery 7, n.º 2 (25 de fevereiro de 2020): 409–11. http://dx.doi.org/10.36472/msd.v7i2.349.
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Objective: There is a complex interaction among to the ischemic cerebrovascular diseases, cognition and depression. The aim of present study is to investigate the relationship between lesion side and depression and attention deficit in patients with Middle Cerebral Artery (MCA) infarction.
Methods: This study was conducted on 41 patients with right and left MCA infarction. Beck Depression Inventory (BDI) was used for determination of depression severity of patients and Montreal Cognitive Assessment (MoCA) scoring was used for evaluation of cognitive status. Attention sub-test of MoCA score was also examined.
Results: 20 patients had right MCS. The mean age of the patients was 72.21 years. 51.2% of the patients were male. BDI mean score was found to be 11.25 in patients with right MCA infarction and 16.9 in patients with left MCA infarction (p:0.04). The total MoCA scores between two groups were similar (right/left MCA infarction: 20.8/21.3). It was seen to be lower attention sub-score in patients with right hemisphere effects compared to patients with left hemispheric lesion (3.1/5.9; p:0.00).
Conclusion: According to our findings, it is understood that attention of patients with right MCA infarction is more affected and patients with left MCA infarction is more depressed. In future studies, depression and attention affects which are at risk of developing after MCA infarctions should be evaluated in detail and should be put emphasis to rehabilitation of these areas.
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Mahr, Greg. "Infarction". Chest 154, n.º 1 (julho de 2018): 222. http://dx.doi.org/10.1016/j.chest.2018.01.047.
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Vavuranakis, Manolis, Maria Drakopoulou, Konstantinos Toutouzas, Dilaveris Polychronis e Christodoulos Stefanadis. "Right Ventricular Infarction Mimicking Anterior Infarction". Annals of Noninvasive Electrocardiology 11, n.º 2 (abril de 2006): 194–97. http://dx.doi.org/10.1111/j.1542-474x.2006.00101.x.
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Inverso, Stephanie M. "Combination Glycoprotein IIb/IIIa Receptor Antagonists With Thrombolytics in Acute Myocardial Infarction". Journal of Pharmacy Practice 15, n.º 4 (agosto de 2002): 344–55. http://dx.doi.org/10.1177/089719002129041331.
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Rupture of an atherosclerotic plaque in a coronary artery with subsequent thrombosis is the cause of most acute myocardial infarctions. Thrombolytics are the standard pharmacologic agents used to restore normal blood flow through the occluded coronary artery. While the use of thrombolytics has decreased both short-term and long-term mortality in patients presenting with acute myocardial infarction, these agents do have limitations. Combining glycoprotein IIb/IIIa receptor antagonists with thrombolytics is one strategy being investigated to try to improve outcomes after acute myocardial infarction.
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Cholakkal, Shanavas, Rajesh Nambiar, Sajeesh Sahadevan e Rohit Ravindran. "Acute idiopathic omental infarction as an unusual cause of left iliac fossa pain: a case report". International Surgery Journal 5, n.º 2 (25 de janeiro de 2018): 743. http://dx.doi.org/10.18203/2349-2902.isj20180387.
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Acute idiopathic omental infarction is an uncommon cause of abdominal pain. Only about 300 cases have been reported in the medical literature so far.15% of cases occur in the pediatric age group. Omental infarctions are common on the right side and present as right iliac fossa pain. Clinical presentation usually mimics acute appendicitis and leads to unnecessary surgical intervention in majority of the cases. Acute idiopathic omental infarction presenting as left iliac fossa pain has not been reported till now in medical literature. Controversy exist regarding the management of acute omental infarction. While a few authors recommend surgical resection of the infarcted omentum, most authors recommend conservative management. Here we report a case 36 years old lady with acute idiopathic omental infarction presenting as the left sided abdominal pain. Diagnosis was made on contrast enhanced CT imaging. She was managed conservatively with NSAIDs and antibiotics. She was discharged after 2 days of in hospital. She improved clinically on outpatient follow up at 1 week, 1 month and 6 months. In short, acute idiopathic omental infarction is an unusual cause of left iliac fossa pain. Patients may benefit from conservative management, once the diagnosis is confirmed based on imaging. Further studies are necessary to devise a correct guideline on surgical intervention and conservative management in omental infarction.
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Jin, Yi, e Yuan Zhao. "Post-stroke upper limb spasticity incidence for different cerebral infarction site". Open Medicine 13, n.º 1 (1 de junho de 2018): 227–31. http://dx.doi.org/10.1515/med-2018-0035.
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AbstractObjectiveThe purpose of this study was to evaluate the incidence rate of post-stroke upper limb spasticity and its correlation with cerebral infarction site.MethodsA total of 498 inpatient and outpatient cases are included in the present study. The post-stroke upper limb spasticity rate of different cerebral infarction site was calculated.ResultsA total of 498 patients with cerebral infarction are enrolled in this study. Of these patients, 91 have dropped out and 407 have completed the study. Of the completed cases, 172 are in the spasm group and 235 are in the non-spasm group. The total incidence of upper limb spasticity is 34.5%. The incidences of upper extremity spasms are 12.5%, 20%, 22.5%, 35%, 40%, and 42.5% in 2 weeks, 1 month, 2 months, 3 months, 6 months, and 12 months, respectively. The incidence of upper extremity spasms increases with time. The incidences of upper limb spasticity are 12.1%, 63.3%, 58.5%, 9.4% and 8.3% when cerebral infarction occurs in the cortical and subcortical mixed areas, basal ganglia and internal capsule, cerebralcortex, brainstem and cerebellum respectively. The incidence of upper limb spasticity varies in different infarction sites (P < 0.05).ConclusionThe post-stroke upper limb spasticity rates were different according to the different cerebral infarction site. Patients with the ganglia and internal capsule infarctions had the highest risk of developing post-stroke upper limb spasticity.
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Pires, Leopoldo Antônio, Marcelo Maroco Cruzeiro, Thiago Cardoso Vale, Luciana de Souza Nogueira, Gláucio Mendes Franco e Sérgio Franca de Souza. "Atypical clinical presentation in an anterior cerebral artery territory infarction". Revista Neurociências 17, n.º 3 (23 de janeiro de 2019): 279–82. http://dx.doi.org/10.34024/rnc.2009.v17.8556.
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Infarction of the anterior cerebral artery (ACA) territory accounts for only 0.3-4.4% of cerebral infarctions. We report an unusually prolonged progressing stroke of the ACA in a 58-yearold patient who had his diagnosis based on neuroimaging investigation and in anatomopathological exclusion of neoplastic disorder.
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Ristic, Andjelka, Milorad Damjanovic, Branislav Baskot e Sasa Rafaelovski. "The tole of ischemic preconditioning in acute myocardial infarction". Medical review 58, n.º 5-6 (2005): 308–12. http://dx.doi.org/10.2298/mpns0506308r.
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Introduction Ischemic preconditioning is a phenomenon in which brief episodes of ischemia and reperfusion increase myocardial tolerance and substantially reduce the infarction size. Case report Two patients with acute left anterior descending artery occlusion received fibrinolytic therapy within 6 hours of symptom onset, but nevertheless developed myocardial infarctions of different size. The first patient, without a history of preinfarction angina, developed a large anterior infarction, because there was no time for ischemic preconditioning or development of coronary collateral vessels. The second patient, with a 4-day history of preinfarction angina, had a more favorable outcome-he developed apical necrosis, with greater myocardial viability in the infarct-related area. Conclusion The beneficial effects of angina occurring 24-48h before infarction are resulting from ischemic preconditioning, which reduces cardiac mortality, infarct size and occurrence of life-threatening ventricular arrhythmias. .
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Grigorovskiy, V. V. "Morphogenesis and Pathogenesis of Traumatic Infarction of Long Bone (experimental 13 studay)". N.N. Priorov Journal of Traumatology and Orthopedics 5, n.º 3 (15 de setembro de 1998): 13–19. http://dx.doi.org/10.17816/vto104547.
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Morphogenesis and pathogenesis of traumatic infarction of long bone was studied in experiment (45 rats and 8 dogs). Tibial osteotomy with section of great branches of the main nutritive arteria were performed. Morphogenic indices of pathologic changes were studied in terms from 3 hours to 60 days and physiologic indices of intraosseous hemodynamics were studied in terms from 10 min to 8 hours During the first hours after osteotomy extensive loci of blood supply occulusion of bone marrow and diaphysial cortex were detected in free fragment ends. Then those loci were transformed into diaphysial infarction. Occulusion loci increased up to the end of the first day after osteotomy, then they started to decrease. Infarctions in distal fragment were reliably more extensive than the infarctions in proximal fragment. Physiologic indices testified severe blood supply aggravation in free distal fragment end.
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Lee, Jongmin, Hyun Young Kim, Young Seo Kim, Sang-Cheol Bae, Ji Young Lee e Young-Jun Lee. "Intractable Progressive Cerebral Infarction with Multiple Atypical Aneurysms in Systemic Lupus Erythematosus". Journal of Neurosonology and Neuroimaging 13, n.º 2 (31 de dezembro de 2021): 71–75. http://dx.doi.org/10.31728/jnn.2021.00103.
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We report a case of intractable progressive cerebral infarction with multiple fusiform aneurysms in a 34-year-old female patient with systemic lupus erythematosus (SLE), non-responsive to massive immunotherapy. The patient visited the emergency department with dysarthria and left-sided hemiparesis that occurred 2 days before. She was diagnosed with SLE involving the brain and received 12 cycles of cyclophosphamide 12 years prior. Brain diffusion-weighted imaging showed acute infarctions involving the pons and medulla. Additionally, multifocal microbleeding-like signals in various cisternal spaces were detected using susceptibility-weighted imaging. Digital subtraction angiography revealed multiple fusiform aneurysms. Despite antithrombotic treatment with trif lusal and immunotherapies, including corticosteroids, mycophenolate mofetil, and immunoglobulins, for cerebral vasculitis associated infarction, her neurologic deficits worsened with recurrent cerebral infarction. Further investigation for accurate diagnosis and treatment is required.
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Jenkins, Crystal P., Diana M. Cardona, Jennifer N. Bowers, Bahram R. Oliai, Robert W. Allan e Sigurd J. Normann. "The Utility of C4d, C9, and Troponin T Immunohistochemistry in Acute Myocardial Infarction". Archives of Pathology & Laboratory Medicine 134, n.º 2 (1 de fevereiro de 2010): 256–63. http://dx.doi.org/10.5858/134.2.256.
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Abstract Context.—Full activation and involvement of the complement pathway follows acute myocardial infarction. Complement fragment C4d is a stable, covalently bound marker of complement activation. Troponin T is specific for cardiomyocytes. Objectives.—To determine the specificity of C4d, C9, and troponin T immunoreactivity in necrotic myocytes and to establish whether they can be used to delineate acute myocardial infarction. Design.—Twenty-six autopsy cases with a total of 54 myocardium areas of infarction were reviewed retrospectively. Immunohistochemistry for C4d, C9, and troponin T was used on paraffin sections of formalin-fixed tissue. Controls consisted of 5 cases without evidence of infarction, and histologically normal myocardium functioned as an internal control. Results.—C4d and C9 antibodies reacted strongly and diffusely with necrotic myocytes in all samples of infarctions for up to 2 days (19 of 19; 100%). Adjacent histologically normal myocytes were nonreactive, resulting in a clear delineation between damaged and viable myocardium. Reactivity declined with increased duration and was absent in scars. Troponin T showed loss of staining in preinflammatory lesions (8 of 13; 62%); however, nonspecific patchy loss of staining was present in negative controls and in viable myocardium. Immunostains provided new diagnoses in 2 cases, including evidence of reinfarction and a newly diagnosed acute myocardial infarction. Conclusions.—C4d and C9 have comparable reactivity and specificity for necrotic myocytes. C4d and C9 staining of necrotic myocytes is apparent before the influx of inflammatory cells, demonstrating utility in early myocardial infarction. Patchy loss of Troponin T in some cases of histologically normal myocardium limited its usefulness as a sole marker of infarction.
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Standke, R., R. P. Baum, S. Tezak, D. Mildenberger, F. D. Maul, G. Hör, M. Kaltenbach e H. Klepzig. "Vergleich von Belastungs- EKG und Radionuklid- Ventrikulographie bezüglich des Nachweises einer Myokardischämie bei isolierten Stenosen des Ramus interventricularis anterior". Nuklearmedizin 27, n.º 02 (1988): 57–62. http://dx.doi.org/10.1055/s-0038-1628908.
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21 patients with LAD-stenoses of at least 70% and 21 patients with LAD- stenoses and additional intramural anterior wall infarctions were studied. 20 patients without heart disease or after successful transluminal coronary angioplasty and 18 patients with intramural anterior wall infarction after successful transluminal dilatation of the LAD (remaining stenosis maximal 30%) served as controls. The normal range of global and regional left ventricular ejection fraction response to exercise was defined based on the data of 25 further patients without relevant coronary heart disease. Thus, a decrease in global ejection fraction and regional wall motion abnormalities were judged pathological. All patients were comparable with respect to age, ejection fraction at rest and work load. Myocardial ischemia could be detected by the exercise ECG in 81 % of all patients without infarction and in 71 % of patients with infarction. The corresponding values for global left ventricular ejection fraction were 76% and 81 %, respectively, and for regional ejection fraction 95% in both groups. No false-positive exercise ECGs were observed in the healthy controls and 2 (11 %) in the corresponding group with intramural infarction. The global ejection fraction was pathological in 1 (5%) healthy subject without infarction and in 3 (17%) corresponding patients with infarction. Sectorial analysis revealed 5 and 22%, respectively. Our findings suggest that the exercise ECG has a limited sensitivity to detect myocardial ischemia in patients with isolated LAD-stenoses and intramural myocardial infarction. Radionuclide ventriculography yields pathological values more often; however, false-positive results also occur more frequently.
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Lio, Ka U., Oisin O’Corragain, Riyaz Bashir, Shari Brosnahan, Gary Cohen, Vladimir Lakhter, Joseph Panaro, Belinda Rivera-Lebron e Parth Rali. "Clinical outcomes and factors associated with pulmonary infarction following acute pulmonary embolism: a retrospective observational study at a US academic centre". BMJ Open 12, n.º 12 (dezembro de 2022): e067579. http://dx.doi.org/10.1136/bmjopen-2022-067579.
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ObjectivePulmonary infarction is a common clinical and radiographic finding in acute pulmonary embolism (PE), yet the clinical relevance and prognostic significance of pulmonary infarction remain unclear. The study aims to investigate the clinical features, radiographic characteristics, impact of reperfusion therapy and outcomes of patients with pulmonary infarction.Design, setting and participantsA retrospective cohort study of 496 adult patients (≥18 years of age) diagnosed with PE who were evaluated by the PE response team at a tertiary academic referral centre in the USA. We collected baseline characteristics, laboratory, radiographic and outcome data. Statistical analysis was performed by Student’s t-test, Mann-Whitney U test, Fischer’s exact or χ2test where appropriate. Multivariate logistic regression was used to evaluate potential risk factors for pulmonary infarction.ResultsWe identified 143 (29%) cases of pulmonary infarction in 496 patients with PE. Patients with infarction were significantly younger (52±15.9 vs 61±16.6 years, p<0.001) and with fewer comorbidities. Most infarctions occurred in the lower lobes (60%) and involved a single lobe (64%). The presence of right ventricular (RV) strain on CT imaging was significantly more common in patients with infarction (21% vs 14%, p=0.031). There was no significant difference in advanced reperfusion therapy, in-hospital mortality, length of stay and readmissions between groups. In multivariate analysis, age and evidence of RV strain on CT and haemoptysis increased the risk of infarction.ConclusionsRadiographic evidence of pulmonary infarction was demonstrated in nearly one-third of patients with acute PE. There was no difference in the rate of reperfusion therapies and the presence of infarction did not correlate with poorer outcomes.
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Añazco, Percy Herrera, Fernando Mayor Balta e Liz Córdova-Cueva. "Bilateral renal infarction in a patient with severe COVID-19 infection". Brazilian Journal of Nephrology 43, n.º 1 (março de 2021): 127–31. http://dx.doi.org/10.1590/2175-8239-jbn-2020-0156.
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Abstract Thromboembolic events are frequent in patients with COVID-19 infection, and no cases of bilateral renal infarctions have been reported. We present the case of a 41-year-old female patient with diabetes mellitus and obesity who attended the emergency department for low back pain, respiratory failure associated with COVID-19 pneumonia, diabetic ketoacidosis, and shock. The patient had acute kidney injury and required hemodialysis. Contrast abdominal tomography showed bilateral renal infarction and anticoagulation was started. Kidney infarction cases require high diagnostic suspicion and possibility of starting anticoagulation.
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Almeida, Leila Azevedo de, João Carlos Hueb, Marcos Augusto de Moraes Silva, Rodrigo Bazan, Bruna Estrozi e Cesar N. Raffin. "Cerebral ischemia as initial neurological manifestation of atrial myxoma: case report". Arquivos de Neuro-Psiquiatria 64, n.º 3a (setembro de 2006): 660–63. http://dx.doi.org/10.1590/s0004-282x2006000400027.
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Cerebral infarctions of cardiac etiology are observed in around 20% of patients with ischemic stroke. Cerebral ischemia is the first clinical manifestation in 1/3 of cases of atrial myxomas. Although almost half of patients with atrial myxoma show changes at neurological exam, non-hemorrhagic cerebral infarction is seen in computed tomography in practically all cases. We present the case of a 40 year-old woman whose first clinical manifestation of atrial myxoma was an ischemic stroke. We point out to the possibility of silent cerebral infarction in atrial myxoma patients.