History Of Transient Ischemic Stroke Research Articles

Spontaneous Remission of Retroperitoneal Fibrosis in a Patient with Inherited Thrombophilia

Retroperitoneal fibrosis (RPF) is a rare condition characterized by a diffuse or localized fibroblastic proliferation associated with chronic inflammation. RPF is generally idiopathic, but can also be secondary to the use of certain drugs, malignant diseases, infections, and surgery. Treatment of RPF aims to relieve ureteral obstruction and to induce disease regression, and includes the use of steroids combined or not with other immunosuppressive agents. We present the case of a 35-years old female with a medical history of transient ischemic stroke, myocardial infarction, miscarriage and inherited thrombophilia, who was diagnosed in our Department with idiopathic RPF. Due to the mentioned associated comorbidities, no immuno-active treatment could be initiated. After one year, MRI exam showed significant spontaneous decrease of RPF mass. Although an uncommon event, the spontaneous resolution of idiopathic RPF could encourage in some selected cases a conservative management. By our knowledge, no previously cases of spontaneously remitted RPF in patients with inherited thrombophilia have been reported.

Stroke Literature Synopses: Clinical Science

Paradoxical embolism via a patent foramen ovale (PFO) is a common cause of cryptogenic stroke. Because PFO is a common anatomic variant seen in 25% of the general population, clinicians are faced with the dilemma of whether a PFO is an incidental finding or stroke related. Recent clinical trials of PFO closure failed to show a benefit of closure compared with medical therapy in reducing composite primary end points. Yet, these trials may have enrolled individuals with incidental PFO. To derive a prediction instrument to stratify patients by attributable fraction (probability that the index event was related to PFO), Kent et al performed a patient-level meta-analysis of observational cohorts of patients with cryptogenic stroke investigated for PFO by transesophageal echocardiogram or transcranial Doppler (n=3023). The patients with cryptogenic stroke with PFO were younger, less likely to have conventional risk factors or a history of transient ischemic stroke (TIA)/stroke and more likely to have large superficial infarcts than those without PFO. Multivariable logistic regression revealed that the odds of PFO presence was lower …

Stroke Literature Synopses: Clinical Science

Paradoxical embolism via a patent foramen ovale (PFO) is a common cause of cryptogenic stroke. Because PFO is a common anatomic variant seen in 25% of the general population, clinicians are faced with the dilemma of whether a PFO is an incidental finding or stroke related. Recent clinical trials of PFO closure failed to show a benefit of closure compared with medical therapy in reducing composite primary end points. Yet, these trials may have enrolled individuals with incidental PFO. To derive a prediction instrument to stratify patients by attributable fraction (probability that the index event was related to PFO), Kent et al performed a patient-level meta-analysis of observational cohorts of patients with cryptogenic stroke investigated for PFO by transesophageal echocardiogram or transcranial Doppler (n=3023). The patients with cryptogenic stroke with PFO were younger, less likely to have conventional risk factors or a history of transient ischemic stroke (TIA)/stroke and more likely to have large superficial infarcts than those without PFO. Multivariable logistic regression revealed that the odds of PFO presence was lower …