Thirty-nine (61%) ipsilateral arteries showed intraplaque hemorrhage. During follow-up, five ipsilateral strokes and a total of 14 ipsilateral ischemic events were observed. Thirteen of these ischemic events, of which five were strokes, occurred in those with ipsilateral carotid intraplaque hemorrhage (hazard ratio = 9.8, 95% confidence interval 1.3-75.1, P=.03).
Conclusions: MR IPH is a good predictor of ipsilateral stroke and TIA in patients with symptomatic mild to moderate (30%-69%) carotid
stenosis. This technique could help in the check details selection of patients for carotid endarterectomy.”
“OBJECTIVE: A penetrating injury to the brainstem is usually a fatal injury. The number of cases in which the brainstem is traversed
during the injury and the patient survives is exceedingly small.
CLINICAL PRESENTATION: We report a case of an automobile collision in which blunt injury to the face of a 22-year-old man resulted in a fragment of the clivus being impacted posteriorly traversing through the pons in a left-sided through-and-through manner. The striking radiographic images demonstrate a potentially devastating brainstem injury. Surprisingly, the patient was able to follow commands and move his left side on arrival at the LY2874455 hospital.
INTERVENTION: The patient required a temporary tracheostomy and underwent surgical repair of his facial fractures. His hospital course was complicated by meningitis, and he required a long stay on the rehabilitation service. The patient made a remarkable recovery and became able to converse and walk with assistance. He has been able to live independently.
CONCLUSION: The striking radiographic images of this rare case illustrate an unusual pathology with
an even more unusual outcome.”
“Objectives: Carotid artery stenting (CAS) is an alternative to carotid endarterectomy (CEA) for treating carotid artery stenosis. We conducted see more a systematic review and meta-analysis of the clinical trials to date comparing these two procedures to determine their relative safety and efficacy.
Methods: Searches of the Cochrane Controlled Trials Register, MEDLINE, and EMBASE identified two cohort studies and eight randomized, controlled trials (RCTs) comparing CEA and CAS. Meta-analysis was performed for the primary outcome of 30-day stroke or death, using an intention-to-treat analysis. Between-trial heterogeneity was assessed using the X(2) test, and fixed-effects models were used to pool estimates in the absence of heterogeneity. Meta-regression was conducted to investigate potential effect differences by patient, intervention, and trial characteristics. To evaluate the effect of study design and inclusion criteria, sensitivity and subgroup analyses were performed.
Results: Ten trials encompassing 3580 patients were analyzed.