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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
06:01

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

Published on: August 18, 2015

[Two cases of cardioembolic stroke with stepwise progression]

Shutaro Takashima1, Koji Hirano, Yoshiharu Taguchi

  • 1Department of Neurology, Toyama University Hospital.

Rinsho Shinkeigaku = Clinical Neurology
|December 4, 2008
PubMed

Insights

Cardioembolic stroke can mimic thrombosis, presenting with stepwise progression and middle cerebral artery (MCA) narrowing. Follow-up imaging revealed recanalization and identified the embolic source, confirming the diagnosis.

Area of Science:

  • Neurology
  • Vascular Neurology
  • Neuroimaging

Background:

  • Cardioembolic stroke is a significant cause of ischemic stroke.
  • Accurate diagnosis is crucial for appropriate management and secondary prevention.

Observation:

  • Two patients presented with stepwise progression of ischemic stroke.
  • Initial neuroimaging (MRA/CTA) showed middle cerebral artery (MCA) stenosis/occlusion.
  • Initial classification was undetermined or large artery atherosclerosis due to lack of acute cardioembolic source evidence.

Findings:

  • Follow-up MRA demonstrated complete recanalization of the MCA in both cases.
  • Cardioembolic sources were identified retrospectively in both patients.
  • Final diagnosis was revised to cardioembolic stroke.

Implications:

  • Cardioembolic stroke can present with apparent stepwise progression, mimicking thrombotic events.
  • Neuroimaging follow-up (MRA) is valuable for assessing recanalization.
  • Thorough investigation for embolic sources is essential, even with initial negative findings.

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