The first objective of this study was to assess the rates of adult experiences of verbal, emotional, physical, and sexual abuse reported by borderline patients and axis II comparison subjects over ten years of prospective follow-up. The second objective was to determine time-to-cessation, recurrence, and new onset of each type of abuse. The Abuse History Interview was administered to 290 borderline patients and 72 axis II comparison subjects at baseline. The AHI Follow-up Version was administered at five contiguous follow-up waves. Over ten years of follow-up, the rates of all four types of abuse declined significantly for borderline patients. For borderline patients, rates of cessation were high for all types of abuse (>90%). However, recurrences and new onsets of verbal and emotional abuse were relatively common (>60%). Contrastingly, they were relatively uncommon for physical and sexual abuse (<30%), suggesting that verbal and emotional abuse represent more stable forms of abuse.
We report a case of a ruptured left atrial myxoma with multiple synchronous sites of embolization, including the intracranial cerebral (left middle cerebral artery (MCA) and basilar), visceral (renal, superior mesenteric artery (SMA)) and peripheral circulatory beds (aorta and lower extremities). This synchronous embolization resulted in a catastrophic neurologic and systemic event. An intracranial stent retriever was used to restore cerebral circulation in the symptomatic left MCA distribution, which resulted in resolution of the acute neurologic deficits. Endovascular and open surgical interventions were later performed to address the residual cardiac mass and other embolic sites. The patient survived the event with the loss of her right leg below the knee and a transient dialysis requirement. The purpose of this case report is to document the successful utilization of a stent-retriever device in removing an embolized myxoma from the cerebral circulation, to review the unique pathology of this source of embolic stroke and to reiterate the importance of considering embolic and non-thrombotic etiologies of acute ischemic stroke, especially in atypical patient populations and patient presentations.
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