Simultaneous acute cardio-cerebral infarction associated with isolated left ventricle non-compaction cardiomyopathy

Abdi, Ishak Ahmed; Karataş, Mesut; Abdi, Ahmed Elmi; Hassan, Mohamed Sheikh; Mohamud, Mohamed Farah Yusuf

doi:10.1016/j.amsu.2022.104172

Cited by 10 publications

(8 citation statements)

References 8 publications

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“…Like other forms of stroke, the prognosis depends on the patient's clinical status, age, early application of thrombolysis, and the extent of the affected area 14–16 . In this case, despite the fact that the patient missed the thrombolytic treatment, his recovery was modest, and he achieved massive clinical improvement in two months of treatment.…”

Section: Discussionmentioning

confidence: 94%

Agitation and somnolence by bilateral paramedian thalamic infarct

Hassan¹,

Sidow²,

Ali³

et al. 2023

Clinical Case Reports

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Key Clinical Message Bilateral thalamic infarction in paramedian artery territory may present with severe acute illness, confusion, coma and memory impairment. However, subtle clinical presentation as in our case should alert the clinician to consider such a diagnosis as it can be associated with good prognosis. Abstract Bilateral thalamic infarct is a rare form of stroke. Mostly thalamic infarcts are unilateral. In most cases, bilateral thalamic infarction leads to cognitive dysfunction, opthalmoparesis, conscious impairment, behavioral disturbance, and corticospinal dysfunction. Here, we describe the case of a 75‐year‐old male patient who presented to the emergency department of our hospital with agitation and somnolence for one day. He had poorly controlled hypertension. There was no previous history of stroke, diabetes mellitus, hyperlipidemia, known cardiac disease, or smoking history. There was no seizure, recent headache, or visual disturbance. The patient was somnolent and not oriented to time, person, or place. Neurological examination did not show any focal weakness or vertical eye movement restrictions. Other systemic examinations, including those of the respiratory and cardiovascular systems, were unremarkable. Extensive laboratory investigations excluded potential metabolic, infectious, endocrine, or toxic etiologies. The patient did not have any recent history of drug misuse, including benzodiazepines. Brain MRI with diffusion‐weighted imaging showed an acute bilateral thalamic infarct. Cerebral angiography was unremarkable. The patient was treated with low molecular weight heparin 60 mg subcutaneously, aspirin 300 mg daily, and haloperidol 5 mg twice daily for agitation. After two weeks of intrahospital treatment, his condition improved (consciousness and orientation massively improved).

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Section: Discussionmentioning

confidence: 94%

Agitation and somnolence by bilateral paramedian thalamic infarct

Hassan¹,

Sidow²,

Ali³

et al. 2023

Clinical Case Reports

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“…A few patients without contraindications received thrombolysis with IV alteplase (Table 1), which was thought to benefit both MI and AIS. 2,4,10,12,13 However, the dosage of IV alteplase in CCI has been a topic of debate as a higher dose is recommended in MI alone 14 as compared to AIS alone. 15 While most reported CCI cases received the 0.9 mg/kg regular IV tPA dose for AIS, 2,10,13 some were given lower doses at 0.6 mg/kg 4 or 0.5 mg/kg 12 to mitigate the risk of hemorrhagic conversion.…”

Section: Discussionmentioning

confidence: 99%

Concurrent Cardio-Cerebral Infarction – A Case Report and Literature Review

de la Torre,

Wagner,

2023

The Neurohospitalist

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Concurrent cardio-cerebral infarction (CCI) describes the simultaneous occurrence of an acute myocardial infarction and an acute ischemic stroke. It is a rare phenomenon, and no consensus yet exists on how to best treat it. CCI patients present with variable clinical scenarios and complications which makes the establishment of a treatment guideline difficult. We present here a case of a 67-year-old male with concurrent acute ST-elevation myocardial infarction and acute ischemic stroke due to right middle cerebral artery occlusion who was successfully treated with Tenecteplase and mechanical thrombectomy. A literature review was also conducted in search of potential reasonable management strategies of CCI.

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“…Like other forms of stroke, the prognosis depends on the patient's clinical status, age, early application of thrombolysis, and the extent of the affected area [14,16] . In this case, despite the fact that the patient missed the thrombolytic treatment, his recovery was modest, and he achieved massive clinical improvement in two months of treatment.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Paramedian Thalamic Infarct without Involvement of Corticospinal Tract

Hassan¹,

Sidow²

2022

Preprint

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Introduction and importance: Bilateral thalamic infarct is a rare form of stroke. Mostly thalamic infarcts are unilateral. Occlusion of the artery of Percheron leads to bilateral thalamic infarction with or without involvement of the midbrain. In most cases, bilateral thalamic infarction leads to cognitive dysfunction, opthalmoparesis, conscious impairment, behavioral disturbance, and corticospinal dysfunction. Case Presentation: A 75-year-old male patient presented to the emergency department of our hospital with agitation and somnolence for one day. He had poorly controlled hypertension. There was no previous history of stroke, diabetes mellitus, hyperlipidemia, known cardiac disease, or smoking history. There was no seizure, recent headache, or visual disturbance. The patient was somnolent and not oriented to time, person, or place. Neurological examination did not show any focal weakness or vertical eye movement restrictions. Other systemic examinations, including those of the respiratory and cardiovascular systems, were unremarkable. Extensive laboratory investigations excluded potential metabolic, infectious, endocrine, or toxic etiologies. The patient did not have any recent history of drug misuse, including benzodiazepines. Brain MRI with diffusion-weighted imaging showed an acute bilateral thalamic infarct. Cerebral MRI angiography was unremarkable. ECG and echocardiography did not show any potential cardioembolic source. The patient was treated with low molecular weight heparin 60 mg subcutaneously, aspirin 300 mg daily, and haloperidol 5mg twice daily. After two weeks of intrahospital treatment, his condition improved (consciousness and orientation massively improved). He was discharged for outpatient neurology clinic follow up. Conclusion: Bilateral thalamic infarcts are rare presentations of posterior circulation stroke; conscious impairment, agitation, and cognitive dysfunction are the major presentations. Here we report an interesting case with hypertension diagnosed bilateral thalamic infarction without corticospinal tract involvement.

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Simultaneous acute cardio-cerebral infarction associated with isolated left ventricle non-compaction cardiomyopathy

Cited by 10 publications

References 8 publications

Agitation and somnolence by bilateral paramedian thalamic infarct

Agitation and somnolence by bilateral paramedian thalamic infarct

Concurrent Cardio-Cerebral Infarction – A Case Report and Literature Review

Bilateral Paramedian Thalamic Infarct without Involvement of Corticospinal Tract

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