Specific mechanisms of subarachnoid hemorrhage accompanied by ischemic stroke in essential thrombocythemia: two case reports and a literature review

Sugiyama, Mizuho; Ueno, Yoshio; Kamo, Hikaru; Edahiro, Yoko; Miyamoto, Nobukazu; Yamashiro, Kazuo; Tanaka, Ryota; Shimo, Yasushi; Komatsu, Norio

doi:10.1007/s00415-019-09347-4

Cited by 16 publications

(15 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, a prior CVA may increase the likelihood of a second ischemic event following the procedure-this was considered a major complication. 29,30 Our theory is supported by the literature, which suggests that 25% of CVA are recurrent, thereby increasing the likelihood of such an event in patients with a history of CVA. 31 In terms of mortality, we found a statistical association in patients using steroids and those with ASA status > 2.…”

Section: Discussionsupporting

confidence: 67%

Quantifying the Impact of Comorbidities on Outcomes Following Surgery for Osteoporotic Vertebral Compression Fractures

Gupta

Cha

Schwab

et al. 2021

Journal of Clinical Interventional Radiology ISVIR

View full text Add to dashboard Cite

Introduction Studies have shown that osteoporotic patients are more likely to have medical or surgical complications postoperatively. In this study, we determine the predictive value of various comorbidities on the likelihood of postoperative complications, mortality, and 30-day readmission following cement augmentation for osteoporotic vertebral compression fractures (OVCFs). Methods A retrospective analysis of the American College of Surgeons National Surgery Quality Improvement Project (ACS-NSQIP) database from 2007 to 2014 identified 1979 patients who met inclusion criteria. A multivariate logistic regression analysis was utilized to determine the relationship between various comorbidities and perioperative mortality, postoperative complications, and 30-day readmission rates. Results A history of cerebrovascular accident (CVA), coagulopathy, diminished preoperative functional status, and/or an American Society of Anesthesiologists (ASA) class > 2 were statistical predictors of postoperative complications. CVA generated the highest odds ratio among these comorbidities (OR = 5.36, p = 0.02 for minor complications; OR = 4.60 p = 0.05 for major complications). Among the 15 comorbidities considered, steroid use (OR =1.81; p = 0.03) and an ASA class > 2 (OR = 14.65; p = 0.01) were the only ones that were correlated with mortality; an ASA class > 2 had a particularly strong effect on the likelihood of mortality (OR = 14.65). Chronic obstructive pulmonary disorder (COPD), obesity, significant weight loss, and an ASA class > 2 were correlated with 30-day readmissions. Congestive heart failure (CHF), diabetes, dialysis, hypertension, or smoking was not correlated with adverse postoperative outcomes. Conclusions Of the 15 comorbidities considered in this study, four were statistically associated with increased rates of postoperative complications, two were associated with increased mortality, and four were associated with increased rates of readmission at 30 days. The presence of CHF, diabetes mellitus (DM), hypertension, ascites, renal failure, or smoking were not associated with the adverse outcomes studied. Level of Evidence III.

show abstract

Section: Discussionsupporting

confidence: 67%

Quantifying the Impact of Comorbidities on Outcomes Following Surgery for Osteoporotic Vertebral Compression Fractures

Gupta

Cha

Schwab

et al. 2021

Journal of Clinical Interventional Radiology ISVIR

View full text Add to dashboard Cite

show abstract

“…The relationship between PRES and ET has not been previously reported or explored. While ET might increase the risk of stroke (acute ischemic stroke and hemorrhagic strokes), [5,14] whether and how ET influences PRES is unclear. Although the pathophysiological changes induced by PRES remain poorly understood, endothelial dysfunction has been implicated in PRES.…”

Section: Discussionmentioning

confidence: 99%

Posterior reversible encephalopathy syndrome with essential thrombocythemia

Zhang

et al. 2019

Medicine

View full text Add to dashboard Cite

Rationale: Posterior reversible encephalopathy syndrome (PRES) is a rare neurological disease of the posterior subcortical white matter that manifests as headache, seizures, visual impairment, disturbance of consciousness, and changes in mental state. While PRES is associated with specific imaging findings involving the posterior circulation area of the brain. In the present study, we report the first case of PRES associated with essential thrombocythemia (ET). Patient concerns: A 49-year-old man suddenly experienced headache, followed by the gradual appearance of consciousness disorders and mental behavior abnormalities. Neurological tests showed that the patient had a Glasgow Coma Scale score of 12, normal muscle strength and tension of the limbs, and was negative for meningeal irritation. Diagnosis: Magnetic resonance imaging of the brain showed extensive vasogenic edema in the deep white matter of the right cerebellum and the left occipital and temporal lobes and a diagnosis of PRES was considered. Routine blood test showed that his platelet count was markedly increased, and the JAK2 V617F mutation analysis with allele-specific real-time polymerase chain reaction was positive. The bone marrow biopsy indicated an increasing number of megakaryocytes. These findings indicated ET. Interventions: PRES was treated with a dehydrating agent and supportive and symptomatic treatments. Aspirin tablets were prescribed to address the patient's ET. Outcome: After treatment, the abnormal findings on head imaging were completely reversed. His neurological symptoms were completely relieved. Lessons: PRES may be correlated with ET; specifically, ET may trigger PRES and be a risk factor for the acute onset of neurological deficits.

show abstract

“…5 Importantly, some specific diseases could be involved in the development of CAD, and, therefore, the mechanisms of CAD remain to be elucidated. 7…”

Section: Introductionmentioning

confidence: 99%

Cerebral artery dissection secondary to antiphospholipid syndrome: A report of two cases and a literature review

Iseki

Yamashita

Ueno

et al. 2020

Lupus

Self Cite

View full text Add to dashboard Cite

Introduction Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by thromboembolic events, including ischemic stroke or complications in pregnancy, and the presence of antiphospholipid antibodies. Cervical artery dissection (CAD) is not an uncommon cause of stroke in young adults. The concomitant presence of APS and CAD is extremely rare. Methods Two cases with APS who developed acute ischemic strokes related to CAD are reported. A comprehensive systematic literature search using the PubMed database was also conducted. Results In Case 1, a 36-year-old woman who had been diagnosed with systemic lupus erythematosus and had been repeatedly positive for lupus anticoagulant tests developed an ischemic stroke caused by a vertebral artery dissection (VAD). After admission, she had a recurrent ischemic stroke, followed by considerable changes in steno-occlusive lesions of the vertebrobasilar artery system. In Case 2, a 36-year-old man developed multiple brain infarcts due to bilateral VAD with aneurysmal formations and associated with pulmonary embolism. The anticardiolipin antibody titer was repeatedly elevated after stroke. The literature review identified 8 patients with CAD associated with APS, involving the internal carotid artery in 6 patients and the middle cerebral artery and vertebral artery in 1 patient each. The patients were predominantly young and female, infrequently had atherosclerotic vascular risk factors, and were positive for various antiphospholipid antibodies. Conclusions The current report described two rare cases of ischemic stroke caused by CAD secondary to APS, along with a review of the literature; the patients displayed characteristic clinical manifestations, implying specific mechanisms for cerebral artery disorders secondary to APS.

show abstract

Specific mechanisms of subarachnoid hemorrhage accompanied by ischemic stroke in essential thrombocythemia: two case reports and a literature review

Cited by 16 publications

References 32 publications

Quantifying the Impact of Comorbidities on Outcomes Following Surgery for Osteoporotic Vertebral Compression Fractures

Quantifying the Impact of Comorbidities on Outcomes Following Surgery for Osteoporotic Vertebral Compression Fractures

Posterior reversible encephalopathy syndrome with essential thrombocythemia

Cerebral artery dissection secondary to antiphospholipid syndrome: A report of two cases and a literature review

Contact Info

Product

Resources

About