Search Our Scientific Publications & Authors

Int J Cardiol Heart Vasc 2019 Mar 8;22:154-155. Epub 2019 Feb 8.

Division of Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.

Fed Pract 2018 Aug;35(8):32-35

is an Associate Professor and an Associate Residency Director at the University of Arkansas for Medical Sciences (South Central). is a Physician at Baptist Medical Center in North Little Rock and is a Physician at Jefferson Regional Medical Center in Pine Bluff, all in Arkansas. Dr Over is affiliated with the Central Arkansas Veterans Healthcare System Pine Bluff Community-Based Outpatient Clinic.

Abrupt onset bilateral leg pain, sphincter dysfunction, and stigmata of vascular compromise with lower extremity mottling and cool skin should alert providers to the possible presence of acute aortic occlusion in a patient. Read More

Clin Imaging 2019 Jan 31;55:71-75. Epub 2019 Jan 31.

Department of Radiology, University of Florida College of Medicine, 1600 SW Archer Road, Gainesville, FL 32611, USA. Electronic address:

Spinal cord watershed ischemia is a rare phenomenon often associated with cardiac arrest, prolonged hypotension, and atherosclerotic disease. It can manifest as central necrosis with peripheral sparing in the transverse axis, and central lesion with rostral and caudal sparing in the longitudinal axis. Few reports provide detailed imaging findings of spinal cord watershed ischemia lesions. Read More

Radiol Clin North Am 2019 Mar 15;57(2):307-318. Epub 2018 Nov 15.

Neuroradiology Division, Department of Radiology and Imaging Sciences, University of Utah Health Sciences Center, 30 North, 1900 East, #1A071, Salt Lake City, UT 84132-2140, USA.

Vascular disorders of the spine are more rare than cerebral vascular entities but can result in significant morbidity. These lesions frequently demonstrate distinguishing characteristics by imaging that are imperative for the radiologist to recognize to properly guide diagnosis and treatment. We review distinguishing imaging characteristics for spinal vascular malformations, spinal emergencies, and spinal vascular masses. Read More

Ann Vasc Surg 2019 Jan 23. Epub 2019 Jan 23.

Department of Vascular Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Purpose: Spinal cord ischemia is a rare complication of endovascular repair of abdominal aortic aneurysm (AAA) that is attributed to the variable anatomy of the artery of Adamkiewicz, embolization of the collateral circulation, or hypoperfusion of cord structures secondary to hypotension.

Case Report: A hypertensive 83-year-old male with chronic obstructive pulmonary disease presented with a 2.3 cm right iliac artery dissecting aneurysm. Read More

J Cardiothorac Vasc Anesth 2018 Dec 5. Epub 2018 Dec 5.

National Cerebral and Cardiovascular Center, Osaka, Japan.

Objectives: The authors investigated the association between intraoperative motor-evoked potential (MEP) changes and the severity of spinal cord infarction diagnosed with magnetic resonance imaging (MRI) to clarify the discrepancy between them, which was observed in patients with postoperative motor deficits after thoracic and thoracoabdominal aortic surgery.

Design: A multicenter retrospective study.

Setting: Motor-evoked potential <25% of control values was deemed positive for spinal cord ischemia. Read More

Ann Vasc Dis 2018 Dec;11(4):562-564

Department of Cardiovascular Surgery, KKR Sapporo Medical Center, Sapporo, Hokkaido, Japan.

We report a rare case of delayed paraplegia triggered by gastrointestinal (GI) bleeding 8 months after thoracic endovascular aortic repair (TEVAR). A 78-year-old male underwent TEVAR of a descending thoracic aortic aneurysm without a postoperative neurological deficit and was discharged. Magnetic resonance image showed spinal cord infarction from Th8 to L1, and enhanced computed tomography showed a patent Adamkiewicz artery. Read More

J Vasc Surg 2019 Jan 3. Epub 2019 Jan 3.

W. L. Gore & Associates, Inc, TAMBE Team, Flagstaff, Ariz.

Objective: This study reports the technical aspects and 30-day outcomes of the prospective, multicenter early feasibility study designed to evaluate the GORE EXCLUDER Thoracoabdominal Branch Endoprosthesis (TAMBE; W. L. Gore & Associates, Flagstaff, Ariz). Read More

Neuroscience 2019 02 26;399:125-134. Epub 2018 Dec 26.

Department of Critical Care Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301 Middle Yanchang Road, Jing'an District, Shanghai 200072, China. Electronic address:

MicroRNAs have been reported to be an important pathophysiological factor in neuropathic pain. However, the potential mechanism through which miRNAs function in neuropathic pain remains unclear. The purpose of this study was to explore the potential role of mir-34c in neuropathic pain in a mouse model of chronic constriction injury (CCI). Read More

J Vasc Surg 2018 Dec 24. Epub 2018 Dec 24.

Division of Vascular Surgery, Department of Surgery, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address:

Objective: To report the outcomes of patients enrolled in a physician-sponsored investigational device exemption trial for endovascular treatment of complex thoracoabdominal aortic aneurysms with fenestrated and/or branched devices.

Methods: This study represents a retrospective analysis of a prospectively maintained database of patients enrolled in a physician-sponsored investigational device exemption trial for endovascular treatment of complex thoracoabdominal aneurysms between July 2012 and July 2017. Subjects included high-risk patients for open repair and patients with unsuitable anatomy for either standard endovascular aneurysm repair or Zenith (Cook Medical, Bloomington, Ind) fenestrated device. Read More

Circulation 2018 Nov 6:CIR0000000000000628. Epub 2018 Nov 6.

Circulation 2018 Nov 6:CIR0000000000000627. Epub 2018 Nov 6.

Clin Interv Aging 2018 7;13:2487-2494. Epub 2018 Dec 7.

Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China,

Background And Purpose: White matter hyperintensities (WMH) is identified as a marker of cerebral small vessel diseases and is a major contributor to cognitive impairment, depression, gait disturbance, and urinary incontinence. However, the risk factors for WMH in patients with type 2 diabetes mellitus (T2DM) has not been well explored. Thus, in this study, we aimed to investigate the relationship between the severity of WMH and vascular risk factors in lacunar infarction patients with T2DM. Read More

Am J Physiol Heart Circ Physiol 2019 Mar 21;316(3):H543-H553. Epub 2018 Dec 21.

Department of Molecular Pharmacology and Therapeutics, Loyola University Chicago, Mawood, Illinois.

Timely reperfusion is still the most effective approach to limit infarct size in humans. Yet, despite advances in care and reduction in door-to-balloon times, nearly 25% of patients develop heart failure postmyocardial infarction, with its attendant morbidity and mortality. We previously showed that cardioprotection results from a skin incision through the umbilicus in a murine model of myocardial infarction. Read More

Medicine (Baltimore) 2018 Nov;97(48):e13311

Department of Neurology, Beijing Chaoyang Hospital Affiliated to Capital Medical University.

Silent cerebrovascular diseases, including silent brain infarcts (SBI), white matter hyperintensity (WMH), and cerebral microbleed, are closely correlated with stroke progression. The purpose of this study was to investigate the prevalence and potential risk factors of SBI and WMH in young patients with first-ever stroke.A total of 400 young patients with first-ever stroke were included in this study and received magnetic resonance imaging test. Read More

Rinsho Shinkeigaku 2018 Dec 29;58(12):745-749. Epub 2018 Nov 29.

Department of Neurology, Seirei Mikatahara General Hospital.

We present the unique case of a patient with lumbosacral radiculoplexus neuropathy (LRPN) and a small intramedullary lesion, probably an infarction, in the spinal cord. A previously healthy 58-year-old female developed acute severe pain involving the entire right lower limb, followed by weakness of the right lower limb a few hours later. The patient could not walk and was referred to our clinic. Read More

Kyobu Geka 2018 11;71(12):989-994

Department of Cardiovascular Surgery, Yokohama Rosai Hospital, Yokohama, Japan.

Recently, advanced technique and device of thoracic endovascular aortic repair (TEVAR) enabled surgical intervention for type B acute aortic dissection (BAD). However, BAD have often serious complications;cerebral infarction, spinal cord infarction, multi-organ ischemia or necrosis, and retrograde type A acute aortic dissection. TEVAR is performed for complicated BAD for the aim of life saving in such a failure case of conservative treatment. Read More

Heart Rhythm 2018 Nov 6. Epub 2018 Nov 6.

Restor Neurol Neurosci 2018 ;36(6):729-740

Department of Neurology and Stroke Center, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Backgrounds: Cerebral infarction does not only cause focal injury in the ischemic site, but also secondary non-ischemic damage at the remote areas of nervous system associated with the primary focus.

Objective: This study investigated the changes in the spinal cord and ventral root after middle cerebral artery occlusion (MCAO) in cynomolgus monkeys (Macaca fascicularis).

Methods: Adult male cynonolgus monkeys (4-5 years, 5. Read More

Pediatr Emerg Care 2018 Nov 5. Epub 2018 Nov 5.

Departments of Medical Education and Pediatrics, Section of General Pediatrics, West Virginia University School of Medicine, Morgantown, WV.

Pediatric emergency medicine providers must be astute at generating the differential diagnosis and performing the appropriate evaluation to promptly determine the underlying cause of new onset paraplegia. Spinal cord infarction (SCI) is a potential etiology of paraplegia in children, and fibrocartilaginous embolization is a rare underlying cause of SCI. We present an illustrative case of SCI secondary to fibrocartilaginous embolization in an otherwise healthy adolescent who developed symptoms of spinal cord dysfunction after basketball play. Read More

Orthopedics 2019 Jan 29;42(1):e131-e134. Epub 2018 Oct 29.

Tumor excision surgeries of the spine present a distinct challenge regarding the maintenance of spinal cord blood supply because they often require preoperative embolization of segmental arteries, ligation of the corresponding nerve roots, and circumferential exposure of the dural sac. The authors present a case of delayed-onset spinal cord infarction after repeated tumor excision surgeries of the thoracic spine. A 49-year-old man had undergone a left nephrectomy for renal cell carcinoma, 2 pulmonary metastasectomies, and excision of a left sixth rib metastasis before referral to the authors' institution. Read More

BMJ Case Rep 2018 Oct 24;2018. Epub 2018 Oct 24.

Department of Medicine (Neurology), School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

Acute bacterial meningitis is not an uncommon central nervous system infection. In severe cases, it can be associated with various neurological or systemic complications. However, acute spinal cord dysfunction rarely occurs. Read More

Stroke 2018 Nov;49(11):e314-e317

From the Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI (M.M., A.B., I.A., L.K., S.Y.).

J Forensic Sci 2018 Oct 23. Epub 2018 Oct 23.

Department of Anatomical Pathology, Singapore General Hospital, 20 College Road, Singapore, 169856, Singapore.

Hepatocellular carcinoma (HCC) is a common cancer worldwide with a great potential for metastatic spread. Hepatocellular carcinoma often arises in people with underlying viral hepatitides or liver cirrhosis and may present in various ways including abdominal pain, liver mass, and signs of hepatocellular decompensation. Many tumors may have metastasized to other organs such as the lungs, lymph nodes, bone, and adrenal glands at the time of diagnosis. Read More

J Neuroinflammation 2018 Oct 15;15(1):288. Epub 2018 Oct 15.

Department of Neurology, University of Kentucky, 741 S. Limestone BBSRB B457, Lexington, KY, 40536-0905, USA.

Background: The migration of peripheral immune cells and splenocytes to the ischemic brain is one of the major causes of delayed neuroinflammation after permanent large vessel stroke. Other groups have demonstrated that leukemia inhibitory factor (LIF), a cytokine that promotes neural cell survival through upregulation of antioxidant enzymes, promotes an anti-inflammatory phenotype in several types of immune cells. The goal of this study was to determine whether LIF treatment modulates the peripheral immune response after stroke. Read More

J Neurol Sci 2018 Dec 1;395:84-87. Epub 2018 Oct 1.

Faculad de Medicina, Universidad de Chile, Chile; Imperial College, London, UK.

This paper illustrates the cases of two patients with an acute onset of right brachial neuropathic pain, flaccid paralysis and contralateral thermal and thermal pain hypoesthesia, without posterior column impairment nor pyramidal signs below the segmental lesion. MRI showed right sided spinal cord infarction, in the anterior spinal artery territory between C1 and C5 in one patient and between C3 and C7 in the other. Contact Heat Evoked Potentials and Quantitative Thermal Sensory testing are consistent with contralateral, but not ipsilateral, spinothalamic tract involvement. Read More

Surg Neurol Int 2018 21;9:195. Epub 2018 Sep 21.

Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Background: Current management of acute spinal cord infarction (SCI) is limited. Lumbar cerebrospinal fluid drainage (CSFD) with blood pressure augmentation is utilized in the thoracic/thoracoabdominal aortic repair and thoracic endovascular aortic repair (TEVAR) populations to increase spinal perfusion pressure.

Case Description: We identified 3 patients who sustained acute SCI and underwent CSFD and maintenance of elevated mean arterial pressure (MAP) within 24 hours of injury. Read More

JAMA Neurol 2019 Jan;76(1):56-63

Department of Neurology, Mayo Clinic, Rochester, Minnesota.

Importance: Spinal cord infarction (SCI) is often disabling, and the diagnosis can be challenging without an inciting event (eg, aortic surgery). Patients with a spontaneous SCI are often misdiagnosed as having transverse myelitis. Diagnostic criteria for SCI are lacking, hindering clinical care and research. Read More

Oper Neurosurg (Hagerstown) 2018 Sep 24. Epub 2018 Sep 24.

Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia.

The presented case is of a 65-yr-old gentleman referred for thoracic myelopathy. He developed bilateral, nondermatomal foot dysesthesia 14 mo prior to presentation, which progressed to numbness below the L3 level. He reported progressive gait instability, bilateral lower extremity weakness, and required a cane for ambulation. Read More

Zhejiang Da Xue Xue Bao Yi Xue Ban 2018 May;47(2):201-206

Department of Cardiology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

Fatal arrhythmias, heart failure, and sudden cardiac death after myocardial ischemia/infarction are serious threats to human health. In recent years, studies have shown that spinal cord stimulation (SCS) can balance autonomic activity, inhibit myocardial structural remodeling, improve blood flow to ischemic myocardium, effectively reduce the incidence of arrhythmia, heart failure and sudden cardiac death after myocardial ischemia/infarction, but its specific mechanism has not yet been fully elucidated. The effect of SCS on cardiac function may be achieved by inhibiting neural remodeling, or by ameliorating structural remodeling and electrical remodeling. Read More

Biotechnol Adv 2018 12 12;36(8):2051-2059. Epub 2018 Sep 12.

Fischell Department of Bioengineering, University of Maryland, 3102 A. James Clark Hall, College Park, MD 20742, United States; Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Baltimore, MD 21201, United States; Program in Molecular and Cell Biology, University of Maryland, College Park, MD 20742, United States. Electronic address:

Extracellular vesicles (EVs), including exosomes, microvesicles, and others, have emerged as potential therapeutics for a variety of applications. Pre-clinical reports of EV efficacy in treatment of non-healing wounds, myocardial infarction, osteoarthritis, traumatic brain injury, spinal cord injury, and many other injuries and diseases demonstrate the versatility of this nascent therapeutic modality. EVs have also been demonstrated to be effective in humans, and clinical trials are underway to further explore their potential. Read More

Methods Mol Biol 2018 ;1826:223-235

Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.

As the systematic work on the pathogenesis of the white matter injury in the spinal cord models progresses, it becomes obvious that a severe and extraordinarily protracted, destructive inflammation follows the initial injury. Appropriate anti-inflammatory therapies of sufficient duration should not only inhibit but also lead to the elimination of this destructive inflammation, thus resulting in neuroprotection of the spinal cord tissue and a greater preservation of the neurologic function. While dexamethasone, a powerful, anti-inflammatory steroid analog administered continuously by subdural infusion for 7 days inhibited severe macrophage infiltration in the cavity of injury, the dose used was remarkably toxic. Read More

Am J Emerg Med 2018 Dec 27;36(12):2337.e3-2337.e5. Epub 2018 Aug 27.

ICU, Ningbo Medical Center Lihuili Eastern Hospital, No 1111, Jiangnan Rd, Ningbo 315100, China. Electronic address:

Electrical injury causes direct damage to nerves. It may manifest as peripheral nerve injury, spinal cord damage, cerebellar ataxia, hypoxic encephalopathy, or intracerebral hemorrhage. Various factors determine the severity of electric injury, including type of current, amperage, voltage, tissue resistance, pathway of the current, and duration of contact with the body. Read More

J Card Surg 2018 Sep 2;33(9):552-560. Epub 2018 Sep 2.

Department of Neuroradiology, Imaging Institute, Cleveland Clinic, Cleveland, Ohio.

Background: Postoperative brain injury is a cause of mortality and morbidity in patients who undergo thoracic aortic replacement. Chronic microvascular white matter ischemic change (WMIC) has been shown to be associated with acute brain infarction in the general population. WMIC has also been shown to be an independent predictor of non-focal neurocognitive changes, generalized seizures, and temporary neurologic dysfunction in patients who undergo thoracic aortic replacement. Read More

Medicine (Baltimore) 2018 Aug;97(35):e12181

Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital.

Rationale: Spinal cord infarction is rarely caused by hypercoagulable states. Polycythemia vera (PV) is a myeloproliferative neoplasm that can contribute to thrombotic events due to increased blood viscosity. We report a case of spinal cord infarction due to extensive aortic thrombosis caused by PV. Read More

Oper Neurosurg (Hagerstown) 2019 Mar;16(3):E85

Department of Neurosurgery, University of Washington, Seattle, Washington.

This 29-yr-old man presented with progressive paraparesis, sensory loss, allodynia, bowel, and bladder dysfunction for 9 mo, acutely exacerbated in the preceding 24 h. Magnetic resonance imaging scan showed multiple dilated vessels involving the thoracic cord. Spinal angiogram revealed a T12-L1 pial arteriovenous malformation (AVM)/arteriovenous fistula on the left side. Read More

Biomed Eng Online 2018 Aug 20;17(1):111. Epub 2018 Aug 20.

College of Artificial Intelligence, National University of Defense Technology, Deya Road, Changsha, 410000, People's Republic of China.

Background: Electroencephalogram-based brain-computer interfaces (BCIs) represent novel human machine interactive technology that allows people to communicate and interact with the external world without relying on their peripheral muscles and nervous system. Among BCI systems, brain-actuated wheelchairs are promising systems for the rehabilitation of severely motor disabled individuals who are unable to control a wheelchair by conventional interfaces. Previous related studies realized the easy use of brain-actuated wheelchairs that enable people to navigate the wheelchair through simple commands; however, these systems rely on offline calibration of the environment. Read More

Neurosci Lett 2018 10 16;685:114-123. Epub 2018 Aug 16.

Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.

Several studies have shown that neural remodeling in stellate ganglia (SG) is induced by myocardial infarction (MI). It remains unclear whether neural remodeling after MI is limited in SG within the sympathetic nervous system (SNS). MI was induced in a rat model by ligation of the left anterior descending artery. Read More

Med Sci Monit 2018 Aug 17;24:5729-5738. Epub 2018 Aug 17.

Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Tongji University, Shanghai, China (mainland).

BACKGROUND This study aimed to investigate the correlation of brain perfusion with white matter hyperintensity (WMH), brain atrophy, and cognition in patients with moderate to severe posterior cerebral artery stenosis (PCAS). MATERIAL AND METHODS 65 patients with memory decline as the main complaint and no history of brain infarction were recruited from the Department of Neurology of Tongji Hospital. Patients with moderate to severe PCAS were included in case group, and subjects with normal intracranial blood vessels served as controls. Read More

J Stroke Cerebrovasc Dis 2018 Oct 6;27(10):2810-2821. Epub 2018 Aug 6.

Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore 560029, India. Electronic address:

Introduction: Spinal cord infarction is an uncommon disease varying in its clinical presentation. This study describes the clinical and radiological presentation of spinal cord infarcts in 17 consecutive patients.

Material And Methods: Clinical and MR imaging data of 17 patients were reviewed. Read More

Case Rep Neurol Med 2018 5;2018:5070712. Epub 2018 Jul 5.

Department of Neurology, University of Mississippi Medical Center, Jackson, USA.

Context: We describe a case of unilateral posterior upper cervical spinal cord infarction and propose a pathophysiologic mechanism causing this lesion after vertebral artery endovascular intervention.

Findings: A 70-year-old male presented with subacute onset of left hemibody sensory changes and gait instability following a left vertebral angioplasty procedure. MRI cervical spine revealed upper posterior cervical spinal cord infarction (PSCI). Read More

Adv Clin Exp Med 2018 Sep;27(9):1259-1262

Department of Vascular Surgery, Chengde Medical University Affiliated Hospital, China.

Background: Thoracic endovascular aortic repair (TEVAR) has been frequently applied in Stanford type B aortic dissection since thoracic aortic diseases were first treated with artificial vessels.

Objectives: The aim of this study was to analyze the clinical value of TEVAR applied in treating Stanford type B aortic dissection.

Material And Methods: Between January 2007 and April 2014, 167 consecutive Stanford type B aortic dissection patients were treated with TEVAR and retrospectively analyzed. Read More

World Neurosurg 2018 Nov 24;119:e250-e261. Epub 2018 Jul 24.

Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. Electronic address:

Background: In the United States, the number of posterior cervical fusions has increased substantially. Perioperative neurologic complications associated with this procedure, such as spinal cord and peripheral nerve injuries, can have significant effects on patient health. We examined the impact of perioperative neurologic deficits on mortality in patients undergoing posterior cervical fusion. Read More

Case Rep Orthop 2018 28;2018:7042829. Epub 2018 Jun 28.

Department of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi, Saitama 332-8558, Japan.

Spinal cord infarction is an uncommon but devastating disorder caused by various conditions. Aortic dissection is a possible etiological factor and is usually associated with severe chest or back pain. We encountered two cases of spinal cord infarction associated with aortic dissection that presented without typical severe pain, and each case resulted in a different clinical course. Read More

PLoS One 2018 12;13(7):e0200474. Epub 2018 Jul 12.

Gill Heart Institute and Division of Cardiovascular Medicine, University of Kentucky, Lexington, KY, United States of America.

Introduction: Acute myocardial infarction (MI) is a primary cause of worldwide morbidity and mortality. Macrophages are fundamental components of post-MI inflammation. Pro-inflammatory macrophages can lead to adverse cardiac remodeling and heart failure while anti-inflammatory/reparative macrophages enhance tissue healing. Read More

Intern Med 2018 Nov 6;57(22):3321-3324. Epub 2018 Jul 6.

Department of Neurology, Otsu Red-Cross Hospital, Japan.

Cervical cord infarction is uncommon but has been increasingly reported as a complication of vertebral artery dissection (VAD). A 54-year-old woman presented with neck pain and neurological deficit following sudden neck movement. Radiological findings suggested cervical cord infarction in the anterior spinal artery territory at the C5-C6 vertebral level and dissection of the intracranial segment of the right vertebral artery. Read More

Tokai J Exp Clin Med 2018 Jul 20;43(2):64-67. Epub 2018 Jul 20.

Division of Neurology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.

We present a 48-year-old man with a history of hypertension, who suddenly noticed dysarthria and right hemiparesis. Diffusion-weighted MRI at 1 day after the onset showed a small high-intensity region in the left corona radiata, indicating the acute phase of lacunar infarction. Fluid attenuation inversion recovery images showed extensive hyperintense lesions predominantly in the white matter of the fronto-temporoparietal lobes and pons, indicating posterior reversible encephalopathy syndrome (PRES). Read More

J Med Case Rep 2018 Jun 22;12(1):180. Epub 2018 Jun 22.

University of Florida College of Medicine, 1600 SW Archer Rd, Gainesville, FL, 32610, USA.

Background: Anticoagulation is the mainstay of treatment for pulmonary embolism. However, if bleeding unfortunately occurs, the risks and benefits of anticoagulation present a challenge. Management of one hemorrhagic complication, retroperitoneal hematoma, is rare, difficult, and controversial. Read More

Medicine (Baltimore) 2018 Jun;97(23):e11058

Introduction: The abrupt onset of sensorimotor deficits is a neurologic emergency that requires immediate management. Acute spontaneous spinal cord infarction (SCI) is rare, but can cause the sudden onset of quadriplegia or quadriparesis. Magnetic resonance imaging (MRI) is an essential imaging modality to diagnose SCI. Read More

Clin Pract Cases Emerg Med 2017 Nov 3;1(4):315-318. Epub 2017 Oct 3.

Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California.

Aortoiliac occlusive disease (AOD) is a rare presentation of thrombosis of the abdominal aorta. Also known as Leriche syndrome, its classic description entails claudication of the buttocks, thighs, and calves, absent femoral pulses, and impotence. AOD risk factors include smoking, hypertension, hyperlipidemia, diabetes, chronic renal insufficiency, and hypercoagulopathy. Read More