Takayasus's Arteritis in Northeast Iran

The carotid artery (artery to the brain) is narrowed in clients with a brain attack (stroke). A bruit is an abnormal sound heard on auscultation resulting from interference with normal blood flow.

* Cerebrovascular Disease: More commonly known as stroke cerebrovascular disease can be cause by either a colt or blockage that cuts off blood flow to a part of the brain or by haemorrhage. In both cases there is damage or death of the brain tissue that can cause paralysis, speech disorder, swallowing problems and immobility. People with diabetes and high blood pressure are at higher risk of stroke.

In many cases, strokes can be diagnosed, prevented and treatable. Symptoms of a stroke can occur quickly and may cause: sudden numbness, tingling, or weakness, or paralysis in your face, arm, or leg, especially on one side of your body. Sudden: vision changes, trouble speaking (slurred speech), confusion or trouble understanding simple statements, problems with walking or balance, severe headache. It's recommended to call a doctor or 911 even if these symptoms last for a short amount of time because a transient ischemic attack, or mini stroke may have occurred. The transient ischemic attack may be a precursor to a stroke occurring soon. Catching these symptoms can dramatically increase chances of prevention additional damage to the body (2).

Cardiovascular Assessment: No visible pulsations, no heaves or lifts. Apical pulse present in the fifth intercostal space at the left midclavicular line. Auscultation of apical rate 62 beats per minute, normal rhythm regular S1 - S2 heart sounds present. Pulsations present when supine and disappear at a 45 degree angle position. Extremities are brown color without redness, cyanosis, lesions or varicosities bilaterally. Temperature warm bilaterally, Allen test was negative. Homan’s sign negative. Carotids: +2 and present bilaterally. Right Radial +2, left radial +1 , Right Brachial: +2

Patient is a 34-year-old left-handed white male who states that in January he was in a parking lot and was hit by a plow truck that was backing up. His back was turned and he did not know what was happening. He fell on his back and hit the back of his head on the tailgate. He denied any loss of consciousness. He did have a significant headache and neck pain, but no neurological symptoms. He did have some pain in his right hand and right ankle after this. He did present to the emergency room, where an unenhanced CAT scan was negative. Since then however, he has been having daily headaches. He has an almost constant, dull, mild bitemporal pressure sensation, but he also has significant

A 23-year-old healthy Caucasian woman presented with a sharp pain in her right lower limb, enlarged circumference, reddening and increased temperature. She was diagnosed with deep vein thrombosis and treated with low-molecular-weight (LMW) heparin (enoxaparin 60mg twice daily) for 3 month. 8 years later, she was readmitted to the emergency room with persistent holocranial headache, more intense at the occipital region, refractory to analgesia and present for two days. Physical examination revealed terminal neck stiffness and fundoscopic examination was suggestive of bilateral macular edema. No focal sensory-motor signs were present. Familial history did not reveal any previous cerebrovascular diseases as vascular risk factors. She used to smoke (4 packs-years) and suspended oral contraception 2 month earlier.

Cerebral blood vessel obstruction may occur due to blood clots less than heartfelt or even in peripheral arteries. Stroke that occurred before the accident, high cholesterol, heart rhythm disorders, diabetes, hypertension, recent surgery or varicose ulcer or thrombosis are favorable factors of the disease. This will be taken into account and make proper treatment to these conditions in order to not reach such an accident.

The patient was initially evaluated at two outside hospitals with non-contrast head CT and CSF analysis which remained grossly unremarkable. Following both evaluations, the patient was discharged with oral analgesics. Following the third episode, the patient presented to our emergency department where was admitted to the Hospital Neurology Service. Upon admission, vital signs and laboratory studies were grossly unremarkable. MR angiography of the head revealed multiple foci of segmental vasoconstriction of the anterior and posterior circulation suggestive of RCVS. The patient was treated with oral calcium channel blockers and discharged home with a mild persistent

The symptoms began 20 minutes prior to arrival. Upon arrival to the emergency department, he was alert and oriented with an initial blood pressure of 188/65 mm Hg, heart rate 73/minute, 98% oxygen saturation on room air, and he was afebrile. Computerized axial tomography (CT) scan of the head was completed with results available 40 minutes after arrival. The emergency physician spoke with the specialist via phone and diagnosed the patient with a cerebrovascular

Each year, around 800,000 people have a new or recurrent stroke. The characteristics include face drooping or feeling numb, difficulties speaking, and muscle weakness on one side of the body. Stroke is caused from reduced or interrupted blood supply to the brain. There are ischemic strokes (thrombic and embolic strokes), hemorrhagic strokes (intracerebral hemorrage and subarachnoid hemorrhage), and transient ischemic attack (TIA).

On the 19th December the patient was transferred from Daisy Hill Hospital to a specialist Neurosurgical unit in the Royal Victoria Hospital. On admission to the neurosurgical unit the Glasgow Coma Scale (GCS) was 14/15 and she had no neurological deficits with the nerve, spinal cord, or brain function, although she was still complaining of neck stiffness and pain in head. Although the CT scans showed no evidence of subarachnoid haemorrhage, due to her very strong history the patient was referred for further imaging through angiogram techniques. This included use of catheters inserted under the skin to provide a contrast material which was detected through the use of magnetic resonance imaging scans (M.R.I). The results for these again showed no evidence of a recent bleed.

CVA is an abbreviation for cerebrovascular accident or stroke. It is described as the rapid loss of neurological function mainly because of an occlusion in the major blood vessels supplying the brain, or from a hemorrhage. However, for a CVA to be considered a stroke, the person must have a neurological blood supply deficit for more than 24 hours. One of the causes for a CVA could be a previous case of hypertension associated to the diet and lifestyle of the patient. The common symptoms of a stroke or CVA are failure to move part of the body or the limbs, blurring of vision and difficulty in speaking. It is also commonly seen that patients suffering a CVA find it difficult to convey speech as well as to

Weakness and drooping that occurs on one side of the body can indicate a stroke. Because each part of the brain controls one-half of the body, the side that is effected by the stroke will effect the coordinating side of the body. Ask your senior loved one to raise their arms above their head. If one arm isn't able to be raised as high as the other, 911 should be called.

Echocardiographic examination revealed diastolic relaxation delay with an ejection fraction of 67%. Cerebral MR angiography demonstrated 85-90% stenosis at the proximal part of the basilar artery and 40-50% stenosis at the cavernous segment of the right internal carotid artery (ICA). Digital subtraction angiography (DSA) was performed, which revealed stenoses in the distal segments of the bilateral internal carotid arteries, V4 segments of the bilateral vertebral arteries and at the junction of basilar artery, which were more prominent on the right side (Figure 2).

Clopidogrel 75 mg/day was added to the treatment. Even though the patient had right medial medullary infarct, due to more widespread stenoses at the left vertebral artery, endovascular stent was implanted into V4 segment of left vertebral artery on the 7th day of the admission. He was in stable condition with no progression and given dual antiaggregant therapy at discharge. However, one month later, the patient presented with deteriorated left arm weakness and newly-emerging right leg weakness. On neurological examination he had right central facial paralysis, marked triparesis (left hemiparesis prominent on upper limb and right leg paresis), positive Babinskisign on the left. There was moderate dysmetria on the right and left-sided hemihypoesthesia.