Anterior Spinal Artery Syndrome in a Patient With Multilevel Cervical Disc Disease: A Case Report.

Anterior spinal artery syndrome (ASAS) is a rare form of spinal cord infarction, making its incidence and prevalence difficult to determine. We present the case of a 60-year-old woman with multiple vascular risk factors who experienced a sudden onset of severe lower limb weakness, raising immediate concerns about spinal cord ischemia. Diagnostic evaluations confirmed ASAS, although the exact cause and mechanism of her spinal cord infarction remained undetermined. The potential presence of significant cervical disc disease suggests fibrocartilaginous embolism (FCE) as a possible underlying mechanism, despite the lack of direct evidence. This case underscores the importance of clinical awareness and timely intervention in patients with similar symptoms and vascular risk factors. Early recognition, cause identification, and appropriate management are crucial for improving outcomes in spinal cord ischemia, guiding specific treatment strategies, and potentially preventing recurrence.

A Rare Case of Contralateral Ischemic Stroke Recurrence Post-Reperfusion: Successful Management Through Timely Thrombectomy.

Stroke is a predominant contributor to global mortality and disability and represents a complex and heterogeneous disease characterized by diverse risk factors and clinical presentations. The likelihood of stroke patients being at risk of a second stroke within the first five years is higher, especially within the initial two weeks. The distressing prospect of experiencing recurrent stroke shortly after reperfusion therapy adds an additional layer of complexity, potentially reversing prior progress. In the present case, we describe a patient who experienced a recurrent stroke within 24 hours, affecting the contralateral middle cerebral artery (MCA). This recurrence occurred after the individual underwent thrombolysis therapy for the initial stroke, emphasizing the intricate challenges associated with managing such cases and the imperative for targeted interventions to mitigate further risks and enhance patient outcomes.

Incidence and risk factors of contrast-induced nephropathy in acute stroke patients undergoing computed tomography angiography: A single-center study.

OBJECTIVES: To investigate the prevalence and risk factors linked to contrast-induced nephropathy in this specific patient population, aiming to ensure the highest quality of clinical care. METHODS: In a retrospective analysis, all patients who presented with an acute stroke to King Fahad Hospital, Jeddah, Emergency Department from March until November 2022 and underwent Computed Tomography Angiography (CTA) brain, Inclusion criteria were as follows: a baseline creatinine results and CTA examination performed within 24 hours of symptom onset and an available early (<5 days after CTA) follow-up creatinine result. RESULTS: Among 246 stroke patients in the emergency, 182 underwent brain CTA and 8.24% had Contrast-Induced Nephropathy (CIN). intracerebral hemorrhage (ICH) increased CIN risk 7-fold (OR=6.7; 95% CI: 1.23-33.3). Abnormal baseline raised CIN risk 8-fold (OR=7.8; 95% CI: 1.74-35.1). hypertension doubled the risk for CIN (OR=2.1; 95% CI: 1.26-6.98) CONCLUSION: The incidence of CIN was 8.2%, particularly elevated in patients with ICH, hypertension, tissue plasminogen administration, and abnormal baseline, necessitating vigilance in managing acute stroke cases.

Hand Knob Syndrome Secondary to Ipsilateral Concomitant Carotid Fibromuscular Dysplasia and Proximal Atherosclerotic Disease.

One of the uncommon stroke presentations is the isolated wrist drop syndrome, caused by a stroke affecting the hand knob area, with the embolic mechanism being the most commonly identified mechanism. Here, we present the case of a 62-year-old female patient who presented with acute-onset isolated wrist drop secondary to right internal carotid artery fibromuscular dysplasia with a string of beads appearance and coexisting proximal atherosclerotic severe stenosis. The patient underwent successful carotid artery stenting. Patients with hand knob stroke may present a diagnostic dilemma and can be misdiagnosed as having peripheral neuropathy due to the absence of pyramidal signs and other symptoms of cortical involvement, leading to delayed or inappropriate treatment.

Reversible CT Scan Hypodensity in Acute Ischemic Stroke Patient With Low Initial Alberta Stroke Program Early CT Score (ASPECTS) Following Endovascular Thrombectomy: A Case Report.

According to current American and European guidelines, mechanical thrombectomy is recommended only for patients with an Alberta Stroke Program Early CT Score (ASPECTS) of 6 or higher. However, recent literature suggests that the potential benefits of reperfusion therapy should not be solely determined by baseline ASPECTS. In this case report, we present a young female patient with a low initial ASPECTS (4-5), who underwent mechanical thrombectomy and showed marked improvement in both CT imaging and clinical symptoms. Our findings potentially show that mechanical thrombectomy may be beneficial even for patients with an initial ASPECTS ≤ 5. These results may contribute to the growing evidence supporting the use of mechanical thrombectomy as a viable treatment option for acute ischemic stroke patients with low baseline ASPECTS.

Challenges and Barriers Toward Medical Research Among Medical and Dental Students at King Khalid University, Abha, Kingdom of Saudi Arabia.

Background: Medical research is a systematic method to obtain new knowledge, reduce diagnosis problems, discover the latest or best treatment for a disease, and also used for disease prevention. Objective: The study aims to assess the challenges and barriers to conduct medical research among medical and dentistry students and determine the reasons that hinder the conduct of the study. Methods: In this cross-sectional study, the research population consisted of medical and dental students affiliated with King Khalid University in Saudi Arabia in 2020. The study followed a descriptive approach based on quantitative analysis. The Statistical Package of the Social Sciences (SPSS) program (V. 16.0, SPSS Inc., Chicago, IL, USA) was used for data analysis. Results: A total of 327 students participated in this study, and the response rate was 100%. Among them, 61.5% were females. In this study majority (63.3%) had a moderate attitude toward conducting medical research and the average was 56.17. The majority (53.8%) had a reasonable behavior toward conducting medical research, and the average was 29.06. Lack of time, skills, funding, facilities, and limited access to medical journals and related databases were the significant barriers found. Most of the students had positive attitudes, except that they are not awarded on their research, do not attend the sessions, and do not speak their thoughts. A significant relationship between demographic characteristics (age, level, and Grade Percentage Average), attitudes & perceived barriers toward research was found (<0.05). Conclusion: The majority of the students demonstrated a positive attitude toward and moderate behavior of research. However, most are not awarded on their research, do not attend the sessions, and do not speak their thoughts. Intensive training and adequate support in research activities of medical and dental students at the undergraduate level may help reduce these challenges and barriers toward research.