The Experts below are selected from a list of 300 Experts worldwide ranked by ideXlab platform
Neeraj Dubey - One of the best experts on this subject based on the ideXlab platform.
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diffusion weighted magnetic resonance imaging in superior Sagittal Sinus Thrombosis
Journal of Neuroimaging, 2002Co-Authors: Mohammad Wasay, Neeraj Dubey, Rohit Bakshi, George Bobustuc, Zahid Cheema, Alper I. DaiAbstract:Background and purpose Diffusion-weighted imaging (DWI) has shown high sensitivity in the diagnosis of acute arterial strokes. The pathophysiology of cerebral venous Thrombosis with associated venous stroke appears to differ from that of arterial strokes. The purpose of this study was to describe DWI findings in venous strokes. Methods The authors reviewed 3 adults with superior Sagittal Sinus Thrombosis who underwent DWI and magnetic resonance imaging within 24 hours of symptom onset. DWI was obtained at 1.5 T using the multishot echo planar technique (TR = 8000, TE = 97, field of view = 30 x 19 cm, slice thickness = 6.0 mm, interslice gap = 0.5 mm, matrix 128 x 128, NEX = 1). The diffusion gradients were applied in 3 orthogonal directions with 3 increasing b values (0-1000 s/mm2) to create average (trace) DWI images. Apparent diffusion coefficient (ADC) values were calculated on a pixel-by-pixel basis and displayed as ADC maps. Results DWI showed hyperintensities in patients 1 and 2 and hypointensity in patient 3 in corresponding to parenchymal lesions on conventional images. As compared to the homologous uninvolved location in the contralateral hemisphere, ADC values were decreased (0.53 x 10(-3) mm2/s [patient 1] and 0.68 x 10(-3) mm2/s [patient 2]) and increased (1.1 x 10(-3) mm2/s [patient 3]). The ADC ratio of the lesion in the involved to uninvolved side was 88% (patient 1), 81% (patient 2), and 120% (patient 3). Conclusion Acute cerebral venous strokes may contain cytotoxic edema and/or vasogenic edema on DWI scans. DWI may be helpful in diagnosing cerebral venous Thrombosis in cases with cryptic presentations.
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nonrandomized comparison of local urokinase thrombolysis versus systemic heparin anticoagulation for superior Sagittal Sinus Thrombosis
Stroke, 2001Co-Authors: Mohammad Wasay, Neeraj Dubey, Rohit Bakshi, Suleman Kojan, George Bobustuc, D H UnwinAbstract:Background and Purpose— We sought to compare the safety and efficacy of direct urokinase thrombolysis with systemic heparin anticoagulation for superior Sagittal Sinus Thrombosis (SSST). Methods— At University at Buffalo (NY) and University of Texas (Dallas, Houston), we reviewed 40 consecutive patients with SSST, treated with local urokinase (thrombolysis group) or systemic heparin anticoagulation (heparin group). The thrombolysis group (n=20) received local urokinase into the SSS followed by systemic heparin anticoagulation. The heparin group (n=20) received systemic heparin anticoagulation only. Neurological dysfunction was rated as follows: 0, normal; 1, mild (but able to ambulate and communicate); 2, moderate (unable to ambulate, normal mentation); and 3, severe (unable to ambulate, altered mentation). Results— Age (P=0.49), sex (P=0.20), baseline venous infarction (P=0.73), and predisposing illnesses (P=0.52) were similar between the thrombolysis and heparin groups. Pretreatment neurological functio...
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superior Sagittal Sinus Thrombosis due to lithium local urokinase thrombolysis treatment
Neurology, 2000Co-Authors: Mohammad Wasay, Rohit Bakshi, Suleman Kojan, George Bobustuc, Neeraj DubeyAbstract:Superior Sagittal Sinus Thrombosis (SSST) is associated with a host of predisposing factors, including pregnancy, collagen vascular disease, malignancy, diabetes insipidus, and medications such as oral contraceptive agents, l-asparaginase, androgens, and heparin.1 The diagnosis of cerebral venous Thrombosis may be challenging,2 so it is important to recognize underlying causes. We report a young woman with SSST associated with lithium-induced nephrogenic diabetes insipidus. This is the first reported case of venous Sinus Thrombosis secondary to lithium therapy. The patient was treated successfully with local urokinase thrombolysis. A 30-year-old woman with a history of bipolar disorder presented with progressive headache, confusion, visual blurring, and left hemiparesis. She had been taking lithium, risperidone, and oral contraceptive agents for many years. Neurologic examination showed confusion, papilledema, and mild left hemiparesis. Urine output was markedly elevated (greater than 200 mL/hour). Significant laboratory abnormalities included serum platelet count 106,000/mm3, sodium …
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Superior Sagittal Sinus Thrombosis secondary to hyperthyroidism
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2000Co-Authors: Alper I. Dai, Mohammad Wasay, Neeraj Dubey, Pierre Giglio, Rohit BakshiAbstract:Superior Sagittal Sinus Thrombosis (SSST) is associated with a variety of hypercoaguable states. Although coagulation disturbances are reported in hyperthyroidism, a direct link between hyperthyroidism and cerebral venous Thrombosis is not established. We report a 39-year-old man who developed increased intracranial pressure, seizures, and rapid atrial fibrillation. Neuroimaging showed SSST, and laboratory studies were consistent with hyperthyroidism. No other causes of a hypercoaguable state were identified. Prompt treatment of his hyperthyroidism led to recanalization of the superior Sagittal Sinus and a full neurological recovery. Given the known effects of hyperthyroidism on factor VIII activity, we hypothesize that hyperthyroidism is an independent risk factor for SSST. A high index of suspicion for SSST is warranted in patients with hyperthyroidism and neurological symptoms. Furthermore, thyroid dysfunction should be excluded in patients with unexplained SSST.
Mohammad Wasay - One of the best experts on this subject based on the ideXlab platform.
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diffusion weighted magnetic resonance imaging in superior Sagittal Sinus Thrombosis
Journal of Neuroimaging, 2002Co-Authors: Mohammad Wasay, Neeraj Dubey, Rohit Bakshi, George Bobustuc, Zahid Cheema, Alper I. DaiAbstract:Background and purpose Diffusion-weighted imaging (DWI) has shown high sensitivity in the diagnosis of acute arterial strokes. The pathophysiology of cerebral venous Thrombosis with associated venous stroke appears to differ from that of arterial strokes. The purpose of this study was to describe DWI findings in venous strokes. Methods The authors reviewed 3 adults with superior Sagittal Sinus Thrombosis who underwent DWI and magnetic resonance imaging within 24 hours of symptom onset. DWI was obtained at 1.5 T using the multishot echo planar technique (TR = 8000, TE = 97, field of view = 30 x 19 cm, slice thickness = 6.0 mm, interslice gap = 0.5 mm, matrix 128 x 128, NEX = 1). The diffusion gradients were applied in 3 orthogonal directions with 3 increasing b values (0-1000 s/mm2) to create average (trace) DWI images. Apparent diffusion coefficient (ADC) values were calculated on a pixel-by-pixel basis and displayed as ADC maps. Results DWI showed hyperintensities in patients 1 and 2 and hypointensity in patient 3 in corresponding to parenchymal lesions on conventional images. As compared to the homologous uninvolved location in the contralateral hemisphere, ADC values were decreased (0.53 x 10(-3) mm2/s [patient 1] and 0.68 x 10(-3) mm2/s [patient 2]) and increased (1.1 x 10(-3) mm2/s [patient 3]). The ADC ratio of the lesion in the involved to uninvolved side was 88% (patient 1), 81% (patient 2), and 120% (patient 3). Conclusion Acute cerebral venous strokes may contain cytotoxic edema and/or vasogenic edema on DWI scans. DWI may be helpful in diagnosing cerebral venous Thrombosis in cases with cryptic presentations.
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nonrandomized comparison of local urokinase thrombolysis versus systemic heparin anticoagulation for superior Sagittal Sinus Thrombosis
Stroke, 2001Co-Authors: Mohammad Wasay, Neeraj Dubey, Rohit Bakshi, Suleman Kojan, George Bobustuc, D H UnwinAbstract:Background and Purpose— We sought to compare the safety and efficacy of direct urokinase thrombolysis with systemic heparin anticoagulation for superior Sagittal Sinus Thrombosis (SSST). Methods— At University at Buffalo (NY) and University of Texas (Dallas, Houston), we reviewed 40 consecutive patients with SSST, treated with local urokinase (thrombolysis group) or systemic heparin anticoagulation (heparin group). The thrombolysis group (n=20) received local urokinase into the SSS followed by systemic heparin anticoagulation. The heparin group (n=20) received systemic heparin anticoagulation only. Neurological dysfunction was rated as follows: 0, normal; 1, mild (but able to ambulate and communicate); 2, moderate (unable to ambulate, normal mentation); and 3, severe (unable to ambulate, altered mentation). Results— Age (P=0.49), sex (P=0.20), baseline venous infarction (P=0.73), and predisposing illnesses (P=0.52) were similar between the thrombolysis and heparin groups. Pretreatment neurological functio...
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superior Sagittal Sinus Thrombosis due to lithium local urokinase thrombolysis treatment
Neurology, 2000Co-Authors: Mohammad Wasay, Rohit Bakshi, Suleman Kojan, George Bobustuc, Neeraj DubeyAbstract:Superior Sagittal Sinus Thrombosis (SSST) is associated with a host of predisposing factors, including pregnancy, collagen vascular disease, malignancy, diabetes insipidus, and medications such as oral contraceptive agents, l-asparaginase, androgens, and heparin.1 The diagnosis of cerebral venous Thrombosis may be challenging,2 so it is important to recognize underlying causes. We report a young woman with SSST associated with lithium-induced nephrogenic diabetes insipidus. This is the first reported case of venous Sinus Thrombosis secondary to lithium therapy. The patient was treated successfully with local urokinase thrombolysis. A 30-year-old woman with a history of bipolar disorder presented with progressive headache, confusion, visual blurring, and left hemiparesis. She had been taking lithium, risperidone, and oral contraceptive agents for many years. Neurologic examination showed confusion, papilledema, and mild left hemiparesis. Urine output was markedly elevated (greater than 200 mL/hour). Significant laboratory abnormalities included serum platelet count 106,000/mm3, sodium …
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Superior Sagittal Sinus Thrombosis secondary to hyperthyroidism
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2000Co-Authors: Alper I. Dai, Mohammad Wasay, Neeraj Dubey, Pierre Giglio, Rohit BakshiAbstract:Superior Sagittal Sinus Thrombosis (SSST) is associated with a variety of hypercoaguable states. Although coagulation disturbances are reported in hyperthyroidism, a direct link between hyperthyroidism and cerebral venous Thrombosis is not established. We report a 39-year-old man who developed increased intracranial pressure, seizures, and rapid atrial fibrillation. Neuroimaging showed SSST, and laboratory studies were consistent with hyperthyroidism. No other causes of a hypercoaguable state were identified. Prompt treatment of his hyperthyroidism led to recanalization of the superior Sagittal Sinus and a full neurological recovery. Given the known effects of hyperthyroidism on factor VIII activity, we hypothesize that hyperthyroidism is an independent risk factor for SSST. A high index of suspicion for SSST is warranted in patients with hyperthyroidism and neurological symptoms. Furthermore, thyroid dysfunction should be excluded in patients with unexplained SSST.
G Aimard - One of the best experts on this subject based on the ideXlab platform.
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congenital protein c deficiency and superior Sagittal Sinus Thrombosis causing isolated intracranial hypertension
Journal of Neurology Neurosurgery and Psychiatry, 1994Co-Authors: Christian Confavreux, P Brunet, P Petiot, M Berruyer, M Trillet, G AimardAbstract:The first case of a superior Sagittal Sinus Thrombosis causing isolated intracranial hypertension as a result of congenital protein C deficiency is reported. Such a possibility must not be overlooked. Anticoagulation is recommended as a treatment for cerebral venous Thrombosis. In the case of congenital protein C deficiency, vitamin K antagonists must be started cautiously due to the risk of skin necrosis.
Rohit Bakshi - One of the best experts on this subject based on the ideXlab platform.
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diffusion weighted magnetic resonance imaging in superior Sagittal Sinus Thrombosis
Journal of Neuroimaging, 2002Co-Authors: Mohammad Wasay, Neeraj Dubey, Rohit Bakshi, George Bobustuc, Zahid Cheema, Alper I. DaiAbstract:Background and purpose Diffusion-weighted imaging (DWI) has shown high sensitivity in the diagnosis of acute arterial strokes. The pathophysiology of cerebral venous Thrombosis with associated venous stroke appears to differ from that of arterial strokes. The purpose of this study was to describe DWI findings in venous strokes. Methods The authors reviewed 3 adults with superior Sagittal Sinus Thrombosis who underwent DWI and magnetic resonance imaging within 24 hours of symptom onset. DWI was obtained at 1.5 T using the multishot echo planar technique (TR = 8000, TE = 97, field of view = 30 x 19 cm, slice thickness = 6.0 mm, interslice gap = 0.5 mm, matrix 128 x 128, NEX = 1). The diffusion gradients were applied in 3 orthogonal directions with 3 increasing b values (0-1000 s/mm2) to create average (trace) DWI images. Apparent diffusion coefficient (ADC) values were calculated on a pixel-by-pixel basis and displayed as ADC maps. Results DWI showed hyperintensities in patients 1 and 2 and hypointensity in patient 3 in corresponding to parenchymal lesions on conventional images. As compared to the homologous uninvolved location in the contralateral hemisphere, ADC values were decreased (0.53 x 10(-3) mm2/s [patient 1] and 0.68 x 10(-3) mm2/s [patient 2]) and increased (1.1 x 10(-3) mm2/s [patient 3]). The ADC ratio of the lesion in the involved to uninvolved side was 88% (patient 1), 81% (patient 2), and 120% (patient 3). Conclusion Acute cerebral venous strokes may contain cytotoxic edema and/or vasogenic edema on DWI scans. DWI may be helpful in diagnosing cerebral venous Thrombosis in cases with cryptic presentations.
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nonrandomized comparison of local urokinase thrombolysis versus systemic heparin anticoagulation for superior Sagittal Sinus Thrombosis
Stroke, 2001Co-Authors: Mohammad Wasay, Neeraj Dubey, Rohit Bakshi, Suleman Kojan, George Bobustuc, D H UnwinAbstract:Background and Purpose— We sought to compare the safety and efficacy of direct urokinase thrombolysis with systemic heparin anticoagulation for superior Sagittal Sinus Thrombosis (SSST). Methods— At University at Buffalo (NY) and University of Texas (Dallas, Houston), we reviewed 40 consecutive patients with SSST, treated with local urokinase (thrombolysis group) or systemic heparin anticoagulation (heparin group). The thrombolysis group (n=20) received local urokinase into the SSS followed by systemic heparin anticoagulation. The heparin group (n=20) received systemic heparin anticoagulation only. Neurological dysfunction was rated as follows: 0, normal; 1, mild (but able to ambulate and communicate); 2, moderate (unable to ambulate, normal mentation); and 3, severe (unable to ambulate, altered mentation). Results— Age (P=0.49), sex (P=0.20), baseline venous infarction (P=0.73), and predisposing illnesses (P=0.52) were similar between the thrombolysis and heparin groups. Pretreatment neurological functio...
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superior Sagittal Sinus Thrombosis due to lithium local urokinase thrombolysis treatment
Neurology, 2000Co-Authors: Mohammad Wasay, Rohit Bakshi, Suleman Kojan, George Bobustuc, Neeraj DubeyAbstract:Superior Sagittal Sinus Thrombosis (SSST) is associated with a host of predisposing factors, including pregnancy, collagen vascular disease, malignancy, diabetes insipidus, and medications such as oral contraceptive agents, l-asparaginase, androgens, and heparin.1 The diagnosis of cerebral venous Thrombosis may be challenging,2 so it is important to recognize underlying causes. We report a young woman with SSST associated with lithium-induced nephrogenic diabetes insipidus. This is the first reported case of venous Sinus Thrombosis secondary to lithium therapy. The patient was treated successfully with local urokinase thrombolysis. A 30-year-old woman with a history of bipolar disorder presented with progressive headache, confusion, visual blurring, and left hemiparesis. She had been taking lithium, risperidone, and oral contraceptive agents for many years. Neurologic examination showed confusion, papilledema, and mild left hemiparesis. Urine output was markedly elevated (greater than 200 mL/hour). Significant laboratory abnormalities included serum platelet count 106,000/mm3, sodium …
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Superior Sagittal Sinus Thrombosis secondary to hyperthyroidism
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2000Co-Authors: Alper I. Dai, Mohammad Wasay, Neeraj Dubey, Pierre Giglio, Rohit BakshiAbstract:Superior Sagittal Sinus Thrombosis (SSST) is associated with a variety of hypercoaguable states. Although coagulation disturbances are reported in hyperthyroidism, a direct link between hyperthyroidism and cerebral venous Thrombosis is not established. We report a 39-year-old man who developed increased intracranial pressure, seizures, and rapid atrial fibrillation. Neuroimaging showed SSST, and laboratory studies were consistent with hyperthyroidism. No other causes of a hypercoaguable state were identified. Prompt treatment of his hyperthyroidism led to recanalization of the superior Sagittal Sinus and a full neurological recovery. Given the known effects of hyperthyroidism on factor VIII activity, we hypothesize that hyperthyroidism is an independent risk factor for SSST. A high index of suspicion for SSST is warranted in patients with hyperthyroidism and neurological symptoms. Furthermore, thyroid dysfunction should be excluded in patients with unexplained SSST.
T Powell - One of the best experts on this subject based on the ideXlab platform.
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isolated inferior Sagittal Sinus Thrombosis a case report
Neuroradiology, 1997Co-Authors: S M Elsherbiny, R Grunewald, T PowellAbstract:We present a case of isolated inferior Sagittal Sinus Thrombosis shown on CT, MRI and angiography. This condition has not, to our knowledge, been described previously.
