Background Approximately 10%-14% of ischemic strokes occur in young adults. Aims To investigate risk factors and etiologies of strokes of young adults admitted to the “stroke unit” of Policlinico ...“Gemelli” of Rome from December 2005 to January 2013. Methods In all, 150 consecutive patients younger than 50 years diagnosed with ischemic stroke were enrolled. Clinical evaluation consisted of a complete neurologic examination and the National Institutes of Health Stroke Scale. Diagnostic workup consisted of anamnesis, extensive laboratory, radiologic, and cardiologic examination. Stroke etiologies were classified according to the Trial of Org 10172 in Acute Stroke Treatment. Results Patients' mean age was 41 ± 8.0 years. The most common risk factors were dyslipidemia (52.7%), smoking (47.3%), hypertension (39.3%), and patent foramen ovale (PFO, 32.8%). Large-artery atherosclerosis was diagnosed as the cause of stroke in 17 patients (11.3%). Cardioembolism was presumed in 36 patients (24%), most of them presented a PFO at transesophageal echocardiography. Small-vessel occlusion was diagnosed in 12 patients (8%); all of them were hypertensive and most of them presented additional risk factors. Forty-one patients (27.3%) presented a stroke of other determined etiology and 44 (29.3%) presented a stroke of undetermined etiology. The 3-year survival was 96.8% and recurrent strokes occurred in only 3 cases. Conclusions Traditional vascular risk factors are also very common in young adults with ischemic stroke, but such factors increase the susceptibility to stroke dependent to other causes as atherosclerosis and small-artery occlusion represent less than 20% of cases. Prognosis quoadvitam is good, being characterized by low mortality and recurrence rate.
The gabbroic bodies from the Jurassic Ligurian ophiolites are structurally and compositionally similar to the gabbroic sequences from the oceanic core complexes of the Mid Atlantic Ridge. Initial ...cooling of the Ligurian gabbros is associated with local development of hornblende-bearing felsic dykes and hornblende vein networks. The hornblende veining is correlated with the widespread development of hornblende as coronas/pseudomorphs after the clinopyroxene in the host gabbros. In addition, the studied gabbroic body includes a mantle sliver locally containing hornblende gabbros and hornblendite veins. The hornblendes from the felsic dykes and the hornblende-rich rocks within the mantle sliver show a similar geochemical signature, characterized by low Mg#, CaO and Al2O3, negligible Cl, and high TiO2, K2O, REE, Y, Zr and Nb concentrations. The whole-rock Sm–Nd isotopic compositions of the felsic dykes and the hornblende-rich rocks define a Sm–Nd isochron corresponding to an age of 154±20Ma and an initial εNd of 9.2±0.5. The δ18O of the hornblendes and coexisting zircons from these rocks (about +4.5‰ and +5.8‰, respectively) do not indicate the presence of a seawater component in these melts. The formation of the felsic dykes and of the hornblende-rich rocks within the mantle sliver involved SiO2-rich silicate melts with negligible seawater component, which presumably were derived from high degree fractional crystallization of MOR-type basalts. The vein and the coronitic/pseudomorphic hornblendes show high Mg# and CaO, significant Cl (0.02–0.17wt%) and low TiO2 and K2O concentrations. The coronitic/pseudomorphic hornblendes have trace element compositions similar to those of the clinopyroxenes from the gabbros and δ18O values (+1.0‰ to 0.7‰) close to seawater, suggesting an origin by reaction between migrating seawater-derived fluids and the host gabbros. The vein hornblendes commonly show slight LREE enrichment, relatively high concentrations of Nb (up to 2.5ppm) and δ18O ranging from +3.7‰ to +0.8‰. The crystallization of these hornblendes most likely involved both seawater and magmatic components.
Narcolepsy in midbrain structural lesion Renna, Rosaria; Koudriavtseva, Tatiana; Renna, Antonio ...
Annals of Indian Academy of Neurology,
07/2016, Volume:
19, Issue:
3
Journal Article
Discrimination between axonotmesis and neurotmesis is crucial in traumatic nerve injury. We present the case of a 43-year-old woman which presented hypoesthesia in the fourth and fifth right fingers, ...started after surgery for Dupuytren syndrome. At ultrasound study, the ulnar digital sensory branch was identified. Before the division into the two terminal branches, a neuroma was observed, while neurotmesis was excluded. This case shows the utility of ultrasonography in peripheral nervous system examination and the possibility of visualization of very small nerves and their terminal branches.
Fabry disease is an inborn error of glycosphingolipid catabolism caused by deficient activity of the lysosomal exoglycohydrolase α-galactosidase A. It has an X-linked inheritance and occurs in all ...ethnic groups, with an incidence of 1 in 40,000 in the general population. The incidence of cerebrovascular accidents in patients affected by Fabry disease is much higher than in the general population. Moreover, there is a greater prevalence of hypertension, cardiac disease, and renal disease in patients affected by Fabry disease that have suffered a stroke. Here we present the case of a paucisymptomatic young man affected by Fabry disease and treated with enzyme replacement therapy who was admitted for hemorrhagic stroke.
The Antampombato–Ambatovy complex is the largest intrusion in the central–eastern part of the Cretaceous flood basalt province of Madagascar, with an exposed surface area of about 80 km2. It has an ...40Ar/39Ar incremental heating age of 89·9 ± 0·4 Ma and a U–Pb age of 90 ± 2 Ma. The outcropping plutonic rocks range from dunite and wehrlite, through clinopyroxenite and gabbro, to sodic syenite. A dyke swarm cross-cutting some of the above lithologies (and the nearby Precambrian basement rocks) is formed of picritic basalts, alkali to transitional basalts, benmoreites and rhyolites; some of the latter are peralkaline. A few basaltic dykes have cumulate olivine textures, with up to 26 wt % MgO and 1200 ppm Ni, whereas others have characteristics more akin to those of primitive liquids (9 wt % MgO; Mg-number 0·61; 500 ppm Cr; 200 ppm Ni). These basalts have relatively high TiO2 (2·2 wt %) and total iron (14 wt % as Fe2O3), and moderate contents of Nb (10–11 ppm) and Zr (c. 100 ppm). Initial (at 90 Ma) Sr- and Nd-isotope ratios of the clinopyroxenites and basalt dykes are 0·7030–0·7037 and 0·51290–0·51283, respectively. Syenites and peralkaline rhyolites have Sr- and Nd-isotope ratios of 0·7037–0·7039 and 0·51271–0·51274, respectively. The data suggest derivation of the parental magmas from a time-integrated depleted mantle source, combined with small amounts of crustal contamination in the petrogenesis of the more evolved magmas. The isotopic compositions of the mafic–ultramafic rocks are most similar to those of the mid-ocean ridge basalt (MORB)-like igneous rocks of eastern Madagascar, and suggest the existence of an isotopically ‘depleted’ component in the source of the entire Madagascar province, even though the Antampombato basalts are chemically unlike the lavas and dykes with the same depleted isotopic signature found in western Madagascar. If this depleted component is plume-related, this suggests that the plume has a broadly MORB-source mantle composition. The existence of isotopically more enriched magma types in the Madagascan province has several possible petrogenetic explanations, one of which could be the interaction of plume-related melts with the deep lithospheric mantle beneath the island.
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