ObjectiveProtocols for posterior circulation ischemic stroke have not been established by randomized clinical trials. Mechanical endovascular thrombectomy (MET) devices are evolving, and many of these devices already developed or in development are suitable for posterior circulation MET.Materials and MethodsWe investigated the medical records of patients who underwent MET for posterior circulation ischemic stroke from January 2012 to August 2016. Fifteen patients were included. MET was performed in patients with or without injected intravenous tissue plasminogen activator. MET was considered in patients with a National Institute of Health Stroke Scale score of 4 or more, older than 18 years, with definite occlusion of the basilar artery or posterior cerebral artery (PCA), and who arrived at the hospital within 24 hours from onset.ResultsThe direct catheter aspiration technique was used in five cases, and the stent retrieval technique was used in seven cases. The stent retrieval technique with the direct aspiration technique was used in three cases. Recanalization failed in two cases. Basilar occlusion without PCA involvement is the only effective factor of successful recanalization (p = 0.03). Successful recanalization (p = 0.005) and the presence of a posterior communicating artery (p = 0.005) affected the good outcome at discharge.ConclusionAn early diagnosis and active MET may improve the patient outcome. MET may help recanalization and good flow restoration and the potential for a good outcome.
Background/Aims: Cervical dystonia (CD) is the most common form of focal dystonia. The treatment options for CD include medical therapy and surgery. The 3 basic types of CD are tonic, phasic and tremulous. Selective peripheral denervation (SPD) and globus pallidus internus (GPi) deep brain stimulation (DBS) have been developed as therapeutic options for the treatment of CD. Methods: Between 1997 and 2009, 24 patients with CD underwent operations: either SPD (n = 16) or DBS (n = 8). The mean follow-up period was 29.5 months (range = 2–59). The mean age at onset of symptoms was 46.6 years (range = 27–65). The patients were evaluated with the subjective scores and the Toronto Western Spasmodic Torticollis Scale scores. Results: All patients showed gradual improvement after SPD and DBS. No statistically significant differences were seen between the SPD group and the DBS group. However, there was a trend toward greater pain reduction in the DBS group (p = 0.094). Conclusion: Both the SPD group and the DBS group showed successful improvement in their Toronto Western Spasmodic Torticollis Scale scores as well as subjective scores. The GPi DBS group showed a remarkable improvement on the pain scale and there was a trend toward greater pain reduction in the DBS group.
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