Background and Purpose— We investigated the predictors and time course for recanalization after vertebral artery dissection. Methods— We prospectively studied 61 consecutive patients with confirmed diagnoses of vertebral artery dissection without intracerebral hemorrhage. Neuroimaging and clinical follow-up were performed at presentation and at 3, 6, and 12 months. Results— We included 61 patients with confirmed vertebral artery dissection; 19 were evaluated and followed up with conventional angiography, 24 with MR angiography, and 18 with CT angiography. Fifty-one patients had a stenotic dissection, 7 had an occlusive dissection, one had a double-lumen image, and 2 had a pseudoaneurysm. The estimated rate of complete recanalization after vertebral artery dissection was 45.9% at 3 months, 62.3% at 6 months, and 63.9% at 12 months. We found no association between outcome and complete or partial recanalization nor did we find any factors associated with recanalization. Conclusions— These results suggest that recanalization of vertebral artery dissection occurs mainly within the first 6 months after the onset of symptoms regardless of the location or pattern of the dissection.

It is well established that several infectious diseases can directly lead to ischemic or hemorrhagic stroke. Neurocysticercosis (NCC), caused by infection of the human central nervous system with the parasite Taenia solium, is recognized as an important public health problem in developing countries. The clinical manifestations of NCC are nonspecific and varied depending on the number and topography of lesions. Cerebrovascular disease is a relatively common but underrecognized complication of NCC; published data indicate that the incidence of stroke is between 4% and 12% in patients with NCC, depicting a clear relationship among these 2 pathologies. We review the cerebrovascular complications of NCC including the possible role of NCC as a cerebrovascular risk factor, including epidemiology, pathogenesis, diagnosis, and management of the cerebrovascular complications derived from cysticercal infarction and those associated with the use of anticysticercal drugs. Common and uncommon clinical manifestations, localization of stroke, and associated syndromes are discussed along with their prognostic significance. Although an underrecognized cause of stroke, present preponderantly in undeveloped countries, NCC still causes significant incapacity and even death in young patients suffering from stroke in the absence of cerebrovascular risk factors; hence, neurologists should become familiar with this potential complication.

Cerebral vasospasm (CV) accounts significant morbimortality after aneurysmal subarachnoid hemorrhage. The objective of this study was to compare the clinical outcome of patients with CV treated by 2 endovascular procedures: intra-arterial nimodipine angioplasty (IANA) and balloon angioplasty (BA). Between 2008 and June 2011, we performed 22 IANA and 8 BA in 30 patients. The mean age was 44 years and 60% was female. In 17 patients, the treatment was clipping, whereas 13 underwent coil treatment. The CV was severe in 63%, moderate in 30%, and mild in 7%. Good outcome between 2 groups was similar (P = .36). The clinical outcome according to the subgroups of CV severity and modality treatment was equivalent (P = .22). Mortality at 3 months was 16% and 20% at 1 year. We did not find differences in the clinical outcome despite the fact that both techniques produce adequate angiographic resolution of CV.

Spontaneous, nontraumatic intracerebral hemorrhage (ICH) is a subtype of stroke that causes a great amount of disability and economic and social burden. This is particularly true in developing countries where it accounts for between 20% and 50% of all strokes. Pharmacological and surgical interventions have been attempted to reduce the mortality and disability caused by ICH, with unsuccessful results. Recently, the use of fluoxetine in addition to physical rehabilitation has been proven useful to improve motor recovery following cerebral infarct. The purpose of this study is to test whether a 3-month treatment with fluoxetine enhances motor recovery in nondepressed patients with acute intracerebral hemorrhage.