Abstract — WCN 2013No: 1602Topic: 3 — StrokeStroke campaign: An experience report

C.D. Rochaa, J.A.D. Oliveira Júniora, L.A.A. Reisa, F.K.M.S. Pintoa,F.O. Gomesa, D.J.D. Silvab. aFaculdade de Medicina, UniversidadeFederal de Goiás, Goiânia, Brazil; bHospital das Clínicas, UniversidadeFederal de Goiás, Goiânia, Brazil

Background: Cerebrovascular accident (CVA) is the second cause ofmortality in Brazil and third in the world. Data from the World HealthOrganization (WHO) predict a 1.4% increase in stroke mortality in menand 0.3% in females by 2030. It is possible to reduce strokemortality anddisability through decreasing incidence and lethality of the disease andthat is why stroke campaigns are indispensable.Objectives: Experience report on campaign to promote health andprevent stroke.Material andmethods: In the campaign about stroke, medical studentsteach about the FAST test to recognize earlier the symptoms. The FASTtest consists of “F”, Face (to smile), “A”, arm (anyarmdrifts downward?),“S”, Speech (speech sound slurred or strange?) and “T”, Time (if any ofsigns are observed) to call emergency immediately. Blood pressuremeasurements were also made to identify the main risk factor forhemorrhagic stroke — hypertension.Results: People were instructed to the prevention of stroke, followingstroke prevention, guidelines make aware of blood pressure, smoking,control alcohol abuse, check cholesterol levels, control diabetes,manage exercise and diet, and act FAST test at the first warning signof stroke. The population empowerment from campaigns like this canreduce the interval between symptoms and diagnosis, reducing strokemorbidity and mortality.Conclusion: Objectives were achieved and from primary attention toharm reduction, health promotion was entirely contemplated. It is ahealth promotion experience to be perpetuated.

doi:10.1016/j.jns.2013.07.824

Abstract — WCN 2013No: 1701Topic: 3 — StrokeAdult on set moya moya like atherosclerotic disease withspontaneous revascularization

M.F. Oztekina, N. Oztekinb, F. Efendizadea, E. Bilgia, O. Ergunc.aNeurology, MOH Ankara Yildirim Beyazit Education and ResearchHospital, Ankara, Turkey; bNeurology, MOH Ankara Numune Educationand Research Hospital, Ankara, Turkey; cRadiology, MOH Ankara YildirimBeyazit Education and Research Hospital, Ankara, Turkey

Background:Moya moya disease is characterized by chronic occlusionof internal carotid arteries with development of fragile new vessels atthe base of the brain with unknown etiology. It is often presented withischemic vascular events in children and intraventricular orintraparenchymal hemorrhages in adults. Adult onset moya moyadisease must be differentiated from atherosclerotic disease. Wepresented an adult onset moya moya like atherosclerotic disease withspontaneous external revascularization.Case presentation: 57 year old female patient was admitted inemergency clinic with sudden loss of consciousness and vomiting. Hersystemic examination revealed mild hypertension. Neurological exam-ination revealed a drowsy patient with stiff neck, and no cranial nervedysfunction was found. She had no motor and sensory lateralizingdeficit. Bilateral extensor planter reflexes and brisk tendon reflexeswere found. She had normal blood count and screening tests.Computerized tomography revealed intraventricular hemorrhage

filling all ventricles. She gained her consciousness in the next day andinformed that she had had another intracerebral eight years ago withfull recovery. Cranial angiography revealed bilateral occlusion of carotidarteries at the level of supraclinoid segment and stenosis of rightinternal carotid artery after bifurcation from common carotid artery andmoya moya vessels at the base of the skull. There was also anastomosisof right external carotid and right middle cerebral artery at the durallevel convexity of the right hemisphere.Conclusion: This case demonstrates that spontaneous revasculariza-tion of dural anastomosis may be a part of the moya moya likesyndrome due to atherosclerosis.

doi:10.1016/j.jns.2013.07.825

Abstract — WCN 2013No: 991Topic: 3 — StrokeIsolated oculomotor nerve palsy: A rare manifestation ofspontaneous internal carotid artery dissection

T. Santosa, P. Barrosa, H. Felgueirasa, G. Oliveirab, A.T. Carvalhoa,H. Moraisa. aNeurology, Centro Hospitalar Vila Nova de Gaia/Espinho,Vila Nova de Gaia, Portugal; bNeuroradiology, Centro Hospitalar VilaNova de Gaia/Espinho, Vila Nova de Gaia, Portugal

Introduction: Internal carotid artery (ICA) dissection commonlypresents with headache, neck pain, Horner syndrome or with focalcerebral ischemic symptoms. Cranial nerve palsies can also be found,accounting for 12% of spontaneous ICA dissection cases and usuallypresenting as a syndrome of lower cranial nerve palsies. Therefore,an isolated oculomotor nerve involvement is extremely rare.Case report: A 58 year-old man complains of a sudden-onset doublevision for 3 days. He denies recent inflammation/infection, headache,cervical pain and trauma. He had well-controlled diabetes, hypertensionand dyslipidemia. Hewas apyretic, without ocular erythema, proptosis orpalpable orbital mass. Neurologic examination: left-sided ptosis andbinocular horizontal diplopia in dextroversion without apparentextraocular-muscle paralysis or pupillary involvement. Other cranialpairs, motor, sensory and coordination systems were spared. Thelaboratory screening was negative for infections and immunologicdiseases. The brain-MRI revealed a crescent-shapedmural hyperintensityin left ICA at the skull base extending to intra-petrous segment, implyingreduced caliber/flow on MRI-angiography — left ICA dissection. Thepatient started antiaggregation therapy and progressively recovered. Ayear later he was asymptomatic and CT-angiography confirmed ICArecanalization.Discussion: An ICA dissection presented only by an incompleteoculomotor nerve palsy is extremely rare. According to the literature,this can be explained by a blood supply impairment to vasa nervorum(embolic/hemodynamic) as the distal III is supplied by the inferiorcavernous sinus and meningohypophyseal arteries, both derivedfrom the intracavernous ICA. This case report enhances theimportance of considering a cervicocerebral dissection in less typicalclinical presentations.

doi:10.1016/j.jns.2013.07.826

Abstract — WCN 2013No: 1694Topic: 3 — StrokeMedullary infarcts: Analysis of 67 patients

M.F. Oztekina, N. Oztekinb, O. Bizpinara. aNeurology, MOH AnkaraYildirim Beyazit Education and Research Hospital, Turkey; bNeurology,MOH Ankara Numune Education and Research Hospital, Ankara, Turkey

Abstracts / Journal of the Neurological Sciences 333 (2013) e152–e214 e207