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Stroke is the leading cause of permanent disability, including post-stroke dementia, pain, depression, and personality changes. While large clinical trials reflect information about large stroke populations, the presentation of each and every stroke patient is individual and special. More Case Studies in Stroke presents a new selection of stroke cases from seven countries prepared by practising stroke physicians. The book includes both common and unusual cases, as well as misleading cases of diseases mimicking stroke. The aim is to reinforce diagnostic skills through careful analysis of individual presenting patterns, and to guide treatment decisions. Each case consists of a clinical history, examination findings and special investigations, followed by diagnosis and discussion. The outline of the actual diagnostic process, including the use of modern diagnostic tools, decision making and course, challenge the reader at all stages of their career from medical students to neurologists and stroke physicians.
Kohlmeier-Degos' disease (KDD) is more common in white boys and men with age of onset ranging between 3 weeks of age to 67 years old, most commonly occurring in the second and third decades. The etiology and pathogenesis, although still unknown, is speculated to be immunologic dysfunction, coagulation or fibrinolysis abnormalities, or possible viral infections. Any organ system may be involved; the clinical manifestations are a result of multifocal infarctions. Laparoscopic examination, however, shows lesions similar in appearance to the skin lesions that may involve multiple areas of the small intestine. These lesions are secondary to infarction and have also been found in the esophagus, duodenum, stomach, colon, and rectum. Ischemia and infarction are key pathophysiological mechanisms of the lesions seen. Therapies that have been used include antiplatelets, anticoagulants, immunosuppressive agents, plasma exchange, and nicotine patches. Surgery is indicated in cases of intestinal perforation.