the Albuquerque Police Department was called to a house that neighbors describe as a problem house with domestic violence calls
That problem neighbor we discovered was an Aryan Brotherhood member and convicted federal felon named Benjamin Raymond
We identified Raymond through property and criminal records and witnesses who refuse to be identified out of fear
When police arrived at the home they found Raymond in the driveway of the home and he was combative with officers
they did advise the individual that he was under arrest
and officers were able to tackle the individual at this point in time for about the next two minutes
Officers are in a wrestling match for their life as the individual is armed with a handgun
and officers are trying to keep the handgun pinned down to the ground,” said APD Chief Harold Medina
APD officers shot and killed Raymond after the wrestling match and Raymond was pronounced dead at the scene
PATREON MEMBERS CAN SEE ADDTIONAL FOOTAGE HERE:https://www.patreon.com/posts/122954424
I don’t want to do this or don’t make me do this,” said Chief Medina
We observed Raymond dead in the street across from the home where the call for service started
There appeared to be a firearm near the body
There were also belongings and baskets of clothes out in the driveway
indicating someone was possibly moving when the incident happened
BACKGROUND ON RAYMOND’S FEDERAL TIME:
was sentenced to 150 months of imprisonment for committing violent crimes in aid of racketeering
The two-count second superseding indictment charged Raymond with committing two violent crimes in aid of racketeering activity: (1) conspiracy to commit murder
Gonzales said that the charges stemmed from the attempted murder of John Mudersbach on September 17
who pled guilty to the indictment on December 23
admitted that he conspired to murder Mudersbach to gain entrance to and maintain and increase his position in the Aryan Brotherhood in New Mexico
Raymond also admitted that he ordered another Aryan Brotherhood member to kill Mudersbach to prevent Mudersbach from talking to law enforcement about a 2002 Aryan Brotherhood related murder
Raymond served a 15-year federal sentence based on a 2003 conviction for being a felon in possession of a firearm
As part of Raymond’s agreement with the government
his 150-month sentence in this case will be served after Raymond completes his current 15-year sentence
He was released from federal prison in 2021
As being a federally convicted felon he was not to have possession of a firearm
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Fuck the pigs they and fuck u to abq raw fuck u guys you pigs don’t serve and protect shit
Sounds like they took out the trash here and we’re all better off for it
I would say that jibberish you just wrote would look good tattooed all over your neck and face but I bet you got that done already
Where’s your mommas grave at you pathetic piece of shit
No respect for the ones grieving the loss of their loved one
I hope people shit on your entire family’s graves
homie was convicted of conspiracy to commit murder
Until you know the real story other then what the pussy ass cops say to cover their asses and what media wants to air you should shut the fuck up and keep your rude ass comments and opinions to yourself
You fucking pussy bitch made piece of shit
You’re trash showing no sympathy for their friends and family
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AZ — Career and technical education programs are often seen as the building blocks for a strong
Arizona are getting national attention for their work -- a video game they designed
where you fly around and collected metal from asteroids you destroyed
and you would sell this metal to get money which will help your ship become more powerful," said Aidan Davidson
"We used a form of art where I could actually sit down and make a sketch about it and then use math to basically refine it into a nice-looking art piece," said Dylan Mudersbach
and recently won the Arizona state championship in the SkillsUSA competition for interactive game design
"I love seeing students take what we're giving them and bring it to a whole different level," said their CTE Teacher
Titkemeyer reached out to ABC15 about her students' achievements hoping to highlight their hard work and showcase what CTE programs can offer
"With a career technical education these kids are preparing for real-world jobs that they really want," Titkemeyer said
"I get emotional talking about it and I wanted them to be able to share it with people and say
Mudersbach and Davidson will take their game to the national SkillsUSA competition this summer and are set to study video game coding and design when they start college in the Fall
"We're going to try to go revisit our shelved projects and make them into fully-fledged games," said Mudersbach
"We're going to become an unstoppable duo," said Davidson
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Background: Giant cell arteritis (GCA) is the most common primary systemic vasculitis predominantly affecting large and medium sized vessels. In rare cases, the vasculitis can affect the vessels of the brain.
Results: We describe four cases of GCA with involvement of the cerebral vessels causing stroke. These cases were unresponsive to aggressive immunosuppression and we opted to treat with endovascular balloon dilatation of the stenotic areas. The procedure was safe. The four patients were treated in nine sessions and a total of 16 vessels were treated. We observed two dissections with no clinical influence on the patients.
Discussion: In patients with stroke due to progressive GCA that is non-responsive to immunosuppression, endovascular therapy is feasible.
Volume 11 - 2020 | https://doi.org/10.3389/fneur.2020.00287
Background: Giant cell arteritis (GCA) is the most common primary systemic vasculitis predominantly affecting large and medium sized vessels
the vasculitis can affect the vessels of the brain
Results: We describe four cases of GCA with involvement of the cerebral vessels causing stroke
These cases were unresponsive to aggressive immunosuppression and we opted to treat with endovascular balloon dilatation of the stenotic areas
The four patients were treated in nine sessions and a total of 16 vessels were treated
We observed two dissections with no clinical influence on the patients
Discussion: In patients with stroke due to progressive GCA that is non-responsive to immunosuppression
We reviewed our cases of GCA with stroke in the period of 2015–2018. The diagnosis of GCA was clinical and followed the definition from American College of Rheumatology (3) demanding three of five criteria: (1) Age >50 years
(4) Erythrocyte sedimentation rate >40 mm/h
(5) Positive biopsy of the superficial temporal artery
Our approach to treatment was first to give high dose glucocorticoid and 2/7 had remission of symptoms on prednisolone alone
cyclophosphamide (CPM) which stopped progression
where the disease was progressing with new transient ischemic attacks (TIA) or strokes
we chose to proceed with balloon angioplasty and CPM to suppress inflammation
Balloon angioplasty was performed in three patients (case 1, 2, and 3, see below) with a non-compliant balloon catheter (Gateway, Stryker, Kalamazoo, MI). The stenoses were dilated to a maximum of 80% of the estimated normal vessel diameter, with at least two repetitive dilatations with successively increasing atmospheric pressures (see Figures 1, 2)
The immediate angiographic results were excellent in all cases with an increase of the vessel diameter to 70–80% at the level of the stenosis
lateral view of the left internal carotid artery
In two of the cases (case 3 in the first treatment round and in case 4) it was not possible to cross the stenotic lesions by the balloon catheter
Angioplasty was instead performed with an adjustable remodeling mesh device
in three stenoses at the level of the siphon and one V4 stenosis
We saw good results in the three siphon stenoses (a triple increase of the diameter in two cases and a double increase in one) and a modest effect on the V4-stenosis with an increase of the diameter of 20%
Angioplasty was repeated twice in two patients and three times in one patient, with intervals of 2 weeks and 3 months. Examples of angioplasty from all the cases can be seen in Supplementary Materials
A 65-year old woman with no vascular risk factors was admitted with sudden aphasia and decreased sensation of the right arm
The patient complained of two episodes during the previous week with weakness of the right arm and 2 days later weakness of the left arm
jaw claudication and fatigue for the last 2 months
Diffusion-weighted MRI showed bilateral ischemic lesions and MR angiography showed stenosis of both internal carotid arteries (ICAs) at the level of the carotid siphon
Oral high dose prednisone (1 mg/kg) was started
The headache and jaw claudication resolved on this treatment
but the patient had progressive episodes of aphasia
Glucocorticoid treatment was increased to methylprednisone 1 g i.v
daily for 3 days followed by oral prednisone 100 mg daily with a taper
but the patient continued to suffer TIAs and small strokes resulting in worsening aphasia
Ten days after admission, balloon dilatation was performed on the left ICA. Figures 1, 2 show a digital subtraction angiography of the stenosis before and after dilatation
She was followed with transcranial color-coded sonography (TCCS)
Repeat balloon angioplasty of the left ICA was performed 1 month later when TCCS showed worsening of the stenosis
CPM was started (first dose i.v. 15 mg/kg and then 2 mg/kg orally daily). This was given for a total of 6 months and the patient was transitioned to methotrexate. The patient had no further strokes. The 90-day outcome for all the patients is found in Table 1
Summary of the key findings and treatment details in the patients
Sixty-four-year old woman with a past medical history of hypertension and diabetes
She presented with severe headache 3 months before she was diagnosed with GCA
Two days after starting high dose oral glucocorticoids
she was admitted with wordfinding difficulties
Angiography showed bilateral stenosis of the intracerebral ICAs
She was treated with balloon angioplasty of the left ICA and had a small dissection
She was admitted again 2 weeks later with apathy and gait disturbances
A further MRI scan showed progressive bilateral anterior infarcts and she was again treated with balloon angioplasty of both intracerebral ICAs
She was readmitted 1 month later after a fall
but both ICAs were dilated again as a precaution
She had no new documented strokes after the second treatment
Her course was complicated with pneumocystis pneumonia successfully treated with Sulfamethoxazole/Trimethoprim
Ischemic lesion in the left hemisphere distributed in the watershed area in case number 3
This indicates an embolic source or compromised flow in the left internal carotid artery
This is the stenotic lesion in the internal carotid artery in case number 3
Two weeks after the initial angioplasty he was readmitted
again with a change in personality and apathy
He was again treated by angioplasty of both intracranial ICAs
he was started on CPM 10 mg/kg every 3 weeks for a total of 6 treatments and then transitioned to methotrexate
He was followed in the outpatient clinic with no new complains
Seventy-one-year old woman with only mild hypertension
She was seen with a TIA (left sided weakness)
but then admitted 2 weeks later with severe left sided weakness
She was taken for thrombectomy and the angiography revealed multiple stenoses
Balloon dilatation was performed on the right intracranial ICA
she complained about headache and jaw claudication 1 month prior to the TIA
She was started on 1 g of methylprednisone i.v
paresis on the left side became worse and a new MRI revealed an infarct in the pons
She was taken for angiography again 7 days after the first treatment
and stenosis on both the carotids and the left vertebral arteries were treated
The dilation of the vertebral was complicated with a dissection
CPM 15 mg/kg every 3 weeks for 6 treatments and transitioned to methotrexate
we present patients with strokes on the basis of GCA
Some of the cases progressed regardless of high dose glucocorticoids and intervention with balloon angioplasty of cerebral vessels was performed as a rescue therapy
The intervention was done with minimal complications
A total of 16 vessel-treatments were performed and we only saw two dissections evident on angiography
Our impression was that rescue balloon angioplasty is safe and maybe beneficial together with immunosuppression after steroid failure
it was a logical step to try this option in patients with progressive symptoms and large vessel stenosis on inflammatory background
We have only found balloon dilatation and stenting described before in three single cases (11–13). The use of stent retrievers in the treatment of cerebral vasospasm in patients with subarachnoid hemorrhage has been described recently (14) and the technique was adopted in cases due to failure of performing balloon angioplasty
As aggressive medical treatment beyond high dose glucocorticoid, we chose CPM. This drug is generally chosen to control severe cases of cerebral vasculitis. The patient in case 1 was treated with the interleukin-6 receptor inhibitor tocilizumab. This drug has shown to be effective in obtaining remission in patients with GCA together with lower cumulated doses of glucocorticoid (15)
the patient's strokes continued after initiation of tocilizumab
The limitations to our study are that the patients were not prospectively collected and treated on a case by case nature
Our aim with this paper is to report that progression of neurological symptoms in a patient with GCA should lead to aggressive treatment with high dose glucocorticoid and CPM
Endovascular therapy with angioplasty for severe symptomatic stenosis in this setting can be considered and appears to be reasonable safe
All datasets generated for this study are included in the article/Supplementary Material
Written informed consent was obtained from the patients for the publication of this case report
CS and DJ researched literature and conceived the study
CS wrote the first draft of the manuscript
All authors were involved in managing the patients
reviewed and edited the manuscript and approved the final version of the manuscript
CS is supported by a research grant from Novo Nordisk Foundation
The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest
The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fneur.2020.00287/full#supplementary-material
PRESENTATION 1| Here are examples of digital subtraction angiography of the 4 treated patients before and after balloon angioplasty
PubMed Abstract | CrossRef Full Text | Google Scholar
Clinical diagnosis and management of large vessel vasculitis: giant cell arteritis
The american college of rheumatology 1990 criteria for the classification of giant cell arteritis
Ischemic stroke in giant-cell arteritis: French retrospective study
Giant cell arteritis-related stroke: a retrospective multicenter case-control study
Reversibility of basilar artery stenosis following timely treatment of temporal arteritis
Severe intracranial involvement in giant cell arteritis: 5 cases and literature review
Two cases of recurrent stroke in treated giant cell arteritis: diagnostic and therapeutic dilemmas
J Clin Rheumatol Pract Rep Rheum Musculosk Dis
Lethal giant cell arteritis with multiple ischemic strokes despite aggressive immunosuppressive therapy
Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials
Intracranial internal carotid artery angioplasthy and stenting in giant cell arteritis
Successful endovascular therapy for multiple intracranial arterial stenosis associated with medically intractable giant cell arteritis
Angioplasty and stent placement for complete occlusion of the vertebral artery secondary to giant cell arteritis
Treatment of cerebral vasospasm with self-expandable retrievable stents: proof of concept
Trial of tocilizumab in giant-cell arteritis
CrossRef Full Text | Google Scholar
Jayne D and von Weitzel-Mudersbach P (2020) Endovascular Treatment of Intracerebral Giant Cell Arteritis
Received: 20 December 2019; Accepted: 26 March 2020; Published: 16 April 2020
Copyright © 2020 Simonsen, Speiser, Hansen, Jayne and von Weitzel-Mudersbach. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY)
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*Correspondence: Claus Z. Simonsen, Y2xhc2ltQHJtLmRr
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