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Case Reports in Neurological Medicine

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https://www.readbyqxmd.com/read/29158929/a-case-report-of-isolated-bilateral-cerebral-peduncular-infarction
#1
Chenguang Zhou, Yuanhong He, Xiaorui Tian, Zhiwen Chao, Yinghui Zhu, Du Cheng, Kui Li
Isolated bilateral cerebral peduncular infarctions (BCPI) presenting as acute pseudobulbar palsy are rarely reported and, to the best of our knowledge, most of the previous reports of BCPI were related to locked-in syndrome and disturbance of consciousness. Herein, we described a case of a 55-year-old man who presented with acute pseudobulbar palsy and mild tetraparesis, but preserved eye movements, with no consciousness disturbance. DWI revealed an acute infarction involving the central portion of the cerebral peduncle with a characteristic "traditional Chinese eight character" sign...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29123931/rapid-ascending-sensorimotor-paralysis-hearing-loss-and-fatal-arrhythmia-in-a-multimorbid-patient-due-to-an-accidental-overdose-of-fluoxetine
#2
Matthew Herrmann, Prissilla Xu, Antonio Liu
Background: Common side effects of selective serotonin reuptake inhibitors (SSRIs) include tachycardia, drowsiness, tremor, nausea, and vomiting. Although SSRIs have less toxic side effects compared to more traditional antidepressants, serious and life threatening cases of SSRI overdose have been reported. We describe a 24-year-old multimorbid female who presented to the emergency department with rapid onset ascending sensorimotor paralysis, complicated by respiratory and cardiac arrest, found to have fatal levels of fluoxetine by toxicological analysis, not taken in a suicidal act...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29109882/successful-mechanical-thrombectomy-of-a-middle-cerebral-artery-occlusion-14-hours-after-stroke-onset
#3
Anelia Dietmann, Kety Wha-Vei Hsieh, Andrea M Humm, Claudio L Bassetti, Urs Fischer, Jan Gralla
A 54-year-old patient presented with mild right-sided weakness of hand and face with a National Institutes of Health Stroke Scale (NIHSS) of 2 and occlusion of the left middle cerebral artery (MCA) in the M1 segment with a large perfusion deficit on computed tomography (CT). Due to mild neurological deficits no IVT was performed. Nine hours after symptom onset the patient gradually deteriorated with a NIHSS fluctuating between 9 and 15. MRI showed a persistent occlusion of the MCA with a large diffusion-perfusion mismatch...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29109881/hypothermia-with-extreme-bradycardia-following-spinal-cord-infarction-of-septic-origin
#4
Philippe Hantson, Thierry Duprez
Among other autonomic dysfunctions complicating acute spinal cord injury, deep hypothermia is rare but may induce serious cardiovascular complications. There are few pharmacological options to influence hypothermia. A 66-year-old woman was transferred to the intensive care unit (ICU) for serious cardiac arrhythmias (atrial fibrillation and asystole) in the context of a deep hypothermia (axillary temperature below 32°C). She had been admitted to the hospital two months before for an acute L4-L5 infectious spondylodiscitis without any initial neurological deficit...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29082053/thoracic-synovial-cyst-at-the-th2-3-level-causing-myelopathy
#5
Martin M Sundskarð, Shahin Gaini
Intraspinal synovial cyst is a rare cause of myelopathy. These cysts present most often in the lumbar and cervical parts of the spine but are more infrequent in the thoracic spine. We present a case of a 73-year-old man with an intraspinal, extradural synovial cyst at the Th2-3 level causing paraesthesia and weakness in the legs. A laminectomy and excision of the cyst were performed and the patient recovered fully. In the thoracic spine, synovial cysts are almost exclusively found in the lower part. Laminectomy, with excision, is the treatment of choice, although steroid injections have been described...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29075542/multiple-sclerosis-presenting-with-facial-twitching-myokymia-and-hemifacial-spasms
#6
Risha Hertz, James Espinosa, Alan Lucerna, Doug Stranges
Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system. The etiology is insufficiently understood. Autoimmune, genetic, viral, and environmental factors have been hypothesized. MS is twice as common in women as in men between the ages of 20 and 50 years. There is no known cure for MS. Current medical treatment helps to prevent new attacks and improve function after an attack. MS is diagnosed by physical examination, diagnostic imaging, and examination of cerebral spinal fluid...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29057132/an-atypical-porencephalic-cyst-manifesting-as-a-simple-partial-seizure-a-case-report-and-literature-review
#7
Abdulaziz Ibrahim Al Thafar, Abdullatif Sami Al Rashed, Bayan Abdullah Al Matar, Abdulaziz Mohammad Al-Sharydah, Abdulrahman Hamad Al-Abdulwahhab, Sari Saleh Al-Suhibani
BACKGROUND: Porencephaly is an extremely rare neurological disease characterized by the presence of solitary or multiple degenerative cerebrospinal fluid (CSF) cavities within the brain parenchyma. CASE REPORT: We describe a case involving a 23-year-old male who presented with involuntary movements of the left upper limb of 6 months' duration. A diagnosis of porencephaly was confirmed by magnetic resonance imaging (MRI). CONCLUSION: The rarity of occurrence and atypical presentation of such a lesion present a challenge to clinicians...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28948056/could-hallucinogens-induce-permanent-pupillary-changes-in-ab-users-a-case-report-from-new-zealand
#8
Ahmed Al-Imam
An eighteen-year-old female patient of the Caucasian ethnicity from Australasia presented with a persistently dilated pupil causing her discomfort and occasional burning sensation when she is outdoors due to oversensitivity to sunlight. However, her pupillary reaction to light (pupillary light reflex) was intact. The patient is a known user of psychedelic substances (entheogens) including LSD, NBOMe, psilocybin, and DMT. The condition affects both eyes to the same extent. Thorough medical, neurological, and radiological examinations, including an EEG and an MRI of the head and neck region, were completely normal...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28932609/neuromyelitis-optica-in-a-nepalese-man
#9
Yogesh Subedi, Utsav Joshi, Sanjeeb Sudarshan Bhandari, Ashbina Pokharel, Ashbita Pokharel
BACKGROUND: Neuromyelitis optica is a severely disabling inflammatory disorder of the central nervous system of autoimmune etiology that mainly affects the optic nerves and spinal cord. Here, we present a case report detailing a patient with tingling and weakness of right upper and lower limbs who was neuromyelitis optica immunoglobulin G-positive. CASE PRESENTATION: A 46-year-old Nepalese man presented to the hospital with a history of tingling and weakness of right upper and lower limbs that developed over a period of two months...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28912988/accidental-intrathecal-administration-of-digoxin-in-an-elderly-male-with-end-stage-renal-disease
#10
Claudia Martin, Kitae Kevin Park, Antonio Liu
The systemic effects of digoxin toxicity have been well-known. However, there has been no case citing the effects of intrathecal digoxin in light of end-stage renal disease in the elderly. Here, we report on the case of the successful management of accidental intrathecal digoxin administration in an elderly male with end-stage renal disease.
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28912987/cerebellar-involvement-in-an-immunocompetent-patient-presenting-with-progressive-multifocal-leukoencephalopathy
#11
Rafael Garcia-Carretero, Blanca San Jose Montano
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease caused by the JC virus, a polyomavirus that can be reactivated under certain immunosuppressive conditions, such as AIDS, immunomodulatory therapy, and haematological malignancies. However, a few cases of immunocompetent patients have been reported in which no immunodeficiency was present. We describe the case of an 83-year-old immunocompetent man who presented with severe cerebellar symptoms with an MRI scan suggestive of severe demyelinating disease...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28890837/why-it-is-not-always-anxiety-a-tough-diagnosis-of-stiff-person-syndrome
#12
Carmen Elena Cervantes, Hsien Lee Lau, Tina Ataian Binazir, Keith O O'Brien, Jonathan S Cross
Anxiety disorder is a commonly used diagnosis that may mask underlying conditions. Stiff person syndrome (SPS) is a rare neuroimmunological disorder characterized by progressive rigidity and painful muscle spasms affecting axial and lower extremity musculature. These episodes can be triggered by sudden movement, noise, or emotional stress, which may present as a psychiatric condition. We report the case of a 30-year-old female who presented with recurrent panic attacks with multiple prior hospital admissions for anxiety, rigidity, and difficulty in walking...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28884035/cooccurrence-of-chorea-acanthocytosis-and-mesial-temporal-sclerosis-a-possible-role-of-caudate-nucleus
#13
Mehri Salari, Alexander C Lehn, Masoud Etemadifar, Seyed Amir Hejazi
Chorea-acanthocytosis (ChAc) is an orphan disease, caused by mutations on chromosome 9. Epileptic seizures of mesial temporal origin can be a predominant symptom. We report on a 29-year-old woman with ChAc and bilateral MTS. Previously, few patients with coexisting ChAc and MTS were reported. The underlying pathophysiology is unknown, and further studies are needed.
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28831319/bilateral-ganglion-cysts-of-the-ligamentum-flavum-in-the-cervical-spine-causing-a-progressive-cervical-radiculomyelopathy-and-literature-review
#14
Juneki Kim, Jin-Gyu Choi, Byung-Chul Son
Here we report a unique case of bilateral ganglion cysts originating from the ligamentum flavum in the cervical spine. Degenerative cysts of the ligamentum flavum are rare lesions, and most had been reported in the lumbar spine. Its occurrence in the cervical spine is extremely rare: only eight have been reported. A 66-year-old male patient presented with progressive paraparesis, pain, and paresthesia in his bilateral T1 dermatomes that had lasted for three weeks. Magnetic resonance imaging of the cervical spine demonstrated a well-demarcated cystic lesion in the bilateral dorsolateral aspects of the C7/T1 segment and significant compression of the cervical cord...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28815096/a-case-of-congenital-brainstem-oligodendroglioma-pathology-findings-and-review-of-the-literature
#15
Stefan Kostadinov, Suzanne de la Monte
Congenital and perinatal primary brain neoplasms are extremely rare. Brainstem neoplasms in the perinatal and neonatal period are typically of high-grade nature and have poor prognoses with survival rates of less than 2 years from diagnosis. Herein, we report an unusual case of congenital anaplastic oligodendroglioma that arose in the pons and was detected as diffuse pontine glioma on in utero imaging studies during prenatal evaluation at 26 weeks' gestation. A male infant was delivered at 36.4 weeks of gestation via Cesarean section who developed progressive dyspnea shortly after birth...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28758039/primary-angiitis-of-the-center-nervous-system-a-clinical-challenge-diagnosed-postmortem
#16
Bayan Al Share, Ali Zakaria, Evan Hiner, Ziyad Iskenderian, Nader Warra
Primary angiitis of the central nervous system (PACNS) is a rare vasculitis involving medium and small blood vessels of the brain, spinal cord, and meninges, without systemic involvement. The diffuse and patchy nature of its pathology is reflected by a wide spectrum of nonspecific clinical symptoms. Diagnosis is challenging due to lack of defined clinical criteria or specific imaging findings. Specific workup should be done only after exclusion of other etiologies, including infectious, neoplastic, toxic, and other vascular etiologies including systemic vasculitis...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28751993/multiple-spontaneous-intracranial-extracranial-arterial-dissections-in-a-patient-with-osteogenesis-imperfecta
#17
Mehmet Kolukısa, Elif Gökçal, Azize Esra Gürsoy, Çiğdem Deniz, Ayşe Aralaşmak, Talip Asil
A 40-year-old male with osteogenesis imperfecta (OI) was admitted to the hospital with an acute right monoparesis. Diffusion-weighted MRI showed infarction in the territory of the left anterior cerebral artery (ACA) and in the left posterior cerebral artery (PCA). In his vascular imaging, occlusion of the left vertebral artery (VA) starting from V2 segment was consistent with dissection and pseudoaneurysm in the right ACA. We presented this case because of the presence of spontaneous and simultaneous occurrence of both intracranial and extracranial arterial dissections in OI...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28717525/differential-effects-of-awake-glioma-surgery-in-critical-language-areas-on-cognition-4-case-studies
#18
Djaina Satoer, Elke De Witte, Marion Smits, Roelien Bastiaanse, Arnaud Vincent, Peter Mariën, Evy Visch-Brink
Awake surgery with electrocorticosubcortical stimulation is the golden standard treatment for gliomas in eloquent areas. Preoperatively, mostly mild cognitive disturbances are observed with postoperative deterioration. We describe pre- and postoperative profiles of 4 patients (P1-P4) with gliomas in "critical" language areas ("Broca," "Wernicke," and the arcuate fasciculus) undergoing awake surgery to get insight into the underlying mechanism of neuroplasticity. Neuropsychological examination was carried out preoperatively (at T1) and postoperatively (at T2, T3)...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28607780/homonymous-superior-quadrantanopia-due-to-erdheim-chester-disease-with-asymptomatic-pituitary-involvement
#19
Roaa Ridha Amer, Sara Mohammed Qubaiban, Eman Abdulkarim Bakhsh
Polyostotic sclerosing histiocytosis, also known as Erdheim-Chester disease (ECD), is a rare form of non-Langerhans histiocytosis. ECD has wide clinical spectrums which mainly affect skeletal, neurological, dermatological, retroperitoneal, cardiac, and pulmonary manifestations. Here we describe a case of ECD in a 45-year-old female who presented initially with bilateral knee pain and homonymous superior quadrantanopia progressed to ophthalmoplegia and complete visual loss of the left eye over a period of one year...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28589049/chronic-lymphocytic-inflammation-with-pontine-perivascular-enhancement-responsive-to-steroids-with-cranial-and-caudal-extension
#20
Mahmood Mubasher, Aseel Sukik, Ahmed Hassan El Beltagi, Ali Rahil
A 23-year-old lady presented with vertigo and imbalance in walking, blurring of vision, diplopia, and headache, in addition to numbness in the lower limbs over a period of six days. On examination patient had nystagmus, ataxia, positive Romberg test, and hyperreflexia. MRI examination of the brain and spinal cord showed evidence of faint bright signal intensity foci in T2/FLAIR involving bilateral cerebral hemispheres, subcortical deep white matter, bilateral thalami, posterior pons and left brachium pontis, and basal ganglia, with small nodular enhancement that aligned along curvilinear structures; those lesions also were apparent along the spinal cord at multiple levels...
2017: Case Reports in Neurological Medicine
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