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Case Reports in Neurological Medicine

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https://www.readbyqxmd.com/read/29785312/a-case-of-progressive-stroke-on-posterior-circulation-with-transient-bilateral-oculomotor-palsy
#1
Chiaki Takahashi
Infarction located in the midbrain and pons presents various ophthalmic symptoms, because of the damage of the nuclei that control the movement of internal and external ocular and palpebral muscles. We experienced a case which presented with rare ocular symptoms and course. A 61-year-old man presented with left hemiparesis and dysarthria, bilateral ptosis, and bilateral impaired eyeball movement: right eyeball movement was totally impaired and left could only perform slight adduction. MRI showed fresh stroke in the right thalamus, cerebral crus, and posterior lobe and cuneate lesion on bilateral paramedian portion of the midbrain...
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29755801/central-hypoventilation-a-rare-complication-of-wallenberg-syndrome
#2
Keithan Sivakumar, Manveer Garcha, Dev Mehta, Megan C Leary, Hussam A Yacoub
Central alveolar hypoventilation disorders denote conditions resulting from underlying neurologic disorders affecting the sensors, the central controller, or the integration of those signals leading to insufficient ventilation and reduction in partial pressures of oxygen. We report a patient who presented with a left lateral medullary ischemic stroke after aneurysm repair who subsequently developed a rare complication of CAH. Increased awareness of this condition's clinical manifestations is crucial to make an accurate diagnosis and understand its complications and prognosis...
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29755800/hypothermia-in-multiple-sclerosis-beyond-the-hypothalamus-a-case-report-and-review-of-the-literature
#3
Francesco Berti, Zeeshan Arif, Cris Constantinescu, Bruno Gran
Hypothermia is a rare and poorly understood complication of Multiple Sclerosis (MS). We report on a 66-year-old patient currently with Secondary Progressive MS (SP-MS) who developed unexplained hypothermia associated with multiple hospitalisations and we review the literature on this topic. In our case, magnetic resonance imaging (MRI) of the brain failed to highlight hypothalamic disease, but spinal MRI identified a number of spinal cord lesions. Given the incidence and clinical significance of spinal involvement in MS and the hypothermic disturbances observed in high Spinal Cord Injury (SCI), we hypothesise that upper spinal cord pathology, along with hypothalamic and brainstem dysfunctions, can contribute to hypothermia...
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29713557/a-novel-cacna1a-nonsense-variant-c-4054c-t-p-arg1352-%C3%A2-causing-episodic-ataxia-type-2
#4
Sean Lance, Stuart Mossman, Gemma Poke
Episodic ataxia is a heterogenous group of uncommon neurological disorders characterised by recurrent episodes of vertigo, dysarthria, and ataxia for which a variety of different genetic variations have been implicated. Episodic ataxia type two (EA2) is the most common and also has the largest number of identified causative genetic variants. Treatment with acetazolamide is effective in improving symptoms, so accurate diagnosis is essential. However, a large proportion of patients with EA2 have negative genetic testing...
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29682373/concentric-and-eccentric-target-mri-signs-in-a-case-of-hiv-associated-cerebral-toxoplasmosis
#5
Adam D Roche, Dominic Rowley, Francesca M Brett, Seamus Looby
Cerebral toxoplasmosis is one of the most common causes of focal brain lesions in immunocompromised patients, such as those with human immunodeficiency virus (HIV). Differentiating toxoplasmosis from other central nervous system (CNS) lesions provides a significant clinical challenge. Magnetic resonance (MR) imaging of the brain is key to prompt diagnosis and treatment of cerebral toxoplasmosis. Several specific signs on MRI of brain have been described in recent literature including the "concentric target sign" and "eccentric target sign...
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29682372/from-postural-orthostatic-tachycardia-syndrome-to-radiologically-isolated-syndrome
#6
Richa Tripathi, Evanthia Bernitsas
Background: Autonomic dysfunction is common in Multiple Sclerosis (MS) patients. Most spinal cord lesions entail some degree of autonomic nervous system dysfunction. MS patients may develop autonomic dysfunction later in their disease course. Methods: We report a patient with no prior history of MS presenting with orthostatic symptoms and diagnosed initially with postural orthostatic tachycardia syndrome (POTS). Four months later, she was diagnosed with radiologically isolated syndrome (RIS)...
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29666731/ischemic-stroke-in-an-hiv-positive-patient-an-initial-presentation-of-neurosyphilis
#7
Kalimullah Jan, Rebecca Hoe Hui Min, Tan Seow Yen, Shekhawat Ravindra Singh
Ischemic stroke occurring in patients with human immunodeficiency virus (HIV) needs to be approached with a vast differential diagnosis in mind. We report a case of middle-aged male patient with immune reconstituted HIV on therapy without known cardiovascular risk factors who had a right middle cerebral artery territory infarct. After a thorough evaluation, he received a final diagnosis of neurosyphilis-associated vasculitis leading to stroke. He recovered without any neurological deficits following treatment with intravenous benzylpenicillin...
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29666730/levodopa-responsive-early-onset-parkinsonism-in-down-syndrome
#8
Padmini Palat, Francis Hickey, Lina Patel, Elise Sannar
Individuals with Down syndrome (DS) can develop Alzheimer's disease as early as 30 to 40 years old, but parkinsonism is rarely described. We report on a 20-year-old woman with Down syndrome and parkinsonism who responded dramatically to carbidopa-levodopa. We propose that the occurrence of parkinsonism in individuals with DS may be underreported. Recognizing and treating this condition may improve quality of life.
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29610691/cerebral-venous-sinus-thrombosis-in-a-patient-with-ulcerative-colitis-flare
#9
L M Conners, R Ahad, P H Janda, Z Mudasir
Inflammatory bowel disease is characterized by a chronic inflammatory state and is therefore associated with abnormalities in coagulation and a hypercoagulable state. Cerebral venous sinus thrombosis is a rare complication of inflammatory bowel disease yet contributes significant morbidity and mortality to those affected. Early diagnosis is critical, as a delay in diagnosis portends a worse prognosis. This paper seeks to highlight the increased risk of venous sinus thrombosis in patients with inflammatory bowel disease...
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29610690/comorbid-normal-pressure-hydrocephalus-with-parkinsonism-a-clinical-challenge-and-call-for-awareness
#10
A Cucca, M C Biagioni, K Sharma, J Golomb, R M Gilbert, A Di Rocco, J E Fleisher
Idiopathic normal pressure hydrocephalus (iNPH) is the most common cause of hydrocephalus in adults. The diagnosis may be challenging, requiring collaborative efforts between different specialists. According to the International Society for Hydrocephalus and Cerebrospinal Fluid Disorders, iNPH should be considered in the differential of any unexplained gait failure with insidious onset. Recognizing iNPH can be even more difficult in the presence of comorbid neurologic disorders. Among these, idiopathic Parkinson's disease (PD) is one of the major neurologic causes of gait dysfunction in the elderly...
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29593921/unilateral-asterixis-in-arm-and-leg-caused-by-internal-capsula-stroke
#11
Katharina Feil, Marion Huber, Nicolina Goldschagg, Lars Kellert
We report an unusual clinical manifestation of ischemic stroke with acute right-sided asterixis affecting the arm as well as the leg due to a lesion in the left posterior limb of the internal capsula. After treatment with intravenous thrombolysis the patient made a good recovery. Notably, in this case unilateral asterixis affected the arm as well as the leg, resulting in postural and gait instability. In addition, damage in the basal ganglia-thalamo-cortical network, as in our patient, has to be distinguished from other supratentorial causes of acute asterixis like thalamic or frontal lobe lesions linked to the cerebello-brainstem-thalamo-frontal lobe circuits...
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29568656/emotional-lability-as-a-unique-presenting-sign-of-suspected-chronic-traumatic-encephalopathy
#12
Shauna H Yuan, Sonya G Wang
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease caused by head trauma. Diagnosis of this disease is difficult as reliable biomarkers have not been established and often this clinical entity is underappreciated with poor recognition of its clinical presentations (Lenihan and Jordan, 2015). The definitive diagnosis of CTE is determined by identification of neurofibrillary tangles in the perivascular space around the sulci in postmortem tissue (McKee et al., 2015). However, performing brain biopsies searching for neurofibrillary tangles is not a feasible option for early diagnosis...
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29441211/a-rare-case-of-craniopharyngioma-in-the-temporal-lobe
#13
Sasan Razmjoo, Seyed Nematollah Jazayeri, Mohammad Bahadoram, Maedeh Barahman
Herein, we report on a rare case of craniopharyngioma arising in the left temporal lobe with no prior history of head trauma or surgery. There was a solid-cystic mass in the left temporal lobe on MR images. To the best of our knowledge, this is the second case of a craniopharyngioma occurring in the temporal lobe.
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29441210/acute-nontraumatic-spontaneous-spinal-subdural-hematoma-a-case-report-and-systematic-review-of-the-literature
#14
Leigh A Rettenmaier, Marshall T Holland, Taylor J Abel
Spontaneous spinal subdural hematoma (sSDH) is a rare condition outright. Moreover, cases that occur spontaneously in the absence of an identifiable etiology are considerably less common and remain poorly understood. Here, we present the case of a 43-year-old man with spontaneous sSDH presenting with acute onset low back pain and paraplegia. Urgent magnetic resonance imaging identified a dorsal SDH from T8 to T11 with compression of the spinal cord. Emergent T8-T10 laminectomies with intradural exploration and hematoma evacuation were performed...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29359056/skin-hyperpigmentation-as-the-presenting-symptom-of-subacute-combined-degeneration-of-the-spinal-cord
#15
Abdulhameed Alhazmi, Abdulrahman Almalki, Safieeldin Ghazala
Vitamin B12 deficiency results in hematological, neurological, and rarely dermatological complications. Subacute combined degeneration of the cord is one of the neurological complications, and usually the presenting symptom is paresthesia. Herein, we report a case of a 46-year-old man with subacute combined degeneration presenting with knuckle hyperpigmentation.
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29348950/carotid-endarterectomy-in-a-patient-with-severe-internal-carotid-artery-stenosis-with-persistent-trigeminal-artery-and-ischemia-of-the-anterior-and-posterior-circulation
#16
Melanie R F Greenway, Hussam A Yacoub, Shweta Varade, Yevgeniy Isayev
Occurrence of cerebral ischemia in the posterior circulation as a result of severe internal carotid artery disease and persistent trigeminal artery is rare. An 81-year-old man with medical history of hypertension and ischemic stroke presented with dizziness, nausea, and mild dysarthria. Magnetic resonance imaging of the brain revealed acute infarcts in the left internal carotid artery territory. CT angiogram revealed a persistent trigeminal artery (PTA) and severe atherosclerosis. The patient developed new neurological symptoms and repeat imaging revealed new acute infarcts in the PTA distribution...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29333306/acute-cervical-dystonia-induced-by-clebopride
#17
Jin Kyo Choi, Jin Yong Hong
Antidopaminergic drugs are known to induce extrapyramidal symptoms. Clebopride, a dopamine antagonist, also can produce parkinsonism, tardive dyskinesia, tardive dystonia, hemifacial dystonia, or oculogyric crisis; however, acute dystonic reaction caused by clebopride has not been reported in adults. We report two young men who experienced acute cervical dystonia within a few days of taking clebopride. The patients recovered after discontinuation of the drug. Physicians prescribing clebopride should be aware of the adverse effects of this drug...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29318067/the-relationship-of-triphasic-waves-with-intracranial-pressure-as-a-possible-prognostic-marker-in-traumatic-brain-injury
#18
Nakul Katyal, Aarti Sarwal, Pravin George, Biswajit Banik, Christopher R Newey
Background: Continuous electroencephalography (CEEG) monitoring is used for detection of convulsive and nonconvulsive seizures and assessing the degree of encephalopathy in critically ill patients. A commonly seen encephalopathic pattern on CEEG is generalized periodic discharges with triphasic wave (TW) morphology. The underlying role and prognostic significance of TW in relationship to intracranial pressure (ICP) remain unknown. We present a case highlighting the relationship of TW with ICP in a case with severe traumatic brain injury (TBI)...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29238622/recurrent-occipital-seizures-with-transient-mri-changes
#19
Mohankumar Kurukumbi, Allison Jacobs
Peri-ictal magnetic resonance imaging (MRI) findings following seizure activity are a recognized phenomenon that is not well understood (Cole, 2004). Transient changes are not usually expected to be present in postictal MRI studies because of their rarity. Here, we present a unique case of peri-ictal MRI findings located in the occipital lobe, present in a 34-year-old female with recurrent occipital seizures occurring twice in four years. MRI changes completely resolved after both episodes with no residual focal damage...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29234548/steroid-responsive-encephalopathy-associated-with-autoimmune-thyroiditis-presenting-with-fever-and-confusion
#20
Chiranthi Kongala Liyanage, Tilak Manthi Janake Munasinghe, Adsareswary Paramanantham
Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis (SREAT) is a diagnostic conundrum as it may present with a myriad of nonspecific clinical features and laboratory and neuroimaging investigations are not diagnostic. We report a case of a 65-year-old female who presented with an acute febrile illness associated with headache and confusion, tangential thoughts, and loose association. Based on neutrophil leukocytosis in the full blood count and elevated inflammatory markers, she was commenced on empirical intravenous antibiotics suspecting meningoencephalitis...
2017: Case Reports in Neurological Medicine
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