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Case Reports in Neurological Medicine

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https://www.readbyqxmd.com/read/28331643/hemifacial-pain-and-hemisensory-disturbance-referred-from-occipital-neuralgia-caused-by-pathological-vascular-contact-of-the-greater-occipital-nerve
#1
Byung-Chul Son, Jin-Gyu Choi
Here we report a unique case of chronic occipital neuralgia caused by pathological vascular contact of the left greater occipital nerve. After 12 months of left-sided, unremitting occipital neuralgia, a hypesthesia and facial pain developed in the left hemiface. The decompression of the left greater occipital nerve from pathological contacts with the occipital artery resulted in immediate relief for hemifacial sensory change and facial pain, as well as chronic occipital neuralgia. Although referral of pain from the stimulation of occipital and cervical structures innervated by upper cervical nerves to the frontal head of V1 trigeminal distribution has been reported, the development of hemifacial sensory change associated with referred trigeminal pain from chronic occipital neuralgia is extremely rare...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28286682/rheumatoid-meningitis-occurring-during-etanercept-treatment
#2
Koji Tsuzaki, Takashi Nakamura, Hiroyuki Okumura, Naoko Tachibana, Toshiaki Hamano
We report a 65-year-old man who had repetitive seizures 6 months after receiving etanercept, methotrexate, and prednisolone for rheumatoid arthritis. Mononuclear cells were mildly increased in the cerebrospinal fluid (CSF). Brain magnetic resonance imaging (MRI) showed high intensity along sulci of the frontal and parietal lobes. Brain biopsy revealed lymphocyte and plasma cell infiltration in the meninges, confirming the diagnosis of rheumatoid meningitis. After steroid pulse therapy, seizures resolved and clinical findings improved...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28265475/improvement-and-neuroplasticity-after-combined-rehabilitation-to-forced-grasping
#3
Michiko Arima, Atsuko Ogata, Kazumi Kawahira, Megumi Shimodozono
The grasp reflex is a distressing symptom but the need to treat or suppress it has rarely been discussed in the literature. We report the case of a 17-year-old man who had suffered cerebral infarction of the right putamen and temporal lobe 10 years previously. Forced grasping of the hemiparetic left upper limb was improved after a unique combined treatment. Botulinum toxin type A (BTX-A) was first injected into the left biceps, wrist flexor muscles, and finger flexor muscles. Forced grasping was reduced along with spasticity of the upper limb...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28261510/is-intravenous-heparin-a-contraindication-for-tpa-in-ischemic-stroke
#4
Zain Kulairi, Nisha Deol, Renee Tolly, Rohan Manocha, Maliha Naseer
There are approximately 2 million cardiac catheterizations that occur every year in the United States and with an aging population this number continues to rise. Adverse events due to this procedure occur at low rates and include stroke, arrhythmia, and myocardial infarctions. Due to the high volume of procedures there are a growing number of adverse events. Stroke after cardiac catheterization (SCC) has an incidence between 0.27 and 0.5% and is one of the most debilitating complications leading to high rates of mortality and morbidity...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28251001/a-case-of-refractory-neuropsychiatric-lupus-responsive-to-anticoagulation
#5
Rui Wu, Sun Hu
Neuropsychiatric disorder is a severe complication in 14% to 75% of systemic lupus erythematosus (SLE) patients, which can result in significant morbidity. A 15-year-old female SLE patient with coexistence of dural sinus thrombosis and intracerebral hemorrhage resistant to two pulses of high dose of glucocorticoid was treated with anticoagulation of the low-molecular-weight [LMW] heparin subcutaneously followed by warfarin. The patient demonstrated a remarkable clinical response.
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28239500/a-pediatric-tumor-found-frequently-in-the-adult-population-a-case-of-anaplastic-astroblastoma-in-an-elderly-patient-and-review-of-the-literature
#6
Christopher Payne, Ali Batouli, Kristen Stabingas, Dunbar Alcindor, Khaled Abdel Aziz, Cunfeng Pu, Elizabeth Tyler-Kabara, Robert Williams, Alexander Yu
Astroblastomas are rare, potentially curable primary brain tumors which can be difficult to diagnose. We present the case of astroblastoma in a 73-year-old male, an atypical age for this tumor, more classically found in pediatric and young adult populations. Through our case and review of the literature, we note that this tumor is frequently reported in adult populations and the presentation of this tumor in the elderly is well described. This tumor is an important consideration in the differential diagnosis when managing both pediatric and adult patients of any age who present with the imaging findings characteristic of this rare tumor...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28210514/hemorrhagic-colloid-cyst-presenting-with-acute-hydrocephaly
#7
Reza Akhavan, Behrouz Zandi, Masoud Pezeshki-Rad, Donya Farrokh, Bita Abbasi
Colloid cysts are benign slow-growing cystic lesions located on the roof of the third ventricle that usually present with symptoms related to gradual rise of intracranial pressure. They mostly remain asymptomatic and sometimes grow progressively and cause diverse symptoms associated with increased intracranial pressure such as headache, diplopia, and sixth cranial nerve palsy. Here we report a 47-year-old female who presented to the emergency department with acute severe headache and nausea/vomiting. On MRI examination acute hydrocephaly due to hemorrhagic colloid cyst was detected...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28210513/seizure-following-the-use-of-the-cox-2-inhibitor-etoricoxib
#8
Valentina Arnao, Marianna Riolo, Brigida Fierro, Paolo Aridon
We describe a case of epileptic seizures occurring after the use of a COX-2 inhibitor. A 61-year-old man was admitted to our department because of a generalized tonic-clonic seizure. EEG showed generalized slowdown of the activity. Neuroimaging and blood samples studies did not evidence alterations, but a careful pharmacological history revealed that the patient had taken the COX-2 inhibitor etoricoxib to treat lumbago few days before the onset of clinical symptoms. No seizures were reported after etoricoxib discontinuation and an EEG resulted to be normal two months after this...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28203468/nonconvulsive-status-epilepticus-resembling-clinical-absence-with-atypical-eeg-pattern
#9
Channaiah Srikanth Mysore, Najib Murr, Rana Zabad, John Bertoni
Objective. We are reporting two cases: a patient with steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT) and another patient with secondary progressive multiple sclerosis (SPMS), both presenting with altered mental status (AMS) and later diagnosed with nonconvulsive atypical absence status epilepticus (AS), with atypical EEG changes. Methods. A report of two cases. Results. A patient with history of SREAT and the other with SPMS had multiple admissions due to AMS. For both, EEG revealed the presence of a high voltage generalized sharply contoured theta activity...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28194288/variability-in-clinical-presentation-of-neonatal-stroke-report-of-four-cases
#10
Sonia Joseph, Dimitrios Angelis, Robert Bennett, Bhargavi Kola, Amanda Hughes
Neonatal stroke can be a cause of long term neurodevelopmental disability, seizures, and impaired cognitive function. We present four cases of neonatal stroke, associated with different risk factors and clinical presentations. Two of these newborns were born to mothers with no prenatal care.
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28182114/evolution-of-cerebral-atrophy-in-a-patient-with-super-refractory-status-epilepticus-treated-with-barbiturate-coma
#11
Christopher R Newey, Pravin George, Premkumar Nattanmai, Christine Ahrens, Stephen Hantus, Aarti Sarwal
Introduction. Status epilepticus is associated with neuronal breakdown. Radiological sequelae of status epilepticus include diffusion weighted abnormalities and T2/FLAIR cortical hyperintensities corresponding to the epileptogenic cortex. However, progressive generalized cerebral atrophy from status epilepticus is underrecognized and may be related to neuronal death. We present here a case of diffuse cerebral atrophy that developed during the course of super refractory status epilepticus management despite prolonged barbiturate coma...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28182102/a-case-report-of-nonvasculitic-autoimmune-inflammatory-meningoencephalitis-with-sensory-ganglionopathy-a-rare-presentation-of-sj%C3%A3-gren-syndrome
#12
João Peres, Simão Cruz, Rita Oliveira, Luís Santos, Ana Valverde
A 68-year-old Caucasian female was admitted to the emergency department with a progressive history of behavioural symptoms and anxiety followed by visual and auditory hallucinations, forgetfulness, and impaired gait in the previous 3 months. On examination she was psychotic and had a postural and rest tremor of the upper limbs, cogwheel rigidity of the four limbs, retropulsion on standing position, and inability to walk. During the following 2 weeks she developed xerostomia and unilateral parotiditis that improved with steroids...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28168070/chronic-subdural-hematoma-associated-with-thrombocytopenia-in-a-patient-with-human-immunodeficiency-virus-infection-in-cameroon
#13
Clovis Nkoke, Engelbert Bain Luchuo, Denis Teuwafeu, Ines Nepetsoun, Cyrille Nkouonlack
Hematological abnormalities including thrombocytopenia are common in patients living with HIV infection. Patients with HIV infection related thrombocytopenia present generally with only minor bleeding problems. But cases of subdural hematoma are very rare. A 61-year-old female with a history of HIV infection of 9 years' duration presented with a 3-month history of generalized headache associated with visual blurring and anterograde amnesia. There was no history of trauma or fever. She was treated empirically for cerebral toxoplasmosis for 6 weeks without any improvement of the symptoms...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28168069/hyperechogenicity-of-the-substantia-nigra-in-parkinson-s-disease-insights-from-two-brothers-with-markedly-different-disease-durations
#14
Julie M Hall, Matthew J Georgiades, Deborah A Hammond, Xiaoting Feng, Ahmed A Moustafa, Simon J G Lewis, Gabrielle Todd
We present clinical features and substantia nigra morphology for two brothers with Parkinson's disease (PD) aged 60 and 59 years. The brothers were diagnosed at 41 and 50 years of age, respectively. Both patients exhibited an abnormally large area of substantia nigra echogenicity bilaterally when viewed with transcranial ultrasound. The abnormality was similar in both brothers despite one having a much longer disease duration than the other. These findings further highlight that transcranial ultrasound is not associated with severity of clinical symptoms, but it might assist in the diagnosis of PD provided that it is combined with other variables known to precede PD...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28168068/treatment-challenges-of-a-primary-vertebral-artery-aneurysm-causing-recurrent-ischemic-strokes
#15
Davide Strambo, Luca Peruzzotti-Jametti, Aurora Semerano, Giovanna Fanelli, Franco Simionato, Roberto Chiesa, Enrico Rinaldi, Vittorio Martinelli, Giancarlo Comi, Marco Bacigaluppi, Maria Sessa
Background. Extracranial vertebral artery aneurysms are a rare cause of embolic stroke; surgical and endovascular therapy options are debated and long-term complication may occur. Case Report. A 53-year-old man affected by neurofibromatosis type 1 (NF1) came to our attention for recurrent vertebrobasilar embolic strokes, caused by a primary giant, partially thrombosed, fusiform aneurysm of the left extracranial vertebral artery. The aneurysm was treated by endovascular approach through deposition of Guglielmi Detachable Coils in the proximal segment of the left vertebral artery...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28127484/chronic-cluster-headache-with-an-atypical-presentation-and-treatment-response
#16
Telma Santos, Hugo Morais
The management of cluster headache (CH) may be challenging. We report a 50-year-old male with recurrent attacks of dull and severe unilateral periorbital pain, lasting 30-45 minutes, twice a day, exclusively during sleep, and accompanied by ipsilateral rhinorrhea and lacrimation. The pain switched sides within every attack. CH treatment was initiated but the patient maintained recurrence rates compatible with chronic CH, even after increasing verapamil to 460 mg/day. Afterwards we decided to add lithium (800 mg/day)...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28127483/relative-hypodense-vertebral-artery-sign-on-computerized-tomography-in-atherosclerotic-near-occlusion
#17
Muhammad Faraz Raghib, Slaven Pikija
A 52-year-old white male presented with an acute onset of slurred speech along with hypoesthesia in the entire left arm. The acute computed tomography (CT) showed relative hypodensity in the intracranial segment of left vertebral artery (VA) that was not present in historical images, pointing to the possible lack of flow. The site of occlusion was confirmed by magnetic resonance imaging (MRI) that showed susceptibility effect in the affected artery. By means of historical native CT comparison the site of VA thrombosis was correctly predicted...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28116189/a-successful-treatment-of-endoscopic-third-ventriculostomy-with-choroid-plexus-cauterization-for-hydrocephalus-in-walker-warburg-syndrome
#18
Tomoko Tanaka, Catharine J Harris, Sarah S Barnett, N Scott Litofsky
Walker-Warburg syndrome (WWS) is a rare autosomal recessive congenital muscular dystrophy with brain malformations and ocular abnormalities that falls under the wider phenotypic spectrum of the dystroglycanopathies. Mutations in a number of genes including POMT1, POMT2, POMGNT1, POMGNT2, FKTN, FKRP, LARGE, and ISPD are known to cause alpha dystroglycan-related muscular dystrophy. Mutations in these genes result in a broad phenotypic spectrum ranging from the severe WWS to a mild congenital muscular dystrophy with no brain involvement...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28116188/fast-growing-meningioma-in-a-woman-undergoing-fertility-treatments
#19
Adam Patterson, Abdurrahim Elashaal
Meningiomas have long been known to be associated with sexual hormones. We discuss here the case of a woman with a huge meningioma that rapidly grew over the course of a couple years while the patient was simultaneously taking fertility treatments. There is substantial evidence suggesting that fertility treatments can fuel the growth of meningiomas. The potential risks should be considered in women with a previous or family history of meningiomas who plan to undergo fertility treatment. These patients need to be evaluated and a screening imaging of brain MRI (Magnetic Resonant Imaging) should be offered in the middle or toward the end of such a treatment to control and prevent complications of these meningiomas...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28101388/bilateral-moyamoya-disease-in-a-2-year-old-pakistani-male-treated-with-bilateral-encephaloduroarteriosynangiosis-a-positive-outcome
#20
Shahvaiz Magsi, Adeel Khoja, Mansoor Ali Merchant Rameez, Ariba Khan, Noman Ishaque
Background. We present a rare case of bilateral moyamoya disease presenting as multiple strokes and neurological deficits, treated with the neurosurgical procedure, encephaloduroarteriosynangiosis (EDAS), in a 2-year-old male Pakistani minor. A positive outcome was achieved and the patient recovered fully. Case Summary. Our patient presented with a history of seizures and multiple episodes of hemiparesis (on and off weakness) at the age of 2 years. He had a delayed speech development and could not speak more than a few words...
2016: Case Reports in Neurological Medicine
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