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Case Reports in Neurological Medicine

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https://www.readbyqxmd.com/read/27891270/primary-diffuse-leptomeningeal-gliomatosis-radiological-pathological-features
#1
Ehtasham Ahmad, Mohamed Mohamed, Apostolos Vrettos
We present the case of a 43-year-old lady who presented with headaches, visual impairment, and seizures, progressing rapidly over the course of a few weeks. Extensive workup excluded an inflammatory or infectious cause. Imaging studies revealed diffuse thickening of the leptomeninges and serial CSF analysis showed raised opening pressures and increased protein levels. A diagnostic biopsy of the lower thoracic dura confirmed the diagnosis of primary diffuse leptomeningeal gliomatosis (PDGL). She was managed supportively for her symptoms and unfortunately she passed away a few weeks later...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27891269/unruptured-basilar-tip-aneurysm-with-internal-septation-coiling-implications
#2
Ayman Khalil, Hong Kuan Kok, Mark Schembri, Paul Brennan, Mohsen Javadpour, John Thornton, Alan O'Hare, Hamed Asadi
An internal septum within a basilar artery aneurysm is an infrequent anomaly and is very rarely reported in the literature. We report a 62-year-old lady that was incidentally diagnosed with basilar tip aneurysm. Further imaging with magnetic resonance imaging (MRI) revealed internal septation within this aneurysm which was later confirmed with digital subtraction angiography (DSA). She underwent coil embolisation, which involved technical manipulation of the microcatheter and the balloon to enable coiling of each separate aneurysm compartment...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27882256/eeg-triggered-functional-electrical-stimulation-therapy-for-restoring-upper-limb-function-in-chronic-stroke-with-severe-hemiplegia
#3
Cesar Marquez-Chin, Aaron Marquis, Milos R Popovic
We report the therapeutic effects of integrating brain-computer interfacing technology and functional electrical stimulation therapy to restore upper limb reaching movements in a 64-year-old man with severe left hemiplegia following a hemorrhagic stroke he sustained six years prior to this study. He completed 40 90-minute sessions of functional electrical stimulation therapy using a custom-made neuroprosthesis that facilitated 5 different reaching movements. During each session, the participant attempted to reach with his paralyzed arm repeatedly...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27882255/tip-of-an-iceberg-skull-fracture-as-an-adult-presentation-of-encephalocraniocutaneous-lipomatosis
#4
Sinead Culleton, Christen D Barras, Hamed Asadi, Seamus Looby, Paul Brennan, Hong Kuan Kok
The severity of seizures presenting to the emergency department ranges from benign to life threatening. There are also a wide number of possible etiologies. Computed tomography (CT) emergency imaging may be required at presentation to elucidate a possible cause and assess signs of intracranial trauma. This case describes a serious seizure episode in a young man while on holiday. A CT brain showed a skull fracture as a consequence of seizure-related head trauma but unexpectedly there were image findings consistent with encephalocraniocutaneous lipomatosis...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27872776/cerebral-venous-sinus-thrombosis-during-everest-expedition-a-case-report-and-review-of-the-literature
#5
P Khanal, L Thapa, A M Shrestha, S Bhattarai, D Sapkota, N Sharma, U P Devkota
Cerebral venous sinus thrombosis (CVST) is a rare but serious disorder that is associated with a poor clinical outcome. We report a 35-year-old man who had a severe headache and diplopia while climbing Mount Everest. His MR venography showed right transverse and right sigmoid sinus thrombosis. He improved on anticoagulant and symptomatic measures. Cerebral venous sinus thrombosis at high altitude is discussed.
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27847661/thermoregulatory-instability-in-childhood-linking-the-normal-brain-to-hypothalamic-storm
#6
William Alves Martins, Rafael do Amaral Cristovam, Helena Fussiger, Viviane Maria Vedana, Marta Hemb
Central core temperature is tightly controlled by hypothalamic centers, a feature that makes sudden changes in body temperature very unusual. A dysfunction of these hypothalamic pathways leads to Shapiro's syndrome, comprising spontaneous hypothermia, hyperhidrosis, and corpus callosum dysgenesis. Although it may affect any age, usually it presents in childhood. Variants to this syndrome with completely normal brain anatomy have been consistently reported, expanding the clinical spectrum of the syndrome. Herein, we report the case of a 4-year-old girl with Shapiro's syndrome and unaffected corpus callosum...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27847660/hemorrhagic-longitudinally-extensive-transverse-myelitis
#7
Chris Y Wu, Tanawan Riangwiwat, Beau K Nakamoto
Longitudinally extensive transverse myelitis (LETM) may be associated with viral triggers, including both infections and vaccinations. We present a case of a healthy immunocompetent 33-year-old woman who developed a hemorrhagic LETM 2 weeks after seasonal influenza vaccination. Hemorrhagic LETM has not to our knowledge been reported after influenza vaccination. It may represent a forme fruste variant of acute hemorrhagic leukoencephalitis.
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27840754/internal-carotid-artery-stenosis-presenting-with-limb-shaking-tia
#8
Awad Javaid, Mostafa Alfishawy
Internal carotid artery (ICA) stenosis may lead to a wide range of clinical symptoms. We describe the case of a 66-year-old female who experienced a transient ischemic attack (TIA) with episodes of limb shaking caused by ICA stenosis. After epilepsy had been suspected and ruled out, studies of her left ICA showed extensive blockage as a result of atherosclerosis. Magnetic resonance angiography (MRA) revealed total occlusion of the left ICA and the patient was eventually medically managed due to the strong possibility of surgical complications...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27840753/mercaptopurine-treatment-in-an-adult-man-with-orbital-and-intracranial-rosai-dorfman-disease
#9
Valentina Arnao, Marianna Riolo, Giovanni Savettieri, Paolo Aridon
Background. Rosai-Dorfmann disease (RDD) is a rare, idiopathic non-Langerhans cell histiocytosis, affecting children and young adults, that commonly presents as painless, massive cervical lymphadenopathy with fever, weight loss, and polyclonal hypergammaglobulinemia. Cervical lymphadenopathy and extranodal involvement are the main presentations. On the contrary, ophthalmic involvement and localisation in the central nervous system are rare. Case Report. An old man was admitted to our hospital for first seizure...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27833768/stroke-from-vasospasm-due-to-marijuana-use-can-cannabis-synergistically-with-other-medications-trigger-cerebral-vasospasm
#10
Marium Jamil, Atif Zafar, Syed Adeel Faizi, Ifrah Zawar
We present a case of imaging proven cerebral vasospasm causing ischemic stroke in a young patient chronically on buprenorphine-naloxone for heroin remission who started smoking cannabis on a daily basis. With cannabis legalization spreading across the states in the USA, it is important for physicians not only to be aware of cannabis reported association with cerebral vasospasm in some patients but also to be on the lookout for possible interacting medications that can synergistically affect cerebral vessels causing debilitating strokes...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27822397/management-of-stable-angina-with-ivabradine-as-safe-alternative-to-patients-with-myasthenia-gravis
#11
Giuliano Ohde Dalledone, Gustavo Lenci Marques, Renata Dal-Prá Ducci, Arnaldo Laffitte Stier Junior, Cláudia Suemi Kamoi Kay, Lineu Cesar Werneck, Paulo José Lorenzoni, Rosana Herminia Scola
Management of cardiac symptoms in myasthenia gravis (MG) patients can be challenging. The aim of this report is to describe the safe use of ivabradine for stable angina in MG patients. A 48 y.o. woman, with MG diagnosis, presented stable angina. Therapies choices were reduced considering concomitant disease as well as previous and unsuccessful cardiologic managements. Ivabradine showed unexpected results. The patient presented an improvement of neurological and cardiac symptoms, bringing ivabradine as one more therapeutic option to similar patients...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27818813/familial-hemiplegic-migraine-with-severe-attacks-a-new-report-with-atp1a2-mutation
#12
E Martínez, R Moreno, L López-Mesonero, I Vidriales, M Ruiz, A L Guerrero, J J Tellería
Introduction. Familial hemiplegic migraine (FHM) is a rare disorder characterized by migraine attacks with motor weakness during the aura phase. Mutations in CACNA1A, ATP1A2, SCN1A, and PRRT2 genes have been described. Methods. To describe a mutation in ATP1A2 gene in a FHM case with especially severe and prolonged symptomatology. Results. 22-year-old woman was admitted due to migraine-type headache and sudden onset of right-sided weakness and aphasia; she had similar episodes in her childhood. Her mother was diagnosed with hemiplegic migraine without genetic confirmation...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27818812/cns-vasculitis-associated-with-waldenstr%C3%A3-m-macroglobulinemia
#13
Tanawan Riangwiwat, Chris Y Wu, Alberto S Santos-Ocampo, Randal J Liu, Aaron M McMurtray, Beau K Nakamoto
Waldenström macroglobulinemia (WM) is an indolent B cell lymphoproliferative disorder with monoclonal IgM secretion. We present a patient with WM who presented with multifocal acute cortical ischemic strokes and was found to have central nervous system (CNS) vasculitis. Workup was negative for cryoglobulins and hyperviscosity syndrome. Immunosuppression with intravenous steroids and cyclophosphamide stabilized the patient's mental status and neurologic deficits. On followup over 7 years, patient gained independence from walking aids and experienced no recurrences of CNS vasculitis...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27803826/a-corticobasal-syndrome-variant-of-familial-creutzfeldt-jakob-disease-with-stroke-like-onset
#14
Ján Necpál, Martin Stelzer, Silvia Koščová, Michal Patarák
Creutzfeldt-Jakob disease (CJD) is an untreatable rare human prion disease characterized by rapidly progressive dementia along with various neurological features, including myoclonus and sometimes other movement disorders. The clinical course is typically insidious and rapid, leading to an early death. In general, the most common form is sporadic CJD; however, Slovakia is typical for a high percentage of genetic cases. We present an unusual case report of a 65-year-old man with a sudden, stroke-like onset of motor aphasia with right-sided levodopa unresponsive parkinsonism, alien hand, and other characteristic features of corticobasal syndrome (CBS), with rapid deterioration and death on the 32nd day of the disease...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27800198/a-case-report-of-neurosarcoidosis-presenting-as-a-lymphoma-mimic
#15
Gurcharanjeet Kaur, Lauren Cameron, Olga Syritsyna, Patricia Coyle, Agnes Kowalska
Objective. To describe a unique presentation of neurosarcoidosis. Background. Central nervous system involvement is rare in sarcoidosis. Sarcoidosis can be severe and can be mistaken for systemic lymphoma. Case Description. A 55-year-old right-handed white male with past medical history of obstructive sleep apnea, Raynaud's disease, and Hashimoto's thyroiditis was noted to have cognitive decline over a duration of few weeks and 20 lb weight loss. His neurologic exam (including cranial nerves) was normal except for five-minute recall...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27777805/two-cases-of-human-t-lymphotropic-virus-type-i-associated-myelopathy-tropical-spastic-paraparesis-caused-by-living-donor-renal-transplantation
#16
Yasutaka Tajima, Mariko Matsumura, Hiroaki Yaguchi, Yasunori Mito
In rare instances, recipients of organ transplants from human T-lymphotropic virus type I- (HTLV-I-) positive donors reportedly developed neurologic symptoms due to HTLV-I-associated myelopathy (HAM). We present herein two cases of HAM associated with renal transplantation from HTLV-I seropositive living-donors. The first patient was a 42-year-old woman with chronic renal failure for twelve years and seronegative for HTLV-I. She underwent renal transplantation with her HTLV-I seropositive mother as the donor, and she developed HAM three years after the transplantation...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27752375/embolic-stroke-due-to-a-common-carotid-artery-thrombus-in-a-young-patient-with-severe-iron-deficiency-anemia-without-thrombocytosis
#17
David Roshal
This case report describes a 41-year-old previously healthy male who presented with stuttering transient ischemic symptoms and radiographic evidence of a left common carotid artery thrombus as well as acute and subacute ischemic infarcts in the left middle cerebral artery territory. An exhaustive stroke work-up did not provide a plausible etiology for his symptoms. His complete blood count and iron studies, however, revealed evidence of severe iron-deficiency anemia without reactive thrombocytosis. His stool guaiac test was positive...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27738537/diffusion-tensor-imaging-tractography-in-pure-neuritic-leprosy-first-experience-report-and-review-of-the-literature
#18
Michele R Colonna, Giuseppe Tallarida, Francesco Stagno d'Alcontres, Salvatore Noto, Aurora Parodi, Alberto Tagliafico
Five years after both right ulnar and median nerve decompression for paraesthesias and palsy, a patient, coming from Nigeria but living in Italy, came to our unit claiming to have persistent pain and combined median and ulnar palsy. Under suspicion of leprosy, skin and left sural nerve biopsy were performed. Skin tests were negative, but Schwann cells resulted as positive for acid-fast bacilli (AFB), leading to the diagnosis of Pure Neuritic Leprosy (PNL). The patient was given PB multidrug therapy and recovered from pain in two months...
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27703823/a-case-of-west-nile-encephalitis-that-develops-into-a-disease-of-deep-white-matter-on-mri-over-a-two-week-span
#19
Adam Puchalski, Antonio Liu
We present a case of serologically proved West Nile encephalitis. This patient had a normal MRI on admission. Given that the patient's clinical picture had worsened during her admission, a repeat MRI was performed, which demonstrated diffuse disease in the deep white matter of the brain. This is a case of West Nice encephalitis presenting as a disease of deep white matter that developed over a two-week span.
2016: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/27688919/parkinson-s-disease-and-cryptogenic-epilepsy
#20
Andre Y Son, Milton C Biagioni, Dorian Kaminski, Alec Gurevich, Britt Stone, Alessandro Di Rocco
Epilepsy is an uncommon comorbidity of Parkinson's disease (PD) and has been considered not directly associated with PD. We present five patients (3 men and 2 women; ages 49-85) who had concomitant PD and cryptogenic epilepsy. Although rare, epilepsy can coexist with PD and their coexistence may influence the progression of PD. While this may be a chance association, an evolving understanding of the neurophysiological basis of either disease may suggest a mechanistic association.
2016: Case Reports in Neurological Medicine
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