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brainstem infarction

Gozde Baran, Tugce Ozdemir Gultekin, Oguz Baran, Cigdem Deniz, Salim Katar, Gulsen Babacan Yildiz, Talip Asil
Background and purpose: To assess the anatomical distribution of the ischemic strokes of the brainstem, the effect of anatomical distribution on clinical features and prognosis, and the association between etiology and anatomical involvement. Methods: A retrospective search of the patient database of our institution was performed for a total of 227 patients who were admitted to the Department of Neurology, Medical Faculty of Bezmialem Vakif University between January 2012 and September 2014...
2018: Neuropsychiatric Disease and Treatment
Chenhui Mao, Jing Gao, Liri Jin, Bin Peng, Yupu Guo
Neurosyphilis occurs in the late stage of systemic syphilis infection; early diagnosis and treatment are crucial to the prognosis. We review 3 autopsy cases with different subtypes of neurosyphilis, that is cases with meningovascular, general paresis, and a combination of the 2, respectively. We investigated the gross morphology and leptomeninges, vessels, cerebral cortex, white matter, brainstem, cerebellum, olfactory bulb and spinal cord microscopically. We found that meningovascular inflammation exists in both early and late phases of neurosyphilis, not only in the meningovascular subtype...
March 12, 2018: Journal of Neuropathology and Experimental Neurology
Zhi-Yong Zhang, Zhi-Qin Liu, Wei Qin, Ya-Wen Chen, Zun-Jing Liu
Background: Wallerian degeneration (WD) of bilateral middle cerebellar peduncles (MCPs) can occur following pontine infarction, but its characteristics have not yet been clarified because of the low incidence. Thus, the present study discussed the clinical and radiological features to improve the awareness of this disease. Methods: Clinical and radiological information from consecutive individuals diagnosed with WD of bilateral MCPs following pontine infarction in three hospitals over the past 4 years between October 2012 and October 2016 were retrospectively investigated and compared with a control group (patients with pontine infarction had no secondary WD)...
March 20, 2018: Chinese Medical Journal
Hendrik Janssen, Hartmut Brückmann, Monika Killer, Suzette Heck, Grete Buchholz, Juergen Lutz
INTRODUCTION: We investigated whether thrombus length measured in Computed Tomography Angiography (CTA) is predictive of the success rate of intravenous thrombolysis (IVT) in acute basilar occlusion and whether recanalization can be achieved by additional mechanical endovascular thrombectomy. METHODS: In 51 patients with acute basilar thrombosis thrombus length was measured on CTA images before intravenous thrombolysis (IVT) with rt-PA was started. After 114 minutes on average success of IVT was evaluated either by CTA or DSA...
2018: PloS One
Prachaya Srivanitchapoom, Yuvadee Pitakpatapee, Panitta Sitthinamsuwan, Sith Sathornsumetee
Cryptococcal meningoencephalitis is one of the most common central nervous system infections affecting immunocompromised patients. However, brainstem involvement is extremely rare and may represent a diagnostic challenge to clinicians. We report a non-HIV infected, chronically immunosuppressed, patient with fatal disseminated cryptococcosis presented with subcutaneous masses at both thighs and progressive brainstem dysfunction. Magnetic resonance imaging demonstrated multiple brainstem infarcts likely derived from small vessel vasculopathy...
February 12, 2018: Clinical Neurology and Neurosurgery
Jun Zhang, Rongming Xu, Zheng Li, Weibin Zha
RATIONALE: Malposition of cervical pedicle screw (CPS) has a risk of vertebral artery (VA) injury which sometimes may cause unexpected and catastrophic outcome. A rare case of delayed onset of cerebral infarction caused by malposition of CPS was reported. PATIENT CONCERNS: A 23-year-old man who underwent a posterior cervical reduction and fusion of C4-5 using CPS fixation and allograft for cervical spine injury is presented. The patient suffered progressively weakness and numbness for both of upper and lower extremities 1 day after the operation...
February 2018: Medicine (Baltimore)
Tameto Naoi, Mitsuya Morita, Tadataka Kawakami, Shigeru Fujimoto
A 67-year-old man with hypertension and type 2 diabetes mellitus was admitted to our hospital because of left hearing loss and vertical diplopia. A neurological examination showed ocular torsion, skew deviation, and sensorineural hearing loss in the left ear. Brainstem and cerebellar neurological signs were not observed. Left middle cerebellar peduncle infarction was evident on magnetic resonance imaging. He was treated with antiplatelet, however, the infarct progressed after this administration. Ocular tilt reaction (OTR) involves the triad of ocular torsion, skew deviation, and head tilt...
February 9, 2018: Internal Medicine
Babak Hooshmand, Tuomo Polvikoski, Miia Kivipelto, Maarit Tanskanen, Liisa Myllykangas, Mira Mäkelä, Minna Oinas, Anders Paetau, Alina Solomon
BACKGROUND: CAIDE Dementia Risk Score is a tool for estimating dementia risk in the general population. Its longitudinal associations with Alzheimer or vascular neuropathology in the oldest old are not known. AIM: To explore the relationship between CAIDE Dementia Risk Score at baseline and neuritic plaques, neurofibrillary tangles, cerebral infarcts, and cerebral amyloid angiopathy (CAA) after up to 10 years follow-up in the Vantaa 85+ population. METHODS: Study population included 149 participants aged ≥85 years, without dementia at baseline, and with available clinical and autopsy data...
January 25, 2018: Journal of Internal Medicine
Mehmet Resid Onen, Kelli Moore, Ulas Cikla, Melih Ucer, Bradley Schmidt, Aaron S Field, Mustafa K Baskaya
INTRODUCTION: Hypertrophic olivary degeneration (HOD) occurs as a result of posterior fossa or brainstem lesions that disrupt the dentato-rubro-olivary tract, well known as the Guillain-Mollaret triangle. Clinical and radiological hallmarks of this condition are palatal myoclonus and T2 hyperintensity of the inferior olivary complex on MRI, respectively. Since symptomatic HOD may complicate the recovery of patients with posterior fossa or brainstem lesions, the purpose of this study is to evaluate clinical and imaging findings of patients with HOD...
January 27, 2018: World Neurosurgery
W Reith, A Haußmann
Virchow-Robin spaces are perivascular fluid-filled cavities that surround perforating arteries and veins in the brain parenchyma. As a rule in healthy people they are approximately 5 mm in diameter. Typical localizations are brainstem ganglia, mesencephalon and the white matter of the brain. Morphological imaging characteristics of Virchow-Robin spaces are round or tubular, smoothly bordered areas which are hyperintense in T2-weighted sequences. Virchow-Robin spaces represent a physiological structure in normal brain parenchyma...
January 26, 2018: Der Radiologe
Alan D Legatt
The electrocochleogram and brainstem auditory evoked potentials (BAEPs) are electrophysiologic signals used to assess the auditory nerve. The electrocohleogram includes the cochlear microphonic, the cochlear summating potential, and the eighth nerve compound action potential. It is used predominantly for hearing assessment and for diagnosis of Ménière disease and auditory neuropathy. Brainstem auditory evoked potentials are used for hearing assessment, diagnosis of dysfunction within the cochlea, the auditory nerve, and the brainstem auditory pathways up to the level of the mesencephalon, and intraoperative monitoring of these structures...
January 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
H Li, B Hu, L Wei, L Zhou, L Zhang, Y Lin, B Qin, Y Dai, Z Lu
BACKGROUND AND PURPOSE: Non-alcoholic fatty liver disease (NAFLD) is closely correlated to visceral obesity, dyslipidaemia, insulin resistance and type 2 diabetes mellitus. We sought to assess the association between a specific stroke subgroup, brainstem infarctions (BSIs) and NAFLD. Furthermore, we evaluated whether NAFLD is an independent risk factor in patients with BSIs. METHODS: Non-alcoholic fatty liver disease was assessed in 306 patients with radiologically confirmed BSIs via liver ultrasound...
March 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Scott Raymond, Natalia Sana Rost, Pamela Whitney Schaefer, Thabele Leslie-Mazwi, Joshua A Hirsch, Ramon Gilberto Gonzalez, James Rabinov
Triage of posterior circulation stroke from emergent large-vessel occlusion (pc-ELVO) is challenging owing to the stuttering clinical course and potential for rapid decline. Growing clinical data support the use of mechanical thrombectomy in pc-ELVO, but there are limited data addressing the clinical and imaging criteria for patient selection. We present our triage algorithm used to select patients for endovascular therapy (EVT) in the setting of pc-ELVOS. We use a consecutive retrospective database from 2004 to 2016 to describe the practice patterns and prognostic factors for pc-ELVO patients treated using both medical and EVT...
January 1, 2017: Interventional Neuroradiology
Salziyan Badrin, Noraini Mohamad, Nor Akma Yunus, Maryam Mohd Zulkifli
Psychiatric symptoms may be related to a silent cerebral infarct, a phenomenon that has been described previously in literature. Acute psychosis or other neuropsychiatric symptoms including depression may present in stroke patients and patients with lesions either within the prefrontal or occipital cortices, or in subcortical areas such as the basal ganglia, thalamus, mid-brain, and brainstem. Psychosis in clinical stroke or in silent cerebral infarction is uncommon and not well documented in the literature...
November 2017: Korean Journal of Family Medicine
Mandip S Dhamoon, Ying-Kuen Cheung, Ahmet Bagci, Noam Alperin, Ralph L Sacco, Mitchell S V Elkind, Clinton B Wright
BACKGROUND/OBJECTIVES: We previously showed that global brain white matter hyperintensity volume (WMHV) was associated with accelerated long-term functional decline. The objective of the current study was to determine whether WMHV in particular brain regions is more predictive of functional decline. DESIGN: Prospective population-based study. SETTING: Northern Manhattan magnetic resonance imaging (MRI) study. PARTICIPANTS: Individuals free of stroke at baseline (N = 1,195; mean age 71 ± 9; n = 460 (39%) male)...
November 20, 2017: Journal of the American Geriatrics Society
Chinmay P Nagesh, Aneesh Mohimen, Santhosh K Kannath, Jayadevan E Rajan
Direct carotid cavernous fistulae (CCF) are often detected early and treated promptly resulting in a paucity of literature regarding its long-term evolution. We present a case of high flow post-traumatic direct CCF that was neglected for over 6 years and presented with a rare manifestation of primary intraventricular haemorrhage. Occlusions of the primary venous outlets likely resulted in engorgement of the deep venous system. The segmental anatomy of the shunting basal vein is critical to the clinical presentation and may range from basal ganglia or brainstem oedema/infarctions to uniquely, as in our case, isolated intraventricular haemorrhage secondary to variceal rupture...
November 16, 2017: BMJ Case Reports
Jingzhe Han, Duanhua Cao, Guomei Ma, Tingting Wang, Ye Ji, Zhilei Kang
RATIONALE: Patients with Klippel-Feil syndrome (KFS) are always anomaly associated with vertebrobasilar dysplasia. That may present commonly as infarction of brainstem, medulla, and cerebellum. In this article, we reported a rare case of lateral medullary infarction (LMI) with similar features of Brown Sequard syndrome caused by vertebrobasilar dysplasia and KFS, and the 2 rare conditions that are causally related. The case is being reported because of its unusual and rare presentation...
November 2017: Medicine (Baltimore)
Ayse Guler, Funda Karbek Akarca, Cenk Eraslan, Ceyda Tarhan, Cem Bilgen, Tayfun Kirazli, Nese Celebisoy
INTRODUCTION: Head impulse test (HIT) is the critical bedside examination which differentiates vestibular neuritis (VN) from posterior circulation stroke (PCS) in acute vestibular syndrome (AVS). Video-oculography based HIT (vHIT) may have aadditional strength in making the differentiation. METHODS: Patients admitted to the emergency department of a tertiary-care medical center with AVS were studied. An emergency specialist and a neurologist performed HIT. vHIT was conducted by an neuro-otology research fellow...
2017: Journal of Vestibular Research: Equilibrium & Orientation
Dilek Yilmaz, Bülent Cengiz
Hyperekplexia is a rare movement disorder characterized by pathologically exaggerated response to unexpected stimuli. It is differentiated from the normal startle reflex by its lower threshold, higher intensity, and resistance to habituation. Many of the acquired hyperekplexias result from brainstem involvement such as encephalitis, infarct, hemorrhage, pontocerebellar hypoplasia and medullary compression. This case report depicts a rare manifestation of hyperekplexia. The unusual aspect of this case was the vocalization that was reproduced in response to startling stimuli...
2017: Neuropsychiatric Disease and Treatment
Tomoya Shibahara, Masahiro Yasaka, Yoshiyuki Wakugawa, Koichiro Maeda, Takeshi Uwatoko, Takahiro Kuwashiro, Gregory Y H Lip, Yasushi Okada
BACKGROUND: Intracranial vertebral artery dissection (VAD) is a well-recognized cause of stroke in young and middle-aged individuals, especially in Asian populations. However, a long-term natural course remains unclear. We investigated the long-term time course of VAD using imaging findings to examine the rate and predisposing factors for improvement. METHODS: We registered 56 consecutive patients (40 males; mean age, 51.8 ± 10.7 years) with acute spontaneous VAD and retrospectively investigated neuroimaging and clinical course within 1 month and at 3 months ± 2 weeks, 6 months ± 2 weeks, and 12 months ± 2 weeks after onset to ascertain predisposing factors and time course for improvement...
October 17, 2017: Cerebrovascular Diseases Extra
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