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https://www.readbyqxmd.com/read/28406779/classic-raymond-syndrome
#1
Majid Khan, Sadaf Naveed, Iqbal Haider, Mohammad Humayun, Abidullah Khan
Classic Raymond syndrome presents with abducens nerve palsy on the ipsilateral side with contralateral hemiparesis and facial nerve paralysis. A 60-year gentleman presented with deviation of left angle of mouth and right sided weakness. Examination showed that he had left sided abducens nerve palsy, with contralateral central facial paralysis and paresis. MRI of brain confirmed left pontine infarct. These findings were consistent with classic Raymond syndrome. Till now, only a few cases have been reported worldwide, this being the first case reported in South Asia...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28400488/predictors-of-dysphagia-in-acute-pontine-infarction
#2
Sriramya Lapa, Sebastian Luger, Waltraud Pfeilschifter, Christian Henke, Marlies Wagner, Christian Foerch
BACKGROUND AND PURPOSE: Little is known about the frequency and the clinical characteristics of neurogenic dysphagia in pontine strokes. In this study, we sought to identify predictors for dysphagia in a cohort of patients with isolated pontine infarctions. METHODS: We included all patients admitted to our department between 2008 and 2014 having an acute (<48 hours after symptom onset) ischemic stroke in the pons, as documented by means of diffusion-weighted magnetic resonance imaging...
April 11, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28337694/the-posterior-fossa-and-foreign-accent-syndrome-report-of-two-new-cases-and-review-of-the-literature
#3
Stefanie Keulen, Peter Mariën, Kim van Dun, Roelien Bastiaanse, Mario Manto, Jo Verhoeven
Foreign accent syndrome is a rare motor speech disorder that causes patients to speak their language with a non-native accent. In the neurogenic condition, the disorder develops after lesions in the language dominant hemisphere, often affecting Broca's area, the insula, the supplementary motor area and the primary motor cortex. Here, we present two new cases of FAS after posterior fossa lesions. The first case is a 44-year-old, right-handed, Dutch-speaking man who suffered motor speech disturbances and a left hemiplegia after a pontine infarction...
March 23, 2017: Cerebellum
https://www.readbyqxmd.com/read/28297687/-a-rare-case-of-cerebellar-hemangioblastoma-causing-taste-disorder
#4
Hiroko Nakashiro, Masatou Kawashima, Fumitaka Yoshioka, Yukiko Nakahara, Yukinori Takase, Atsushi Ogata, Shoko Shimokawa, Jun Masuoka, Tatsuya Abe, Toshio Matsushima
Taste(gustation)is one of the five senses, and comprises the types: sweet, bitter, salty, sour, and umami. Taste disorders, such as dysgeusia and parageusia, are classified into 2 types: those with peripheral origin and those with central origin. The peripheral origin-type taste disorder is caused by zinc deficiency, mouth dryness, a side effect of radiotherapy or complication of systemic diseases such as, diabetes, hepatopathy, and nephropathy. The central origin-type taste disorder is reported to be caused due to demyelinating disease, pontine hemorrhage, pontine infarction, and thalamic infarction; it is very rarely caused by a brain tumor...
March 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28250306/body-lateropulsion-and-cerebellar-tremor-in-a-patient-with-pontine-infarction
#5
Ai Hosaka, Ryoya Tsunoda, Tetsuto Yamaguchi, Yasuro Shibagaki
Body lateropulsion is known to be caused commonly by lateral medullary lesions but rarely by pontine lesions. It is also known to be associated with lesions of the dorsal spinothalamic tract or ascending graviceptive pathways. We herein report the case of a 75-year-old woman presenting with contralateral lateropulsion and cerebellar tremor caused by pons infarction. To our knowledge, this is the first case report of pontine infarction causing both lateropulsion and cerebellar tremor. Our case may be helpful in anatomical studies of ascending graviceptive pathways...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28220368/embolization-of-ruptured-arteriovenous-malformations-in-the-cerebellopontine-angle-cistern
#6
Hidenori Endo, Shin-Ichiro Osawa, Yasushi Matsumoto, Toshiki Endo, Kenichi Sato, Kuniyasu Niizuma, Miki Fujimura, Teiji Tominaga
Among brainstem arteriovenous malformations (AVMs), there exist small AVMs predominantly located in the cerebellopontine angle cistern (CPAC) with minimal extension into the pial surface of the brainstem. However, previous studies of CPAC AVMs did not particularly discuss the role of embolization in the treatment of these lesions. This study was conducted to clarify the effectiveness and validity of embolization in the treatment of CPAC AVMs. We retrospectively reviewed five patients with CPAC AVMs who underwent endovascular treatment...
February 20, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28208139/mri-based-neuroanatomical-predictors-of-dysphagia-dysarthria-and-aphasia-in-patients-with-first-acute-ischemic-stroke%C3%A2
#7
Heather L Flowers, Mohammed A AlHarbi, David Mikulis, Frank L Silver, Elizabeth Rochon, David Streiner, Rosemary Martino
BACKGROUND: Due to the high post-stroke frequency of dysphagia, dysarthria, and aphasia, we developed comprehensive neuroanatomical, clinical, and demographic models to predict their presence after acute ischemic stroke. METHODS: The sample included 160 randomly selected first-ever stroke patients with confirmed infarction on magnetic resonance imaging from 1 tertiary stroke center. We documented acute lesions within 12 neuroanatomical regions and their associated volumes...
February 16, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28093369/rehabilitation-of-the-pontine-ataxia-dysmetria-syndrome
#8
Stephanie Li, Kasondra Hartman, Krishna Surapaneni, Eric L Altschuler
We present a case of a patient with significant ataxia and dysmetria following a lacunar pontine infarction and review the literature on this uncommon syndrome. The patient had an excellent clinical course with near resolution of symptoms and signs in less than 3 weeks. We illustrate the patient's ataxia and dysmetria with videos and also use the videos to demonstrate and characterize the features of the dysmetria. Interestingly, the characteristics of the dysmetria appear to be different from those seen in patients with dysmetria arising from a cerebellar or thalamic lesion...
January 16, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28072702/hypersomnia-due-to-injury-of-the-ventral-ascending-reticular-activating-system-following-cerebellar-herniation-a-case-report
#9
Sung Ho Jang, Chul Hoon Chang, Young Jin Jung, Hyeok Gyu Kwon
RATIONALE: We report on a patient with hypersomnia who showed injury of the lower ascending reticular activating system (ARAS) following cerebellar herniation due to a cerebellar infarct, detected on diffusion tensor tractography (DTT). PATIENT CONCERNS: A 53-year-old male patient was diagnosed as a left cerebellar infarct, and underwent decompressive suboccipital craniectomy due to brain edema at 2 days after the onset of a cerebellar infarct. Three weeks after onset when the patient started rehabilitation, he showed hypersomnia without impairment of consciousness; he fell asleep most of daytime without external stimulation and showed an abnormal score on the Epworth Sleepiness Scale: 15 (full score: 24, cut off for hypersomnia: 10)...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28068949/plaque-distribution-of-low-grade-basilar-artery-atherosclerosis-and-its-clinical-relevance
#10
Jin Yu, Ming-Li Li, Yu-Yuan Xu, Shi-Wen Wu, Min Lou, Xue-Tao Mu, Feng Feng, Shan Gao, Wei-Hai Xu
BACKGROUND: The underlying pathophysiology of BA distribution is unclear and intriguing. Using high-resolution magnetic resonance imaging (HR-MRI), we sought to explore the plaque distribution of low-grade basilar artery (BA) atherosclerosis and its clinical relevance. METHODS: We retrospectively analyzed the imaging and clinical data of 61 patients with low-grade atherosclerotic BA stenosis (<50%). On HR-MRI, the plaques were categorized based on the involvement of the ventral, dorsal, or lateral sides of BA wall...
January 10, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28068928/newly-recognized-cerebral-infarctions-on-postmortem-imaging-a-report-of-three-cases-with-systemic-infectious-disease
#11
Sakon Noriki, Kazuyuki Kinoshita, Kunihiro Inai, Toyohiko Sakai, Hirohiko Kimura, Takahiro Yamauchi, Masayuki Iwano, Hironobu Naiki
BACKGROUND: Postmortem imaging (PMI) refers to the imaging of cadavers by computed tomography (CT) and/or magnetic resonance imaging (MRI). Three cases of cerebral infarctions that were not found during life but were newly recognized on PMI and were associated with severe systemic infections are presented. CASE PRESENTATIONS: An 81-year-old woman with a pacemaker and slightly impaired liver function presented with fever. Imaging suggested interstitial pneumonia and an iliopsoas abscess, and blood tests showed liver dysfunction and disseminated intravascular coagulation (DIC)...
January 10, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/27960164/clinical-stroke-syndromes
#12
REVIEW
Jong S Kim, Louis R Caplan
The main mechanism of stroke in patients who have extracranial atherosclerosis is artery to artery embolism, occasionally associated with hemodynamic disturbances. Although these mechanisms are also important in patients with intracranial atherosclerosis, branch occlusion and in-situ thrombotic occlusion play a relatively more important role in these patients. Accordingly, clinical stroke syndromes differ between extracranial atherosclerosis and intracranial atherosclerosis. In anterior circulation, middle cerebral artery atherosclerosis frequently produces subcortical infarction by way of branch occlusion...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27924054/frequency-and-predictors-of-dysphagia-in-patients-with-recent-small-subcortical-infarcts
#13
Simon Fandler, Thomas Gattringer, Sebastian Eppinger, Kathrin Doppelhofer, Daniela Pinter, Kurt Niederkorn, Christian Enzinger, Joanna M Wardlaw, Franz Fazekas
BACKGROUND AND PURPOSE: Detailed data on the occurrence of swallowing dysfunction in patients with recent small subcortical infarcts (RSSI) in the context of cerebral small vessel disease are lacking. This prompted us to assess the frequency of and risk factors for dysphagia in RSSI patients. METHODS: We identified all inpatients with magnetic resonance imaging-confirmed RSSI between January 2008 and February 2013. Demographic and clinical data were extracted from our stroke database, and magnetic resonance imaging scans were reviewed for morphological changes...
January 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27854093/posterior-reversible-encephalopathy-syndrome-mimicking-brainstem-infarction-a-dilemma
#14
Tsung-Han Ho, Chia-Lin Tsai, Yaw-Don Hsu, Jiunn-Tay Lee, Fu-Chi Yang, Chia-Ching Hsu, Chun-Chieh Lin
PURPOSE: We had recently reported one case at American Journal of Emergency Medicine about centralvariant posterior reversible encephalopathy syndrome (PRES) in an 84-year-old woman with an initial misdiagnosis as central pontine myelinolysis (CPM). Here, we introduce another case of centralvariant PRES in a 49-year-old man mimicking as acute brainstem infarction in the cranial computed tomography (CT) findings. CASE REPORT: A 49-year-old man was admitted to the emergency department with a 5-day history of vertigo, cognitive decline, and difficulty in walking...
June 15, 2016: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/27801767/pontine-warning-syndrome-a-chameleon-of-ischemic-stroke
#15
Alejandro Enriquez-Marulanda, Pablo Amaya-Gonzalez, Jorge L Orozco
INTRODUCTION: Crescendo transient ischemic attacks or "Stroke Warning Syndromes" consist of stereotyped frequent short-lasting episodes of focal neurological deficits. This is explained by intermittent hypoperfusion of the vascular territory of terminal arteries with insufficient collateral flow, presenting a high risk for subsequent infarction. Pontine warning syndrome (PWS) is a subtype of this atypical presentation of stroke/transient ischemic attack and is considered a challenge for diagnosis...
November 2016: Neurologist
https://www.readbyqxmd.com/read/27790399/acute-pontine-infarction-due-to-basilar-artery-dissection-from-strenuous-physical-effort-one-from-sexual-intercourse-and-another-from-defecation
#16
Su-Ho Kim, Yoon-Soo Lee, Sang-Jun Suh, Jeong-Ho Lee, Kee-Young Ryu, Dong-Gee Kang
A basilar artery dissection (BAD) is an extremely rare disease. It can lead to hemorrhage or infarction involving the brain stem, and is often associated with grave outcome. However, little is known about the pathophysiology of BAD, and its proper managements are yet in controversy. Herein, we report on two rare cases of basilar artery dissection from strenuous physical effort; one from sexual intercourse and another from defecation. The treatment modalities and the outcomes are also discussed.
June 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27783098/-degenerative-cerebellar-diseases-and-differential-diagnoses
#17
W Reith, S Roumia, P Dietrich
CLINICAL/METHODICAL ISSUE: Cerebellar syndromes result in distinct clinical symptoms, such as ataxia, dysarthria, dysmetria, intention tremor and eye movement disorders. STANDARD RADIOLOGICAL METHODS: In addition to the medical history and clinical examination, imaging is particularly important to differentiate other diseases, such as hydrocephalus and multi-infarct dementia from degenerative cerebellar diseases. Degenerative diseases with cerebellar involvement include Parkinson's disease, multiple system atrophy as well as other diseases including spinocerebellar ataxia...
November 2016: Der Radiologe
https://www.readbyqxmd.com/read/27781047/functional-independence-following-endovascular-treatment-for-basilar-artery-occlusion-despite-extensive-bilateral-pontine-infarcts-on-diffusion-weighted-imaging-refuting-a-self-fulfilling-prophecy
#18
Diogo C Haussen, Renato A C Oliveira, Vikas Patel, Raul G Nogueira
BACKGROUND AND PURPOSE: Extensive brainstem diffusion-weighted imaging (DWI) hyperintensity has been associated with poor outcomes. We aim at documenting a series of patients with extensive DWI pontine lesions who achieved independence following endovascular therapy and aggressive medical therapy in the setting of posterior circulation basilar artery occlusion (BAO). METHODS: This is a retrospective endovascular database review of a single-operator experience over a 9-year period for patients with (1) complete BAO, (2) extensive bilateral pontine DWI changes and (3) 90-day modified Rankin scale 0-2...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27707197/location-of-acute-infarcts-and-agitation-and-aggression-in-stroke
#19
Wai Kwong Tang, Xiang Xin Liu, Huajun Liang, Yang Kun Chen, Winnie Chiu Wing Chu, Anil T Ahuja, Jill Abrigo, Vincent Chung Tong Mok, Gabor S Ungvari, Ka Sing Wong, Gianfranco Spalletta
The role of the infarct location in the development of poststroke agitation (PSA) is largely unknown. This study examined the association between the locations of infarcts and PSA at 9 months following the index stroke in 213 patients with the Chinese version of the Neuropsychiatric Inventory. Compared with the non-PSA group, PSA patients had a higher number and volume of acute pontine infarcts. Ventral pontine and lateral cerebellar infarcts were independent predictors of PSA in the multivariate analysis.
2017: Journal of Neuropsychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/27666438/disruption-of-a-mir-29-binding-site-leading-to-col4a1-upregulation-causes-pontine-autosomal-dominant-microangiopathy-with-leukoencephalopathy
#20
Edgard Verdura, Dominique Hervé, Françoise Bergametti, Clémence Jacquet, Typhaine Morvan, Carol Prieto-Morin, Alexandre Mackowiak, Eric Manchon, Hassan Hosseini, Charlotte Cordonnier, Isabelle Girard-Buttaz, Sophie Rosenstingl, Christian Hagel, Gregor Kuhlenbaümer, Elena Leca-Radu, Didier Goux, Lauren Fleming, Tom Van Agtmael, Hugues Chabriat, Françoise Chapon, Elisabeth Tournier-Lasserve
OBJECTIVE: Cerebral small vessel disease (cSVD) is a heterogeneous group of disorders. Screening of known cSVD genes identifies the causative mutation in <15% of familial cSVD cases. We sought to identify novel causes of cSVD. METHODS: We used linkage analysis and exome sequencing to identify the causal mutation in a French cSVD family. The identified candidate gene was then screened in 202 cSVD unrelated probands, including 1 proband from the first reported pontine autosomal dominant microangiopathy with leukoencephalopathy (PADMAL) family...
November 2016: Annals of Neurology
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