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https://www.readbyqxmd.com/read/28724595/hypertensive-encephalopathy-mimicking-cerebral-vasculitis-with-pontine-oedema-cerebellar-white-matter-lesions-and-multiple-cerebral-infarctions
#1
Daniela Ceccarelli, David Hargroves, Ibrahim Balogun, Thomas Webb
A 47-year-old man with poorly controlled hypertension presented with headaches, right-sided weakness and dysarthria. CT and MRI scans of the brain showed widespread abnormalities including significant pontine oedema, basal ganglia and corona radiata infarctions and cerebellar white matter high signal. Imaging of the intracerebral vasculature also demonstrated wall irregularities. Initially a central nervous system inflammatory disorder was thought to be the most likely diagnosis, possibly acute demyelinating encephalomyelitis or cerebral vasculitis, and the patient was treated with high-dose intravenous steroids...
July 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28638704/lipid-and-hyperglycemia-factors-in-first-ever-penetrating-artery-infarction-a-comparison-between-different-subtypes
#2
Shaoyang Sun, Yanqiang Wang, Yuge Wang, Xuejiao Men, Jian Bao, Xueqiang Hu, Zhengqi Lu
BACKGROUND: The pathogenesis and progression of branch atheromatous disease (BAD), which differs from lipohyalinotic degeneration (LD), remains controversial. Few studies have investigated the lipid indices and glycometabolism status factors for BAD in first-ever penetrating artery infarction (PAI). METHODS: We retrospectively examined acute stroke patients with PAI admitted within 3 days after stroke. All patients underwent diffusion weight magnetic resonance imaging (DWI) and magnetic resonance angiography (MRA) and/or computed tomography angiography (CTA)...
June 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28567027/transient-vestibulopathy-in-wallenberg-s-syndrome-pathologic-analysis
#3
Jorge C Kattah, Ali S Saber Tehrani, Sigrun Roeber, Meena Gujrati, Sarah E Bach, David E Newman Toker, Ari M Blitz, Anja K E Horn
OBJECTIVE: To report an unusual lateral medullary stroke (LMS) associated with transient unidirectional horizontal, nystagmus, and decreased horizontal vestibulo-ocular reflex (h-VOR) gain that mimicked a peripheral vestibulopathy. MRI suggested involvement of caudal medial vestibular nucleus (MVN); however, the rapid resolution of the nystagmus and improved h-VOR gain favored transient ischemia without infarction. Decreased h-VOR gain is expected with peripheral vestibular lesions within the labyrinth or superior vestibular nerve; less frequently lateral pontine strokes involving the vestibular root entry, the vestibular fascicle, or neurons within the MVN may be responsible...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28559083/superior-petrosal-vein-sacrifice-during-microvascular-decompression-perioperative-complication-rates-and-comparison-with-venous-preservation
#4
Brandon D Liebelt, Sean M Barber, Viren R Desai, Richard Harper, Jonathan Zhang, Rob Parrish, David S Baskin, Todd Trask, Gavin W Britz
OBJECTIVE: To investigate potential effect of sacrifice of the superior petrosal vein (SPV) on postoperative complications after microvascular decompression (MVD). METHODS: Retrospective review of 98 consecutive patients undergoing MVD of cranial nerve V was performed. Frequency of division of the SPV during surgery was recorded, and postoperative complications and imaging were recorded and analyzed. In patients with complications, the specific anatomic variation of the superior petrosal venous complex was noted...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28542605/voxelwise-distribution-of-acute-ischemic-stroke-lesions-in-patients-with-newly-diagnosed-atrial-fibrillation-trigger-of-arrhythmia-or-only-target-of-embolism
#5
Timolaos Rizos, Andreas J Bartsch, Timothy D Johnson, Felix Dittgen, Thomas E Nichols, Uwe Malzahn, Roland Veltkamp
OBJECTIVE: Atrial fibrillation (AF) is frequently detected after ischemic stroke for the first time, and brain regions involved in autonomic control have been suspected to trigger AF. We examined whether specific brain regions are associated with newly detected AF after ischemic stroke. METHODS: Patients with acute cerebral infarctions on diffusion-weighted magnetic resonance imaging were included in this lesion mapping study. Lesions were mapped and modeled voxelwise using Bayesian Spatial Generalised Linear Mixed Modeling to determine differences in infarct locations between stroke patients with new AF, without AF and with AF already known before the stroke...
2017: PloS One
https://www.readbyqxmd.com/read/28471893/midbrain-infarction-resulting-in-bilateral-pseudoabducens-palsies
#6
Bonnie M Kaas, David S Zee, Amir Kheradmand, Daniel R Gold
INTRODUCTION: Pseudoabducens palsy refers to abduction paresis in the absence of a pontine or peripheral nerve process. This finding has been described with mesodiencephalic lesions, and likely has a common mechanism with thalamic esotropia. CASE REPORT: We describe the case of a 55-year-old man who presented with near-complete ophthalmoparesis, sparing only adduction of the left eye. Magnetic resonance imaging of the brain demonstrated midbrain infarction. CONCLUSIONS: Pseudoabducens palsy is likely underrecognized, but can be highly localizing when identified...
May 2017: Neurologist
https://www.readbyqxmd.com/read/28453595/-eyelid-retraction-of-neurologic-origin-report-of-three-cases
#7
Luis Cartier R, Jorge Guzmán S, Renzo Pasquali F
Eyelid retraction, has received limited attention and it has passively been interpreted as the result of an overactive levator palpebrae superioris muscle secondary to midbrain injury. However, eyelid retractions can occur in other neurological diseases, not directly related with the midbrain. We report three patients who developed eyelid retraction. One patient had a bilateral eyelid retraction, related with Creutzfeldt-Jakob disease (CJD). Another patient had a unilateral right eyelid retraction associated with a thalamic-mesencephalic infarct...
February 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28406779/classic-raymond-syndrome
#8
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
#9
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...
May 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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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