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https://www.readbyqxmd.com/read/27906952/conus-medullaris-infarction-after-a-right-l4-transforaminal-epidural-steroid-injection-using-dexamethasone
#1
Christopher G Gharibo, Michael Fakhry, Sudhir Diwan, Alan D Kaye
BACKGROUND: For decades, epidural steroid injections have been an effective tool in the management of many pain related conditions, including lumbar radiculopathy. Transforaminal epidural steroid injections in particular have been reported to potentially result in central nervous system infarctions which have not been reported with interlaminar epidural steroid injections, while providing comparable efficacy. This rare, catastrophic complication has been attributed by some authors to be due to vascular injury secondary to vasospasm, thrombus formation, dissection, as well as concerns with placing the needle at the so-called "safe triangle...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27867692/osteonecrosis-of-both-knees-in-a-woman-with-crohn-s-disease
#2
Mara Barbosa, José Cotter
Osteonecrosis is a very rare complication of Crohn's disease (CD). It is not clear if it is related to corticosteroid therapy or if it occurs as an extraintestinal manifestation of inflammatory bowel disease. We present the case of a patient with CD who presented with osteonecrosis of both knees. A 22 years old woman was diagnosed with CD in April 2012 (Montreal Classification A2L1 + L4B3p). She was started on prednisolone (40 mg/d), azathioprine (100 mg/d) and messalazine (3 g/d). In July 2012, due to active perianal disease, infliximab therapy was initiated...
November 6, 2016: World Journal of Gastrointestinal Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27829533/dermatomal-sensory-manifestations-in-opalski-syndrome
#3
Tomoya Kon, Yukihisa Funamizu, Tatsuya Ueno, Rie Haga, Haruo Nishijima, Akira Arai, Chieko Suzuki, Jinichi Nunomura, Masayuki Baba, Masahiko Tomiyama
A 31-year-old Japanese woman presented with sudden-onset unstable gait followed by nuchal pain. A neurological examination revealed right-sided limb weakness and decreased pain and thermal sensation on the left side below the level of the L1 dermatome. A lower lateral medullary infarction with ipsilateral hemiplegia, known as Opalski syndrome, caused by spontaneous vertebral artery dissection was diagnosed by magnetic resonance imaging. The spinothalamic tract in the medulla oblongata has a topographic arrangement of sensory fibers, and the dermatomal sensory deficit in this case can be explained in relation to that...
November 7, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27805839/prominent-cortical-and-medullary-veins-on-susceptibility-weighted-images-of-acute-ischaemic-stroke
#4
Seyedmehdi Payabvash, John C Benson, Shayandokht Taleb, Jeffrey B Rykken, Benjamin Hoffman, Mark C Oswood, Alexander M McKinney
OBJECTIVE: To determine the clinical and imaging implications of prominent cortical and medullary veins on susceptibility-weighted images (SWI) of patients with acute stroke. METHODS: Consecutive patients with acute ischaemic stroke who had SWI scan within 24 h of symptom onset or time last-seen-well were included. The SWI series were reviewed for the presence of prominent cortical and medullary veins and were graded independently by two neuroradiologists. The correlations between prominent vein grades with different imaging and clinical variables were determined...
December 2016: British Journal of Radiology
https://www.readbyqxmd.com/read/27744467/perfusion-weighted-imaging-in-the-assessment-of-the-pathology-and-outcomes-of-lateral-medullary-infarction
#5
Dao P Zhang, Hong T Zhang, Suo Yin, Fu L Yan
This series case report aimed to elucidate the underlying pathology and outcomes of lateral medullary infarction (LMI) using perfusion weighted imaging (PWI). Four patients were diagnosed with LMI based on high-field diffusion-weighted magnetic resonance imaging (MRI-DWI) and PWI. The national institutes of health stroke scale (NIHSS) scores were recorded on days 1, 7, and 30, and the Barthel index was assessed on days 7 and 30. Three patients exhibited relative regional hypoperfusion of medullary lesion in the perfusion maps...
October 2016: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/27703110/-isolated-severe-dysphagia-associated-with-medial-medullary-infarction-a-case-report-and-review-of-the-literature
#6
Keiko Tamaki, Jun Tsugawa, Takeshi Murakami, George Umemoto, Yoshio Tsuboi
A 59-year-old man developed a sudden onset of vertigo and nausea, and after a few hours, he could not swallow at all. On admission, neurological examination revealed severe dysphagia associated with other transient and mild neurological deficits, including left facial paresis, and hypesthesia in the right side of his body. MRI with diffusion weighted imaging showed a hyperintense signal lesion at the left rostral medial region of the medulla, prompting the diagnosis of an acute medial medullary infarction. His facial paresis and hypesthesia disappeared within 2 weeks...
October 2016: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/27680211/critical-neural-targets-for-the-level-of-human-consciousness-arousal-arrest-and-unconsciousness-after-sumatriptan-administration
#7
Jaakko W Långsjö, Kai Lehtimäki, Jyrki Ruohonen, Anne Sajanti, Satu Sandell, Hannu T Heikkilä, Antti Brander, Kari Saarinen, Lauri Herrala
BACKGROUND: Insufficient understanding of the mechanisms of consciousness can make unconsciousness a diagnostic challenge, directly effecting the treatment and the outcome of the patient. Consciousness is a product of brainstem arousal (wakefulness, the level of consciousness) and cortical information integration (awareness, the contents of consciousness). The thalamus serves as a critical hub in the arousal pathway. The nuclei within the internal medullary lamina, together with the associated thalamocortical connections, have been implicated as being especially important for human consciousness...
September 28, 2016: Brain Injury: [BI]
https://www.readbyqxmd.com/read/27651873/inadvertent-complication-of-a-pipeline-embolization-device-for-treatment-with-vertebral-artery-dissecting-aneurysm-distal-tip-fracture-of-delivery-wire
#8
Jung Soo Park, Hyo Sung Kwak, Jong Myong Lee
Use of the Pipeline embolization device (PED) has increased based on studies about its safety and effectiveness, and new reports that describe peri- or postprocedural complications are now emerging. We report a rare periprocedural device-related complication that occurred during endovascular treatment with the pipeline embolization device for a dissecting aneurysm on the vertebral artery. A 55-year old woman was admitted due to left medullary infarction, and angiography showed a fusiform dilatation in the left vertebral artery that was suspicious for dissecting aneurysm...
September 2016: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/27624122/altered-processing-of-otolithic-information-in-isolated-lateral-medullary-infarction
#9
Hyo-Jung Kim, Seoyeon Kim, Jae Han Park, Ji-Soo Kim
Ocular and cervical vestibular-evoked myogenic potentials (VEMPs) evaluate the function of otolithic pathways in central as well as peripheral vestibular disorders. This study aimed to determine the associations and dissociations of otolithic dysfunction in lateral medullary infarction (LMI), the most well-known disorder of central vestibulopathy. At the Dizziness Clinic of a referral-based University Hospital, 45 patients with isolated LMI (28 men, mean age = 55.6 ± 12.5) had evaluation of the ocular tilt reaction (OTR), tilt of the subjective visual vertical (SVV), and ocular and cervical VEMPs from Janurary 2011 to August 2015 during the acute phase, 1-11 days from the symptom onset (median = 2 days)...
December 2016: Journal of Neurology
https://www.readbyqxmd.com/read/27614629/anterior-disco-osteo-arterial-conflict-as-a-cause-of-intersegmental-arterial-flow-impairment-and-spinal-cord-ischemia
#10
Natalie Ullman, Lydia Gregg, Daniel Becker, Carlos Pardo, Philippe Gailloud
INTRODUCTION: This article describes anterior disco-osteo-arterial conflict as an insofar unsuspected mechanism of arterial flow impairment potentially leading to spinal cord ischemia and infarction. METHODS: The anterior disco-osteo-arterial conflict described in this report is illustrated with angiographic observations of patients presenting with spinal cord ischemia documented by MRI, and radiculomedullary flow impairment diagnosed by spinal digital subtraction angiography and spinal CTA...
September 10, 2016: Neuroradiology
https://www.readbyqxmd.com/read/27538643/spontaneous-headshaking-and-positional-nystagmus-in-post-lateral-medullary-infarction-dizziness
#11
Kazumitsu Amari, Yosuke Kudo, Kosuke Watanabe, Masahiro Yamamoto, Koji Takahashi, Osamu Tanaka, Ken Johkura
BACKGROUND AND PURPOSE: Lateral medullary infarction (LMI) sometimes causes long-lasting dizziness. However, the characteristics of nystagmus in patients with post-LMI dizziness are unknown. We undertook a prospective, comparative study of nystagmus in patients with and without post-LMI dizziness to determine the characteristic pattern of nystagmus of chronic post-LMI dizziness. METHODS: We evaluated and compared nystagmus under spontaneous, head-shaking, and positional testing conditions in 12 patients with post-LMI dizziness and in 6 patients without post-LMI dizziness...
September 15, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27444755/proliferation-and-recruitment-contribute-to-myocardial-macrophage-expansion-in-chronic-heart-failure
#12
Hendrik B Sager, Maarten Hulsmans, Kory J Lavine, Marina B Moreira, Timo Heidt, Gabriel Courties, Yuan Sun, Yoshiko Iwamoto, Benoit Tricot, Omar F Khan, James E Dahlman, Anna Borodovsky, Kevin Fitzgerald, Daniel G Anderson, Ralph Weissleder, Peter Libby, Filip K Swirski, Matthias Nahrendorf
RATIONALE: Macrophages reside in the healthy myocardium, participate in ischemic heart disease, and modulate myocardial infarction (MI) healing. Their origin and roles in post-MI remodeling of nonischemic remote myocardium, however, remain unclear. OBJECTIVE: This study investigated the number, origin, phenotype, and function of remote cardiac macrophages residing in the nonischemic myocardium in mice with chronic heart failure after coronary ligation. METHODS AND RESULTS: Eight weeks post MI, fate mapping and flow cytometry revealed that a 2...
September 16, 2016: Circulation Research
https://www.readbyqxmd.com/read/27356660/conus-medullaris-stroke-does-f-wave-predict-return-of-ambulation
#13
Mohammed H Alanazy
Absent F wave in the stage of spinal shock has been described in cases of traumatic spinal cord injury. The role of F wave in predicting prognosis after conus medullaris infarct has not been described. We describe herein a middle aged-man with a conus medullaris infarct. Both tibial and peroneal F waves were absent on day 4. The left tibial F wave reappeared in the following study on day 18. All F waves reappeared on day 56 at which time the patient was still wheelchair bound. He regained walking on day 105...
July 2016: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/27284303/relationship-between-deep-medullary-veins-in-susceptibility-weighted-imaging-and-ipsilateral-cerebrovascular-reactivity-of-middle-cerebral-artery-in-patients-with-ischemic-stroke
#14
Xianjun Han, Linhui Ouyang, Chunning Zhang, Hailing Ma, Jingcui Qin
Deep cerebral veins have been recently associated with the severity of hemodynamic impairment in moyamoya disease. The aim of the current study was to determine the correlation of deep medullary veins (DMVs) in susceptibility-weighted imaging (SWI) with ipsilateral cerebrovascular reactivity (CVR) of and anterior cecebrocervical artery stenosis in patients with ischemic stroke. Patients with unilateral TIA or infarction who underwent 3.0 T magnetic resonance imaging SWI, digital subtraction angiography and transcranial Doppler with CO2 stimulation within the first 7 days of hospitalization were retrospectively selected...
June 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27228995/bidirectional-signalling-between-epha2-and-ephrina1-increases-tubular-cell-attachment-laminin-secretion-and-modulates-erythropoietin-expression-after-renal-hypoxic-injury
#15
Stéphane Rodriguez, Stefan Rudloff, Katrin Franziska Koenig, Swapna Karthik, David Hoogewijs, Uyen Huynh-Do
Acute kidney injury (AKI) is common in hospitalized patients and has a poor prognosis, the severity of AKI being linked to progression to chronic kidney disease. This stresses the need to search for protective mechanisms during the acute phase. We investigated kidney repair after hypoxic injury using a rat model of renal artery branch ligation, which led to an oxygen gradient vertical to the corticomedullary axis. Three distinct zones were observed: tubular necrosis, infarction border zone and preserved normal tissue...
August 2016: Pflügers Archiv: European Journal of Physiology
https://www.readbyqxmd.com/read/27226002/medullary-infarction-causing-coexistent-sunct-and-trigeminal-neuralgia
#16
Giorgio Lambru, Michele Trimboli, Veronica S Tan, Adnan Al-Kaisy
BACKGROUND: Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) or with autonomic symptoms (SUNA) are grouped together within the trigeminal autonomic cephalalgias (TACs). However, the SUNCT and SUNA phenotype and management overlap with those of trigeminal neuralgia (TN). Additionally, a broad variety of cerebral pathologies are reportedly able to trigger either TN- or SUNCT-like pain, and emerging structural neuroimaging findings suggest the possible role of neurovascular conflict with the trigeminal nerve in SUNCT, further supporting aetiological and pathophysiological overlaps among SUNCT, SUNA and TN...
May 24, 2016: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/27206871/ipsilateral-hemiparesis-in-lateral-medullary-infarction-clinical-investigation-of-the-lesion-location-on-magnetic-resonance-imaging
#17
Masahiro Uemura, Hiroaki Naritomi, Hisakazu Uno, Arisa Umesaki, Kotaro Miyashita, Kazunori Toyoda, Kazuo Minematsu, Kazuyuki Nagatsuka
BACKGROUND: In 1946, Opalski reported two cases of Wallenberg syndrome with ipsilateral hemiparesis (IH). His hypothesis seems to be based on the view that IH is caused by post-decussating pyramidal tract damage. Afterwards, other researchers proposed a different hypothesis that ipsilateral sensory symptoms of limbs (ISSL) or ipsilateral limb ataxia (ILA) caused by lateral medullary infarction (LMI) might lead to ipsilateral motor weakness. The present study is aimed to clarify whether IH in LMI patients is attributable mainly to ISSL/ILA or disruption of ipsilateral post-decussating pyramidal tract...
June 15, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27143185/-the-clinical-radiological-and-prognostic-factor-analysis-of-medullary-infarction
#18
A P Sun, X Y Liu, Q L Sun, L Chen, X L Liu, D S Fan
OBJECTIVE: To investigate the clinical and radiological features of medullary infarction (MI), and to compare the clinical characteristics of lateral medullary infarction (LMI) and medial medullary infarction (MMI). METHODS: Patients diagnosed as acute MI who were treated from January 2009 to December 2014 in Department of Neurology, Peking University Third Hospital, were retrospectively enrolled in the study and data were analyzed including risk factors, clinical features, laboratory findings, radiological characteristics, etiology and outcomes...
May 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/27082966/surfer-s-myelopathy-a-rare-form-of-spinal-cord-infarction-in-novice-surfers-a-systematic-review
#19
Brett A Freedman, David G Malone, Peter A Rasmussen, Jason M Cage, Edward C Benzel
BACKGROUND: Surfer's myelopathy is a rare, acute, atraumatic myelopathy that occurs in novice surfers. OBJECTIVE: To review the literature and to present an illustrative case. METHODS: Medical literature was queried for all reports of this condition, systematically abstracted, and analyzed. An illustrative case that provides the most definitive support for a vascular cause is presented. Treatment considerations based on prior cases and expert opinions are provided...
May 2016: Neurosurgery
https://www.readbyqxmd.com/read/26954960/bilateral-medial-medullary-infarction-with-a-heart-appearance-sign
#20
Muhammed Jasim Abdul Jalal, Murali Krishna Menon
No abstract text is available yet for this article.
March 2016: Neurology India
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