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https://www.readbyqxmd.com/read/28094079/a-stroke-mimic-methotrexate-induced-neurotoxicity-in-the-emergency-department
#1
Patrick Rogers, Wilbur J Pan, Richard A Drachtman, Christopher Haines
BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common form of childhood leukemia. The treatment of ALL involves multimodality therapy, and methotrexate (MTX) remains a mainstay of treatment. A complication of MTX therapy includes acute, subacute, and chronic neurotoxocity. Signs and symptoms may range from headaches, dizziness, and mood disorders to seizures and stroke-like symptoms. CASE REPORT: An 18-year-old woman with a history of ALL presented to the emergency department with acute onset of right-sided facial paralysis, right upper extremity flaccid paralysis, and right lower extremity weakness after receiving MTX therapy 3 days earlier...
January 13, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28094022/a-case-report-of-an-adolescent-with-cluster-headaches-following-neck-trauma-coincidence-or-trigger
#2
Agnieszka Biedroń, Marek Kaciński, Małgorzata Steczkowska, Anna Świerczyńska
Posttraumatic headaches usually have tension-type or migraine-like characteristics. A correlation between head trauma and cluster headaches (CH) has been previously reported. CH in children are rare and require thorough differential diagnosis. We present an original case of a 15-year-old boy with cluster headaches associated with allodynia probably evoked by a neck trauma. Severe headache attacks started one month after neck trauma. At the beginning clinical presentation of our patient's headaches was very misleading...
January 10, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28050478/multiple-cerebrovascular-complications-due-to-sphenoid-sinusitis
#3
Raghu Teja Sadineni, Sandeep Velicheti, Chandra Sekhar Kondragunta, Narayan Chander Bellap
Sphenoiditis is of particular interest because the sphenoid sinus has thin wall and its special anatomical location facilitate dissemination of infection to many intracranial structures including vascular structures. The main objective of this report is to gain insight into patterns of presentation and imaging findings in cerebrovascular complications of sphenoid sinusitis and to emphasize the need of reviewing Brain Computed Tomography Scan in all windows. This is a report of 32-year-old young female presented with fever and headache who was diagnosed to have sphenoid sinusitis after radiological examination...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28043726/an-unusual-cause-of-unilateral-sixth-nerve-palsy
#4
Mehran Sotoodehnia, Arash Safaei, Fatemeh Rasooli, Maryam Bahreini
BACKGROUND: The diagnosis of cerebral venous sinus thrombosis still remains a real challenge. Seizure, unusual headache with sudden onset, unexplained persistently unilateral vascular headache and neurologic deficit-which is difficult to be attributed to a vascular territory are some of the suggestive symptoms. CASE: An isolated sixth nerve palsy is discussed as a rare presentation for cerebral venous thrombosis. Following the extensive investigation to rule out other possible diagnoses, magnetic resonance venogram revealed the final etiology of sixth nerve palsy that was ipsilateral left transverse sinus thrombosis; therefore, anticoagulant treatment with low molecular weight heparin was administered...
December 12, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28002537/cerebral-arteriopathy-with-subcortical-infarcts-and-leukoencephalopathy-in-acromegalic-patient-with-severe-headache
#5
LuminiŢa Nicoleta Cima, Simona Vasilica Fica, Alice Ioana Albu, Ioana Maria Lambrescu, Ioana SmărăndiŢa Lăcău, Bogdan Ovidiu Popescu, Mihaela Gherghiceanu, Corin Virgil Badiu, Carmen Gabriela Barbu
A 68-year-old female patient was admitted in our clinic with severe frontal bilateral headache, dizziness, depression and cognitive decline in the context of a previously diagnosed acromegaly. She also had high blood pressure, dyslipidemia, secondary diabetes mellitus. Acromegaly was caused by a growth hormone (GH) secreting-pituitary macroadenoma, so a transsphenoidal surgery was performed. The postoperative magnetic resonance imaging (MRI) scan revealed a 20÷22÷25 mm pituitary mass remnant and medical therapy with somatostatin analogues (SSAs) was started...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/27999539/an-overview-of-systematic-reviews-of-ginkgo-biloba-extracts-for-mild-cognitive-impairment-and-dementia
#6
REVIEW
Hong-Feng Zhang, Li-Bo Huang, Yan-Biao Zhong, Qi-Hui Zhou, Hui-Lin Wang, Guo-Qing Zheng, Yan Lin
Ginkgo biloba extracts (GBEs) have been recommended to improve cognitive function and to prevent cognitive decline, but earlier evidence was inconclusive. Here, we evaluated all systematic reviews of GBEs for prevention of cognitive decline, and intervention of mild cognitive impairment (MCI) and dementia. Six databases from their inception to September 2015 were searched. Ten systematic reviews were identified, including reviews about Alzheimer's disease (n = 3), about vascular dementia (n = 1), about both Alzheimer's disease and vascular dementia (n = 2), about Alzheimer's disease, vascular dementia and mixed dementia (n = 3), and a review about MCI (n = 1)...
2016: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/27984052/beta-adrenergic-receptor-blockers-in-hypertension-alive-and-well
#7
William H Frishman
βeta-Adrenergic receptor blockers (β-blockers) are an appropriate treatment for patients having systemic hypertension (HTN) who have concomitant ischemic heart disease (IHD), heart failure, obstructive cardiomyopathy, aortic dissection or certain cardiac arrhythmias. β-blockers can be used in combination with other antiHTN drugs to achieve maximal blood pressure control. Labetalol can be used in HTN emergencies and urgencies. β-blockers may be useful in HTN patients having a hyperkinetic circulation (palpitations, tachycardia, HTN, and anxiety), migraine headache, and essential tremor...
October 27, 2016: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/27975139/foramina-parietalia-permagna-familial-and-radiological-evaluation-of-two-cases-and-review-of-literature
#8
Larissa Gabor, Huseyin Canaz, Gokhan Canaz, Nursu Kara, Elif Yilmaz Gulec, Ibrahim Alatas
PURPOSE: Foramina parietalia permagna is a variable intramembranous ossification defect of the parietal bones. Foramina parietalia permagna have an autosomal dominant inheritance, and it is showed that mutations in chromosome 5 and 11 are causing this anomaly. Enlarged parietal foramina occurs extremely rare. They are usually asymptomatic, but occasional headache, vomiting, pain over unprotected cerebral cortex, and seizures may be experienced by the patients. In the literature, some associated congenital bony defects, soft tissue pathologies, underlying neuronal deficits, and vascular variations have been described...
December 14, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27940753/a-5-year-old-with-fever-headache-neck-stiffness-and-leg-pain
#9
Joy Solano, Grace Winningham, Duha Al Zubeidi, Angela Myers
A 5-year-old boy presented with fever, headache, fatigue, neck stiffness, and 2 episodes of nocturnal urinary incontinence, prompting a visit to the emergency department. He had experienced intermittent frontal headaches and leg and buttock pain for several months, which had worsened over the previous 2 weeks. His history was notable for a spinal hemangioma with vascular tract, but he was otherwise healthy. On examination, he was febrile and tachycardic. He held his neck slightly rotated to the right with limited range of motion in all directions due to pain...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27925184/a-case-report-about-cluster-tic-syndrome-due-to-venous-compression-of-the-trigeminal-nerve
#10
Ilse de Coo, J Marc C van Dijk, Jan D M Metzemaekers, Joost Haan
BACKGROUND: The term "cluster-tic syndrome" is used for the rare ipsilateral co-occurrence of attacks of cluster headache and trigeminal neuralgia. Medical treatment should combine treatment for cluster headache and trigeminal neuralgia, but is very often unsatisfactory. CASE: Here, we describe a 41-year-old woman diagnosed with cluster-tic syndrome who underwent microvascular decompression of the trigeminal nerve, primarily aimed at the "trigeminal neuralgia" part of her pain syndrome...
December 7, 2016: Headache
https://www.readbyqxmd.com/read/27923749/spinal-glomus-arteriovenous-malformation-manifesting-with-a-subarachnoid-hemorrhage
#11
Badih Daou, Elias Atallah, Fadi Al-Saiegh, Kenan Alkhalili, Stavropoula Tjoumakaris, Robert H Rosenwasser, Pascal Jabbour
BACKGROUND: Spinal arteriovenous malformations (AVMs) are rare lesions that may cause serious neurologic morbidity. With developments in endovascular technology and embolic materials, endovascular management of spinal AVMs has gained popularity. CASE DESCRIPTION: A 61-year-old woman presented with the worst headache of her life and an acute onset of nausea and vomiting and was shown to have a grade 2 subarachnoid hemorrhage (SAH) on computed tomography scan. A 6-vessel cerebral angiogram was negative for any vascular abnormalities...
December 3, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27917332/a-rare-case-of-diploic-venous-anomaly-asymptomatic-venous-sac-expanding-in-the-diploe
#12
Hirokazu Iwamuro, Shunsuke Ikeda, Makoto Taniguchi
BACKGROUND: Vascular anomalies accompanied with the diploic veins are rare. Among them, sinus pericranii, which is characterized by abnormal connections between intra- and extracranial venous systems, is relatively common. Besides sinus pericranii, a few cases of subepicranial varix with connections to diploic veins have been reported, but these varices had no connections to intracranial venous sinuses. Herein, we present a rare case of an expanding venous sac in the diploe which communicated with the intracranial sinus but not with the extracranial venous systems...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27904122/triptan-induced-reversible-cerebral-vasoconstriction-syndrome-two-case-reports-with-a-literature-review
#13
Yuji Kato, Takeshi Hayashi, Satoko Mizuno, Yohsuke Horiuchi, Masayuki Ohira, Norio Tanahashi, Masaki Takao
We encountered two patients with sumatriptan-induced reversible cerebral vasoconstriction syndrome (RCVS). The present patients were taking sumatriptan for the first time because they had been tentatively diagnosed with a migraine. On reviewing the literature, we found nine other cases of triptan-induced RCVS, predominantly among women aged 30 to 40 years. RCVS has been precipitated by triptan at the first ever use, after daily use, and even with long-term use at a normal dose. Patients with acute onset of severe headache should be thoroughly evaluated, and triptan should be administered appropriately...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27890189/diplopia-what-to-double-check-in-radiographic-imaging-of-double-vision
#14
REVIEW
Claudia F E Kirsch, Karen Black
When patients see double with both eyes open, known as "binocular diplopia," this may be a harbinger of underlying life-threatening causes. This article presents pertinent anatomy, critical abnormality, and radiographic features that should be double checked for in diplopia. Key areas requiring a double check using the acronym VISION include Vascular, Infectious and Inflammatory, the Scalp for giant cell arteritis, Sphenoid and Skull base in trauma, Increased intracranial pressure (pseudotumor cerebri), Onset of new headaches or psychosis, and Neoplasm...
January 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/27884882/lymphomatosis-cerebri-diagnostic-challenges-and-review-of-the-literature
#15
Paul J Lee, Idanis Berrios, Carolina Ionete, Thomas Smith
Lymphomatosis cerebri (LC) is a rare variant of a primary central nervous system non-Hodgkin's lymphoma (PCNSL) characterised by diffuse infiltration of tumour cells throughout the brain parenchyma. We present a 68-year-old immunocompetent woman with headaches, dizziness, blurred vision, localised right leg weakness and rapidly progressive dementia. A brain MRI demonstrated diffuse T2 hyperintense white matter lesions that did not enhance with contrast. The clinical differential diagnosis of these lesions included metastatic disease, infectious or inflammatory process such as sarcoidosis, lymphoma, demyelinating disease and less likely vascular aetiology, such as vasculitis or ischaemic stroke...
November 24, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27874892/idiopathic-livedo-racemosa-presenting-with-splenomegaly-and-diffuse-lymphadenopathy
#16
Laura Bukavina, Joshua Weaver, Teri Nagy, Robert T Brodell, Eliot N Mostow
Sneddon syndrome (SS) is a rare condition and the diagnosis is made only when other more common disease entities have been excluded. Common manifestations in SS patients include hypertension, coronary artery disease, venous thrombosis, miscarriages, psychiatric disturbances, and arterial and venous thrombotic events. Most patients present in their early 30s with classic neurovascular and dermatologic signs. Currently, the main criteria for the diagnosis of SS include livedo racemosa, focal neurological deficits or evidence of stroke on magnetic resonance imaging, or characteristic vascular alterations seen on biopsy...
October 2016: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/27861830/hemicrania-continua-beneficial-effect-of-non-invasive-vagus-nerve-stimulation-in-a-patient-with-a-contraindication-for-indomethacin
#17
Ozan Eren, Andreas Straube, Florian Schöberl, Christoph Schankin
Hemicrania continua (HC) is a primary chronic headache disorder, characterized by a continuous and strictly unilateral headache, with possible cranial autonomic symptoms during episodes of pain exacerbation. The unilateral headache generally responds well to indomethacin; however, continuous indomethacin intake is often not tolerated due to severe adverse effects, like hypertension, gastrointestinal discomfort (especially if combined with aspirin), slightly increased risk of vascular events, and bronchial spasms...
November 11, 2016: Headache
https://www.readbyqxmd.com/read/27858938/triptans-and-third-nerve-paresis-a-case-series-of-three-patients
#18
E S Novitskaya, C A Cates, O M Bowes, A J Vivian
PurposeThe aim of this report is to increase awareness of a possible association between cranial nerve paresis and the use of sumatriptan in migraine sufferers, particularly in patients who have additional vascular risk factors.Patients and methodsWe describe a series of three cases where third nerve paresis developed in patients who were treated with the oral form of sumatriptan. All of the patients had a clear history of repetitive migraine headache and none of them had previous third nerve paresis.ConclusionAmong a variety of medications for the treatment of migraine, there are some drugs with vasoconstrictive effects, particularly triptans...
November 18, 2016: Eye
https://www.readbyqxmd.com/read/27857870/persistent-trigeminal-artery-in-endonasal-resection-of-skull-base-tumors-a-systematic-review
#19
Jasper Shen, James Tourje, Elena E Chang, Adam N Mamelak, Arthur W Wu
Background Primitive persistent trigeminal artery (PTA) is an uncommon embryologic vascular communication between the carotid and basilar arteries, which can be intimately involved by skull base tumors (SBT). Owing to its rarity, skull base surgeons should familiarize themselves with the anatomical variations of PTA to avoid catastrophic complications. Objective To appraise and summarize the available evidence of PTA involved by SBTs while advocating a standardized algorithm for the surgical planning of these patients...
December 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27847770/delayed-rebleeding-of-cerebral-aneurysm-misdiagnosed-as-traumatic-subarachnoid-hemorrhage
#20
Seung-Yoon Song, Dae-Won Kim, Jong-Tae Park, Sung-Don Kang
An intracranial saccular aneurysm is uncommonly diagnosed in a patient with closed head trauma. We herein present a patient with delayed rebleeding of a cerebral aneurysm misdiagnosed as traumatic subarachnoid hemorrhage (SAH). A 26-year-old female visited our emergency department because of headache after a motorcycle accident. Brain computed tomography (CT) showed a right-side dominant SAH in Sylvian fissure. Although traumatic SAH was strongly suggested because of the history of head trauma, we performed a CT angiogram to exclude any vascular abnormalities...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
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