cerebral locking syndrome

INTRODUCTION: There are no previously reported cases of locked-in syndrome occurring following cervical spinal surgery. We describe a case of locked-in syndrome following an elective cervical foraminotomy and discuss potential etiologies and contributing factors to our patient's presentation. CASE PRESENTATION: A 54-year-old male with a history of head and neck cancer and prior anterior cervical discectomy and fusion presented with neck pain following a motor vehicle accident...

How to cite this article: Finsterer J. Transient Locked-in Syndrome after Aneurysmal Subarachnoid Bleeding due to Spasm Hypoxemia? Indian J Crit Care Med 2024;28(1):86.

This is a description of the case of quite severe neurolisteriosis in an adult man resulting in the rare combination of neurological symptoms such as complete bilateral ophtalmoplegia and locked-in syndrome. The case illustrates clinical features that are special for this disorder and also highlights management of such patients.

BACKGROUND: Osmotic demyelination syndrome (ODS) with cerebral cortical involvement is a rare complication of severe hyponatremia correction. Careful management of hyponatremia is crucial, particularly in patients with risk factors, such as alcohol use disorder and diabetes insipidus. CASE: A patient in his 40s with a history of alcohol use disorder and central diabetes insipidus developed ODS after a 24 mEq/L osmolar increase during the treatment of hyponatremia...

BACKGROUND: Autism spectrum disorders (ASD) encompass a wide array of debilitating symptoms, including sensory dysfunction and delayed language development. Auditory temporal processing is crucial for speech perception and language development. Abnormal development of temporal processing may account for the language impairments associated with ASD. Very little is known about the development of temporal processing in any animal model of ASD. METHODS: In the current study, we quantify auditory temporal processing throughout development in the Fmr1 knock-out (KO) mouse model of Fragile X Syndrome (FXS), a leading genetic cause of intellectual disability and ASD-associated behaviors...

Locked-in syndrome (LiS) is a condition of motor paralysis involving all the voluntary muscles of 4 extremities with retained consciousness and alertness. Meanwhile, Takayasu arteritis (TA) is a systemic inflammatory disease affecting large arteries, including the aorta and the branches. This disease often affects the extracranial arteries but rarely occurs in the intracranial arteries. An 18-year-old male presented with a sudden onset of decreased consciousness and bilateral weakness. The patient exhibited normal horizontal and vertical eye movements but presented with impairment of the trigeminal nerve, peripheral-type facial palsy, absence of gag reflex and tongue movement, and neck weakness...

The Diving Bell and the Butterfly is a movie based on the true story of an editor-in-chief, Jean-Dominique Bauby, who had locked-in syndrome due to a cerebral infarction. He made an entire story by communication with his staff using solely eye movements. The patient's real emotions to the medical staff was presented in the movie. I would highly recommend this movie, and in this article, I explain and describe locked-in syndrome and my impressions of this movie.

Central pontine myelinolysis (CPM) is a rare demyelinating condition which has been reported to occur in a variety of clinical settings, but most commonly in association with a rapid rise in plasma osmolality during correction of chronic hyponatremia. The clinical consequences can vary from a mild motor weakness that resolves completely over time to the devastating locked-in syndrome. In this presentation, we report a case of hyperosmolar hyperglycemic syndrome (HHS) with ponto-occipital disintegration. A 71-year-old female was transferred to our ER by an ambulance due to consciousness disorder and continuous fever for 10 days...

PURPOSE: The cerebral ventricles deform in a non-uniform fashion in response to increased CSF volume and/or pressure in hydrocephalic syndromes. Current research is focused on volumetric analyses, while topological analysis of ventricular surfaces remains understudied. We developed a method of quantitatively modeling the curvature of ventricular surfaces to analyze changes in ventricular surfaces in normal pressure hydrocephalus (NPH) and Alzheimer's disease (AD), using the left frontal horn as an example...

Blunt cerebrovascular injury is a very rare complication of blunt trauma and a diagnostic challenge. A 14 year old male fell 10 m sustaining multi system trauma. The atypical Glasgow Coma Score was six with a fully preserved eye component. Initial whole-body CT scanning demonstrated multiple injuries but no obvious brain injury. Trauma management involved non-operative resuscitation and was successful, however profound coma occurred and brain stem reflexes disappeared on day two. Repeat brain CT scan demonstrated multiple cerebral and cerebellar ischemic lesions and no opacification of the vertebral or basilar arteries...

Objective : To investigate the clinical manifestations, magnetic resonance imaging (MRI) features, and prognosis of patients diagnosed with bilateral cerebral peduncular infarction (BCPI) with the 'Mickey Mouse ears' sign. Methods : This study, retrospectively summarized the clinical features, MRI and magnetic resonance angiography (MRA) manifestations, and prognosis of 5 patients diagnosed with BCPI and with the 'Mickey Mouse ears' sign from our hospital. In the meantime, we also systematically analyzed and summarized the clinical and imaging features, and prognosis in combination with relevant cases from the national and international literature that had been reported...

BACKGROUND: Diffuse cerebral angiomatosis (DCA) is a diffuse infiltration of normal brain by complex vascular structures. It differs from arteriovenous malformations (AVMs) that are composed of a nidus of vessels through which arteriovenous shunting occurs without interposed functional brain parenchyma. A rare subgroup of AVMs is diffuse with no recognizable nidus with functional neuronal tissue interspersed within the malformed vessels. We present a rare association of DCA and cerebral arterial aneurysm, which dramatically influenced the patient's prognosis...

Objective: To investigate the anatomical characteristics, clinical manifestations, and imaging features of bilateral cerebral peduncular infarction. Methods: A retrospective analysis was performed on 11 patients diagnosed with bilateral cerebral peduncular infarction in the Affiliated Hospital of Xuzhou Medical University from December 2014 to December 2018. Their clinical and imaging features were analyzed and summarized in combination with the relevant national and international literature. Results: Among all the patients, there were eight cases with a history of hypertension, four cases with a history of diabetes mellitus, and four cases with a history of smoking...

INTRODUCTION: Vertebrobasilar occlusion poses difficult diagnostic issues and even when properly diagnosed has a poor prognosis. Newer studies highlight a better outcome when thrombectomy was carried out between six and twenty-four hours after an initial diagnosis of stroke. This paper reports a case where a patient suffered a vertebrobasilar stroke secondary to a traumatic bilateral vertebral arteries dissection was treated with late thrombectomy. CASE PRESENTATION: A 34-year-old woman was manipulated on the cervical spinal column by a chiropractor...

In this review, our intension is to present imaging features of several categories of uncommon cases of brain infarctions including infarctions associated with neurovascular variants, infarctions along small arterial territories, and brainstem stroke syndromes. Infarctions associated with neurovascular variants include azygos anterior cerebral artery territory infarction and artery of Percheron infarction. In the second group, we discuss anterior choroidal artery infarction and artery of Heubner infarction...

In this review, our intension is to present imaging features of several categories of uncommon cases of brain infarctions including infarctions associated with neurovascular variants, infarctions along small arterial territories, and brainstem stroke syndromes. Infarctions associated with neurovascular variants include azygos anterior cerebral artery territory infarction and artery of Percheron infarction. In the second group, we discuss anterior choroidal artery infarction and artery of Heubner infarction...

Chimeric antigen receptor T-cell (CAR-T) therapy has proven to be a very effective cancer immunotherapy. Axicabtagene ciloleucel and tisagenlecleucel are the first-in-class anti-CD19 CAR-T currently available for relapsed/refractory adult large B-cell lymphoma. Tisagenlecleucel is also available for pediatric and young adult (up to age 25 years) patients with relapsed/refractory B-acute lymphoblastic leukemia. Cytokine release syndrome (CRS) and CAR-T-associated encephalopathy syndrome (neurotoxicity) are the most common adverse effects associated with CAR-T therapy...

Brain death (BD) is an irreversible cessation of functions of the entire brain, including the brainstem. The diagnosis of BD is made on clinical grounds and neurologic examination. In the United States, clinical criteria set by the American Academy of Neurology (AAN) emphasize 3 specific clinical findings to confirm BD, which include coma, absence of brainstem reflexes and apnea. Ancillary tests are needed when neurologic examination or apnea test cannot be performed. AAN recommended ancillary tests include electroencephalogram, which confirms electrical activity loss; catheter cerebral angiogram, which confirms loss of cerebral blood flow; as well as transcranial Doppler and nuclear scintigraphy...

The widely accepted concept of brain death (BD) comprises the demonstration of irreversible coma in combination with the loss of brainstem reflexes and irreversible apnea. In some countries the combined clinical finding of coma, apnea, and loss of all tested brainstem reflexes ("brainstem death") is sufficient for diagnosing BD irrespective of the primary location of brain lesion. The present article aims to substantiate the need for ancillary testing in patients with primary infratentorial brain lesions. Anatomically, the "brainstem-death" syndrome can theoretically occur without relevant lesion of the mesopontine tegmental reticular formation (MPT-RF)...

Augmentative and alternative communication (AAC) is typically used by people with severe speech and physical disabilities (SSPI) and is one of the main application areas for brain computer interface (BCI) technology. The target population includes people with cerebral palsy (CP), amyotrophic lateral sclerosis (ALS) and locked-in-syndrome (LIS). Word-based AAC systems are mainly faster than letter-based counterparts and are usually supplemented by icons to aid the users. Those iconbased AAC systems that use binary signaling methods such as single click can convert into a single input BCI systems such as ERP detection...