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25 papers 0 to 25 followers 小僧悟道
Elizabeth Spurgeon, Justin Abbatemarco, Richard Prayson, Mary Willis
Sarcoidosis is a multisystem granulomatous disease that can cause a wide range of neurologic symptoms. Leptomeningeal enhancement is frequently described but reports of stroke-like symptoms or the appearance of ischemia on magnetic resonance imaging are rare. We present a case of a patient with both leptomeningeal enhancement and multifocal restricted diffusion in a patient with sarcoidosis.
July 25, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Claudia-Alexandrina Irimie, Mihai Vârciu, Marius Irimie, Petru-Iulian Ifteni, Dan-Ioan Minea
BACKGROUND: Several studies have shown that high level of plasma C-reactive protein (CRP) is associated with stroke outcomes and future vascular events, and a decrease in serum triiodothyronine (T3) was reported to be associated with stroke severity and poor prognosis. OBJECTIVE: The goal of this study is to evaluate CRP and T3 as independent predictors of poor functional and cognitive outcomes in patients with acute ischemic stroke at hospital discharge. METHODS: This study evaluated 120 patients who were admitted to the Clinical Hospital of Neurology and Psychiatry Brasov, between July 2016 and January 2017...
July 25, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Thomas Grüter, Ilya Ayzenberg, Anna Gahlen, Janina Kneiphof, Ralf Gold, Ingo Kleiter
BACKGROUND: Neuromyelitis optica spectrum disorders (NMOSD) typically lead to spastic paraparesis and spare the peripheral nervous system (PNS). CASE REPORT: Here, we describe an anti-aquaporin-4-seropositive NMOSD patient suffering from acute transverse myelitis with painful, flaccid paralysis and incontinence of urine and feces. Due to the involvement of the PNS as indicated by electrodiagnostic examination, we verified the expression of aquaporin-4-channels on the proximal dorsal spinal radix of rats by staining rat tissue with human NMOSD serum...
July 20, 2018: Multiple Sclerosis and related Disorders
Alex Guri, Eric Scheier, Yael Garty
A 12-year-old girl presented with red spots appearing on the left side of her face. The girl was usually healthy and fully vaccinated, including varicella vaccination.Six years prior to her presentation, she had suffered an episode of blister rash on the left side of her face, including lesions in the ear canal and buccal mucous membrane. A diagnosis of herpes zoster was made, and she was treated with acyclovir with complete skin recovery. A hearing examination demonstrated mild-to-moderate left neurosensory hearing loss...
July 25, 2018: BMJ Case Reports
Ram Narayan, Alexandra Simpson, Katelyn Fritsche, Sara Salama, Santiago Pardo, Maureen Mealy, Friedemann Paul, Michael Levy
MOG antibody disease is an autoimmune disease of the central nervous system associated with a serological antibody against MOG, myelin oligodendrocyte glycoprotein. MOG is a glycoprotein expressed on the outer membrane of myelin and solely found within the central nervous system, including in the brain, optic nerves and spinal cord. Clinically, the disease resembles neuromyelitis optica spectrum disorders in the predilection for relapses of optic neuritis and transverse myelitis. In addition, acute disseminated encephalomyelitis (ADEM) is a well-recognized phenotype of MOG antibody disease in children...
July 23, 2018: Multiple Sclerosis and related Disorders
G Lakshmi Prasad, Sumit Sinha, Gopal Krishna
No abstract text is available yet for this article.
July 2018: Neurology India
Mehmet Akif Topcuoglu, Eva A Rocha, Ahmer Khawdja Siddiqui, Brittany B Mills, Gisele S Silva, Lee H Schwamm, Glenn M Lamuraglia, Aneesh B Singhal
OBJECTIVE: To characterize isolated upper extremity (UE) weakness from stroke. METHODS: In our Get with the Guidelines-Stroke dataset (n = 7643), 87 patients (1.14%) had isolated UE weakness and underwent thorough stroke evaluation with diffusion-weighted magnetic resonance imaging and good-quality arterial imaging. We analyzed clinical-imaging features, etiology, management, and outcome. Since isolated UE weakness is typically associated with contralateral hand-knob area infarcts, patients were classified into Group-A (motor strip infarct) or Group-B (non-motor strip infarct)...
July 19, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Samuel Tribich, Colin J Mahoney, Nicholas W Davies
A 49-year-old man presented with a 1-week history of right facial paraesthesia with blurred vision and diplopia. Examination was normal apart from reduced facial sensation. Following appropriate neuroimaging, we considered a diagnosis of silent sinus syndrome. He underwent a middle meatal antrostomy with complete resolution of symptoms. Silent sinus syndrome results from occlusion of the osteomeatal complex, preventing normal aeration of the maxillary sinus. Maxillary sinus hypoventilation typically causes inferior displacement of the globe in the orbit (unilateral hypoglobus)...
July 20, 2018: Practical Neurology
José Luis Treviño González, German A Soto-Galindo, Rafael Moreno Sales, Josefina A Morales Del Ángel
The Cogan's syndrome (CS) is a very uncommon inflammatory condition that appears in young adults without a gender predisposition. It can be presented as typical, with interstitial non-syphilitic keratitis and Ménière-like audiovestibular manifestations. An atypical form of CS involves uveitis, scleritis, episcleritis, and systemic vascuitis symptoms. This is a case of a 41-year old male who reported eye redness, photophobia, and gait instability. His condition progressed to a sudden sensorineural hearing loss, tinnitus, and constant vertigo accompanied by cephalea...
June 2018: Annals of Medicine and Surgery
Lauren Blayney, Paul Morrish
Neurological disease is the most common extrahepatic manifestation of autochthonous infection with hepatitis E virus (HEV). The association between acute neurological symptoms and hepatitis E is not well known, and hence HEV testing is often omitted. This case describes aberrant neurology in a 35-year-old woman with a background of HEV infection, highlighting the need for increased awareness of acute hepatitis E infection as a cause of unexplained neurological illness.
July 17, 2018: BMJ Case Reports
Ayesha S Ahmad, Rizwan A Tahir, Panayiotis D Mitsias
Moyamoya disease and syndrome constitute two distinct pathological entities with a primary finding of progressive distal internal carotid artery occlusion, which results in either an ischemic or hemorrhagic sequela. While the disease entity stands as a primary arterial vasculopathy, moyamoya syndrome represents a secondary vasculopathy associated with a systemic inflammatory process. We describe a patient with an ischemic stroke and angiographic findings of moyamoya in the setting of positive antinuclear antibodies and anti-Scl-70 antibodies with clinical features of scleroderma on exam...
July 12, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Florian Gessler, Joshua D Bernstock, Bedjan Behmanesh, Uta Brunnberg, Patrick Harter, Daniel Ye, Gregory K Friedman, Martin-Leo Hansmann, Marlies Wagner, Volker Seifert, Lutz Weise, Gerhard Marquardt
BACKGROUND: The optimal timing of corticosteroid (CS) treatment in patients with primary central nervous system (CNS) lymphoma (PCNSL) remains controversial. While poor clinical presentation may justify early treatment with CS, this may ultimately result in reduced concentrations of chemotherapeutic agents via perturbations in the permeability of the blood-brain barrier. OBJECTIVE: To investigate whether early CS exposure is associated with beneficial outcomes and/or reduced occurrence of adverse events as opposed to delayed/concomitant administration...
July 17, 2018: Neurosurgery
Harsh Bhatt, Gulam Zilani, Caroline Hayhurst
A 75-year-old man with type 2 diabetes mellitus presented with complete loss of vision in his right eye and severe headaches for the past 24 hours. He had been treated for suspected giant cell arteritis (GCA) with high-dose corticosteroids which were being tapered to stop after an inconclusive right temporal artery biopsy and an erythrocyte sedimentation rate (ESR) value of 8. His current acute presentation, however, raised further concern for partially treated GCA and precipitated treatment with pulsed methylprednisolone...
July 15, 2018: BMJ Case Reports
Pedro Aguilar-Salinas, Roberta Santos, Manuel F Granja, Sabih Effendi, Eric Sauvageau, Ricardo Hanel, Amin Aghaebrahim
Stroke is the leading cause of serious long-term disability in the USA. Recent clinical trials, DAWN and DEFUSE 3, have expanded the endovascular therapeutic time window which has been adopted by the American Heart Association stroke guideline. However, there continues to be a dilemma as to what is the best approach for patients who present beyond the time window set by these trials and the current guideline. The interval from arterial occlusion to completion of brain tissue infarction varies from patient to patient and depends on the actual time and also a physiological clock or a tissue time window...
July 16, 2018: BMJ Case Reports
Xiao-Chun Wang, Yan-Yao Du, Yan Tan, Jiang-Bo Qin, Le Wang, Xiao-Feng Wu, Liang Xin, Lei Zhang, Li-Na Li, Xin Zhou, Dui-Ping Feng, Guo-Lin Ma, Hui Zhang
BACKGROUND: Dural arteriovenous fistulas (DAVF) at the craniocervical junction are quite uncommon, and clinical manifestations range from acute/chronic myelopathy to subarachnoid hemorrhage (SAH) to brainstem dysfunction. In this report, we presented four cases of DAVFs at the craniocervical junction with progressive brainstem dysfunction, and investigated the typical imaging features using T2 WI, SWI, DWI and contrast enhanced images. Literature was reviewed and revealed 10 case reports of DAVFs at the craniocervical junction presenting with brainstem dysfunction...
July 13, 2018: World Neurosurgery
Rebecca White, David Shackleton
Changes in atmospheric pressure have been reported to cause a transient lower motor neuron weakness of the facial nerve. We report the case of a passenger on an international flight who developed a unilateral facial weakness after take-off which resolved within 45 min. The effect is thought to be due to an ischaemic neuropraxia of the facial nerve caused by increased middle ear pressure compressing the facial nerve in an exposed facial canal. The condition has been commonly reported in scuba-divers but less frequently in airline passengers...
July 6, 2018: BMJ Case Reports
Cristhian Valor, Katherine Huber
A 28-year-old man presented to our clinic over the course of 3 weeks with symptoms that progressed from mild headaches to fever, fatigue, myalgia and an enlarged right preauricular lymph node with ipsilateral conjunctivitis and upper eyelid weakness. Our differential included Epstein Barr Virus/Cytomegalovirus mononucleosis, bacterial conjunctivitis and lymphoma. We evaluated with CBC, EBV IgM Ab, lactate dehydrogenase level and a CMV IgG Ab which were all within normal limits. During his third visit, we discovered our patient had been scratched by two stray kittens he had adopted 2 months prior...
July 6, 2018: BMJ Case Reports
Edite Marques Mendes, Amélia Mendes, Carlos Ribeiro, Diana Guerra
Aphasia is a language disorder characterised by loss of ability to produce or comprehend written or spoken language. In majority of the cases, it is due to stroke. Aphasia may also present as an ictal or postictal state of temporal or frontal lobe seizures. Nevertheless, its isolated occurrence in individuals without a clear-cut history of seizures raises diagnostic difficulties with important therapeutic implications.A case of epileptic aphasia is reported in which the diagnosis was confirmed by electroencephalogram with a dramatic therapeutic response to an antiepileptic drug...
June 29, 2018: BMJ Case Reports
Rajesh Verma, Mannan Mehta, Chetan Shettigar, Shinu Singla
Young-onset cerebellar syndromes are quite interesting and challenging for treating clinicians. While dealing with such cases, a clinician should be aware of rare possible causes too. We report a rare case of Gordon Holmes syndrome-an autosomal recessive cerebellar ataxia with endocrinal abnormalities.
June 28, 2018: BMJ Case Reports
Afsaneh Shirani, Gregory F Wu, Caterina Giannini, Anne H Cross
Tumefactive appearing lesions on brain imaging can cause a diagnostic dilemma. We report a middle-aged man who presented with right-sided optic neuritis. A brain MRI showed enhancement of the right optic nerve, and non-enhancing white matter lesions including a 3 cm right frontal lesion with adjacent gyral expansion. Cerebrospinal fluid analysis showed five oligoclonal bands not present in serum. Glatiramer acetate was started for suspected tumefactive multiple sclerosis (MS). A follow-up brain MRI 6 months later showed persistence of the frontal gyral expansion...
June 28, 2018: BMJ Case Reports
2018-07-30 23:29:16
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