journal
https://read.qxmd.com/read/37701265/subacute-brachial-plexopathy-due-to-intraneural-epithelioid-hemangioma-a-case-report
#21
Vihang Nakhate, Robert P McInnis, Albert Sy, Marcelo Matiello
Brachial plexopathy is a common consideration in the differential diagnosis of upper extremity sensory and motor deficits, and neoplasms signify one possible etiology of brachial plexopathy. Of the neoplastic brachial plexopathies, hemangiomas involving the brachial plexus are rare. Most reported cases describe extraneural brachial plexus hemangiomas that present as a palpable, tender neck mass associated with pain and sensory disturbance, with minimal motor deficits. Here we share the case of a 48 year-old man with intraneural epithelioid hemangioma of the brachial plexus who presented with prominent motor weakness and no palpable mass...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701264/post-covid-mrna-vaccine-associated-cerebral-ischemia-comment
#22
JOURNAL ARTICLE
Amnuay Kleebayoon, Viroj Wiwanitkit
No abstract text is available yet for this article.
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701263/gummatous-neurosyphilis-with-transient-worsening-of-neurological-symptoms-after-treatment-initiation
#23
Valeria Ariza Hutchinson, Aya Shnawa, David P Lerner, Kenneth Wener, Anna Cervantes-Arslanian, Joseph D Burns
Cerebral syphilitic gumma is an atypical presentation of neurosyphilis, the clinical manifestations of which depend on the size and location of the lesions. It radiologically presents as enhancing nodular lesion(s) in brain parenchyma. We present a case of a patient with cerebral syphilitic gummas who had worsening neurological symptoms a few hours after initiation of anti-syphilitic antibiotic treatment. We aim to illustrate the clinical and radiological characteristics that might be helpful to clinicians when approaching the challenges they might encounter while treating neurosyphilis...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701262/multidisciplinary-approach-to-sedation-and-early-mobility-of-intubated-critically-ill-neurologic-patients-improves-mobility-at-discharge
#24
JOURNAL ARTICLE
Megan E Barra, Christine Iracheta, Joseph Tolland, Johnathan Jehle, Ljubica Minova, Karen Li, Mary Amatangelo, Patricia Krause, Ayush Batra, Henrikas Vaitkevicius
BACKGROUND AND PURPOSE: Over-sedation may confound neurologic assessment in critically ill neurologic patients and prolong duration of mechanical ventilation (MV). Decreased sedative use may facilitate early functional independence when combined with early mobility. The objective of this study was to evaluate the impact of a stepwise, multidisciplinary analgesia-first sedation pathway and early mobility protocol on medication use and mobility in the neuroscience intensive care unit (ICU)...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701261/subacute-sclerosing-panencephalitis-in-a-63-year-old-woman-presenting-as-generalized-choreoathetosis
#25
JOURNAL ARTICLE
Ritwick Mondal, Shramana Deb, Manoj Mahata, Somesh Saha, Durjoy Lahiri, Julián Benito-León
The persistence of measles virus infection in childhood and early adolescence can rarely lead to a fatal progressive neurodegenerative disorder known as subacute sclerosing panencephalitis (SSPE), characterized by behavioral disturbances and intellectual disability followed by myoclonic jerks and occasional negative myoclonus. Movement disorders are rarely presenting manifestations in SSPE. We herein report a 63-year-old woman with generalized choreoathetosis as the presenting manifestation of stage-I SSPE...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701260/recurrent-intraventricular-haemorrhage-in-cerebral-proliferative-angiopathy-a-case-report-and-review-of-the-literature
#26
JOURNAL ARTICLE
Jakob V E Gerstl, Joshua D Bernstock, Ari D Kappel, Erickson F Torio, Rose Du
Cerebral proliferative angiopathy (CPA) is an entity distinct from that of classical arteriovenous malformations. As such, few reports have considered the long-term follow-up of patients with hemorrhage in CPA. Accordingly, herein the authors present a case of recurrent hemorrhage in CPA with 32 years of follow-up and in so doing summarize the literature of hemorrhagic cases in CPA. A 19-year-old presented with focal awareness seizures and diagnostic work-up revealed a left hemispheric vascular lesion...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701259/vertebral-and-basilar-artery-dissection-in-a-patient-with-alport-syndrome
#27
Haley K Talbot-Stetsko, Sara Saleh, Ashley Brent, Sandra Camelo-Piragua, David Gordon, Craig A Williamson
Basilar artery occlusion (BAO) is a rare cause of stroke associated with significant morbidity and mortality. It is most frequently thromboembolic in nature, but may be caused by vertebral artery dissection. We present a case of BAO in a 36-year-old woman with Alport syndrome. She was treated with emergent thrombectomy via the right vertebral artery with return to baseline neurological status. Her clinical status deteriorated later the same day and she was found to have re-occlusion. Repeat thrombectomy was complicated by persistent re-occlusion requiring 7 passes to achieve reperfusion...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701258/continuous-eeg-characteristics-in-critically-ill-patients-presenting-with-seizures-prior-to-death-from-cardiac-arrest
#28
JOURNAL ARTICLE
Tian Wang, Venkatesh K Raman, Gholam K Motamedi
Background : There have been limited reports about brain activity during cardiac arrest. Here we report 4 patients presenting with seizure who had cardiac arrest leading to their deaths while being on continuous video-EEG (cVEEG) monitoring and one-lead cardiac telemetry. Purpose : We illustrate characteristic stepwise EEG and EKG changes in these critically ill patients prior to their death. Research Design/Study Sample : All patients showed progressive broad spectrum of cardiac arrhythmias at or before the beginning of EEG suppression while there were no such changes seen in a control group of 4 randomly selected patients without cardiac arrest who had seizure on presentation and underwent cVEEG monitoring...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701257/prolonged-transient-global-amnesia-part-of-the-clinical-spectrum-or-a-separate-disease-entity
#29
Heather Y F Yong, Carlos R Camara-Lemarroy
BACKGROUND: Transient global amnesia (TGA) is the prototypical neurologic disease for acute-onset reversible amnesia. It is currently defined by resolution of symptoms within 24-hours. In this case report we describe an atypical case of prolonged TGA, emphasizing our current lack of knowledge surrounding this disease entity and its pathophysiology. RESULTS: A 66-year old female presented acutely with profound anterograde amnesia and variable retrograde amnesia with no inciting event...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701256/bilateral-and-symmetrical-basal-ganglia-calcifications-may-aid-in-mitochondrial-disease-diagnosis-in-resource-limited-settings
#30
JOURNAL ARTICLE
Amado Jiménez-Ruiz, Victor Aguilar-Fuentes, Fátima Gabriela Macías-Ortíz, José Luis Ruiz-Sandoval
No abstract text is available yet for this article.
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701255/superficial-cerebellar-siderosis-and-spontaneous-intracranial-hypotension-secondary-to-dural-tear
#31
JOURNAL ARTICLE
Priscilla Nethala, Sandhya Gh, Sumanth Shivaram
Spinal dural tears are being increasingly recongnized to cause superficial siderosis and intracranial hypotension. We report a patient with chronic headache who was detected to have cerebellar superficial siderosis and subtle signs of intracranial hypotension on imaging. Spinal imaging showed an upper thoracic dural tear secondary to a paradiscal osteophyte. She improved significantly with surgical repair of the tear. We highlight the importance of recognizing superficial sideorsis in patients with chronic headache as it serves as a marker for dural tear and intracranial hypotension...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701254/utility-of-repetitive-nerve-stimulation-in-the-diagnosis-of-myasthenia-gravis-in-the-inpatient-setting
#32
JOURNAL ARTICLE
Katherine M Clifford, Connie K Wu, David Post, Ruba Shaik, Srikanth Muppidi
OBJECTIVES: Sensitivity and specificity of Repetitive Nerve Stimulation (RNS) is typically reported from outpatient centers, and we hypothesized that these values might not apply to hospitalized patients with higher grades of weakness. RNS may be helpful in rapidly confirming diagnosis of myasthenia gravis (MG) in the inpatient setting, as results from confirmatory antibody testing are often delayed. We sought to characterize the sensitivity and specificity of RNS in the inpatient setting to assist in the early diagnosis of MG...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701253/elevations-in-norclobazam-concentrations-and-altered-mental-status-in-cyp2c19-poor-metabolizer-phenotype-a-case-report
#33
Kristy M Phillips, Josanna M Rodriguez-Lopez, Andrew J Webb
Clobazam is a 1,5-benzodiazepine frequently used as an adjunctive agent for refractory seizures and status epilepticus. Clobazam undergoes metabolism to an active metabolite norclobazam which is subsequently hydroxylated by CYP2C19, a cytochrome with several pharmacogenetic variants. Patients with poor metabolizer phenotypes may have elevated norclobazam levels and subsequent adverse effects. We present a case of an Asian American male receiving clobazam at a standard therapeutic dose for seizure disorder who became comatose secondary to significantly elevated norclobazam concentrations...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701252/neuromyelitis-optica-spectrum-disorder-management-in-the-setting-of-chronic-hepatitis-b-and-latent-tuberculosis-a-case-report
#34
Dylan Sadowsky, Kevin Delijani, William Davis, Amy Safadi, Petra Brayo, Benjamin Osborne
Neuromyelitis Optica Spectrum Disorder (NMOSD) is an inflammatory autoimmune disorder of the central nervous system, with optic neuritis and transverse myelitis as its most common presentations. Although immunomodulatory treatment options for NMOSD have expanded, preventing reactivation of latent infections in patients can be both a therapeutic challenge and a special consideration for the neurohospitalist in an inpatient setting. We present a challenging case of a NMOSD patient who presented to the emergency department with worsening weakness and numbness in the setting of an NMOSD pseudo-relapse, later found to have untreated latent tuberculosis (TB) and chronic hepatitis B (HBV)...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701251/reversible-cerebral-vasoconstriction-syndrome-exacerbation-after-calcitonin-gene-related-peptide-inhibitor-administration
#35
Megan Zhao, Eric Kaiser, Brett Cucchiara, Jonah Zuflacht
Background: Reversible cerebral vasoconstriction syndrome (RCVS) is a non-inflammatory vasculopathy. While most patients have good clinical outcomes, RCVS can be associated with severe brain injury from ischemic stroke, subarachnoid, and intracerebral hemorrhage. Purpose: A number of vasoactive medications have been implicated in RCVS, including triptans, amphetamines, antidepressants, and decongestants. Given the role of CGRP in modulating cerebral vasodilation, the possibility of CGRP inhibitors contributing to RCVS has been raised...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701250/intravascular-lymphoma-as-a-cause-of-recurrent-strokes-case-report-and-review-of-the-literature
#36
Charlie Weige Zhao, Tracey H Fan, Thomas Denize, Alba Coraini, Andrew Kraft, Anusha M Kumar, Lucy G Gao, Mayra E Lorenzo, Lyn M Duncan, Erica C Camargo Faye, David J Lin
BACKGROUND: Intravascular lymphoma is an uncommon cause of ischemic strokes. Because of its rarity and atypical pattern, most diagnoses are made post-mortem. CASE STUDY: We present a case of a 68-year-old male with multiple cardiovascular risk factors and recent SARS-CoV-2 infection who presented with recurrent strokes. Because of his stroke risk factors, he was initially managed with a sequentially escalating antithrombotic regimen. A malignant process was low on the differential at this point given his lack of systemic symptoms...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701249/perplexing-initial-presentations-of-mogad-in-two-children-intracranial-hypertension-and-new-onset-seizure
#37
Daniel J Zhou, Andria M Powers, Caleb A Cave, Emily K Dickas, Mary C Rickard, Geetanjali Rathore, Rhonda R Wright, Rana K Zabad, Sookyong Koh
We report two distinct challenging initial presentations of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Case 1 describes a 12-year-old boy who developed headaches refractory to pain medication followed by cranial neuropathies and intracranial hypertension, confirmed by lumbar puncture with an opening pressure >36 cm H2 O. Case 2 describes a 3-year-old boy who developed new-onset seizures refractory to antiseizure medications, a presentation of FLAIR-hyperintense lesions in MOG-antibody associated encephalitis with seizures (FLAMES)...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701248/postpartum-sciatic-neuropathy-after-uncomplicated-vaginal-delivery
#38
Nader Boutros, Dina Saba, Bhavesh Trikamji
Postpartum neuropathies are common, including femoral neuropathy, peroneal neuropathy, lumbosacral trunk plexopathy, and lateral femoral cutaneous neuropathy. Sciatic mononeuropathy in the peripartum period is rare. Postpartum sciatic neuropathy (PSN) in the setting of cesarean section has been reported before. We present a case series of 2 sciatic mononeuropathies after vaginal delivery. Case 1 is a 25-year-old woman who presented with a left foot drop after normal vaginal delivery after being in labor for 3 hours...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701247/neuro-sweet-syndrome-a-diagnostic-conundrum
#39
Karlos Acurio, Miguel Chuquilin
Sweet Syndrome presents as acute fever, leucocytosis and characteristic skin plaques. It can involve many organ systems but rarely affects the nervous system. We report the case of a 51-year-old female that presented with fever, rash, headache and encephalopathy. Brain magnetic resonance imaging showed extensive T2 hyperintensities involving cerebral hemispheres, cerebellum, and brainstem. A skin biopsy revealed dermal infiltration by neutrophils consistent with Sweet Syndrome. She started steroid treatment with a good clinical response...
October 2023: Neurohospitalist
https://read.qxmd.com/read/37701246/inpatient-neurology-deaths-and-factors-associated-with-discharge-to-hospice
#40
JOURNAL ARTICLE
Shefali Dujari, Janet Wei, Lironn Kraler, Tarini Goyal, Eric Bernier, Neil Schwartz, Karen Hirsch, Carl A Gold
BACKGROUND AND PURPOSE: The Neurology Mortality Review Committee at our institution identified variability in location of death for patients on our inpatient neurology services. Hospice may increase the number of patients dying in their preferred locations. This study aimed to characterize patients who die on inpatient neurology services and explore barriers to discharge to hospice. METHODS: This retrospective study was completed at a single, quaternary care medical center that is a Level I Trauma Center and Comprehensive Stroke Center...
October 2023: Neurohospitalist
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