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49 papers 0 to 25 followers 小僧悟道
Nooshin Salehi, Adam K Yuan, Gizelle Stevens, Ruby Koshy, Walter F Klein
BACKGROUND Anti-N-methyl D-Aspartate (anti-NMDA) receptor encephalitis is a rare autoimmune panencephalitis that typically presents with acute psychiatric disturbances and neurological deficits. Anti-NMDA receptor encephalitis is associated with certain tumors, most commonly ovarian teratomas. First-line therapy typically involves immunotherapy and tumor resection, if present, with up to 53% of patients experiencing improvement within 4 weeks. Cardiac arrhythmias and increased intracranial pressure have been reported in anti-NMDA receptor encephalitis, but these complications have usually been self-limited...
October 12, 2018: American Journal of Case Reports
Chiu-Jung Lin, Hsiu-Fen Lin
PURPOSE: Hemiballism caused by hypoglycemia is rare. We presented a case who suffered from episodic hemiballism induced by hypoglycemia with spontaneously recovery after sleep. The possible mechanism of these self-limited episodes was also discussed. CASE REPORT: An 82-year-old female diabetic patient took oral anti-diabetic drugs (OADs) regularly. The doctor changed OADs doses and her appetite became poor before admission. She suffered from episodic left side involuntary movements with consciousness disturbance, and recovered spontaneously after a six-to-eight hour sleep in every attack at home...
March 15, 2018: Acta Neurologica Taiwanica
Omid Salaami, Dennis Michael Manning
A 62-year-old woman was admitted with a 3-week history of atraumatic bilateral lower back pain, progressive ascending flaccid paralysis, hyponatraemia and constipation. She was otherwise in good health with only a recent diagnosis of acute gastroenteritis that preceded her presenting symptoms. Her initial laboratory evaluation was consistent with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) but was otherwise unremarkable. MRI of the spine revealed bilateral diffuse nerve root enhancement from at least C6 to the conus level, suggesting an inflammatory process...
October 7, 2018: BMJ Case Reports
O D Ostroumova, M S Cherniaeva, O V Golovina
This article presents an overview of data of Russian and foreign literature on possible associations between cognitive impairment and atrial fibrillation (AF). It includes modern classification of cognitive impairment, mechanisms of the effect of AF on cognitive functions and development of dementia, recommendations for the prevention of cognitive impairment in patients with AF. Special attention is paid to the assessment of cognitive status, and safe anticoagulant therapy, which is a priority in the prevention of cognitive impairment in patients with AF...
September 2018: Kardiologiia
Hsin-Chen He, Ming-Chun Hsu, Chun-Sheng Hsu, Yuan-Yang Cheng, Shin-Tsu Chang
RATIONALE: The brain circulation of the dentato-rubro-thalamo-cortical tract (DRTT) has been reported for decade, but is rarely observed using nuclear medicine imaging tools, to analyze a patient with midbrain hemiatrophy syndrome. We present a case that revealed notable interruption in the middle of the DRTT. Finding out whether the superior cerebellar peduncle of the midbrain was injured was a decisive element for developing bidirectional effect of DRTT. PATIENT CONCERNS: A 34-year-old right-handed female presented with progressive weakness and bradykinesia in the left-sided limbs for about 6 months...
October 2018: Medicine (Baltimore)
Syed Omar Kazmi, Oliver Achi, Rahul Damani
Intravenous recombinant tissue plasminogen activator (IV r-tpa) is the standard of care for patients suffering from neurological deficits due to an acute ischemic stroke within 4.5 hours in the absence of intracranial hemorrhage. We report a case of a patient with an acute right middle cerebral artery stroke due to an acute aortic dissection (Stanford Type A) who was treated with full dose IV r-tpa resulting in a good outcome.
July 2018: Annals of Indian Academy of Neurology
Hidenori Suzuki, Masashi Fujimoto, Fumihiro Kawakita, Lei Liu, Yoshinari Nakatsuka, Fumi Nakano, Hirofumi Nishikawa, Takeshi Okada, Hideki Kanamaru, Kyoko Imanaka-Yoshida, Toshimichi Yoshida, Masato Shiba
Subarachnoid hemorrhage (SAH) by a rupture of cerebral aneurysms remains the most devastating cerebrovascular disease. Early brain injury (EBI) is increasingly recognized to be the primary determinant for poor outcomes, and also considered to cause delayed cerebral ischemia (DCI) after SAH. Both clinical and experimental literatures emphasize the impact of global cerebral edema in EBI as negative prognostic and direct pathological factors. The nature of the global cerebral edema is a mixture of cytotoxic and vasogenic edema, both of which may be caused by post-SAH induction of tenascin-C (TNC) that is an inducible, non-structural, secreted and multifunctional matricellular protein...
September 22, 2018: Journal of Neuroscience Research
Devin W McBride, Eric C K Gren, Wayne Kelln, William K Hayes, John H Zhang
Hemorrhagic transformation after ischemic stroke is an independent predictor for poor outcome and is characterized by blood vessel rupture leading to brain edema. To date, no therapies for preventing hemorrhagic transformation exist. Disintegrins from the venom of Crotalus atrox have targets within the coagulation cascade, including receptors on platelets. We hypothesized that disintegrins from C. atrox venom can attenuate hemorrhagic transformation by preventing activation of matrix metalloproteinase after middle cerebral artery occlusion (MCAO) in hyperglycemic rats...
September 22, 2018: Journal of Neuroscience Research
Mohammad Hassan A Noureldine, Wared Nour-Eldine, Munther A Khamashta, Imad Uthman
The Antiphospholipid syndrome (APS), formerly known as Anticardiolipin or Hughes syndrome, is a systemic autoimmune disorder characterized by obstetrical complications and thrombotic events affecting almost every organ-system in patients persistently testing positive for antiphospholipid antibodies (aPL). The contribution of the extra-criteria aPL to the pathogenesis of APS have exceeded the expectations of a simple, direct pathologic 'hit' leading to thrombogenesis or obstetrical complications, and more pathologic pathways are being linked directly or indirectly to aPL...
August 23, 2018: Seminars in Arthritis and Rheumatism
Kristin Bergmann, Hanne Elisabeth Højsgaard Møller, Olav Jonas Bergmann
Febrile neutropenia (FN) is a common complication in patients with cancer during treatment with antineoplastic drugs. The initial cause is usually bacterial, and treatment of FN follows well-defined algorithms. We report a case of a 62-year-old patient with chronic lymphocytic leukaemia (CLL), who developed FN, which was unresponsive to both empirical antibacterial and empirical antifungal therapy. Surprisingly, a diagnosis of the life-threatening condition haemophagocytic lymphohistiocytosis (HLH) associated with cytomegalovirus (CMV) infection was made and treated successfully...
September 14, 2018: BMJ Case Reports
Jose Díaz-Pérez, Guillermo Parrilla, Mariano Espinosa de Rueda, Jose María Cabrera-Maqueda, Blanca García-Villalba, Maria Teresa Alba-Isasi, Ana Morales, Joaquín Zamarro
BACKGROUND: Strokes due to carotid artery occlusion (CAO) are associated with bad clinical prognosis and poor response to intravenous thrombolysis. Several studies in the past have shown the benefits of mechanical thrombectomy (MT) and compared bridging therapy (BT) and primary MT (PMT) in large vessel occlusions, but only a few studies have focused on the specific population of CAO and their response to endovascular treatment. METHODS: Retrospective review of patients treated at our center between January 2010 and June 2017 that (1) presented with acute ischemic stroke caused by CAO in the first 4...
2018: Cerebrovascular Diseases
David Moreno-Ajona, Ester Moreno-Artero, María Reyes García de Eulate, Pablo Irimia, Agustín España
Background Localized facial scleroderma usually presents as frontal linear morphea or progressive hemifacial atrophy. Only isolated cases of trigeminal painful neuropathy have been described. Case report A 43-year-old woman developed an oval lesion on the right cheek. After 1 year, she noticed constant "pulling" pain and episodes of lancinating pain, both spontaneous and triggered by chewing and cold drinks. She was diagnosed with solitary morphea profunda and CT scan, ultrasonography, cranial MRI and biopsy were completed...
September 13, 2018: Cephalalgia: An International Journal of Headache
Jonathon Cavaleri, Jennifer L Perez, Alp Ozpinar, Nima Alan, Edward Monaco
Background: Cerebrospinal fluid (CSF) leakage into the epidural space following lumbar puncture (LP) has been documented in pediatric patients, but there have been no reported cases in adults. Case Description: We report an epidural CSF leak in an adult who presented with back pain, positional headache, urinary retention, and constipation following an LP performed as a part of a research study. The patient's magnetic resonance (MR) scan showed an extensive epidural CSF collection...
2018: Surgical Neurology International
Tomoyoshi Kuribara, Koichi Haraguchi, Shunya Ohtaki, Tadakazu Shimizu, Nobuki Matsuura, Kazumi Ogane, Yasunori Maruo, Noriyuki Yokoyama, Takeshi Mikami, Takeo Itou, Nobuhiro Mikuni
Background: The appearance of edematous lesions in the subacute phase is a rare complication following neuroendovascular therapy. Effective management of these lesions remains unclear. In this report, a case with progressive edematous lesions in the subacute phase after neuroendovascular therapy was described, and the clinical features and therapeutic strategies were discussed. Case Description: A 54-year-old female with a large, right cavernous internal carotid artery aneurysm was treated with a flow diverter...
2018: Surgical Neurology International
Etimbuk Umana, Raazi Bajwa, Ian Davidson, David Gallagher
Carotid artery dissection from rupture of the vasa vasorum is under-recognised. We report the case of a 60-year-old woman presenting to our hospital with a 2-week history of right-sided headache, neck pain, unequal pupils and ptosis after being hit by a wave on the beach. She was diagnosed with painful Horner's syndrome. MR angiogram revealed dissection of the right internal carotid artery with an intramural haematoma without an intimal flap. A diagnosis of carotid artery dissection from rupture of the vasa vasorum was made...
September 12, 2018: BMJ Case Reports
Jenelle Raynowska, Dhanashri P Miskin, Bidyut Pramanik, Saeed Asiry, Todd Anderson, John Boockvar, Souhel Najjar, Asaff Harel
OBJECTIVE: We report a series of 2 brothers who each developed tumefactive brain lesions, initially thought to have brain tumors or tumefactive multiple sclerosis (MS), but who were ultimately diagnosed with a rare autosomal dominant condition known as retinal vasculopathy with cerebral leukoencephalopathy (RVCL). METHODS: Case series and literature review. RESULTS: We present 2 brothers who developed tumefactive right frontal brain lesions leading to gait disturbances and cognitive changes...
October 9, 2018: Neurology
Satoshi Koizumi, Takahiro Ota, Keigo Shigeta, Tatsuo Amano, Masayuki Ueda, Yuji Matsumaru, Yoshiaki Shiokawa, Teruyuki Hirano
BACKGROUND: Mechanical thrombectomy (MT) has become the standard of care for acute ischemic stroke with large vessel occlusion; however, evidence remains insufficient for MT for elderly patients, especially with respect to factors affecting their outcomes. METHODS: This study was a retrospective analysis of a multicenter registry of MT, called Tama Registry of Acute Endovascular Thrombectomy. Patients were divided by their age into 2 groups: Nonelderly (NE; < 80) and elderly (E; ≥80)...
2018: Cerebrovascular Diseases
Hidesaku Asakura
Among all types of myeloproliferative neoplasms (MPNs), polycythemia vera (PV) and essential thrombocythemia (ET) require careful management of both thrombosis and hemostasis. One recent concern associated with MPNs is the JAK2 mutation (V617F). This mutation is essential for MPN pathology, but it has also garnered attention for its association with thrombosis. Several studies have reported the mechanisms underlying the onset of thrombosis in both PV and ET and have also discussed the association between JAK2 mutations and thrombotic tendencies...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Thomas Ratschiller, Hannes Müller, Markus Pirklbauer, Rene Silye, Gregor Sulzbacher, Andreas Zierer
Giant cell arteritis is an inflammatory vasculopathy of unknown etiology that typically affects the carotid artery and its branches. Symptomatic involvement of upper extremity arteries is uncommon. We report a case of a 70-year-old woman with polymyalgia rheumatica who presented with critical arm ischemia, constitutional symptoms, and elevated erythrocyte sedimentation rate. Urgent revascularization by a carotid-brachial artery bypass was performed. Histopathologic evaluation of a specimen obtained intraoperatively from the occluded axillary artery confirmed the diagnosis, and corticosteroid therapy was initiated...
September 2018: Journal of vascular surgery cases and innovative techniques
Junji Uno, Katsuharu Kameda, Ryosuke Otsuji, Nice Ren, Shintaro Nagaoka, Maeda Kazushi, Yoshiaki Ikai, Hidefuku Gi
BACKGROUND: We sought to examine the presentation, treatment, and outcomes of anterior cerebral artery (ACA) occlusions in patients undergoing mechanical thrombectomy (MT). METHODS: Two-hundred ninety-eight consecutive patients with large-vessel occlusion treated with MT were analyzed to identify all patients with acute ACA occlusion who underwent MT. The primary end point was defined as achieving a thrombolysis in cerebral infarction score ≥2b. The secondary end point included the 90-day modified Rankin Scale (mRS) score and symptomatic intracranial hemorrhage...
December 2018: World Neurosurgery
2018-09-08 10:30:59
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