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By EFRAIN PAEZ Internal Medicine since 1988. Interested in all aspects of Medicine.
Ralph Werner, Johannes C Wöhrle, Wolfgang Neumeister
No abstract text is available yet for this article.
September 21, 2018: Deutsches Ärzteblatt International
Neetu Soni, Girish Bathla, Ravishankar Pillenahalli Maheshwarappa
Purpose Spinal sarcoidosis, referring to involvement of the spine in sarcoidosis, is relatively rare and may mimic other neurological disease affecting the spine. The authors present a clinic radiological review of 18 spinal sarcoidosis patients who presented to a tertiary hospital, with emphasis on initial imaging and radiological response to treatment. Materials and methods We retrospectively reviewed our departmental imaging archives over a 15-year period and found 49 cases of neurosarcoidosis out of which 18 patients had spinal magnetic resonance imaging...
October 12, 2018: Neuroradiology Journal
C Zamora, S-C Hung, C Tomingas, C Atkinson, M Castillo
We describe the prevalence and potential significance of deep medullary vein engorgement on SWI in patients with neurosarcoidosis, a finding that has not been described previously. Engorgement was evaluated for possible associations with meningeal or perivascular disease, intracranial hemorrhage, and venous thrombosis, as well as with modified Rankin Scale scores at the time of MR imaging and at follow-up. Deep medullary vein engorgement was seen in 7 of 21 patients and was more common in men. Patients with venous engorgement had a significantly increased incidence of microhemorrhages, perivascular disease, and hydrocephalus...
November 2018: AJNR. American Journal of Neuroradiology
Ceris Ifan Owen, Farrah Jabeen, Anupam Bhattacharjee
Neurosarcoidosis represents a significant diagnostic challenge, as clinical features overlap with other neuroinflammatory conditions, and biopsy of affected neuronal tissue is often high risk or not feasible. Here we highlight application of the modified Zajicek criteria to diagnose probable spinal neurosarcoidosis in the absence of histology from affected neuronal tissue.
September 2018: Clinical Case Reports
Barney J Stern, Walter Royal, Jeffrey M Gelfand, David B Clifford, Jinny Tavee, Siddharama Pawate, Joseph R Berger, Allen J Aksamit, Allan Krumholz, Carlos A Pardo, David R Moller, Marc A Judson, Marjolein Drent, Robert P Baughman
Importance: The Neurosarcoidosis Consortium Consensus Group, an expert panel of physicians experienced in the management of patients with sarcoidosis and neurosarcoidosis, engaged in an iterative process to define neurosarcoidosis and develop a practical diagnostic approach to patients with suspected neurosarcoidosis. This panel aimed to develop a consensus clinical definition of neurosarcoidosis to enhance the clinical care of patients with suspected neurosarcoidosis and to encourage standardization of research initiatives that address this disease...
December 1, 2018: JAMA Neurology
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.
October 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Fen Wang, Dongmei Guo, Zheng Liu, Aihong Zhou, Cuibai Wei, Jianping Jia
Neurosarcoidosis is relatively rare and has diverse manifestations. The clinical characteristics, diagnosis, treatment, and outcome for neurosarcoidosis in China are poorly understood. We retrospectively analyzed the clinical features, laboratory and imaging results, treatment, and outcomes in patients who met the criteria for definite or probable neurosarcoidosis in Xuan Wu Hospital of Capital Medical University from 2000 to 2015. Eight patients were included in this study, accounting for 5.84% of all cases with sarcoidosis...
October 2018: Neurological Sciences
Vincent Jachiet, Raphael Lhote, Pierre Rufat, Micheline Pha, Julien Haroche, Sophie Crozier, Corinne Dupel-Potier, Dimitri Psimaras, Zahir Amoura, Fleur Cohen Aubart
OBJECTIVES: Clinical involvement of the nervous system is uncommon during sarcoidosis. Cerebrovascular events are rarely reported during sarcoidosis and may be confused with primary angiitis of the central nervous system. The characteristics and outcomes of cerebrovascular events during sarcoidosis have not been well-evaluated. PATIENTS AND METHODS: We conducted a retrospective case series in our institution with an updated review of the literature from 1962 to 2017 to characterize the clinical presentation, imaging, histology and outcomes of stroke that were thought to be causally related to sarcoidosis...
October 2018: Journal of Neurology
G Bathla, P Watal, S Gupta, N Soni, A A Capizzano, C P Derdeyn, T Moritani
AIM: To determine the occurrence of ischaemic and haemorrhagic events in patients with neurosarcoidosis at presentation and follow-up and to evaluate its association with perivascular enhancement. MATERIALS AND METHODS: The MRI findings in patients with neurosarcoidosis who presented to our institute from 2002-2017 were retrospectively reviewed, with emphasis on cerebrovascular events. A chi-squared test was used to evaluate the statistical association with presence of perivascular enhancement...
October 2018: Clinical Radiology
Katsunori Shijo, Nobuhiro Moro, Mari Sasano, Mitsuru Watanabe, Hiroshi Yagasaki, Shori Takahashi, Taku Homma, Atsuo Yoshino
BACKGROUND: Sarcoidosis is a multi-organ disease of unknown etiology characterised by the presence of epithelioid granulomas, without caseous necrosis. Systemic sarcoidosis is rare among children, while neurosarcoidosis in children is even rarer whether it is systemic or not. CASE PRESENTATION: We described the case of a 12-year-old boy who presented with monocular vision loss accompanied by unusual MRI features of an extensive meningeal infiltrating mass lesion...
May 29, 2018: BMC Neurology
Pojen Deng, Olga Krasnozhen-Ratush, Christopher William, Jonathan Howard
Spinal neurosarcoidosis is a rare form of neurosarcoid which can be challenging to diagnose given its clinical or radiographic findings are often indistinguishable from other causes of spinal demyelinating disease. We present a series of three patients with spinal neurosarcoid, all of whom demonstrated concurrent longitudinally enhancing transverse myelitis as well as spinal nerve root enhancement. These findings may be suggestive of spinal neurosarcoid and may help clinicians make the diagnosis as well as reduce the need for invasive biopsy...
May 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
Amanda Mary Scott, Janeth Yinh, Timothy McAlindon, Robert Kalish
Neurosarcoidosis is uncommon with an incidence of approximately 5 to 15%. Central nervous system involvement can be divided into brain and spinal cord neurosarcoidosis. Spinal cord sarcoidosis is extremely rare, occurring in less than 1% of all sarcoidosis cases. Its manifestations may include cauda equina syndrome, radiculopathy, syringomyelia, cord atrophy, arachnoiditis, and myelopathy or transverse myelitis. We highlight two cases of spinal cord sarcoidosis, each presenting with longitudinally extensive transverse myelitis, that demonstrate the dilemmas that physicians face with regard to diagnosis and treatment...
May 17, 2018: Clinical Rheumatology
Melissa Vereecken, Karolien Hollanders, Deborah De Bruyn, Virginie Ninclaus, Julie De Zaeytijd, Ilse De Schryver
BACKGROUND: Sarcoidosis, a multisystem, granulomatous disorder, sometimes manifests with a neuro-ophthalmic subtype. The latter can pose a diagnostic challenge, especially when ocular symptoms appear before systemic involvement, as the clinical picture then can be non-specific and systemic laboratory and standard imaging investigations can be negative. FINDINGS: A 71-year-old woman presented with a 4-month history of sudden-onset visual loss in the left eye. Slit lamp examination revealed anterior chamber cells, iris, and angle neovascularization...
April 18, 2018: Journal of Ophthalmic Inflammation and Infection
Tracey A Cho, Shamik Bhattacharyya
PURPOSE OF REVIEW: Myelopathy is commonly encountered in clinical practice and is associated with a large number of causes. This article reviews the anatomy of the spinal cord and discusses how the clinical findings, time course, and radiographic patterns can help to identify the causes of myelopathy. RECENT FINDINGS: Imaging observations such as MRI "pancake" gadolinium enhancement pattern with spondylotic myelopathy and subpial enhancement with neurosarcoidosis have improved diagnostic specificity...
April 2018: Continuum: Lifelong Learning in Neurology
Michael A Galgano, Carlos R Goulart, Karen Chisholm, Melissa Hazen, Scellig Stone
BACKGROUND: Isolated intraspinal neurosarcoidosis is a rare clinical entity, with most reports describing intramedullary involvement in adults. CASE DESCRIPTION: We detail the case of a 9-year-old girl with rapid-onset compressive myelopathy secondary to a thoracic epidural lesion. Although pathologic diagnosis was challenging, a presumptive diagnosis of isolated extradural neurosarcoidosis was made in light of the patient's investigations and dramatic response to corticosteroids...
March 2018: World Neurosurgery
Mark Peter Maskery, Paul N Cooper, Adrian Pace
Sarcoidosis is an idiopathic multisystem granulomatous disorder of unknown cause. Nervous system involvement (central and/or peripheral) is uncommon, developing in 5%-10%. The presenting symptoms are variable, reflecting the level of involvement, and frequently fluctuate and progress. Diagnosing neurosarcoidosis in people with previously confirmed systemic disease may be relatively straightforward, but diagnosing primary neurosarcoidosis is challenging. Managing neurosarcoidosis is primarily consensus based; corticosteroid is its mainstay, alongside corticosteroid-sparing agents and emerging novel therapies...
June 2018: Practical Neurology
Richard Conway, John J Carey
Methotrexate is the first line drug treatment for a number of rheumatic and non-rheumatic diseases. It is effective in controlling disease activity and preventing disease-related damage, and significantly cheaper than many alternatives. Use in rheumatoid arthritis infers a significant morbidity and mortality benefit. Methotrexate is generally well tolerated but can cause symptomatic adverse events. Multiple serious adverse events have been attributed to methotrexate, based largely on older reports using high or daily doses, and subsequent case reports and circumstantial evidence...
September 18, 2017: World Journal of Hepatology
Nicholas L Zalewski, Eoin P Flanagan, B Mark Keegan
OBJECTIVE: To evaluate specific myelopathy diagnoses made in patients with suspected idiopathic transverse myelitis (ITM). METHODS: A total of 226 patients 18 years and older were referred to Mayo Clinic Neurology for suspected ITM from December 1, 2010, to December 31, 2015. Electronic medical records were reviewed for detailed clinical presentation and course, laboratory and electrophysiologic investigations, and neuroimaging to determine the etiology. Current diagnostic criteria for ITM and alternative myelopathy diagnoses were applied...
January 9, 2018: Neurology
Maxime O Baud, Jeffrey R Vitt, Nathaniel M Robbins, Rafael Wabl, Michael R Wilson, Felicia C Chow, Jeffrey M Gelfand, S Andrew Josephson, Steve Miller
Objective: The mechanism of hypoglycorrhachia-low CSF glucose-in meningitis remains unknown. We sought to evaluate the relative contribution of CSF inflammation vs microorganisms (bacteria and fungi) in lowering CSF glucose levels. Methods: We retrospectively categorized CSF profiles into microbial and aseptic meningitis and analyzed CSF leukocyte count, glucose, and protein concentrations. We assessed the relationship between these markers using multivariate and stratified linear regression analysis for initial and repeated CSF sampling...
January 2018: Neurology® Neuroimmunology & Neuroinflammation
G Bathla, P Watal, S Gupta, P Nagpal, S Mohan, T Moritani
Involvement of the central nervous system by sarcoidosis, also referred to as neurosarcoidosis, is seen clinically in about 5% of patients with systemic disease. CNS involvement most frequently affects the leptomeninges and cranial nerves, though the ventricular system, brain parenchyma, and pachymeninges may also be involved. Even though the involvement of the intracranial vascular structures is well-known on postmortem studies, there is scant literature on imaging manifestations secondary to the vessel wall involvement, being confined mostly to isolated case reports and small series...
July 2018: AJNR. American Journal of Neuroradiology
2018-01-04 03:26:06
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