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Degeneration of paramedian nuclei in the thalamus induces Holmes tremor in a case of artery of Percheron infarction

Abstract Rationale: Holmes’ tremor is an uncommon neurologic disorder following brain insults, and its pathogenesis is undefined. The interruption of the dento-rubro-thalamic tract and secondary deterioration of the nigrostriatal pathway are both required to initiate Holmes’ tremor. We used nuclear medicine imaging tools to analyze a patient with concurrent infarction in different zones of each side of the thalamus. Finding whether the paramedian nuclear groups of the thalamus were injured was a decisive element for developing Holmes’ tremor. Patient concerns: A 36-year-old woman was admitted to our department due to a bilateral paramedian thalamic infarction. Seven months after the stroke, a unilaterally involuntary trembling with irregularly wavering motions occurring in both her left hand and forearm. Diagnosis: Based on the distinct features of the unilateral coarse tremor and the locations of the lesions on the magnetic resonance imaging (MRI), the patient was diagnosed with bilateral paramedian thalamic infarction complicated with a unilateral Holmes’ tremor. Interventions: The patient refused our recommendation of pharmacological treatment with levodopa and other dopamine agonists based on personal reasons and was only willing to accept physical and occupational training programs at our outpatient clinic. Outcomes: We utilized serial anatomic and functional neuroimaging of the brain to survey the neurologic deficit. A brain magneti...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

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Nationally, postoperative atrial fibrillation (POAF) occurs in up to 40% of patients after coronary artery bypass grafting (CABG), 50% of patients after valve surgery, 64% of patients after mitral valve and CABG, and 49% after aortic valve replacement.1 Atrial fibrillation worsens a patient ’s hemodynamic status and increases the risk of congestive heart failure, embolic events, and longer intensive care unit stays, leading to increased patient morbidity and strain on financial resources. In the United States, POAF carries a higher risk of stroke, worsened survival, and an additional 4.9 days and $10,000 to $11,500 i...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research
CONCLUSION: Although not always the most effective method of treatment in off-label usage, use of STS has been frequently selected for a variety of applications for reasons of simplicity, low cost, lack of availability of technologically advanced equipment, and intricacies related to anatomic location.
Source: Dermatologic Surgery - Category: Dermatology Tags: Review Article Source Type: research
Conclusion: Our case highlights the need to evaluate silent ischemic stroke in case of prolonged headache with a history of migraine as well as the need for precaution to avoid the use of triptans or opioids in such a case. It also highlights the conditions that need to be excluded before labeling it as a migrainous infarct.Case Rep Neurol 2017;9:241 –251
Source: Case Reports in Neurology - Category: Neurology Source Type: research
CONCLUSIONS: Embolization with coils is a minimally invasive, safe, and effective procedure for the treatment of carotid cavernous fistulas, including those related to iatrogenic causes. PMID: 28458950 [PubMed - in process]
Source: Surgical Neurology International - Category: Neurosurgery Tags: Surg Neurol Int Source Type: research
Conclusions:Given this patient’s recent transient ischemic attack, the uncertainty of the onset of his visual field defect appropriately prompted concern for new stroke. However, the presence of GCL thinning on SD-OCT consistent with RTSD provided reassurance that the infarction was remote and this conclusion was confirmed by inspection of an MRI from four years prior. SD-OCT may serve as a widely available, non-invasive, and cost-effective adjunct in differentiating acute from chronic post-geniculate visual pathway injury.Disclosure: Dr. Pham has nothing to disclose. Dr. Dinkin has received personal compensation for...
Source: Neurology - Category: Neurology Authors: Tags: Neuro-opthalmology/Neuro-otology II Source Type: research
CONCLUSION: LSAs and the circumferential deep brain are an interactive and mutually affected entity. We propose a new concept called lenticulostriate-artery neural complex (LNC) to integrate the structural, functional and pathological characteristics of this area, which would be a pragmatic paradigm in directing the future basic and clinical studies on ICH. PMID: 28228074 [PubMed - as supplied by publisher]
Source: Current Pharmaceutical Design - Category: Drugs & Pharmacology Authors: Tags: Curr Pharm Des Source Type: research
Rationale: Thalamic pain is a distressing and treatment-resistant type of central post-stroke pain. Although stellate ganglion block is an established intervention used in pain management, its use in the treatment of thalamic pain has never been reported. Patient concerns: A 66-year-old woman presented with a 3-year history of severe intermittent lancinating pain on the right side of the face and the right hand. The pain started from the ulnar side of the right forearm after a mild ischemic stroke in bilateral basal ganglia and left thalamus. Weeks later, the pain extended to the dorsum of the finger tips and the whole pa...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Publication date: Available online 3 January 2017 Source:Progress in Retinal and Eye Research Author(s): Carol Yim-lui Cheung, M. Kamran Ikram, Christopher Chen, Tien Yin Wong With increase in life expectancy, the number of persons suffering from common age-related brain diseases, including neurodegenerative (e.g., dementia) and cerebrovascular (e.g., stroke) disease is expected to rise substantially. As current neuro-imaging modalities such as magnetic resonance imaging may not be able to detect subtle subclinical changes (resolution <100–500 μm) in dementia and stroke, there is an urgent need for other ...
Source: Progress in Retinal and Eye Research - Category: Opthalmology Source Type: research
CONCLUSIONS: At low clinical equivalent doses corresponding to 25 µg/0.1 ml in humans, intravitreal rtPA is not toxic for healthy rat retinas and does not enhance NMDA-induced excitotoxicity. Vitreal equivalent doses ≥200 µg/0.1 ml should be avoided in patients, due to potential RGC toxicity. PMID: 27881907 [PubMed - in process]
Source: Molecular Vision - Category: Molecular Biology Tags: Mol Vis Source Type: research
This study solidified the notion that long-term exposure to continuous light can have a significant impact on health. Interestingly, most of the health parameters measured quickly returned to normal after restoring a regular light-dark cycle. Nevertheless, it becomes clear that exposure to artificial light is not at all harmless. By messing with our circadian rhythms through constant exposure to light, we may be accelerating our aging process and be actively weakening our health and resistance to disease. References Lucassen EA, et al (2016). Environmental 24-hr Cycles Are Essential for Health. Curr Biol, 26(14):1843-53. d...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Brain Blogger Publishers Sleep Artificial Lighting biological clock Circadian Rhythm cyclic health Sara Adaes PhD Sunlight suprachiasmatic nucleus Source Type: blogs
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