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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Postoperative atrial fibrillation (POAF) frequently complicates cardiac surgery, and is associated with prolonged hospitalization, increased risk of development of AF during follow-up, stroke and mortality. Several comorbidities predispose to POAF, among which inflammation and oxidative stress, but also structural atrial remodeling is associated with an increased POAF risk(1). One potential pathway that caught attention recently is the autonomic dysbalance during cardiac surgery in relation to the occurrence of POAF.
Source: Heart Rhythm - Category: Cardiology Authors: Source Type: research
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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
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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
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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
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Source: Current Pharmaceutical Design - Category: Drugs & Pharmacology Authors: Tags: Curr Pharm Des Source Type: research
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Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
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