Late Diagnosis of Multiple Cerebral Aneurysms A Decade after Resection of Cardiac Myxoma
We report a case of delayed presentation of neurological manifestations in form of multiple intracranial aneurysms many years after treatment of a cardiac myxoma. Our patient, a 55-year-old right-handed female with a background history of hypertension, first presented at the age of 45 years with a sudden onset of right hemiplegia. A CT brain scan detected multiple infarcts in the territory of the left middle cerebral artery. Echocardiography revealed a cardiac myxoma for which she underwent immediate total surgical resection. Nearly 10 years after this diagnosis, she presented again with right-sided weakness and left ptosi...
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research
Nonbacterial Thrombotic Endocarditis Related to Adenocarcinoma of the Uterine Cervix
We report a 66-year-old female patient who presented with acute onset of visual loss with relative afferent pupillary defect, hemineglect, hemihypesthesia, and apraxia. Magnetic resonance imaging of the brain demonstrated different stages of ischemic stroke in different vascular territories, suggesting cardiogenic embolism. Past history was significant for advanced-stage adenocarcinoma of the uterine cervix under chemoradiation treatment. On echocardiogram, vegetation at the aortic valve was observed. With the absence of evidence of infectious endocarditis, diagnosis of nonbacterial thrombotic endocarditis was made, and th...
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research
Acute Ischemic Stroke in a Young Patient with Left Ventricular Thrombus Attributed to Doxorubicin Cardiomyopathy
We report a case of acute middle cerebral territory ischemic infarction caused by left ventricular thrombus (LVT) in a doxorubicin cardiomyopathy patient. A major adverse effect of doxorubicin is cardiotoxicity. In doxorubicin cardiomyopathy, as the ventricular contractility decreases, LVT can occur and lead to systemic embolic events such as stroke.Case Rep Neurol 2020;12:178 –182 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research
Uncommon Causes of Cardioembolic Stroke and Related Complications
Case Rep Neurol 2020;12:176 –177 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research
Subarachnoid Hemorrhage due to Ruptured Spinal Artery Aneurysm: A Diagnostic Challenge
In conclusion, rupture of a spinal aneurysm should be considered a possible cause of SAH in appropriate clinical settings, and clinicians must be aware of the possibility of cord compression.Case Rep Neurol 2020;12:169 –175 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research
Small Intracranial Aneurysms and Subarachnoid Hemorrhage: Is the Size Criterion for Risk of Rupture Relevant?
The current understanding is that small intracranial aneurysms (#x3c;7 mm) are not at a significant risk for rupture. However, there have been several published series of rupture and subarachnoid hemorrhage from aneurysms #x3c;5 mm. Three cases of intracranial aneurysms rupturing at #x3c;3 mm are presented in this paper. Patient age ranged between 38 and 57 years. The aneurysms were located in different parts of the circulation in the brain. This case series highlights that the size criterion alone is not adequate when evaluating patients with unruptured brain aneurysms for observational follow-up or treatment.Case Rep Neu...
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research
Psychogenic Seizure Imitating Narcolepsy
We describe a 55-year-old man with frequent brief and sudden sleep-like attacks in combination with nocturnal sleep disturbance. During attacks he was unresponsive, snoring but maintained posture. He resisted passive eye opening but with rolling eyes. The patient was confused on waking. In the interictal period, there were FND signs including give-way weakness of the left hand, typical functional “leg-dragging” gait, mistake in the finger-to-nose test. Video-electroencephalogram monitoring did not detect specific epileptic activity or sleep pattern during the attacks. Polysomnography showed multiple waking episodes dur...
Source: Case Reports in Neurology - December 11, 2020 Category: Neurology Source Type: research
Fragile-X-Associated Tremor/Ataxia Syndrome or Alcohol-Induced Cerebellar Degeneration? A Case Report
We present and discuss a male patient whose diagnosis of FXTAS was delayed due to his concomitant alcohol abuse.Case Rep Neurol 2020;12:466 –471 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - December 11, 2020 Category: Neurology Source Type: research
Unilateral Dorsolateral Medullary Hemorrhage Presenting with Severe Dysphagia
We report an 87-year-old woman with right dorsolateral medullary hemorrhage. She did not show all of the usual symptoms of Wallenberg syndrome and her main symptom was severe dysphagia. Dorsolateral medullary hemorrhage may be overlooked, because it is rare and does not exhibit the typical Wallenberg syndrome presentation usually seen in patients with infarction at the dorsolateral medulla.Case Rep Neurol 2020;12:460 –465 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - November 27, 2020 Category: Neurology Source Type: research
Bell ’s Palsy in Pregnancy: A Case Series
The association between pregnancy-associated Bell ’s palsy (PABP) and gestational hypertension (GHT), preeclampsia (PE), and eclampsia (EC) remains inconclusive. We aimed to study the characteristics of PABP cases and the neonatal outcomes at our institution. All cases diagnosed with PABP from 2006 to 2016 were identified. Demographic and clinica l characteristics including maternal age, previous medical and obstetric illnesses, gestational age at the onset of PABP, the development of PE/EC, GHT, gestational diabetes mellitus (GDM), treatment and outcomes, as well as neonatal health indices and anomalies were described. ...
Source: Case Reports in Neurology - November 26, 2020 Category: Neurology Source Type: research
Prominent Prolongation of Cortical Silent Period Induced by Transcranial Magnetic Stimulation in Creutzfeldt-Jakob Disease
The cortical silent period (CSP) induced by transcranial magnetic stimulation (TMS) has been reported to be prolonged in 2 Creutzfeldt-Jakob disease (CJD) patients who presented with periodic myoclonus. Herein, we will show a prominent prolongation of TMS-induced CSP in a patient with CJD who did not have periodic myoclonus. The patient was a 66-year-old woman who developed rapidly progressive dementia. No myoclonic jerks were observed. Brain magnetic resonance imaging showed high-intensity lesions in the cerebral cortex, basal ganglia, and thalamus on diffusion-weighted images. Electroencephalography (EEG) showed diffuse ...
Source: Case Reports in Neurology - November 17, 2020 Category: Neurology Source Type: research
Reversible Cerebral Vasoconstriction Syndrome after Nifedipine Withdrawal
Reversible cerebral vasoconstriction syndrome (RCVS) is an essential but often unrecognized cause of intracranial haemorrhage. While there are no specific causes of the syndrome, associations with many clinical conditions and drugs have been observed, and calcium channel blockers (CCBs) are often used to relieve the symptoms. This is a case of RCVS that was triggered by the sudden withdrawal of nifedipine, a CCB.Case Rep Neurol 2020;12:440 –446 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - November 17, 2020 Category: Neurology Source Type: research
Gasperini Syndrome: A Case Report and Systematic Review and Proposing a New Definition
We report a new case and reviewed the clinical features of this syndrome from all published reports to propose a new definition. A 57-year-old man with acute br ainstem stroke had right CN V–VIII and XII palsies, left body hypoesthesia and ataxia. Brain MRI showed an acute stroke in the right caudal pons and bilateral cerebellum. After a systematic review, we classified the clinical manifestations into core and associate features based on the frequencies of occurring neurological deficits. We propose that a definitive GS requires the presence of ipsilateral CN VI and VII palsies, plus one or more of the other three core ...
Source: Case Reports in Neurology - November 13, 2020 Category: Neurology Source Type: research
Rare Case of Late-Onset Narcolepsy Type 1
A 69-year-old male developed symptoms typical of the diagnosis of narcolepsy type 1 without any previous triggering events. First, daytime sleepiness occurred, soon followed by cataplexy. Nocturnal polysomnography revealed rapid eye movement (REM) sleep behavior disorder, a apnea-hypopnea index of 25.8 events/h, and no sleep-onset REM. Multiple Sleep Latency Test showed a mean sleep latency of 2.1 min and REM sleep in 3 tests. HLA DQB1*06:02 was positive and hypocretin-1 in cerebrospinal fluid unmeasurable. A treatment with 50 mg clomipramine controlled the cataplexy; excessive daytime sleepiness was sufficiently managed b...
Source: Case Reports in Neurology - November 12, 2020 Category: Neurology Source Type: research
Wound Botulism Caused by Botulinum Neurotoxin Type A in a Chronic Parenteral Drug Abuser
Botulism is an acute paralytic disease caused by botulinum neurotoxin (BoNT)-mediated inhibition of neurosignaling at the neuromuscular junction. BoNTs are produced by gram positive, anaerobic, spore-forming bacteria from the genusClostridium,most commonly Clostridium botulinum. Over the last decade, a previously uncommon form of botulism, wound botulism, has increased in prevalence possibly due to the rise in parenteral drug abuse. A 53-year-old patient with a history of drug abuse presents to a rural emergency department with rapidly progressing lower extremity weakness over the past few days. He reports a recent heroin ...
Source: Case Reports in Neurology - November 12, 2020 Category: Neurology Source Type: research
