Reversal of Acute Spinal Cord Ischemia by Intravenous Thrombolysis
Systemic thrombolysis may be considered as treatment in acute spinal cord ischemia. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Focke, J. K., Seitz, R. J. Tags: MRI, DWI, Spinal cord infarction Case Source Type: research
Cerebral Venous Sinus Thrombosis With Severe Thrombocytopenia: A Fatal Adverse Event After Johnson & Johnson COVID-19 Vaccination
A high index of suspicion is required to identify the very rare case of CVST after vaccination with an adenovirus vector SARS-CoV-2 vaccine. Headache is very common after vaccination. Onset is within 24 hours. However, headache related to CVST starts 5–7 days after vaccination. This distinction can help clinicians risk stratify headache after SARS-CoV-2 vaccine administration. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Ali, M., Goshgarian, C., Jameson, A. Tags: COVID-19, Cerebral venous thrombosis Case Source Type: research
Waxing and Waning Neuroimaging Abnormalities in Langerhans Cell Histiocytosis
In adult Langerhans cell histiocytosis, progressive and accumulating imaging lesions in the CNS can regress. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: McCarron, L. V., Kelly, P., McConville, C., Flynn, P., McCarron, M. O. Tags: MRI, All Clinical Neurology, Endocrine, All Oncology Case Source Type: research
Progressive and Fatal Brainstem Stroke in Systemic Giant Cell Arteritis
A 74-year-old woman presented with acute worsening of a 6-month long history of vertigo and postural instability with MRI evidence of cerebellar and brainstem acute infarcts. Extensive neurovascular assessment revealed a severe vascular damage with multiple stenoses and occlusions along the vertebrobasilar axis (Figure 1). Duplex ultrasonography showed hypoechoic halo sign along facial artery, whereas PET-CT highlighted increased fluorine-18-fluorodeoxyglucose uptake along vertebral and other larger arteries, thus allowing a diagnosis of giant cell arteritis (Figure 2).1,2 Despite prompt treatment with high-dose steroids a...
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Poretto, V., Piffer, S., Bignamini, V., Tranquillini, E., Donner, D., Cavatorta, F. P., Barbareschi, M., Petralia, B., Giometto, B. Tags: MRI, PET, Ultrasound, Vasculitis Case Source Type: research
Catastrophic Cerebral Fat Embolism Syndrome Lacks Hyperacute MRI Findings
In patients who experience stroke due to cerebral fat embolism, hyperacute MRI may lack the characteristic diffusion-weighted imaging/fluid-attenuated inversion recovery changes expected in acute ischemic stroke. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Gusler, M. T., Vagal, A., Gilday, S. D., Flaherty, M. L. Tags: Stroke in young adults, MRI, Other cerebrovascular disease/ Stroke, Hematologic, Embolism Case Source Type: research
Caveats to Acute Imaging for Acute Stroke in the Setting of Venoarterial Extracorporeal Membrane Oxygenation
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used for cardiorespiratory support in medically refractory cases. The high rate of neurologic complications, specifically cerebrovascular disorders such as acute ischemic stroke, in VA-ECMO patients frequently prompts the acquisition of neuroimaging studies such as CT with angiography and perfusion imaging. Clinicians must be familiar with the ECMO-related artifacts when interpreting such studies. Here, we describe a case of asymmetric contrast opacification in a VA-ECMO patient with axillary artery cannulation. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Viamonte, M. A., Yu, J., Echevarria, F. D., Nagae, L., Youn, T. S., Tahsili-Fahadan, P., Simpkins, A. N. Tags: Stroke in young adults, CT, All Cerebrovascular disease/Stroke Case Source Type: research
Selective Dysarthria Due to Clival Chordoma
Selective dysarthria is unusual and requires evaluation of other etiologies in addition to vascular ones (mainly pathology of the oral cavity or brainstem). (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Perez-Lopez, C., Abenza-Abildua, M. J., Rodriguez-Dominguez, V., Gonzalez-Martin, L., Hernandez-Garcia, B. J. Tags: Primary brain tumor Case Source Type: research
Amyloid-PET-Positive Patient With bvFTD: Wrong Diagnosis, False Positive Scan, or Copathology?
Positive amyloid PET does not exclude FTD pathology in the diagnostic workup of dementia patients. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Langheinrich, T., Kobylecki, C., Jones, M., Thompson, J. C., Snowden, J. S., Hinz, R., Pickering-Brown, S., Mann, D., Roncaroli, F., Herholz, K., Gerhard, A. Tags: Diagnostic test assessment, PET, Alzheimer's disease, Frontotemporal dementia, Assessment of cognitive disorders/dementia Case Source Type: research
Subacute CNS Demyelination After Treatment With Immune Checkpoint Inhibitors
In a patient who develops neurologic symptoms while taking immune checkpoint inhibitors such as pembrolizumab, do consider CNS demyelination as a differential diagnosis. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Tan, E., Shaw, H., Nathan, P., Ghosh-Ray, S., Ottaviani, D. Tags: MRI, All Clinical Neurology, All Oncology, All Demyelinating disease (CNS) Case Source Type: research
Loss of Vision Because of Bilateral Lateral Geniculate Body Infarction After Traumatic Brain Injury
In patients with TBI, LPG infarction as a consequence of descending transtentorial herniation should be considered as a possible etiology of bilateral blindness. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Rausch, C., Bartsch, L., Gorodetski, B., Salih, F. Tags: MRI, Visual loss, All Cerebrovascular disease/Stroke, Brain trauma, Evoked Potentials/Visual Case Source Type: research
Myelopathy Because of CAR-T-Related Neurotoxicity Treated With Siltuximab
Siltuximab may be effective in patients with severe neurotoxicity after chimeric antigen receptor T-cell (CAR-T) therapy by lowering CNS interleukin-6 levels. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Aghajan, Y., Yu, A., Jacobson, C. A., Kim, A. I., Kean, L., Robertson, M., Vaitkevicius, H. Tags: All Oncology, All Spinal Cord, Critical care Case Source Type: research
Afternoon Tea Hemichorea
A 78-year-old woman, with a medical history of hypertension, presented to the Accident & Emergency Department after a sudden onset of right-sided involuntary movements while she was having afternoon tea with her friends. Examination showed isolated unilateral chorea, affecting the right arm and leg (Video 1). Her blood glucose and sodium levels were normal. The MRI head scan showed a left globus pallidus infarct (Figure). Tetrabenazine was prescribed with very good response and weaned off after 4 weeks. Hyperkinetic movement disorders are uncommon in acute stroke (1%).1 Lesions in regions functionally connected to the ...
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Williams, S., Kirby, J., Garcia, A. M. Tags: MRI, Clinical neurology examination, Chorea, All Cerebrovascular disease/Stroke, Infarction Case Source Type: research
Case of Guillain-Barre Syndrome After Coronavirus Disease 2019
Consider a possible association between SARS-CoV-2 infection and GBS. More epidemiologic data are required to support a causal relationship. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Gomez-Porro, P., Valenzuela-Chamorro, S., Cabal-Paz, B., Ochoa-Lopez, C., Garcia-Fleitas, B., Ebrat-Mancilla, E., Novo-Ponte, S., Gonzalez-Santiago, R. Tags: All Clinical Neurology, Viral infections, Guillain-Barre syndrome, All clinical neurophysiology, COVID-19 Case Source Type: research
Bilateral Optic Neuropathy Mimicking Neuromyelitis Optica in the Setting of Intracranial Germinoma
Biopsy is prudent to guide treatment when conventional diagnostics fail to provide an answer. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Abdalla, K. M. S., Tamhankar, M., Prabhu, A. M. Tags: All Clinical Neurology, Neuroendocrinology, Visual loss Case Source Type: research
Two Cases of Peripheral Facial Palsy With Negative CSF Analysis Despite an Infectious Etiology
Even in cases of the most common pathogens (i.e., Borrelia and VZV), basic CSF analysis as performed in the ER or "outside business hours" may not always rule out an infectious etiology. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Lambeck, J., Hieber, M., Niesen, W.-D., Bardutzky, J. Tags: All Infections, Clinical neurology examination, All Neuromuscular Disease, Cranial neuropathy, Cerebrospinal Fluid Case Source Type: research
