Clinical Correlations of Positive Herpes Simplex PCR in Cerebrospinal Fluid
Objectives:
Herpes simplex viruses (HSV) can produce encephalitis (HSE), which requires early detection, typically using polymerase chain reaction (PCR) in cerebrospinal fluid (CSF). However, other neurological conditions not directly caused by HSV may also present with a positive HSV PCR in the CSF (NCNHPCR+). We aimed to analyze the clinical features of both groups of patients (HSE vs. NCNHPCR+) and to consider the potential relevance of this finding in the latter.
Methods:
A retrospective analysis of clinical presentation, workup (CSF, EEG, and MRI) and outcome of patients with an HSV+ result in CSF was conducted f...
Source: The Neurologist - November 1, 2018 Category: Neurology Tags: Original Article Source Type: research
Clinical Presentation and Cranial MRI Findings of Listeria monocytogenes Encephalitis: A Literature Review of Case Series
Conclusions:
Listeria encephalitis is a severe disease and should be remembered in cases admitted with symptoms related to the brainstem and cranial nerve dysfunction. Cranial magnetic resonance imaging with brainstem and cerebellum involvements and contrast enhancement with or without abscess are particularly suggestive of the listeria-related infection. (Source: The Neurologist)
Source: The Neurologist - November 1, 2018 Category: Neurology Tags: Review Article Source Type: research
Right Insular Cortex Ischemia Caused by Middle Cerebral Artery Occlusion: A Possible Pathogenesis of Decreased Sympathetic Nervous System Activity?
No abstract available (Source: The Neurologist)
Source: The Neurologist - November 1, 2018 Category: Neurology Tags: Letter to the Editor Source Type: research
Thrombolysis After Protamine Reversal of Heparin for Acute Ischemic Stroke After Cardiac Catheterization: Case Report and Literature Review
Conclusions:
There are limited reports of protamine reversal of heparin before IV-tPA administration. To our knowledge, there are only 6 AIS cases including ours. Three cases received 0.6 mg/kg of tPA dose. All have favorable outcomes and no intracranial hemorrhage was reported. Protamine reversal of heparin for AIS after CC seems to be safe. Further studies are needed to confirm the therapeutic safety and efficacy of this strategy. (Source: The Neurologist)
Source: The Neurologist - November 1, 2018 Category: Neurology Tags: Case Report/Case Series Source Type: research
Disseminated High-grade Glioma in a Long-term Survivor of Medulloblastoma: Implications and Management of Radiation-induced Malignancies
We describe a gentleman diagnosed with a posterior fossa medulloblastoma in 1998, successfully treated with craniospinal radiation therapy (RT) and posterior fossa RT boost, followed by 12 months of adjuvant chemotherapy. Nineteen years later, at the age of 28, the patient presented with multiple cranial neuropathies and was found to have disseminated high-grade glioma with leptomeningeal dissemination. In addition to the salient features of this case, we provide a brief review of RT-induced malignancies and the need for further research regarding surveillance and prevention strategies. (Source: The Neurologist)
Source: The Neurologist - November 1, 2018 Category: Neurology Tags: Case Report/Case Series Source Type: research
High-resolution Intracranial Vessel Wall Imaging in Monitoring Treatment Response in Primary CNS Angiitis
Conclusions:
Our report illustrates the utility of HR-VWI in diagnosing a case of PCNS angiitis through the demonstration of a vasculitic pattern of mural enhancement. Furthermore, it has provided evidence of disease response to treatment, assisting us in modifying treatment accordingly. Tracking disease activity and response to treatment in cases of central nervous system vasculitis can be another important use of HR-VWI in clinical practice besides assisting in establishing the diagnosis. (Source: The Neurologist)
Source: The Neurologist - November 1, 2018 Category: Neurology Tags: Case Report/Case Series Source Type: research
Safety of Therapeutic Plasma Exchange for the Treatment of Guillain-Barré Syndrome in Polycythemia Vera
Polycythemia vera (PV) is a risk factor for systemic thromboses and ischemic stroke. This has been attributed to blood hyperviscosity, the result of increased blood cell production. Intravenous immunoglobulin, which is indicated for the treatment of numerous hematologic and neurological conditions also causes increased serum viscosity and has been associated with ischemic strokes in the setting of PV. Here we report a case of a 70-year-old man with prior stroke and PV who developed Guillain-Barré syndrome, an acute inflammatory demyelinating disorder of peripheral nerves causing ascending paresis, numbness, and paresthesi...
Source: The Neurologist - November 1, 2018 Category: Neurology Tags: Case Report/Case Series Source Type: research
Anti-aquaporin-4 Antibody Positive Optic Neuritis Following Scrub Typhus in an Elderly Female
Conclusions:
Optic neuritis (ON) associated with scrub typhus is extremely rare. Our case support that scrub typhus could trigger ON in a lifelong asymptomatic patient with AQP4-Ab and AQP4-Ab should be considered in a very old age patient with suspected postinfectious inflammatory ON. (Source: The Neurologist)
Source: The Neurologist - November 1, 2018 Category: Neurology Tags: Case Report/Case Series Source Type: research
Inter-rater Agreement for the Diagnosis of Stroke Versus Stroke Mimic: Erratum
No abstract available (Source: The Neurologist)
Source: The Neurologist - September 1, 2018 Category: Neurology Tags: Erratum Source Type: research
Is Patent Foramen Ovale Closure More Effective Than Medical Therapy in Preventing Stroke Recurrence in Patients With Cryptogenic Stroke?: A Critically Appraised Topic
Conclusions:
Among patients who had a recent CS attributed to PFO with a large interatrial shunt or with an associated atrial septal aneurysm, the rate of stroke recurrence was lower among those assigned to PFO closure combined with antiplatelet therapy than among those assigned to antiplatelet therapy alone. (Source: The Neurologist)
Source: The Neurologist - September 1, 2018 Category: Neurology Tags: Critically Appraised Topics Source Type: research
Investigation of the Video-EEG Findings and Clinical Data in Patients Diagnosed With Epilepsy and Psychosis
Conclusions:
Although our sample size could be considered small, slowed EEG background activity, and the marked frequency of initial precipitant factors such as status epilepticus, perinatal cerebral injury, and detected neuronal autoantibodies suggested that EP is associated with more extensive involvement. EP is not a contraindication for epilepsy surgery, when appropriately investigated preoperatively. (Source: The Neurologist)
Source: The Neurologist - September 1, 2018 Category: Neurology Tags: Original Article Source Type: research
Response to BRAF/MEK Inhibition After Progression With BRAF Inhibition in a Patient With Anaplastic Pleomorphic Xanthoastrocytoma
We present the case of an anaplastic PXA initially treated with the BRAF inhibitor vemurafenib. After progression of disease the MEK inhibitor trametinib was added to the regimen leading to radiographic improvement. The rationale for combined BRAF and MEK inhibition in PXA is reviewed. (Source: The Neurologist)
Source: The Neurologist - September 1, 2018 Category: Neurology Tags: Case Report/Case Series Source Type: research
Triptan-induced Reversible Cerebral Vasoconstriction Syndrome Presenting With Thunderclap Headache and Paraparesis
We report a rare case of Rizatriptan-induced reversible cerebral vasoconstriction syndrome presenting with thunderclap headache and paraparesis with complete recovery of neurological and imaging findings. (Source: The Neurologist)
Source: The Neurologist - September 1, 2018 Category: Neurology Tags: Case Report/Case Series Source Type: research
Wall-eyed Bilateral Internuclear Ophthalmoplegia (WEBINO) in a Patient With Idiopathic Intracranial Hypertension
Conclusions:
To our knowledge this is the first case description of a patient with WEBINO and idiopathic intracranial hypertension. The diagnosis is supported by the very high opening pressure, the absence of neuroimaging abnormalities, the papilledema, and the response to ventriculoperitoneal drainage. (Source: The Neurologist)
Source: The Neurologist - September 1, 2018 Category: Neurology Tags: Case Report/Case Series Source Type: research
Bilateral Hypoglossal Nerve Palsy in an Adult Patient With Repaired Tetralogy of Fallot
Conclusions:
This is the first case of multiple-vessel sCAD, and more associated with an unusual clinical presentation, in a patient with surgically repaired ToF, supporting the hypothesis that defective large artery elastogenesis plays a role in this congenital disorder, and suggesting the importance of continuous long-term vascular follow-up. (Source: The Neurologist)
Source: The Neurologist - September 1, 2018 Category: Neurology Tags: Case Report/Case Series Source Type: research
