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Thrombotic Thrombocytopenic Purpura Without Schistocytes: Beware of Misdiagnosis
A 43-year-old woman was admitted for acute unusual headache, vertigo, and left upper limb weakness. She had been complaining of asthenia for the past few weeks. Her medical history included uterine cervix cancer treated with conisation and 2 pregnancies without serious complications. No allergy or recent drug introduction was noted. After ruling out current pregnancy, magnetic resonance imaging (MRI) was immediately performed and showed recent ischemic strokes in multiple territories. Doppler ultrasound imaging showed no carotid or vertebral arteries lesion. Electrocardiogram showed no ST elevation or atrial fibrillation, ...
Source: Neurology Clinical Practice - October 11, 2021 Category: Neurology Authors: Decker, P., Moulinet, T., Revuz, S., Perez, P., Jaussaud, R. Tags: Autoimmune diseases, Hematologic, All Cerebrovascular disease/Stroke Case Source Type: research

Histamine and Delirium: Current Opinion
This study indicated that switch from H2 blockers to PPIs reduced delirium and, thus, providing an appropriate strategy to combat drug-induced delirium using antiulcer drugs (Fujii et al., 2012). The ventrolateral preoptic nucleus is a sleep-promoting nucleus located in the basal forebrain. A commonly used intravenous anesthetic, propofol, had been reported to induce sleep and augment the firing rate of neurons in ventrolateral GABAergic preoptic nucleus, but the underlining mechanism is yet to be clearly determined. Interestingly, the propofol-induced inhibition of inhibitory postsynaptic currents on noradrenalin-inhibite...
Source: Frontiers in Pharmacology - April 8, 2019 Category: Drugs & Pharmacology Source Type: research

A fatal case of 'primary' headache
We describe a case of a 33 year old caucasian male with a subacute history of headaches presenting to the medical team with pyrexia, confusion and hallucinations. He subsequently became disorientated, agitated and initially needed sedation and ventilation after becoming acutely hypoxic with autonomic instability. He was subsequently found to have dense, pre–geniculate blindness and generalised arreflexia. Magnetic resonance imaging demonstrated normal brain parenchyma but diffuse nodular thickening and enhancement of the basal leptomeninges in the brain and throughout the entire spinal cord. Lumbar puncture revealed ...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Dayanandan, R., Bindman, D., Chhetri, S. K., Jacob, J., Mathur, S., Mills, R. J. Tags: Immunology (including allergy), HIV/AIDS, Meningitis, Headache (including migraine), Infection (neurology), Neurooncology, Pain (neurology), CNS cancer, Ophthalmology, Radiology, Surgical diagnostic tests, Radiology (diagnostics) Association of British Source Type: research