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Teaching NeuroImages: Intracranial vertebral dissection in a 15-year-old boy with sickle cell disease
A 15-year-old boy with sickle cell disease became unresponsive after sudden-onset headache. There was no antecedent trauma. A head CT scan demonstrated subarachnoid hemorrhage at the medulla (figure). Magnetic resonance angiography of the head and neck identified the patient's known bilateral internal carotid artery stenosis (a moyamoya-like arteriopathy associated with stroke in sickle cell disease) and a new right vertebral artery dissection, which was confirmed on conventional angiography (figure). Prior MRI performed as part of routine cerebral monitoring did not reveal any preexisting abnormality of the vertebral artery.
Source: Neurology - December 11, 2016 Category: Neurology Authors: Siegler, J. E., Banwell, B., Ichord, R. N. Tags: Pediatric stroke; see Cerebrovascular Disease/ Childhood stroke RESIDENT AND FELLOW SECTION Source Type: research

Teaching NeuroImages: Multicompartmental intracranial hemorrhage in a pediatric patient
A previously healthy 9-year-old girl presented with sudden-onset headache followed by confusion. In the emergency department, she was hypertensive, bradycardic, and no longer responsive to any stimuli. An emergent head CT scan demonstrated a left frontal intraparenchymal hematoma with intraventricular and subarachnoid extension as well as subfalcine herniation (figure). She underwent decompressive hemicraniectomy, and digital subtraction angiography confirmed a 7-mm left middle cerebral artery aneurysm (figure).
Source: Neurology - December 4, 2016 Category: Neurology Authors: Siegler, J. E., Ichord, R. N. Tags: Childhood stroke, Intracerebral hemorrhage, Subarachnoid hemorrhage RESIDENT AND FELLOW SECTION Source Type: research

Cohort of renal infarction during 2years at Grenoble teaching hospital.
CONCLUSION: Delay of diagnosis is a real problem for renal infarction, and need to be evocated every flank pain. LDH elevation may help clinician to suggest renal infarction and lead to CT scan. Association of delayed inflammatory syndrome, hypertension and hypokalemia after flank pain strongly suggest renal infarction. PMID: 27180563 [PubMed - as supplied by publisher]
Source: Annales de Cardiologie et d'Angeiologie - May 11, 2016 Category: Cardiology Authors: Cerba Y, Franko B, Zaoui P Tags: Ann Cardiol Angeiol (Paris) Source Type: research

Teaching NeuroImages: Cortical blindness following acute obstructive hydrocephalus by a colloid cyst
A 46-year-old woman was admitted for acute headache, postseizure confusion, and visual loss. Urgent head CT scan showed obstructive hydrocephalus due to a colloid cyst (figure 1). External ventricular drains inserted emergently demonstrated CSF under pressure, above 40 mm H2O. MRI confirmed the suspected diagnosis of a colloid cyst and highlighted bilateral occipital lobe infarcts (figure 2). CT angiography showed no thrombosis of the posterior cerebral arteries (PCAs). After neurosurgical excision of the colloid cyst, the patient remained blind. The presumed mechanism of infarction was acute compression of the PCAs agains...
Source: Neurology - February 9, 2015 Category: Neurology Authors: Champeaux, C., Grivas, A. Tags: Hydrocephalus, Stroke in young adults, MRI, Clinical neurology examination, Visual loss RESIDENT AND FELLOW SECTION Source Type: research

Quick magnesium treatment fails to improve stroke outcomes, but study has silver lining
In the first study of its kind, a consortium led by UCLA physicians found that giving stroke patients intravenous magnesium within an hour of the onset of symptoms does not improve stroke outcomes.   However, the 8-year trial did find that with the help of paramedics in the field, intravenous medications can frequently be administered to stroke victims within that so-called "golden hour," during which they have the best chance to survive and avoid debilitating, long-term neurological damage.   The latter finding is a "game-changer," said Dr. Jeffrey Saver, director of the UCLA Stroke Center and a professor of ...
Source: UCLA Newsroom: Health Sciences - February 13, 2014 Category: Universities & Medical Training Source Type: news