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Condition: Hypertension
Infectious Disease: Meningitis

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Total 46 results found since Jan 2013.

266 A drowsy patient: beyond the familiar territory
A 72-year-old man was brought to the hospital after he was found unresponsive at home by his wife who reported that he has been sleepy in the last few days. He has a background of hypertension, myocardial infarct, and osteoarthritis. His medications include anti-hypertensive and morphine sulphate. On examination, he was drowsy with GCS fluctuating between 9–11 but maintaining his airways. He was moving all four limbs; pupils were small and unequal but reactive to light. Planter reflexes were downgoing. Opioid toxicity was suspected and treated with naloxone without any response. The CT head scan showed no acute patho...
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 27, 2022 Category: Neurosurgery Authors: Oo, A., Khine, N. Tags: Poster Presentations Source Type: research

Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies
We describe a pregnant lady who presented with sensorineural deafness of the right ear and paralysis of the 9 th , 10 th , and 12 th cranial nerves on the right side. She was diagnosed to have thrombosis of the right transverse sinus and sigmoid sinus with extension to the jugular vein and confluence of sinuses. She improved with anticoagulant treatment.
Source: Indian Journal of Critical Care Medicine - January 25, 2013 Category: Intensive Care Authors: N ByjuJames JoseK SaifudheenV Abdul GafoorP Jithendranath Source Type: research

Idiopathic hypertrophic cranial pachymeningitis: a rare but treatable cause of headache and facial pain
Introduction Idiopathic Hypertrophic Cranial Pachymeningitis (IHCP) is a rare disease with pain and compression related cranial nerve dysfunction as main clinical features. The leading diagnostic finding of IHCP consists of diffuse or localised thickening of the dura, which demands appropriate imaging and image interpretation. This case description aims at increasing the awareness for the clinical symptoms and imaging findings of this rare disease to allow prompt diagnosis and treatment initiation. Case description An 82-year-old man presented with recurrent left sided headache and worsening facial pain, which had begun mo...
Source: Journal of Neurology, Neurosurgery and Psychiatry - February 15, 2013 Category: Neurosurgery Authors: Khalil, M., Ebner, F., Fazekas, F., Enzinger, C. Tags: Immunology (including allergy), Meningitis, Brain stem / cerebellum, Cranial nerves, Headache (including migraine), Infection (neurology), Multiple sclerosis, Pain (neurology), Stroke, Hypertension, Ophthalmology, Radiology, Surgical diagnostic tests, Ear Source Type: research

Clinical Reasoning: A 44-year-old woman with headache followed by sudden neurologic decline
A 44-year-old woman with a history of migraines and idiopathic intracranial hypertension presented to the emergency room with 1 day of headache and nausea. She had been otherwise healthy with no sick contacts. She was afebrile without nuchal rigidity, rash, or cardiac murmur, and her neurologic examination was normal. Migraine therapy was initiated with IV prochlorperazine, ketorolac, and magnesium. Two hours later, she developed fever (101.4°F) and confusion, continually stating, "It hurts," but unable to answer questions or follow commands despite an otherwise unremarkable examination. Noncontrast head CT demonstrate...
Source: Neurology - March 25, 2013 Category: Neurology Authors: Berkowitz, A. L., Kimchi, E. Y., Hwang, D. Y., Vaitkevicius, H., Henderson, G. V., Feske, S. K., Chou, S. H.- Y. Tags: Hydrocephalus, Stroke in young adults, Meningitis, Critical care RESIDENT AND FELLOW SECTION Source Type: research

Cerebral microbleeding in varicella-zoster viral meningitis: An early sign of vasculopathy?
A 75-year-old man undergoing chemotherapy for prostate cancer for 3 months presented with headache after having blisters in his left ear canal and auricle. His body temperature at presentation was 38°C. Neurologic examination revealed nuchal stiffness and left peripheral facial palsy. We also noted leukocytopenia (2,000/µL) and elevated serum C-reactive protein (8.51 mg/dL). CSF analysis showed no erythrocytes, elevated leukocytes (640/µL; 3% monocytes, 97% neutrophils), an increased protein level (473 mg/dL), and slightly decreased glucose level (51 mg/dL, serum glucose 120 mg/dL). Brain MRI and magnetic r...
Source: Neurology - March 3, 2014 Category: Neurology Authors: Ohtomo, R., Shirota, Y., Iwata, A., Shimizu, J., Tsuji, S. Tags: MRI, Other cerebrovascular disease/ Stroke, Vasculitis, Viral infections CLINICAL/SCIENTIFIC NOTES Source Type: research

'Ping-Pong' Gaze in Hypoglycemic Encephalopathy (P6.302)
Conclusion: A proposed mechanism for PPG is disconnection of bilateral cerebral hemispheres from the horizontal gaze center in the brainstem. It has been previously reported in structural brain lesions. However, as demonstrated in this case it may be seen in other encephalopathes.Disclosure: Dr. Ali has nothing to disclose. Dr. Haines has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Ali, S., Haines, S. Tags: Neuro-ophthalmology/Neuro-otology II Source Type: research

CNS disease triggering Takotsubo stress cardiomyopathy
There are a number of hereditary and non-hereditary central nervous system (CNS) disorders, which directly or indirectly affect the heart (brain-heart disorders). The most well-known of these CNS disorders are epilepsy, stroke, infectious or immunological encephalitis/meningitis, migraine, and traumatic brain injury. In addition, a number of hereditary and non-hereditary neurodegenerative disorders may impair cardiac functions. Affection of the heart may manifest not only as arrhythmias, myocardial infarction, autonomic impairment, systolic dysfunction/heart failure, arterial hypertension, or pulmonary hypertension, but al...
Source: International Journal of Cardiology - August 26, 2014 Category: Cardiology Authors: Josef Finsterer, Karim Wahbi Source Type: research

Multiple intracranial arteritis and hypothyroidism secondary to Streptococcus anginosus infection
A 50-year-old Chinese woman reported a sharp paroxysmal headache and abrupt paralysis of the left leg. She then developed ptosis, blurred vision, diplopia and fever. On admission, a neurological examination revealed right III, IV, VI and left V1 cranial nerve palsy, bilateral upper eyelid oedema and left leg monoplegia (Medical Research Council grade 2/5). In addition, a left Babinski sign and nuchal rigidity were observed. Blood tests revealed elevated white cell count (WCC) and a majority of the cells were neutrophils. Lumbar puncture revealed that the WCC (120x106/μL) and protein level (0.79 g/L) of the cerebros...
Source: Journal of Neurology, Neurosurgery and Psychiatry - August 13, 2015 Category: Neurosurgery Authors: Zhang, C., Xie, B., Shi, F.-D., Hao, J. Tags: Open access, Immunology (including allergy), Meningitis, Brain stem / cerebellum, Cranial nerves, Drugs: CNS (not psychiatric), Headache (including migraine), Infection (neurology), Pain (neurology), Stroke, Hypertension, Ophthalmology, Radiology, Musculo Source Type: research

Sudden neuropathological deaths: An autopsy study
Background Sudden or unexpected death can occur from unnatural causes, such as violence or poisoning, as well as from natural causes. Second to cardiac causes, neuropathology is one of the main causes of sudden natural death. In spite of the increasing incidence of neuropathological deaths, few studies have been conducted in Asia – hence the reason for the present study. Methods A 10-year (January 2003 to December 2012) retrospective study was conducted at the MS medico-legal institute in a metropolitan city of southern India. All the cases of sudden natural death, where the cause of death was opined to be due to a ...
Source: Medicine, Science and the Law - September 16, 2015 Category: Medical Law Authors: Hugar, B. S., Shetty, H., Girishchandra, Y., Hosahally, J. S. Tags: Original articles Source Type: research

Management of Intracranial Pressure
Purpose of Review:: Intracranial pressure (ICP) can be elevated in traumatic brain injury, large artery acute ischemic stroke, intracranial hemorrhage, intracranial neoplasms, and diffuse cerebral disorders such as meningitis, encephalitis, and acute hepatic failure. Raised ICP is also known as intracranial hypertension and is defined as a sustained ICP of greater than 20 mm Hg. Recent Findings:: ICP must be measured through an invasive brain catheter, typically an external ventricular catheter that can drain CSF and measure ICP, or through an intraparenchymal ICP probe. Proper recognition of the clinical signs of elevated...
Source: CONTINUUM - October 1, 2015 Category: Neurology Tags: Review Articles Source Type: research

Valacyclovir and Acyclovir Neurotoxicity With Status Epilepticus
We present the case of a 52-year-old man with hypertension, diastolic congestive heart failure, end-stage renal disease on hemodialysis 3 times a week and a remote history of a hemorrhagic stroke who presented to the emergency department with a vesicular rash on his left arm. The rash was observed to be in a dermatomal distribution, and a diagnosis of herpes zoster was made. The patient was discharged home on valacyclovir 1 g 3 times a day for a duration of 7 days. The patient took 2 doses of valacyclovir before presenting to the hospital again with irritability and hallucinations. Over the next several days, the patient's...
Source: American Journal of Therapeutics - January 1, 2016 Category: Drugs & Pharmacology Tags: Case Reports Source Type: research

Pituitary aspergillus infection
We report a case of Aspergillus infection involving the pituitary gland and sellar region discovered in a 74-year-old man. The patient had a history of hypertension, chronic renal disease, autoimmune hemolytic anemia and presented with right eye pain, headaches and worsening hemiparesis. Imaging studies revealed a right internal carotid artery occlusion and an acute right pontine stroke along with smaller infarcts in the right middle cerebral artery distribution. Clinically, the patient was thought to have vasculitis. An infectious etiology was not identified. He developed respiratory distress and died. At autopsy, necroti...
Source: Journal of Clinical Neuroscience - May 29, 2016 Category: Neuroscience Source Type: research

Neurology: Images in Clinical Medicine
Editor: V. Dimov, M.D., Cleveland ClinicHypoglossal Nerve Palsy during Meningococcal Meningitis. NEJM, 10/2014.Absent Superficial Abdominal Reflex due to thoracic spinal cord neuromyelitis. NEJM, 05/2014.Kayser-Fleischer Rings in Wilson ' s Disease. NEJM, 03/2012.Perilymph Fistula Test leads to nystagmus. NEJM, 01/2012.A stray bullet in the brain - with no deficit of power, cognition, sense of touch, or speech. Lancet, 01/2012.Blindness after Fat Injections. NEJM, 12/2011.Internal-Carotid-Artery Dissection and Cranial-Nerve Palsies. NEJM, 12/2011.A Head Shot. NEJM, 12/2011.Multiple Intracranial Tuberculomas. NEJM, 10/2011....
Source: Clinical Cases and Images - August 22, 2009 Category: General Medicine Tags: Images Neurology Source Type: news