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Ramsay Hunt Syndrome with Pharyngolaryngeal Involvement Mimicking Acute Stroke: A Case Report
We present a 56-year-old male patient who was diagnosed with acute pharyngitis. Two days later, the patient developed dysarthria, hoarseness, and left side facial weakness. Considering a patient's history of cardiovascular events, the acute stroke was suspected. Magnetic resonance imaging ruled out an acute cerebrovascular accident. The patient's otalgia aggravated and he reported hearing loss. Clinical examination revealed facial paralysis affecting the left side of the face, erythematous rash on the left auricle, multiple vesicles present on patient's left tympanic membrane, ulcerous lesion on the left side of the soft p...
Source: Herpes - August 28, 2023 Category: Infectious Diseases Authors: Svetlana Valjarevic Jelena Gavric Sara Dragovic Milan B Jovanovic Source Type: research

Neurosarcoidosis Presenting with Prominent Periventricular White-Matter Lesions during Steroid Treatment for Autoimmune Hepatitis
A 63-year-old woman under treatment of autoimmune hepatitis presented with headache, memory loss, and somnolence. Three months before admission, the patient experienced liver inflammation relapse after prednisolone (PSL) cessation. Consequently, PSL was resumed and then tapered. Cerebrospinal fluid (CSF) examination showed lymphocytic pleocytosis with remarkably reduced glucose and elevated angiotensin-converting enzyme and soluble interleukin-2 receptor levels. Magnetic resonance imaging (MRI) revealed prominent bilateral periventricular white-matter lesions, hydrocephalus, ischemic stroke with gadolinium enhancement of f...
Source: Case Reports in Neurology - August 19, 2022 Category: Neurology Source Type: research

Immunoglobulin G4-Related Disease Presenting as Temporal Bone Lesion with Facial Nerve Palsy
We report a case of IgG4-RD with infiltration of the temporal bone and surrounding structures in a patient with systemic vasculitis on systemic steroids. A 31-year-old woman presented with right-sided facial weakness, headache, and right ear hearing loss. On examination, redness and retraction of the right tympanic membrane and facial paresis (House-Brackman IV) were noted. Computed tomography imaging showed mastoiditis, temporal lobe stroke, and brain abscess. Magnetic resonance imaging (MRI) showed infiltration in the infratemporal fossa, nasopharynx, spreading along the Eustachian tube and perineurally along the branche...
Source: ORL - June 7, 2022 Category: ENT & OMF Source Type: research

Multiple Cerebral Infarctions Accompanied by Subcortical and Subarachnoid Hemorrhaging in Bilateral Border Zone Areas in a Patient with Eosinophilic Granulomatosis with Polyangiitis
Intern Med. 2021 Sep 4. doi: 10.2169/internalmedicine.7999-21. Online ahead of print.ABSTRACTEosinophilic granulomatosis with polyangiitis (EGPA) is often associated with peripheral neuropathy, but reports of central nervous system involvement are quite rare. We herein report a patient with EGPA first identified as having hypereosinophilia who later developed asthma, eosinophilic otitis media, sinusitis, and hemorrhagic colitis. She subsequently developed hemiparesis. Head magnetic resonance imaging revealed multiple cerebral infarctions with subcortical and subarachnoid hemorrhaging colocalized at the bilateral border zon...
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Toshikazu Mino Hiroka Sakaguchi Itsuki Hasegawa Akitoshi Takeda Takahito Yoshizaki Takato Abe Yoshiaki Itoh Source Type: research

Atypical presentation of giant cell arteritis in a patient with vertebrobasilar stroke: A case report
Rationale: Giant cell arteritis (GCA) is known to present with typical manifestations like temporal headache and visual abnormalities. However, several cases with atypical manifestations were reported. Stroke occurs in 3% to 7% of patients with GCA. Patient concerns: A 67-year-old male patient with known hypertension presented with somnolence, disorientation and mild bilateral limb ataxia. The magnetic resonance imaging showed multiple acute infarctions in the territory of the vertebrobasilar system with occlusion of the left vertebral artery. Diagnosis: Ten months later, during a routine neurovascular follow-up, r...
Source: Medicine - August 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Does adjunctive corticosteroid and aspirin therapy improve the outcome of tuberculous meningitis ?
Conclusion: Aspirin with corticosteroid adjunctive treatment seems to be beneficial in reducing mortality in TBM.
Source: Neurology India - November 28, 2018 Category: Neurology Authors: Usha Kant Misra Jayantee Kalita Betai Sagar Sanjeev Kumar Bhoi Source Type: research

Embolic Stroke due to Carotidynia Potentially Associated with Moving Carotid Artery Caused by Swallowing
A 63-year-old woman with end-stage renal disease on maintenance hemodialysis discontinued her medication for rheumatoid arthritis with prednisolone and azathioprine. One month later, she was admitted because of consciousness disturbance and right hemiparesis. Diffusion-weighted brain magnetic resonance imaging (MRI) revealed multiple hyperintensities in her left frontal and parietal lobes. She also developed high fever and left neck pain. Carotid ultrasonography showed calcified plaque with vessel wall swelling at the bifurcation of the left common carotid artery (LCCA) and surrounding hypoechoic soft tissue.
Source: Journal of Stroke and Cerebrovascular Diseases - November 15, 2017 Category: Neurology Authors: Yoshitaka Yamaguchi, Mikito Hayakawa, Naoto Kinoshita, Chiaki Yokota, Toshiya Ishihara, Kazunori Toyoda Tags: Case Studies Source Type: research

Role of high-resolution magnetic resonance imaging in the diagnosis of primary angiitis of the central nervous system.
CONCLUSIONS: The present case emphasizes the importance of wall imaging in the diagnosis and treatment of PACNS. PMID: 25045382 [PubMed]
Source: Journal of Clinical Neurology - December 2, 2014 Category: Neurology Tags: J Clin Neurol Source Type: research

Efficacy of Extracranial–Intracranial Bypass for Progressive Middle Cerebral Artery Occlusion Associated with Active Sjögren's Syndrome: Case Report
Sjögren syndrome affecting the major cerebral arteries is rare, and an optimal therapeutic strategy to counteract such a lesion has not yet been established. We herein report a case of a 39-year-old woman with a history of primary Sjögren syndrome, which had previously been treated with immunosuppressive therapy, manifesting with a crescendo transient ischemic attack because of left middle cerebral artery stenosis. Despite the administration of high doses of prednisolone and azathioprine for active Sjögren syndrome, the frequency of crescendo transient ischemic attacks increased with the progression of stenosis and magn...
Source: Journal of Stroke and Cerebrovascular Diseases - August 4, 2014 Category: Neurology Authors: Hiroyuki Sakata, Miki Fujimura, Kenichi Sato, Hiroaki Shimizu, Teiji Tominaga Tags: Case Reports Source Type: research

Recurrent headaches: a case of neurological Behçet's disease.
Abstract A 48-year-old black male, of Nigerian heritage, presented with a 24-hour history of frontal headache of gradual onset. The headache characteristic was migranous, being described as throbbing in nature and located to the right frontal area with associated blurring of vision. Although similar to prior frequent headaches, there was now increasing unsteadiness on walking. Diagnosed 10 years earlier with Behçet's disease, the initial presentation was with oral and genital ulceration. Recurrent episodes of headache caused by neurological flare-ups resulted in a stroke at the age of 46 years. This previous stro...
Source: British Journal of Hospital Medicine - October 9, 2013 Category: Internal Medicine Authors: M Ismail A, W Dubrey S, C Patel M Tags: Br J Hosp Med (Lond) Source Type: research