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HIV-associated multiple intracranial aneurysms and stroke in an adult patient: successful treatment with a combination of glucocorticoid and antiviral agents
AbstractA 35-year-old Iranian man with an 18-year history of human immunodeficiency virus (HIV) infection developed sudden left-sided hemiparesis and mild dysarthria. Based on laboratory results, brain and neck computerized tomography angiography (CTA), echocardiography, hypercoagulability tests, and vasculitis tests, the patient was diagnosed with a stroke with multiple intracranial aneurysms secondary to HIV. Cerebral aneurysms and stroke are uncommon in HIV-infected patients, and the aneurysms ’ exact cause and risk factors are unknown. There is currently no effective regimen or definitive treatment for HIV-associated...
Source: Journal of NeuroVirology - December 13, 2022 Category: Neurology 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

Percheron Artery-Plus Syndrome: A Syndrome Beyond Stroke Chameleon
J Nippon Med Sch. 2021;88(4):375-379. doi: 10.1272/jnms.JNMS.2021_88-414.ABSTRACTThe artery of Percheron (AOP) is an anatomical variant of the thalamoperforating arteries. AOP occlusion can cause bilateral paramedian thalamic infarctions and is referred to as a "stroke chameleon" because it lacks the classic signs of stroke. Coexistence of AOP occlusion and other neurologic disease is rare and can cause disturbance of consciousness. A 78-year-old woman had acute onset of left limb weakness and drowsy consciousness. Brain magnetic resonance angiography (MRA) revealed acute bilateral paramedian thalamic infarctions. However,...
Source: Journal of Nippon Medical School - September 2, 2021 Category: Universities & Medical Training Authors: Fu-Yi Yang Jeng-Luen Hung Shinn-Kuang Lin Source Type: research

P030  Antiphospholipid syndrome and giant cell arteritis: a coincidence or connection?
Conclusion In summary, this is a case of GCA and APS, treated with prednisolone, aspirin, warfarin and tocilizumab. There is increasing evidence describing the presence of antiphospholipid antibodies in patients with vasculitis. However, the role of these antibodies in GCA and the clinical significance rema ins unclear. This case reports highlights the need for physicians to consider APS in patients who have a history of GCA and subsequently develop arterial or venous embolic events.Disclosure L. Sammut: None.E. Htut: None.
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research

A severe, relapsing case of myelin oligodendrocyte glycoprotein IgG-associated CNS inflammation
A 55-year-old man presented in October 2004 with general unease, vomiting, and gait disturbance. Initially diagnosed with an inner ear infection, the patient's symptoms did not improve and he was evaluated further. MRI revealed a cerebellar lesion, which led to the suspicion of a posterior circulation stroke, and he was started on antiplatelet drugs. However, an angiogram suggested no vascular pathology. In March 2011, he had another episode of ataxia and MRI showed a right brainstem lesion. Cryptogenic stroke was reconsidered. In March 2013, the patient developed paraparesis with urinary and bowel symptoms. MRI revealed m...
Source: Neurology Clinical Practice - February 12, 2018 Category: Neurology Authors: Saviour, M., Hamid, S., Moore, P., Mutch, K., Bhojak, M., Duddy, M., Jacob, A. Tags: All Demyelinating disease (CNS), Devic's syndrome, Optic neuritis; see Neuro-ophthalmology/Optic Nerve, Transverse myelitis Case Source Type: research

A Young Woman with Ischemic Stroke: Should We Pay More Attention to Varicella Zoster Infection?
In conclusion, VZV vasculopathy needs to be considered in young adults with stroke. A high index of suspicion and early treatment seem to be important to minimize morbidity and mortality. Anticoagulation should probably be avoided in stroke associated with VZV vasculopathy.Case Rep Neurol 2016;8:145–150
Source: Case Reports in Neurology - July 7, 2016 Category: Neurology 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

Teaching NeuroImages: Macaroni sign
A 35-year-old patient with previously diagnosed and currently untreated Takayasu arteritis presented with motor aphasia. The symptom had started 24 hours before presentation and ceased after another 12 hours. Cranial MRI and magnetic resonance angiography were normal. Plasma concentration of C-reactive protein was elevated (9.1 mg/dL). Duplex ultrasonography showed hypoechoic, homogeneous thickening of the intima–media complex of the left common carotid artery (figure). This finding, also referred to as "macaroni sign," has been reported in Takayasu arteritis.1,2 The patient was transferred to the rheumatologic depar...
Source: Neurology - June 30, 2014 Category: Neurology Authors: Siepmann, T., Bodechtel, U. Tags: Ultrasound, Autoimmune diseases, Vasculitis, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research