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Role of bedside video-oculography in selecting neuroimaging in patients with acute vertigo and ataxia posterior fossa mass lesions
The acute vestibular syndrome ((AVS) is the sudden onset of continuous vertigo, nausea, vomiting and head motion intolerance [1]. The most common peripheral cause is a vestibular neuritis [2], and the most frequent central lesion associated with an AVS is an ischemic stroke in about 10 to 15% of cases [3 –5]; less frequently demyelinating plaques (multiple sclerosis (MS) and neuromyelitis optica (NMO)) [6], and inflammatory lesions associated with infectious and paraneoplastic disorders may be responsible.
Source: Journal of the Neurological Sciences - December 1, 2022 Category: Neurology Authors: Daniel Getz, Anusha Mangalampalli, Jeffrey Klopfenstein, Andrew Tsung, Jorge C. Kattah Source Type: research

Cancer-Associated Atherothrombosis: The Challenge
Int J Angiol DOI: 10.1055/s-0041-1729920The association between venous thrombosis and malignancy, having typical features of a paraneoplastic syndrome, has been established for a century. Currently, it is recognized that arterial thromboembolism (ATE) may also behave as a paraneoplastic syndrome. Recent matched cohort studies, systematic reviews, and observational studies concur in showing an increased incidence of acute coronary events, ischemic stroke, accelerated peripheral arterial disease, and in-stent thrombosis during the 6-month period before cancer diagnosis, peaking for 30 days immediately before cancer diagnosis...
Source: International Journal of Angiology - July 19, 2021 Category: Cardiology Authors: Naschitz, Jochanan E. Tags: Review Article Source Type: research

Ischemic stroke caused by giant cell arteritis associated with pulmonary adenocarcinoma
We describe a 77-year-old man with a sudden onset of dizziness, vomiting, and gait disturbances. Following imaging studies, a diagnosis of bulbar ischemic stroke with left vertebral artery stenosis was made. Based on a history of polymyalgia rheumatica, on laboratory tests, and brain digital subtraction angiography, a diagnosis of GCA was advanced and the patient underwent high-dose steroidal therapy. After a total body 18-FGD PET imaging, a pulmonary adenocarcinoma was found.Vertebral artery involvement is a rare but important occurrence in GCA as it carries a high mortality rate, and may require a vigorous therapeutic ap...
Source: Journal of Clinical Neuroscience - November 5, 2019 Category: Neuroscience Source Type: research

Floating Aortic Thrombus: A Rare Cause of Acute Ischemic Stroke Necessitating Modification of Access Route for Thrombectomy
We report 2 patients with acute occlusion of middle cerebral artery successfully treated by mechanical thrombectomy performed via transbrachial access. Both patients had floating aortic arch thrombi precluding safe transfemoral access due to risk of further iatrogenic embolization. Moreover both patients were diagnosed with hypercoagulopathy secondary to lung malignancy (paraneoplastic etiology, Trousseau's syndrome) as the cause of both aortic thrombi and acute ischemic stroke. Mechanical thrombectomy in the setting of a floating aortic thrombus has been mentioned only once as part of general management of floating aortic...
Source: Journal of Stroke and Cerebrovascular Diseases - August 20, 2019 Category: Neurology Authors: Sinan Balci, Ethem Murat Arsava, Mehmet Akif Topcuoglu, Anil Arat Source Type: research

Time Is Cerebellum.
Abstract The cerebellum characteristically has the capacity to compensate for and restore lost functions. These compensatory/restorative properties are explained by an abundant synaptic plasticity and the convergence of multimodal central and peripheral signals. In addition, extra-cerebellar structures contribute also to the recovery after a cerebellar injury. Clinically, some patients show remarkable improvement of severe ataxic symptoms associated with trauma, stroke, metabolism, or immune-mediated cerebellar ataxia (IMCA, e.g., multiple sclerosis, paraneoplastic cerebellar degeneration, gluten ataxia, anti-GAD6...
Source: Cerebellum - February 19, 2018 Category: Neuroscience Authors: Mitoma H, Manto M, Hampe CS Tags: Cerebellum Source Type: research

Time Is Cerebellum
AbstractThe cerebellum characteristically has the capacity to compensate for and restore lost functions. These compensatory/restorative properties are explained by an abundant synaptic plasticity and the convergence of multimodal central and peripheral signals. In addition, extra-cerebellar structures contribute also to the recovery after a cerebellar injury. Clinically, some patients show remarkable improvement of severe ataxic symptoms associated with trauma, stroke, metabolism, or immune-mediated cerebellar ataxia (IMCA, e.g., multiple sclerosis, paraneoplastic cerebellar degeneration, gluten ataxia, anti-GAD65 antibody...
Source: The Cerebellum - February 19, 2018 Category: Neurology Source Type: research

Fatal Atypical Progressive Multifocal Leukoencephalopathy (PML) in an African American Female with Sarcoidosis Associated Lymphopenia (SAL). A Rare Case Report and Literature Review. (P2.317)
Conclusions:This is the first case of SAL presenting with medullary PML in an African-American patient not on immunosuppressive therapy. The role of SAL in PML pathogenesis or Sarcoidosis Associated Immunodeficiency is unclear. No guidelines for CD4/CD8 monitoring are available and needs further investigation. We suggest an aggressive diagnostic approach in evaluating Sarcoidosis with atypical neurologic manifestations and neuroimaging to reduce morbidity-mortality.Study Supported by: Not applicable.Disclosure: Dr. Rathore has nothing to disclose. Dr. Sweiss has nothing to disclose. Dr. Campanella has nothing to disclose. ...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Rathore, J., Sweiss, N., Campanella, F., Andreoni, J., Wichter, M. Tags: HIV, HTLV-I, PML, Other Viral Infections, and CJD Source Type: research

Brain findings on FDG PET-MRI body sequences that include the head
Conclusions FDG PET-MRI imaging is a rapidly evolving modality that is most commonly employed for cancer evaluation. The standardized base of skull to mid thigh imaging may miss many important pathologies that are discovered even with MRI body sequences. We propose that PET-MRI body sequences that include the head may show added value in the management of patients.
Source: Journal of Nuclear Medicine - May 23, 2016 Category: Nuclear Medicine Authors: Franceschi, A., Matthews, R., Bangiyev, L., Relan, N., Chaudhry, A., Franceschi, D. Tags: Outcomes/Comparative Effectiveness Research & amp; Radiation Safety Source Type: research

Paraneoplastic Progressive Vasculopathy as the Presenting Manifestation of Polyneuropathy, Organomegaly, Endocrinopathy or Edema, M-Spike, and Skin Manifestations: A Case Report
We report a patient with ischemic stroke due to an underlying vasculopathy as the initial presentation of POEMS. This case highlights the importance of recognizing ischemic stroke as a presenting sign for POEMS as early diagnosis and treatment in patients with POEMS may prevent progression of multisystem involvement and may potentially stabilize the vasculopathy associated with it.
Source: Journal of Stroke and Cerebrovascular Diseases - May 9, 2016 Category: Neurology Authors: Shadi Yaghi, Mitchell S.V. Elkind Tags: Case Studies Source Type: research

A Rare Presentation of Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids (CLIPPERS) as Acute Ischemic Stroke (P6.112)
CONCLUSIONS: This case illustrates not only a classic clinical and radiographic case of CLIPPERS, but also that this recently recognized disorder can be easily misdiagnosed as a neuromuscular disease in the early stages, and stroke in the more severe stages. Rarely, the inflammatory infiltrate can result in stroke in these patients, and is likely the cause of the acute exacerbation of our patient’s symptoms. This case also demonstrates the need for contrast imaging whenever possible, as the non-contrast imaging failed to identify the characteristic diffuse enhancing punctate lesions.Disclosure: Dr. Gadhia has nothing...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Gadhia, R., Smith, S., Lai, E., Lee, A. Tags: MS and CNS Inflammatory Disease: CNS Inflammatory Diseases and Differential Diagnosis Source Type: research

Paraneoplastic Neurological Syndrome in Fallopian Tube Cancer.
We report on a rare case of paraneoplastic syndrome (PS) that was discovered on completion of diagnostic work-up to be an undifferentiated fallopian tube carcinoma. A 49-year-old Caucasian woman was admitted to neurology with vertigo, gait ataxia and dysarthria, transient ischaemic attack (TIA) and stroke were quickly excluded. Indicative for the further diagnosis of a paraneoplastic syndrome was the identification of onconeuronal antibodies the detection of which can be associated with certain tumour entities. The strongly positive anti-Yo antibody that is formed above all by breast and lung cancers as well as ovarian can...
Source: Geburtshilfe und Frauenheilkunde - December 12, 2015 Category: OBGYN Tags: Geburtshilfe Frauenheilkd Source Type: research

An Unusual Cause Of Recurrent Ischemic Stroke: Trousseau's Syndrome From Gastric Cancer (P4.231)
CONCLUSIONS: Trousseau’s Syndrome must be considered in those presenting with recurrent strokes with an otherwise negative embolic work up especially in the elderly and those with cancer risk factors. It must prompt the clinician to look for an associated malignancy.Disclosure: Dr. JADEJA has nothing to disclose. Dr. Johnson has nothing to disclose. Dr. Soetanto has nothing to disclose. Dr. Nalleballe has nothing to disclose. Dr. DeNiro has nothing to disclose. Dr. Qureshi has nothing to disclose. Dr. Graber has received personal compensation for activities with Stemedica Inc., Novocure Inc., and Biogen Idec.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Jadeja, N., Johnson, J., Soetanto, A., Nalleballe, K., DeNiro, L., Qureshi, I., Graber, J. Tags: Neuro-oncology: Paraneoplastic Disorders Source Type: research

Primary Central Nervous System Vasculitis Triggered by Cytomegalovirus Encephalitis (P01.231)
CONCLUSIONS: Our case is the first reported case in the literature of proven CMV encephalitis triggering a subsequent non-infectious CNS vasculitis probably secondary to an autoimmune response. The absence of findings in the initial MRIs of the brain in spite of an intermittently symptomatic patient and the subsequent development of ischemic infarcts supports the theory of intermittent focal hypoperfusion, finally leading to infarction. The high clinical suspicion even with lack of clear evidence of the disease process and empirical treatment led to a successful clinical recovery.Disclosure: Dr. Rosales has nothing to disc...
Source: Neurology - February 14, 2013 Category: Neurology Authors: Rosales, D., Garcia-Gracia, C., Salgado, E., Salanga, V. Tags: P01 Cerebrovascular Disease I Source Type: research