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Talking to God in the Walls: Prolonged Psychosis Associated with Left Insular Stroke
We describe a 74-year old Caucasian man with a medical history of ESRD status post renal transplant, admitted for a 4-month history of worsening, abrupt-onset psychosis. Initial treatment with several different antipsychotics was unsuccessful. An extensive medical evaluation including multiple Neurology consultations was unrevealing. Cerebrospinal fluid and paraneoplastic panel were negative. No malignancy was identified. Head MRI revealed an area of T2 hyperintensity in the left insular region.
Source: Psychosomatics - March 22, 2018 Category: Psychiatry & Psychology Authors: Nuria Thusius, Magdalena Romanowicz, Karolina Mlynek, Christopher Sola Source Type: research

Teaching NeuroImages: Posterior reversible encephalopathy syndrome resulting in hydrocephalus
A woman with prior lung transplantation presented with headaches, seizure, and obtundation. Head MRI (figure) revealed obstructive hydrocephalus and hyperintensity on T2-weighted imaging in the bilateral thalami and brainstem. Management included antiepileptic medications, ventriculostomy placement, and cessation of tacrolimus for concern of atypical posterior reversible encephalopathy syndrome (PRES). Infectious and paraneoplastic etiologies were ruled out. An autoimmune process was unlikely due to immunosuppression. There was rapid clinical improvement with repeat MRI revealing resolution of hydrocephalus and T2 changes....
Source: Neurology - June 5, 2016 Category: Neurology Authors: Paolini, S., Jadhav, A. P. Tags: Hydrocephalus, Secondary headache disorders, Other cerebrovascular disease/ Stroke RESIDENT AND FELLOW SECTION Source Type: research