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Herpes Simplex Virus Meningoencephalitis Masquerading as Acute Stroke With Broca's Aphasia: A Case Report
This report highlights the importance of considering herpes encephalitis as a potential etiology in patients presenting with atypical neurological symptoms, even in the absence of typical radiological findings. Early diagnosis and appropriate management with acyclovir are crucial in improving outcomes in such cases.PMID:37476130 | PMC:PMC10354683 | DOI:10.7759/cureus.40618
Source: Herpes - July 21, 2023 Category: Infectious Diseases Authors: Gagandeep Singh Arora Don Phung Parneet Kaur Source Type: research

Letter to the Editor: Pneumocephalus: Is the needle size significant?
Discussion. Pneumocephalus is defined by two mechanisms: a ball-valve and an inverted bottle concept.1 The ball-valve type implies positive pressure events, such as coughing or valsalva maneuvers, that prevent air escape. Tension pneumocephalus is included in this mechanism, causing a parenchymal mass effect. The inverted bottle theory includes a negative intracranial pressure gradient following cerebrospinal fluid drainage, relieved by air influx. A small pneumocephalus is usually sealed by blood clots or granulation, allowing spontaneous reabsorption and resolution.[1] Otherwise, the lateral positioning of a patient duri...
Source: Innovations in Clinical Neuroscience - February 1, 2018 Category: Neuroscience Authors: ICN Online Editor Tags: Assessment Tools CNS Infections Current Issue Letters to the Editor Neurologic Systems and Symptoms Neurology Stroke Traumatic Brain Injury epidural needle size Pneumocephalus spinal tap Source Type: research

The syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis mimicking an acute stroke
ConclusionsThe decision to thrombolyse or perform an LP in HaNDL patients mimicking a stroke is difficult in the acute setting. Perfusion CT can provide misleading results and CTA may be useful in ruling out occlusion of a cerebral vessel.
Source: European Journal of Neurology - April 22, 2016 Category: Neurology Authors: M. Guillan, A. DeFelipe‐Mimbrera, A. Alonso‐Canovas, M. C. Matute, R. Vera, A. Cruz‐Culebras, N. Garcia‐Barragan, J. Masjuan Tags: Original Article Source Type: research

Unique CT Perfusion Imaging in a Case of HaNDL: New Insight into Pathophysiology of Acute Attacks (P4.114)
Conclusions: The pattern of global left hemispheric hypoperfusion seen in this case supports previous hypotheses of secondary oligemia induced by a hemispheric wave of cortical spreading depression (CSD). However, the right ACA territory hypoperfusion represents a phenomenon never previously reported in this field. We speculate that the secondary vasomotor changes induced by CSD in the left hemisphere, spread to the right hemisphere via the anomalous vascular supply. Such a mechanism of direct vascular propagation through vessel gap junctions has been described in animal studies. This unique case provides a valuable contri...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Burke, M., Lamb, M., Hohol, M., Lay, C. Tags: Headache: Imaging and Other Source Type: research

De novo status epilepticus with isolated aphasia
Conclusions Magnetic resonance imaging findings were only subtle, and EEG was without clear ictal pattern, so the diagnosis of aphasic status remains with some uncertainty. However, status epilepticus can mimic stroke symptoms and has to be considered in patients with aphasia even when no previous stroke or structural lesions are detectable and EEG shows no epileptic discharges. Epileptic origin is favored when CT or MR imaging reveal no hypoperfusion. In this case, MRI was superior to CT in detecting hyperperfusion. This article is part of a Special Issue entitled “Status Epilepticus”.
Source: Epilepsy and Behavior - June 12, 2015 Category: Neurology Source Type: research

De novo status epilepticus with isolated aphasia.
CONCLUSIONS: Magnetic resonance imaging findings were only subtle, and EEG was without clear ictal pattern, so the diagnosis of aphasic status remains with some uncertainty. However, status epilepticus can mimic stroke symptoms and has to be considered in patients with aphasia even when no previous stroke or structural lesions are detectable and EEG shows no epileptic discharges. Epileptic origin is favored when CT or MR imaging reveal no hypoperfusion. In this case, MRI was superior to CT in detecting hyperperfusion. This article is part of a Special Issue entitled "Status Epilepticus". PMID: 26044094 [PubMed - as supplied by publisher]
Source: Epilepsy and Behaviour - June 1, 2015 Category: Neurology Authors: Flügel D, Kim OC, Felbecker A, Tettenborn B Tags: Epilepsy Behav Source Type: research

Acute Lyme Neuroborreliosis With Transient Hemiparesis and Aphasia
We report a case of a female teenager presenting with sudden-onset aphasia and transient right-sided faciobrachial hemiplegia, along with headache and agitation. Ischemia, vasculitis, or another structural lesion was excluded by brain imaging. Toxicologic evaluation results were negative. Cerebral perfusion computed tomography and electroencephalography showed left parietotemporal brain dysfunction. Lumbar puncture result, although atypical, suggested bacterial infection and intravenous ceftriaxone was initiated. Finally, microbiological cerebrospinal fluid analysis revealed Lyme neuroborreliosis, showing specific intrathe...
Source: Annals of Emergency Medicine - March 2, 2015 Category: Emergency Medicine Source Type: research

The Rhino Without It's Sugar (P2.324)
We present a case of a non-diabetic patient with stroke like symptoms that was determined to be due to mucormycosis invading the sphenoid sinus.A 64 year old female was admitted for slurred speech and right-sided weakness. She was brought to the ER after being found unresponsive. Family members stated she had been experiencing difficulty speaking, and mild right facial weakness. She has been complaining of headaches for the past seven months and 15 pound weight loss. On admission, temperature was 98.4°F, BP 122/77, PR 78, and RR 18. Exam was significant for right-sided facial asymmetry/droop, expressive aphasia, and sl...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Kahlon, J., Gahley, H., Sonpal, N., Graham, R. Tags: Fungi, Parasites, and Other Pathogens Source Type: research

Reversible leukoencephalopathy as a presentation of cerebral amyloid angiopathy
A 73 year old man with a past medical history of hypertension, osteoathritis and asthma presented to the local district general hospital with recurrent episodes of spontaneously resolving encephalopathy. The initial presentation was characterised by acute confusion and visual hallucinations followed by a generalised tonic–clonic seizure. On examination his blood pressure was 215/115 mmHg. Neurological examination did not reveal any lateralising signs but the patient was found to be encephalopathic with a Montreal Cognitive Assessment (MOCA) score of 9/30. Routine blood tests were unremarkable. A CT brain scan showed ...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Lilleker, J., Vassallo, J., Punter, M. Tags: Genetics, Immunology (including allergy), Epilepsy and seizures, Stroke, Hypertension, Drugs: psychiatry, Radiology, Surgical diagnostic tests Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP), London, 23 Source Type: research

Recognition and evaluation of nontraumatic subarachnoid hemorrhage and ruptured cerebral aneurysm.
Abstract Swift diagnosis and treatment are critical for good outcomes in patients with nontraumatic subarachnoid hemorrhage, which is usually caused by a ruptured aneurysm. This type of stroke often results in death or disability. Rates of misdiagnosis and treatment delays for subarachnoid hemorrhage have improved over the years, but these are still common occurrences. Subarachnoid hemorrhage can be more easily diagnosed in patients who present with severe symptoms, unconsciousness, or with thunderclap headache, which is often accompanied by vomiting. The diagnosis is more elusive in patients who present in good c...
Source: American Family Physician - October 1, 2013 Category: Primary Care Authors: Cohen-Gadol AA, Bohnstedt BN Tags: Am Fam Physician Source Type: research