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HSV-2 Encephalitis Presenting as Multifocal Ischemic Stroke (P4.375)
CONCLUSION A high index of suspicion needs to be maintained to diagnose infectious vasculitis. A history of immunosuppression and headache preceding cerebral infarction were important factors that ultimately led to the appropriate work up and diagnosis in this case. Lumbar puncture and prompt initiation of antiviral treatment is essential in stroke case of suspected CNS infection with HSV-2.Disclosure: Dr. Zhang has nothing to disclose. Dr. Sumida has nothing to disclose. Dr. Margolesky has nothing to disclose. Dr. Tornes has nothing to disclose. Dr. Ramos has nothing to disclose. Dr. Koch has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Zhang, F., Sumida, A., Margolesky, J., Tornes, L., Ramos, A., Koch, S. Tags: Cerebrovascular Case Reports 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

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

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

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

Anti glutamic acid decarboxylase antibody mediated encephalopathy while on etanercept in a patient with multiple autoimmune diseases
A 39 year old lady presented with an altered mental state and unsteadiness of gait. She had a history of juvenile idiopathic arthritis, autoimmune thyroiditis and alopecia, protein S deficiency with vena cava thrombosis, previous excision of ovarian mass and vasculitic rash. There was a previous history of ovarian mass and her immunomodulatory therapy for arthritis over the previous year was Etanercept. She used recreational cannabis but denied any other illicit drug usage. Her affect was variable and at times inappropriate with frequent laughter. She would spit regularly. There was anxiety and a prevailing sensation of do...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: MacDougall, N., Waddell, B., O'Riordan, J. I. Tags: Immunology (including allergy), Brain stem / cerebellum, Drugs: CNS (not psychiatric), Epilepsy and seizures, Infection (neurology), Stroke, Drugs misuse (including addiction), Connective tissue disease, Musculoskeletal syndromes Association of British Source Type: research

Artery of percheron occlusion: a rare cause of coma
Conclusions AOP occlusion is a rare cause of coma and should be suspected in patients who present with acute loss of consciousness, once other common aetiologies are excluded. This case raises pertinent questions regarding the indications and benefits of thrombolysis and/or clot retrieval in such patients.
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 8, 2017 Category: Neurosurgery Authors: El-Wahsh, S., Weerasinghe, D., McDougall, A. Tags: Abstracts Source Type: research

Septic Shock From Pan-Spinal Epidural Abscess Attributed to Recent Acupuncture and Trigger Point Injections for Acute Lower Back Pain in a Previously Undiagnosed Diabetic Patient: A Case Report
We report the case of a 60-year-old woman with undiagnosed diabetes mellitus who presented to the hospital with a complaint of progressive altered mental status for the past two days. Eight days prior to presentation, the patient tripped over a pillow at home and developed mildly nagging, acute lower back pain. Upon the recommendation of her friends, she underwent two sessions of acupuncture around the lumbar area on days six and five prior to being brought to the hospital. She also saw her primary care physician on day three prior to presentation, who performed a history and physical examination and, after feeling that sh...
Source: Pain Physician - June 9, 2023 Category: Anesthesiology Authors: Shaheryar Usman Faraz Badar Carlos Collado Andrew Weber Alan Kaell Source Type: research