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Recognition of giant cell arteritis in patients with polymyalgia rheumatica who have a stroke: a cautionary tale
Abstract An 82‐year‐old woman with polymyalgia rheumatica (PMR) on prednisone 7 mg daily was admitted to an acute stroke unit with a right homonymous hemianopia, a left posterior cerebral artery occlusion and occipital lobe infarct. She had raised inflammatory markers, did not have a temporal artery biopsy, and was discharged on the same dose of prednisone. After 21 months, off prednisone, her ophthalmologist, concerned about giant cell arteritis (GCA), restarted prednisone 40 mg daily, with rapid, profound visual improvement. After 3 days her general practitioner, noting normal baseline inflammatory markers, stopp...
Source: Internal Medicine Journal - October 9, 2017 Category: Internal Medicine Authors: Donald H. Gutteridge, Frank L. Mastaglia Tags: Brief Communication Source Type: research

An Update of the Mayo Clinic Cohort of Patients With Adult Primary Central Nervous System Vasculitis: Description of 163 Patients
This study is based on a cohort of 163 consecutive patients with PCNSV who were examined at the Mayo Clinic over a 29-year period from 1983 to 2011. The aim of the study was to define the characteristics of these patients, which represents the largest series in adults reported to date. A total of 105 patients were diagnosed by angiographic findings and 58 by biopsy results. The patients diagnosed by biopsy more frequently had at presentation cognitive dysfunction, greater cerebrospinal fluid total protein concentrations, less frequent cerebral infarcts, and more frequent leptomeningeal gadolinium-enhanced lesions on magnet...
Source: Medicine - May 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Seizure syndrome as a first manifestation of solitary tumor-like mass lesion of PACNS: Two case reports
Rationale: Primary angiitis of the central nervous system (PACNS) is an inflammatory disease involving cerebrovascular and parenchymal, and solitary tumor-like mass lesion of PACNS (TLML-PACNS) is frequently misdiagnosed as neoplastic or other inflammatory diseases. However, seizure syndrome as a first manifestation of TLML-PACNS has rarely reported before. Patient concerns: Here, we report 2 cases of seizure syndrome, which was the first sign that presented prior to the diagnosis of TLML-PACNS by brain biopsy. Diagnoses: A mass lesion in the white and gray matters was detected by magnetic resonance imaging. The patholog...
Source: Medicine - March 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Bilateral thalamic and mesencephalic infarctions with hypopituitarism as long-term complications postradiotherapy: A case report
Conclusion: To our knowledge, this is the first report of bilateral thalamic and mesencephalic infarction together with hypopituitarism following radiotherapy for NPC.
Source: Medicine - August 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Intravascular large B-cell lymphoma presenting as multiple stroke: A case report
Conclusion: IVLBCL is an aggressive disease with high mortality. Timely diagnosis and treatment can be lifesaving.
Source: Medicine - October 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research