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Stroke-like presentation of autoimmune chorea with positive anti-Yo and anti-MOG antibodies: a case report
AbstractWith the in-depth study of autoimmune encephalitis, more and more antibody combinations and clinical manifestations appear in our sights, enriching the spectrum of autoimmune encephalitis. Here, we report a case of a 58-year-old male patient with sudden involuntary movement of the left limb. The brain MRI was normal. CSF analysis showed slightly elevated protein (548.38  mg/L) and normal cell count(1.00 10^6/L). No tumors were detected by the whole-body PET-CT. Positive anti-Yo and anti-MOG antibodies were found in the blood. So we considered the diagnosis of autoimmune chorea with positive anti-Yo and anti-MOG a...
Source: Neurological Sciences - October 25, 2022 Category: Neurology Source Type: research

Aseptic meningitis in Fabry disease due to a novel GLA variant: an expanded phenotype?
ConclusionWe described aseptic meningitis in a family with a novelGLA variant. Meningitis might be a common phenomenon in FD and not a particularity of this variant. Understanding the mechanisms underlying meningitis and its association with cerebrovascular events may lead to a new paradigm of treatment for stroke in these patients. Further prospective studies with CSF collection in patients with FD and recurrent headache could help to elucidate this question.
Source: Neurological Sciences - September 12, 2022 Category: Neurology Source Type: research

COVID-19 Infection and Recurrent Stroke in Young Patients With Protein S Deficiency: A Case Report
Conclusions: SARS-CoV-2 infection potentializes the prothrombotic effect and vascular inflammation by accentuating protein S deficit. The place of steroids seems justifiable in the presence of symptoms of vasculitis in brain imaging.
Source: The Neurologist - November 1, 2021 Category: Neurology Tags: Case Report/Case Series Source Type: research

Methylprednisolone Reduces Persistent Post-ischemic Inflammation in a Rat Hypoxia-Ischemia Model of Perinatal Stroke
In conclusion, we demonstrated that administration of MPSS during the tertiary phase of perinatal stroke results in attenuation of the chroni c inflammatory response, leading to pathophysiological and functional recovery. This work validates the high clinical impact of MPSS to treat neonatal conditions linked to chronic inflammation.
Source: Translational Stroke Research - March 4, 2020 Category: Neurology Source Type: research

High-resolution Intracranial Vessel Wall Imaging in Monitoring Treatment Response in Primary CNS Angiitis
Conclusions: Our report illustrates the utility of HR-VWI in diagnosing a case of PCNS angiitis through the demonstration of a vasculitic pattern of mural enhancement. Furthermore, it has provided evidence of disease response to treatment, assisting us in modifying treatment accordingly. Tracking disease activity and response to treatment in cases of central nervous system vasculitis can be another important use of HR-VWI in clinical practice besides assisting in establishing the diagnosis.
Source: The Neurologist - November 1, 2018 Category: Neurology Tags: Case Report/Case Series Source Type: research

A severe, relapsing case of myelin oligodendrocyte glycoprotein IgG-associated CNS inflammation
A 55-year-old man presented in October 2004 with general unease, vomiting, and gait disturbance. Initially diagnosed with an inner ear infection, the patient's symptoms did not improve and he was evaluated further. MRI revealed a cerebellar lesion, which led to the suspicion of a posterior circulation stroke, and he was started on antiplatelet drugs. However, an angiogram suggested no vascular pathology. In March 2011, he had another episode of ataxia and MRI showed a right brainstem lesion. Cryptogenic stroke was reconsidered. In March 2013, the patient developed paraparesis with urinary and bowel symptoms. MRI revealed m...
Source: Neurology Clinical Practice - February 12, 2018 Category: Neurology Authors: Saviour, M., Hamid, S., Moore, P., Mutch, K., Bhojak, M., Duddy, M., Jacob, A. Tags: All Demyelinating disease (CNS), Devic's syndrome, Optic neuritis; see Neuro-ophthalmology/Optic Nerve, Transverse myelitis Case Source Type: research

Intra-arterial milrinone may differentiate fulminant RCVS from vasculitis
A 39-year-old woman taking a monoamine oxidase inhibitor presented with a 1-week history of severe non-thunderclap headache and visual field deficits. Brain CT showed infarcts in both parietal lobes, with narrowing of intracranial vessels on CT angiogram (figure 1), suggesting either vasculitis or reversible cerebral vasoconstriction syndrome (RCVS). Despite treatment with both methylprednisolone and nimodipine, she experienced progressive aphasia and right leg weakness. She underwent an urgent cerebral angiogram (figure 2), during which intra-arterial milrinone reversed both the vasoconstriction and its symptoms, thereby ...
Source: Neurology - September 4, 2017 Category: Neurology Authors: Laneuville, M., Ding, J., Shamy, M., Lum, C., Dowlatshahi, D. Tags: All Headache, Other cerebrovascular disease/ Stroke NEUROIMAGES Source Type: research

Parvovirus B19 infection associated with hemolytic anemia and cranial polyneuropathy
AbstractParvovirus B19 (PB19) is a common, widespread, small, single-stranded DNA virus which has been linked with a broad spectrum of clinical illnesses, including a variety of neurological complications such as encephalitis, meningitis, myelitis, stroke, cerebellar ataxia, and neuropathy. The authors describe a case of PB19 infection associated with hemolytic anemia and cranial polyneuropathy involving the second and third cranial nerves in a 23-year-old immunocompetent woman. The diagnosis of acute PB19 infection was established with detection of positive DNA and anti-PB19 IgM antibodies in blood samples. Antigangliosid...
Source: Journal of NeuroVirology - August 22, 2017 Category: Neurology Source Type: research

Suprascapular nerve block for the treatment of hemiplegic shoulder pain in patients with long-term chronic stroke: a pilot study
AbstractHemiplegic shoulder pain is the most common pain condition after stroke. Suprascapular nerve block is an effective treatment for shoulder pain. The aim of this pilot study was to evaluate the effects of suprascapular nerve block on pain intensity, spasticity, shoulder passive range of motion, and quality of life in long-term chronic stroke patients with hemiplegic shoulder pain. Ten chronic stroke patients (over 2  years from onset) with hemiplegic shoulder pain graded ≥30 mm on the Visual Analogue Scale underwent suprascapular nerve block injection with 1 mL of 40 mg/mL methylprednisolone and 10 mL 0.5% bup...
Source: Neurological Sciences - July 11, 2017 Category: Neurology Source Type: research

Teaching NeuroImages: Takayasu arteritis: Neuroimaging progression after immunosuppressant treatment
A 29-year-old woman presented with a 2-year history of heel pain, constitutional symptoms, and increased acute phase reactants. CT and magnetic resonance (MR) angiography revealed a thickening of aortic walls and a thread-like appearance of bilateral subclavian and common carotid arteries. The findings were consistent with Takayasu arteritis (TA)1 and the patient was prescribed methylprednisolone, followed by azathioprine. Follow-up MR angiography, 6 years later, showed an important improvement with only a mild luminal narrowing of both common carotid arteries (figures 1 and 2, A and B). TA is a large-artery inflammatory d...
Source: Neurology - May 15, 2017 Category: Neurology Authors: Martinez Rodriguez, L., Caminal Montero, L., Pena Suarez, J., Garcia-Cabo Fernandez, C., Calleja Puerta, S. Tags: MRI, Vasculitis, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research

Rapidly Progressive atypical Posterior Reversible Encephalopathy Syndrome (PRES) associated with B-cell lymphoma (P4.065)
Conclusions:This case illustrates a rapidly progressive clinicoradiological syndrome with remarkable radiographical features of atypical PRS, and association with diffuse B-cell lymphomaDisclosure: Dr. Bronstein has nothing to disclose. Dr. Danesh has nothing to disclose. Dr. Petrovic has nothing to disclose. Dr. Ashikian has nothing to disclose. Dr. Arbuckle has nothing to disclose. Dr. Homafar has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Bronstein, Y., Danesh, M., Petrovic, M., Ashikian, N., Arbuckle, R., Homafar, H. Tags: General Neurology: Vascular Neurology Source Type: research

Acute ischemic stroke in a young female: a novel presentation of anti-GAD autoimmunity (P3.272)
Conclusions:Restricted diffusion, seen typically in ischemia, indicates cytotoxic oedema and irreversible cell damage. In this patient, we postulate a mechanism of severe CNS inflammation with cellular toxicity and small vessel vasculitis. Anti-GAD autoimmunity should be considered in young patients presenting with stroke-like episodes, particularly when accompanied by positive phenomenon.Disclosure: Dr. Neo has nothing to disclose. Dr. Lee has nothing to disclose. Dr. Lee has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Neo, X. S., Lee, K. E., Lee, R. Tags: Cerebrovascular Disease Case Reports II Source Type: research

Acute spinal cord syndrome secondary to venous congestion
A 13-year-old boy developed lower limb flaccid paralysis 24 hours after accidental ingestion of an odorless and tasteless potassium hydroxide liquid. He had absent abdominal reflexes, brisk deep tendon reflexes, and no sensation distal to the umbilicus. MRI demonstrated T2 hyperintensities throughout the spinal cord and engorgement of basilar vertebral venous plexus (figure). He made a full recovery within 48 hours of empirical IV methylprednisolone.
Source: Neurology - September 18, 2016 Category: Neurology Authors: Woodcock, I. R., Coscini, N., Mandelstam, S., Rodriguez-Casero, V., Dabscheck, G. Tags: MRI, Other cerebrovascular disease/ Stroke, All Pediatric, Spinal cord infarction, Other toxicology NEUROIMAGES Source Type: research

Non-traumatic Cerebral Fat Embolism in Sickle Cell Disease (P3.234)
Conclusions:Our case series illustrates the following clinical pearls: a) SCD-related CFES is vastly under-diagnosed, as it closely mimics sepsis, vasculitis or hypoxic ischemic encephalopathy; b) The diagnosis is confirmed with SWI that demonstrates pathognomonic microbleeds in the splenium and subcortical location; c) SCD-related CFES carries considerable morbidity and mortality.Disclosure: Dr. Ramachandiran has nothing to disclose. Dr. Raniga has nothing to disclose. Dr. Al Kindi has nothing to disclose. Dr. Dennison has nothing to disclose. Dr. Al Farsi has nothing to disclose. Dr. Al Busaidi has nothing to disclose. D...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Ramachandiran, N., Raniga, S., Al Kindi, S., Dennison, J., Al Farsi, K., Al Busaidi, M., Al Hashim, A., Al Azri, F., Gujjar, A., Al-Asmi, A. Tags: Stroke in the Young Source Type: research

Antiphospholipid Syndrome-Associated Crescendo Stroke Events Treated with Rituximab (P4.351)
Discussion APS is an autoimmune condition associated with persistent antiphospholipid antibodies, characterised by thrombosis and pregnancy morbidity [1].Regarding APS and stroke the optimal antithrombotic agent, intensity of anticoagulation, and duration of treatment remains controversial[2]. Analysis of the APASS subgroup in the WARS study found aspirin and warfarin to be equally effective agents for secondary stroke prevention [2]. The majority of panel members at the International Congress on Antiphospholipid Antibodies recommended warfarin or combination aspirin and warfarin for patients with definite APS and arterial...
Source: Neurology - April 3, 2016 Category: Neurology Authors: O' Connor, A., Murphy, G., Cronin, S. Tags: Cerebrovascular Case Reports Source Type: research

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