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Total 126 results found since Jan 2013.
Detection of meningoencephalitis caused by Listeria monocytogenes with ischemic stroke-like onset using metagenomics next-generation sequencing: A case report
Rationale:
Listeria monocytogenes (L. monocytogenes) is a compatible intracellular bacterial pathogen that can invade different mammalian cells and reach the central nervous system (CNS), leading to meningoencephalitis and brain abscesses. In the diagnosis of L. monocytogenes meningoencephalitis (LMM), conventional tests are often reported as negative due to antibiotic therapy or low bacterial content in cerebrospinal fluid. To date, prompt diagnosis and accurate treatment remain a challenge for patients with Listeria infections.
Patient concerns:
Here, we report a case of a 64-year-old male diagnosed with LMM b...
Source: Medicine - August 6, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Recovery of an injured arcuate fasciculus via transcallosal fiber in a stroke patient: A case report
We report on a patient whose arcuate fasciculus (AF) and corticobulbar tract (CBT) recovered following an infarct in the middle cerebral artery (MCA) territory, demonstrated on serial diffusion tensor tractography (DTT).
Patient concerns:
The patient showed moderate conduction aphasia on the Western Aphasia Battery with an aphasia quotient of 46.5‰ (spontaneous speech: 35.0‰, auditory comprehension: 36.0‰, and naming: 53.1‰) at 1 month after onset. His aphasia improved with an aphasia quotient of 49‰ (spontaneous speech: 71.0‰, auditory comprehension: 52.0‰, and naming: 59.0‰) at 10 months after onse...
Source: Medicine - August 6, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Efficacy of virtual reality therapy in ideomotor apraxia rehabilitation: A case report
We report the possible therapeutic efficacy of immersive virtual reality (VR) rehabilitation for the treatment of ideomotor apraxia in a patient with stroke.
Patient concerns:
A 56-year-old man with sudden weakness of his left side caused by right frontal, parietal, and corpus callosal infarction was transferred to rehabilitation medicine center for intensive rehabilitation. Although his left-sided weakness had almost subsided 10 days after the onset of symptoms, he presented difficulty using his left hand and required assistance in most activities of daily living.
Diagnoses:
Ideomotor apraxia in a patient wi...
Source: Medicine - July 16, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Intracardiac thrombus in a patient with mitral bioprosthesis and atrial fibrillation treated with direct oral anticoaugulant: A case report
Rationale:
Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with increased morbidity, especially stroke and heart failure. There is also increasing awareness that atrial fibrillation is a major cause of embolic events which in 75% of cases are complicated by cerebrovascular accidents.
Patient concerns:
A 50-year-old woman with mitral bioprosthesis under warfarin for nonvalvular atrial fibrillation was referred to our Coronary Intensive Care Unit due to acute myocardial infarction without evidence of significant coronary artery stenosis.
Diagnoses:
Cardiovascular examination...
Source: Medicine - June 11, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Meningioma preceding CASPR2 antibody limbic encephalitis with a stroke mimic: A case report
We report a contactin-associated protein-like 2-antibody (CASPR2-Ab)-positive patient who presented with atypical LE.
Diagnoses:
CASPR2-Ab-positive LE was the presumed diagnosis. Re-evaluation of cerebrospinal fluid (CSF) samples revealed autoantibodies targeting CASPR2 at an immunoglobulin G titer of 1:1. The clinical presentation of subacute onset seizures, abnormal electroencephalography, hypermetabolism on positron emission tomography, good immunotherapy response, and the presence of specific antibodies in serum supports a diagnosis of autoimmune LE.
Intervention:
The patient received glucocorticoids (1â€...
Source: Medicine - June 11, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Perfusion image guided mechanical thrombectomy combined with tirofiban successfully revascularize systemic lupus erythematosus related acute large vessel occlusion: A case report
Rationale:
Systemic lupus erythematosus (SLE) is an important cause of stroke, more than a half the cases present as acute ischemic stroke. Thrombolysis is an effective choice in most cases, but for large vessel occlusion, mechanical thrombectomy is more effective. Here we reported a case of SLE-related stroke with left middle cerebral artery (MCA) occlusion, who was successfully treated by MT and tirofiban.
Patient concern:
A 38-year-old female suffered from right hemiplegia and aphasia for 8 hours. She was diagnosed with SLE 20 years ago, and neuropsychiatric SLE was considered 8 months before this onset...
Source: Medicine - May 7, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Wrist-hand extension function recovery in spastic hemiplegia patient by botulinum toxin injection plus surface electromyography biofeedback therapy: A case report
We reported a 46-year-old male suffered a spastic hemiplegia with wrist- hand extension deficit.
Diagnoses:
Computed tomography showed cerebral hemorrhage in the left basal ganglia region.
Interventions:
Four hundred units of BoNTA were injected into the spasticity flexors, and four-week post injection surface electromyography (sEMG) biofeedback therapy was applied to the patient.
Outcomes:
The patient exhibited post-intervention improvement in wrist-hand extensors performance (strength, range of motion, sEMG signals), the flexors spasticity, and upper extremity function.
Lessons:
The present ca...
Source: Medicine - April 9, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Changes in the prefronto-thalamic tract following cranioplasty: Case reports
We report on three women with hemorrhagic stroke who showed changes in the PTT following cranioplasty (C/P) using diffusion tensor tractography (DTT) images.
Patient concerns:
The 3 women with hemorrhagic stroke showed reductions of cognitive impairment following C/P. Mini-Mental State Examination scores (MMSE) were increased by 7-, 8-, and 5-point in patient 1, 2, and 3, respectively, after C/P compared with the patients’ pre-C/P MMSE scores.
Diagnosis:
Three patients were diagnosed with spontaneous intracerebral hemorrhage. Three patients underwent C/P using auto-bone at 7 (patient 1 and 3) and 13 (patien...
Source: Medicine - April 9, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Y-configuration double-stent-retriever thrombectomy for refractory thrombus in middle cerebral artery bifurcation: A case report
Rationale:
Stent retriever mechanical thrombectomy is a recommended treatment for acute ischemic stroke. However, refractory thrombus in artery bifurcation can reduce the rate of successful revascularization.
Patient concerns:
A 72-year-old male, owing to the acute onset of almost complete right-sided hemiplegia and global aphasia, received bridging therapy. National Institutes of Health Stroke Scale score was 16 at the time of admission.
Diagnoses:
Cerebral digital subtraction angiography revealed occlusion of the M1 segment of the left MCA.
Interventions:
Thrombectomy with 3 passes of the Solitai...
Source: Medicine - March 19, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Pathogeny of cerebral venous thrombosis in SARS-Cov-2 infection: Case reports
We describe 2 cases of women admitted during the spring of 2020 for intracranial hypertension signs, in stroke units in Great-east, a French area particularly affected by COVID-19 pandemia.
Diagnoses:
Cerebral imaging revealed extended CVT in both cases. The first case described was more serious due to right supratentorial venous infarction with hemorrhagic transformation leading to herniation. Both patients presented typical pneumonia due to SARS-Cov-2 infection, confirmed by reverse transcription polymerase chain reaction on a nasopharyngeal swab in only one.
Interventions:
The first patient had to undergo ...
Source: Medicine - March 12, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Two cases of rt-PA with dual antiplatelet therapies with capsular warning syndrome
Rationale:
Capsular warning syndrome (CWS) is a term to describe stereotyped lacunar transient ischemic attacks (TIAs). Patients with CWS are at high risk of developing completed stroke. However, the exact pathophysiology of CWS is still unclear, and there is no conclusive clinical strategy for CWS patients.
Patient symptoms:
Two cases of middle-aged men with hypertension, hyperlipidemia, and diabetes mellitus presented with fluctuating right-sided weakness, numbness, and dysarthria.
Diagnoses:
These two patients were diagnosed with CWS.
Interventions:
Recombinant tissue plasminogen activator (rt-P...
Source: Medicine - March 5, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Alterations of functional connectivity in auditory and sensorimotor neural networks: A case report in a patient with cortical deafness after bilateral putaminal hemorrhagic stroke
Rationale:
Cortical deafness is a rare auditory dysfunction caused by damage to brain auditory networks. The aim was to report alterations of functional connectivity in intrinsic auditory, motor, and sensory networks in a cortical deafness patient.
Patient concerns:
A 41-year-old woman suffered a right putaminal hemorrhage. Eight years earlier, she had suffered a left putaminal hemorrhage and had minimal sequelae. She had quadriparesis, imbalance, hypoesthesia, and complete hearing loss.
Diagnoses:
She was diagnosed with cortical deafness. After 6 months, resting-state functional magnetic resonance imagin...
Source: Medicine - January 22, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Anesthetic considerations in hyperparathyroid crisis: A case report
Introduction:
Hyperparathyroid crisis is a rare and potentially life-threatening complication of severe calcium intoxication. Parathyroidectomy is the only curative method for hyperparathyroid crisis. Several case reports and case series have been published on the medical and surgical treatments for hyperparathyroid crisis, however, few reports have focused on the associated perioperative anesthetic management.
Patient concerns:
A 48-year-old Chinese woman presented with a 2-week history of nausea and vomiting and complained of mental status alteration including confusion and agitation in the 24 hours prior to...
Source: Medicine - January 8, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Acute ischemic stroke due to unruptured small aneurysm of internal carotid artery: A case report
Rationale:
Intracranial small aneurysm is a rare cause of ischemic stroke, and been described only in sparse case reports. The exact pathophysiology, treatment strategies, and prognosis remain incompletely understood.
Patient concerns:
A 42-year-old man presented with an acute onset weakness of the right limbs.
Diagnoses:
Neuroimaging evaluation confirmed a diagnosis of acute ischemic stroke and left internal carotid artery (ICA) small aneurysm.
Interventions:
The patient underwent oral anti-platelet therapy (100 mg aspirin daily).
Outcomes:
The patient recovered to normal status within 4 weeks following an...
Source: Medicine - October 9, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Transdermal opioid patch in treatment of paroxysmal autonomic instability with dystonia with multiple cerebral insults: A case report
Rationale:
Paroxysmal autonomic instability with dystonia (PAID) is an underdiagnosed syndrome that describes a collection of symptoms following diverse cerebral insults, such as traumatic brain injury, hydrocephalus, hemorrhagic stroke, or brain anoxia. It is manifested by systemic high blood pressure, hyperthermia, tachycardia, tachypnea, diaphoresis, intermittent agitation, and certain forms of dystonia.
Patient concerns:
A semi-comatose 46-year-old man was transferred from the regional rehabilitation hospital with various complaints involving fluctuating vital signs, including uncontrolled hyperthermia, hypertensi...
Source: Medicine - October 2, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
