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Chorea-ballism as a dominant clinical manifestation in heteroplasmic mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes syndrome with A3251G mutation in mitochondrial genome: a case report
ConclusionThe dominance of hyperkinetic movements in the clinical scenario and the finding of a point mutation A3251G inMT-TL1 gene make this a rare presentation.
Source: Journal of Medical Case Reports - March 5, 2019 Category: General Medicine Source Type: research

Ischemic stroke and disseminated tuberculosis in a child living with human immunodeficiency virus: a case report and review of the literature
ConclusionsExtrapulmonary tuberculosis should be considered a cause of sudden focal neurologic deficits in children with human immunodeficiency virus infection residing in endemic countries.
Source: Journal of Medical Case Reports - February 20, 2019 Category: General Medicine Source Type: research

Twenty-and-a-half syndrome: a case report
ConclusionsTwenty-and-a-half syndrome is reported for the first time. It is due to posterior circulation stroke; in our case, it was due to lacunar infarcts in the pons and medulla, manifesting as one-and-a-half syndrome with bilateral seventh and right fifth nerve palsy.
Source: Journal of Medical Case Reports - February 15, 2019 Category: General Medicine Source Type: research

A serious thrombotic event in a patient with immune thrombocytopenia requiring intravenous immunoglobulin: a case report
ConclusionsWe performed an extensive literature review to determine the possible causes of serious thrombotic events in immune thrombocytopenia between the predictive factors of the disease and intravenous immunoglobulin. Although intravenous immunoglobulin is an effective treatment, thrombotic complications can occur. We emphasize that in patients with atherosclerosis risk factors or thrombophilia, the appropriateness of administering an intravenous immunoglobulin infusion should be carefully evaluated.
Source: Journal of Medical Case Reports - January 28, 2019 Category: General Medicine Source Type: research

Hereditary cardiac amyloidosis associated with Pro24Ser transthyretin mutation: a case report
ConclusionsHere we report the case of a patient with hereditary cardiac amyloidosis associated with a Pro24Ser mutation in transthyretin, which is the first case reported in Japan. Technetium pyrophosphate scintigraphy was extremely useful for definitive diagnosis. Thus, we propose that the nuclear imaging technique should be taken into account even for an exploratory diagnosis of transthyretin cardiac amyloidosis.
Source: Journal of Medical Case Reports - December 16, 2018 Category: General Medicine Source Type: research

Ischemic stroke following a wasp sting – a rare complication: a case report
ConclusionTreating physicians should be aware of the rare but possible complication of ischemic stroke following a case of wasp sting.
Source: Journal of Medical Case Reports - October 14, 2018 Category: General Medicine Source Type: research

A difficult situation – balancing critical anticoagulation versus the risk of permanent neurologic deficit: a case report
ConclusionsManagement of a retroperitoneal hematoma can commence with recognition of the warning signs of bleeding and neurological impairment, and consulting the appropriate services in case the need for intervention arises. A conservative approach of volume resuscitation and blood transfusion can be used initially, with the need for pausing or reversing anticoagulation being assessed on an individual basis with expert consultation. If intervention becomes necessary, other interventional radiology-based modalities can be used to identify and stop the bleeding source, and interventional radiology-guided drainage can be per...
Source: Journal of Medical Case Reports - June 22, 2018 Category: General Medicine Source Type: research

Moyamoya disease in a Moroccan baby: a case report
ConclusionThis case highlights the importance of considering moyamoya disease to be one of the classic etiologies of acute ischemic strokes in children from North Africa. It also emphasizes the rare presentation among the African population and the use of neurovascular imaging techniques to facilitate diagnosis of moyamoya disease.
Source: Journal of Medical Case Reports - June 13, 2018 Category: General Medicine Source Type: research

Wernekink commissure syndrome with palatal myoclonus at onset: a case report and review of the literature
ConclusionsWernekink commissure syndrome with palatal myoclonus at onset suggests the presence of a prior ischemic insult in the medulla. Careful examination is important to identification of this presentation.
Source: Journal of Medical Case Reports - May 1, 2018 Category: General Medicine Source Type: research

Cerebral vasculitis and lateral rectus palsy – two rare central nervous system complications of dengue fever: two case reports and review of the literature
ConclusionsCentral nervous system vasculitis due to dengue infection is a very rare phenomenon, and to the best of our knowledge, only one case of central nervous system vasculitis has been reported to date, in a patient of pediatric age. Cranial nerve palsy related to dengue infection is also rare, and only a few cases of isolated abducens nerve palsy have been reported to date. The two cases described in this report illustrate the rare but important central nervous system manifestations of dengue fever and support the fact that the central nervous system is one of the important systems that can be affected in patients with dengue infection.
Source: Journal of Medical Case Reports - April 19, 2018 Category: General Medicine Source Type: research

Left ventricular hypertrophy diagnosed after a stroke: a case report
ConclusionsElectrocardiogram diagnosis of left ventricular hypertrophy led to the diagnosis of apical hypertrophic cardiomyopathy in this patient. Left ventricular hypertrophy was only evident a few days after our patient suffered a stroke. The underlying mechanisms responsible for this remain unclear. Furthermore, differential diagnosis of hypertrophic cardiomyopathy should be considered in people with electrocardiogram criteria for left ventricular hypertrophy. Cardiovascular magnetic resonance imaging is an important diagnostic tool in identifying causes of left ventricular hypertrophy. Family screening should be recomm...
Source: Journal of Medical Case Reports - March 22, 2018 Category: General Medicine Source Type: research

Cervico-shoulder dystonia following lateral medullary infarction: a case report and  review of the literature
ConclusionsTo date, to the best of our knowledge, there has been only one reported case of cervical dystonia associated with a single medullary lesion. It is interesting to note the similarities in the clinical characteristics of the previously reported case and our patient: the involvement of the dorsal and caudal parts of the medullary and associated ipsilateral hemiplegia. The present case may support the speculation that the lateral and caudal regions of the medulla may be the anatomical sites responsible for inducing cervical dystonia.
Source: Journal of Medical Case Reports - February 10, 2018 Category: General Medicine Source Type: research

Combined use of high doses of vasopressin and corticosteroids in a patient with Crohn ’s disease with refractory septic shock after intestinal perforation: a case report
ConclusionsThe significant increase in her cardiac index and stroke volume index resulted in an improvement in peripheral resistance, gas exchange, and urine output and a decrease in her heart rate, interleukin-6 level, and tumor necrosis factor- α level. The administration of high doses of vasopressin and corticosteroids was demonstrated to be safe for the immune system, to reduce the systemic inflammatory response, and to have direct cardiovascular effects. Further studies are required to examine the use of vasopressin as an initial vasop ressor as well as its use in high dosages and in combination with corticosteroids.
Source: Journal of Medical Case Reports - November 13, 2017 Category: General Medicine Source Type: research

Successful intravenous thrombolysis for ischemic stroke after reversal of dabigatran anticoagulation with idarucizumab: a case report
ConclusionsOur case report adds to the evidence that idarucizumab administration is safe in the setting of patients with atrial fibrillation treated with dabigatran who develop acute ischemic stroke requiring thrombolysis.
Source: Journal of Medical Case Reports - August 15, 2017 Category: General Medicine Source Type: research

Artery of Percheron infarction: a case report
ConclusionsArtery of Percheron infarcts are rare. The radiological diagnosis can initially often be judged as normal and in combination with variability in the neurological symptoms it is a rather difficult condition to diagnose. For these reasons few clinicians have much experience with this type of infarct, which may delay diagnosis and initiation of appropriate treatment.
Source: Journal of Medical Case Reports - August 12, 2017 Category: General Medicine Source Type: research

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