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Ischemic stroke caused by giant cell arteritis associated with pulmonary adenocarcinoma
We describe a 77-year-old man with a sudden onset of dizziness, vomiting, and gait disturbances. Following imaging studies, a diagnosis of bulbar ischemic stroke with left vertebral artery stenosis was made. Based on a history of polymyalgia rheumatica, on laboratory tests, and brain digital subtraction angiography, a diagnosis of GCA was advanced and the patient underwent high-dose steroidal therapy. After a total body 18-FGD PET imaging, a pulmonary adenocarcinoma was found.Vertebral artery involvement is a rare but important occurrence in GCA as it carries a high mortality rate, and may require a vigorous therapeutic ap...
Source: Journal of Clinical Neuroscience - November 5, 2019 Category: Neuroscience Source Type: research

Brain abscess complicating ischemic embolic stroke in a patient with cardiac papillary fibroelastoma – Case report and literature review
Publication date: Available online 13 May 2019Source: Journal of Clinical NeuroscienceAuthor(s): Monique Boukobza, Sarah Nahmani, Lydia Deschamps, Jean-Pierre LaissyAbstractA 72-year-old man without obvious risk factors initially presented with acute ischemic stroke and fever, without concomitant infection. Broad spectrum antibiotic therapy was initiated. Transthoracic and Transesophageal echocardiography, and cardiac MRI revealed a 20 mm round mass attached to the anterior mitral valve leaflet, suggesting the diagnosis of a benign cardiac tumor or a vegetation. At the site of infarction an abscess of 11 mm in diameter...
Source: Journal of Clinical Neuroscience - May 15, 2019 Category: Neuroscience Source Type: research

Metastatic prostate cancer mimicking a subdural hematoma: A case report and literature review
Publication date: Available online 4 July 2018Source: Journal of Clinical NeuroscienceAuthor(s): Andrew Nunno, Mahlon D. Johnson, Guan Wu, Yan Michael LiAbstractOccurrences of metastatic prostate cancer imitating a subdural hematoma are limited to a small number of case reports, even though prostate cancer spreads to the dura more than other types of cancer. Here, we present the case of a 64 year-old male whose prostate carcinoma’s metastasis mimicked a subdural hematoma, and he suffered a middle cerebral artery stroke. Prostate cancer’s high rate of progression to the dura is disproportionate to its relatively low r...
Source: Journal of Clinical Neuroscience - July 10, 2018 Category: Neuroscience Source Type: research

High prevalence of small vessel disease long after cranial irradiation
In conclusion, small vessel disease is not a rare complication after cranial irradiation, even in young patients. Patients after cranial irradiation should be followed up with MR imaging including a hemosiderin-sensitive sequence.
Source: Journal of Clinical Neuroscience - October 27, 2017 Category: Neuroscience Source Type: research

Intravascular lymphoma mimicking vasculitis
This report documents the presence of intravascular lymphoma diagnosed on a brain biopsy in a 60-year-old man. He initially presented 6months before brain biopsy with chest pain and hypotension, warranting coronary artery bypass graft surgery. Four months later, he presented with signs attributed to a stroke (diaphoresis, slumped over in a chair and left hand weakness). He subsequently developed a sudden onset wide-based gait, left leg numbness, word finding difficulties and worsening confusion. A MRI study showed multiple infarcts in the brain, including cerebellum. Invasive angiogram suggested vasculitis. He was started ...
Source: Journal of Clinical Neuroscience - November 10, 2016 Category: Neuroscience Source Type: research

Metastatic chromophobe renal cell carcinoma to the brain
This report documents an unusual case of a patient with a chromophobe renal cell carcinoma presenting with a brain metastasis. A 58-year-old man presented with stroke-like symptomatology, including expressive aphasia, right side facial weakness, headaches and vomiting. CT imaging demonstrated a 4.7cm left frontal lobe hemorrhagic mass. He underwent surgery with excision of the mass, which was marked by sheets of large cells with lightly eosinophilic to clear cytoplasm. PAX8 staining was positive and a diagnosis of clear cell carcinoma of probably renal origin was rendered. Subsequently, CT imaging of the abdomen revealed a...
Source: Journal of Clinical Neuroscience - November 17, 2015 Category: Neuroscience Source Type: research

In-hospital outcomes of thrombolysis for acute ischemic stroke in patients with primary brain tumors
Publication date: March 2015 Source:Journal of Clinical Neuroscience, Volume 22, Issue 3 Author(s): Santosh B. Murthy , Yogesh Moradiya , Shreyansh Shah , Aditi Shastri , Eric M. Bershad , Jose I. Suarez Data on thrombolysis outcomes in patients with primary brain tumors are limited. Our aim was to study stroke outcomes following thrombolysis in these patients in a population-based study. Patients with acute ischemic stroke who received thrombolysis were identified from the 2002–2011 USA Nationwide Inpatient Sample. We compared demographics, comorbidities, and outcomes between primary brain tumor-associated strokes (BT...
Source: Journal of Clinical Neuroscience - February 16, 2015 Category: Neuroscience Source Type: research