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Subarachnoid Hemorrhage due to Spinal Cord Schwannoma Presenting Findings Mimicking Meningitis
We report an unusual case of spinal SAH mimicking meningitis with normal brain computed tomography (CT)/magnetic resonance imaging (MRI) and negative CT angiography. Cerebrospinal fluid examination results were consistent with the manifestation of SAH. Spinal MRI performed subsequently showed an intradural extramedullary mass. The patient received surgery and was finally diagnosed with spinal cord schwannoma.
Source: Journal of Stroke and Cerebrovascular Diseases - May 23, 2016 Category: Neurology Authors: Hong-Mei Zhang, Yin-Xi Zhang, Qing Zhang, Shui-Jiang Song, Zhi-Rong Liu Tags: Case Studies Source Type: research

Valacyclovir and Acyclovir Neurotoxicity With Status Epilepticus
We present the case of a 52-year-old man with hypertension, diastolic congestive heart failure, end-stage renal disease on hemodialysis 3 times a week and a remote history of a hemorrhagic stroke who presented to the emergency department with a vesicular rash on his left arm. The rash was observed to be in a dermatomal distribution, and a diagnosis of herpes zoster was made. The patient was discharged home on valacyclovir 1 g 3 times a day for a duration of 7 days. The patient took 2 doses of valacyclovir before presenting to the hospital again with irritability and hallucinations. Over the next several days, the patient's...
Source: American Journal of Therapeutics - January 1, 2016 Category: Drugs & Pharmacology Tags: Case Reports Source Type: research

Sudden neuropathological deaths: An autopsy study
Background Sudden or unexpected death can occur from unnatural causes, such as violence or poisoning, as well as from natural causes. Second to cardiac causes, neuropathology is one of the main causes of sudden natural death. In spite of the increasing incidence of neuropathological deaths, few studies have been conducted in Asia – hence the reason for the present study. Methods A 10-year (January 2003 to December 2012) retrospective study was conducted at the MS medico-legal institute in a metropolitan city of southern India. All the cases of sudden natural death, where the cause of death was opined to be due to a ...
Source: Medicine, Science and the Law - September 16, 2015 Category: Medical Law Authors: Hugar, B. S., Shetty, H., Girishchandra, Y., Hosahally, J. S. Tags: Original articles Source Type: research

Nosocomial infections after aneurysmal subarachnoid hemorrhage: time course and causative pathogens
ConclusionNosocomial infections after subarachnoid hemorrhage are common and mostly occur in the first week after ictus. Future studies should investigate if general hygienic measures, infection awareness, minimizing the duration of mechanical ventilation and use of catheters/drains, or prophylactic antibiotics reduce infections and improve functional outcome.
Source: International Journal of Stroke - April 1, 2015 Category: Neurology Authors: Kamil G. Laban, Gabriel J. E. Rinkel, Mervyn D. I. Vergouwen Tags: Research Source Type: research

Symptomatic contralateral subdural hygromas after decompressive craniectomy: plausible causes and management protocols.
CONCLUSIONS Arachnoid tears and blockage of arachnoid villi appear to be the underlying causes of a CLSDC. The absence of sufficient fluid pressure required for CSF absorption after a DC further aggravates such fluid collections. Underlying hydrocephalus may appear as subdural collections in some patients after the DC. Bur hole drainage appears to be only a temporary measure and leads to recurrence of a CLSDC. Therefore, cranioplasty is the definitive treatment for such collections and, if performed early, may even avert CLSDC formation. A temporary ventriculostomy or an external lumbar drainage may be added to aid the cra...
Source: Journal of Neurosurgery - December 12, 2014 Category: Neurosurgery Authors: Salunke P, Garg R, Kapoor A, Chhabra R, Mukherjee KK Tags: J Neurosurg Source Type: research

Intracranial Pressure and Cerebral Perfusion Pressure Monitoring in Non-TBI Patients: Special Considerations
Abstract The effect of intracranial pressure (ICP) and the role of ICP monitoring are best studied in traumatic brain injury (TBI). However, a variety of acute neurologic illnesses e.g., subarachnoid hemorrhage, intracerebral hemorrhage, ischemic stroke, meningitis/encephalitis, and select metabolic disorders, e.g., liver failure and malignant, brain tumors can affect ICP. The purpose of this paper is to review the literature about ICP monitoring in conditions other than TBI and to provide recommendations how the technique may be used in patient management. A PubMed search between 1980 and September 2013 identifie...
Source: Neurocritical Care - September 11, 2014 Category: Neurology Source Type: research

The Case Files: Unusual Headache
By Al-Hashimi, Siddhartha DO; Leavens, John MD A 23-year-old woman with a history of migraine headaches presented to the emergency department for a different-than-usual headache. She had a six-day history of intermittent headaches. The onset was at rest, and there was no history of trauma.   The headache was located behind her left eye, and it radiated into the posterior portion of her head. She characterized it as being 8/10 in intensity. Bright lights were reported as an exacerbating factor. The headache was associated with nausea and multiple episodes of emesis. She had 10 episodes of vomiting the evening prior to arri...
Source: The Case Files - June 5, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Sheehan syndrome: acute presentation with severe headache
Postpartum headache has an incidence of 11–80%.1,2 The majority of headaches in the postpartum period are of primary etiology, and include migraine, tension-type, cervicogenic, cluster headaches, and other trigeminal autonomic cephalgias.2–5 While secondary headaches are less common, they can be associated with significant morbidity and mortality, and a high index of suspicion and low threshold for neurodiagnostic imaging should be maintained. Secondary headaches may be due to complications of neuraxial anesthesia such as post-dural puncture headache (PDPH) and pneumocephalus, obstetric disease including hypertensive d...
Source: International Journal of Obstetric Anesthesia - May 14, 2014 Category: Anesthesiology Authors: B. Hale, A.S. Habib Tags: Case report Source Type: research

Meningeal Disease Masquerading as Transient Ischemic Attack
Conclusions: Our study confirmed that serious meningeal disease could present as TIA, but this disease was relatively uncommon among patients treated in a TIA clinic. The findings highlight the diagnostic value of MRI in patients with suspected TIA.
Source: Journal of Stroke and Cerebrovascular Diseases - April 25, 2014 Category: Neurology Authors: Line Cuinat, Nathalie Nasr, Jeanine Manuela Kamsu, Frédéric Tanchoux, Fabrice Bonneville, Vincent Larrue Tags: Case Reports Source Type: research

The causes of hypopituitarism in the absence of abnormal pituitary imaging
Conclusion: These results show that hypopituitarism in the absence of pituitary pathology or an identifiable cause is rare. In patients with multiple anterior pituitary hormone deficiencies haemochromatosis and sarcoidosis should be considered.
Source: QJM - December 20, 2013 Category: Internal Medicine Authors: Wilson, V., Mallipedhi, A., Stephens, J. W., Redfern, R. M., Price, D. E. Tags: Original papers Source Type: research

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