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Intracranial rheumatoid nodule causing recurrent transient neurological deficits
Pract Neurol. 2022 Oct 5:pn-2022-003489. doi: 10.1136/pn-2022-003489. Online ahead of print.ABSTRACTA 67-year-old man with rheumatoid arthritis developed recurrent acute onset of stereotyped focal neurological abnormalities. Cerebral imaging showed a mass lesion in the left parieto-occipital lobe. Imaging did not show the time evolution expected in stroke and so he underwent an extensive workup, which was inconclusive. Brain biopsy identified a rheumatoid nodule causing an extensive inflammatory reaction that mimicked a mass. Following treatment with intravenous corticosteroids and rituximab infusions, his clinical conditi...
Source: Practical Neurology - October 5, 2022 Category: Neurology Authors: Natalie Brossard-Barbosa Laura Donaldson Elena Sokolova Laila AlShafai Edward Margolin Source Type: research

Guidelines for the Acute Treatment of Cerebral Edema in Neurocritical Care Patients
ConclusionThe available evidence suggests hyperosmolar therapy may be helpful in reducing ICP elevations or cerebral edema in patients with SAH, TBI, AIS, ICH, and HE, although neurological outcomes do not appear to be affected. Corticosteroids appear to be helpful in reducing cerebral edema in patients with bacterial meningitis, but not ICH. Differences in therapeutic response and safety may exist between HTS and mannitol. The use of these agents in these critical clinical situations merits close monitoring for adverse effects. There is a dire need for high-quality research to better inform clinicians of the best options ...
Source: Neurocritical Care - May 14, 2020 Category: Neurology Source Type: research

Acute bacterial meningitis and stroke.
Abstract INTRODUCTION: Acute bacterial meningitis remains a common disease, especially in developing countries. Although advances over the last century have improved mortality and morbidity, the neurological adverse effects remain high. Specifically, acute ischaemic stroke is a serious comorbidity that represents both disease severity and poor prognosis. This review presents the clinical connection between meningitis and stroke, and discusses the neuroinflammatory components that have direct ties between these diseases. STATE OF THE ART: Ischaemic stroke is the direct result of the inflammatory response produ...
Source: Neurologia i Neurochirurgia Polska - August 22, 2019 Category: Neurology Authors: Siegel J Tags: Neurol Neurochir Pol Source Type: research

Neurological Involvement in Primary Systemic Vasculitis
Conclusion Neurological involvement is a common complication of PSV (Table 1), and neurologists play an important role in the identification and diagnosis of PSV patients with otherwise unexplained neurological symptoms as their chief complaint. This article summarizes the neurological manifestations of PSV and hopes to improve neuroscientists' understanding of this broad range of diseases. TABLE 1 Table 1. Common CNS and PNS involvements of primary systemic vasculitis. Author Contributions SZ conceived the article and wrote the manuscript. DY and GT reviewed and edited the manuscript. All authors ...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Does adjunctive corticosteroid and aspirin therapy improve the outcome of tuberculous meningitis ?
Conclusion: Aspirin with corticosteroid adjunctive treatment seems to be beneficial in reducing mortality in TBM.
Source: Neurology India - November 28, 2018 Category: Neurology Authors: Usha Kant Misra Jayantee Kalita Betai Sagar Sanjeev Kumar Bhoi Source Type: research

Intracranial tuberculous mass lesions treated with thalidomide in an immunocompetent child from a low tuberculosis endemic country: A case report
We describe a case of an Italian child. Diagnoses: we diagnosed early a Tuberculous meningitis complicated by the occurrence of hydrocephalus, stroke, and paradoxical reaction with brain pseudo-abscesses. Interventions: The child started readily a specific therapy associated with steroids and thalidomide was introduced few month later. Outcomes: the patient had a favorable outcome without neurologic sequelae. Lessons: Despite the prompt specific anti-tubercular and adjuvant corticosteroid therapies, only the addition of thalidomide to the treatment allow to a favorable clinical outcome.
Source: Medicine - July 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Not as Simple as Canker Sores
BY ​NANA P. MATSUMOTO, & DEREK MEEKS, DO​​A 16-year-old boy presented to a rural ED with a swollen jaw, painful blisters in the mouth, and earache for the past day. One week before, he had a fever with chills, sore throat, and dry coughs. He was not taking any medications, and his immunizations were up-to-date. He had a mild learning disorder but no significant past medical or surgical history.​An apthous ulcer, the most common and one of the earliest signs of Behçet's disease.The patient's vital signs were within normal limits, and his physical examination revealed anterior cervical lymphadenopathy, sinus con...
Source: The Case Files - October 11, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Neurotoxocariasis, a treatable infectious etiology of Stroke (P3.318)
Conclusions:Toxocara infection is an uncommon but treatable etiology of stroke, and should be particularly considered in patients with eosinophilia, positive serology, myocarditis and embolic strokes.Disclosure: Dr. Garcia Monco has nothing to disclose. Dr. Azkune Calle has nothing to disclose. Dr. Ruisanchez nieva has nothing to disclose. Dr. Anguizola Tamayo has nothing to disclose. Dr. Pardina Vilella has nothing to disclose. Dr. Bocos Portillo has nothing to disclose. Dr. Gomez-Beldarrain has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Monco, J. G., Calle, I. A., nieva, A. R., Tamayo, D. A., Vilella, L. P., Portillo, J. B., Gomez-Beldarrain, M. Tags: Fungal and Parasitic Disease of the Nervous System Source Type: research

Fungal Infections of the Central Nervous System
This article summarizes current knowledge on the epidemiology, clinical presentations, diagnosis, and management of selected fungal infections of the central nervous system (CNS). Key syndromes, differential diagnoses, and therapeutic interventions according to host immune status and exposure are reviewed. Recent Findings:: Advancements in imaging of the brain and spinal cord, and molecular DNA and antigen-based laboratory diagnostics afford improved sensitivity for CNS mycoses. Newer therapeutic strategies may improve outcomes if provided early and host immunosuppression is abrogated. Adjunctive corticosteroid use for dis...
Source: CONTINUUM - December 1, 2015 Category: Neurology Tags: Review Articles Source Type: research

Cervical aspergillosis with dissemination to the central nervous system: Case reports and review of the literature.
CONCLUSION: IA must be considered a possibility whenever an immunocompromised patient presents with a new brain lesion. These lesions require surgical evacuation, a procedure that allows for diagnostic confirmation and enhances prognosis. Appropriate anti-fungal therapy must be started as soon as the diagnosis is confirmed. In addition, the patient's neurological exam must be repeated and images obtained periodically to monitor treatment and detect possible recurrences. PMID: 26600985 [PubMed - as supplied by publisher]
Source: Surgical Neurology International - November 25, 2015 Category: Neurosurgery Tags: Surg Neurol Int Source Type: research