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Absence of susceptibility vessel sign and hyperdense vessel sign in patients with cancer-related stroke
ConclusionThe absence of SVS but not HVS could help to identify paraneoplastic hypercoagulability in stroke patients with active cancer and guide patient care.
Source: Frontiers in Neurology - March 20, 2023 Category: Neurology Source Type: research

Role of bedside video-oculography in selecting neuroimaging in patients with acute vertigo and ataxia posterior fossa mass lesions
The acute vestibular syndrome ((AVS) is the sudden onset of continuous vertigo, nausea, vomiting and head motion intolerance [1]. The most common peripheral cause is a vestibular neuritis [2], and the most frequent central lesion associated with an AVS is an ischemic stroke in about 10 to 15% of cases [3 –5]; less frequently demyelinating plaques (multiple sclerosis (MS) and neuromyelitis optica (NMO)) [6], and inflammatory lesions associated with infectious and paraneoplastic disorders may be responsible.
Source: Journal of the Neurological Sciences - December 1, 2022 Category: Neurology Authors: Daniel Getz, Anusha Mangalampalli, Jeffrey Klopfenstein, Andrew Tsung, Jorge C. Kattah Source Type: research

Case report: Dueling etiologies: Longitudinally extensive spinal cord lesion mimicking spinal cord infarct with simultaneous positive Lyme serology and amphiphysin antibody
ConclusionWe describe an unusual steroid-responsive, longitudinally extensive spinal cord lesion with radiological features of spinal cord infarct and a simultaneous finding of intrathecal Lyme antibodies and serum amphiphysin antibodies.
Source: Frontiers in Neurology - September 13, 2022 Category: Neurology Source Type: research

Case report: Acute vestibular syndrome and cerebellitis in anti-Yo paraneoplastic syndrome
We report three patients evaluated over the past decade with an acute AVS along with subtle downbeat nystagmus (DBN), followed by dysarthria and progressive truncal and limb ataxia, as well as increasing DBN intensity.MethodsAll patients underwent neurologic examination, video-oculography, MRI, serum cancer markers, spinal fluid examination, paraneoplastic panel testing, and oncologic workup. With a consolidated diagnosis of cancer/paraneoplastic syndrome, we treated with plasma exchange (PLEX), high-dose steroids, surgery, and oncologic investigation. We additionally provided oncotherapy in one out of three patients.Resul...
Source: Frontiers in Neurology - August 26, 2022 Category: Neurology Source Type: research

Stroke-Like Presentation of Paraneoplastic Cerebellar Degeneration: a Single-Center Experience and Review of the Literature
We report herein incidence and clinical features of hyperacute onset PCD, a vertebrobasilar stroke mimic. We performed a retrospective analysis of all suspected PCD cases referred to the Udine University Hospital between 2009 and 2017. Our center provides the only neuroimmunology laboratory for three provinces of the Friuli-Venezia Giulia region, Italy (983,190 people as of January 1, 2017). Inclusion criteria were (1) abrupt onset of neurological symptoms; (2) initial consideration of a vascular etiology; (3) final diagnosis of “definite PCD.” We also carried out a systematic review of the literature in order to ident...
Source: The Cerebellum - August 28, 2019 Category: Neurology Source Type: research

Floating Aortic Thrombus: A Rare Cause of Acute Ischemic Stroke Necessitating Modification of Access Route for Thrombectomy
We report 2 patients with acute occlusion of middle cerebral artery successfully treated by mechanical thrombectomy performed via transbrachial access. Both patients had floating aortic arch thrombi precluding safe transfemoral access due to risk of further iatrogenic embolization. Moreover both patients were diagnosed with hypercoagulopathy secondary to lung malignancy (paraneoplastic etiology, Trousseau's syndrome) as the cause of both aortic thrombi and acute ischemic stroke. Mechanical thrombectomy in the setting of a floating aortic thrombus has been mentioned only once as part of general management of floating aortic...
Source: Journal of Stroke and Cerebrovascular Diseases - August 20, 2019 Category: Neurology Authors: Sinan Balci, Ethem Murat Arsava, Mehmet Akif Topcuoglu, Anil Arat Source Type: research

A Novel Variant in Non-coding Region of GJB1 Is Associated With X-Linked Charcot-Marie-Tooth Disease Type 1 and Transient CNS Symptoms
Conclusion A novel GJB1 variant of c.-170T>G in non-coding region was found in this big Chinese CMTX1 pedigree. This is the first report of variant in non-coding DNA sequence associated with transient CNS symptoms. Thyroid malfunction may contribute to the CNS symptoms in this case. Ethics Statement This study has been reviewed and approved by the Ethics Committee of the China-Japan Union Hospital of Jilin University. Each member of the family provided written informed consent to the participation in the study, the genetic test, and authorized to publish the study including the photos in accordance with the Decl...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Acute cerebellar ataxia: differential diagnosis and clinical approach
ABSTRACT Cerebellar ataxia is a common finding in neurological practice and has a wide variety of causes, ranging from the chronic and slowly-progressive cerebellar degenerations to the acute cerebellar lesions due to infarction, edema and hemorrhage, configuring a true neurological emergency. Acute cerebellar ataxia is a syndrome that occurs in less than 72 hours, in previously healthy subjects. Acute ataxia usually results in hospitalization and extensive laboratory investigation. Clinicians are often faced with decisions on the extent and timing of the initial screening tests, particularly to detect treatable causes. Th...
Source: Arquivos de Neuro-Psiquiatria - April 4, 2019 Category: Neurology Source Type: research

Time Is Cerebellum
AbstractThe cerebellum characteristically has the capacity to compensate for and restore lost functions. These compensatory/restorative properties are explained by an abundant synaptic plasticity and the convergence of multimodal central and peripheral signals. In addition, extra-cerebellar structures contribute also to the recovery after a cerebellar injury. Clinically, some patients show remarkable improvement of severe ataxic symptoms associated with trauma, stroke, metabolism, or immune-mediated cerebellar ataxia (IMCA, e.g., multiple sclerosis, paraneoplastic cerebellar degeneration, gluten ataxia, anti-GAD65 antibody...
Source: The Cerebellum - February 19, 2018 Category: Neurology Source Type: research

A severe, relapsing case of myelin oligodendrocyte glycoprotein IgG-associated CNS inflammation
A 55-year-old man presented in October 2004 with general unease, vomiting, and gait disturbance. Initially diagnosed with an inner ear infection, the patient's symptoms did not improve and he was evaluated further. MRI revealed a cerebellar lesion, which led to the suspicion of a posterior circulation stroke, and he was started on antiplatelet drugs. However, an angiogram suggested no vascular pathology. In March 2011, he had another episode of ataxia and MRI showed a right brainstem lesion. Cryptogenic stroke was reconsidered. In March 2013, the patient developed paraparesis with urinary and bowel symptoms. MRI revealed m...
Source: Neurology Clinical Practice - February 12, 2018 Category: Neurology Authors: Saviour, M., Hamid, S., Moore, P., Mutch, K., Bhojak, M., Duddy, M., Jacob, A. Tags: All Demyelinating disease (CNS), Devic's syndrome, Optic neuritis; see Neuro-ophthalmology/Optic Nerve, Transverse myelitis Case Source Type: research

Fatal Atypical Progressive Multifocal Leukoencephalopathy (PML) in an African American Female with Sarcoidosis Associated Lymphopenia (SAL). A Rare Case Report and Literature Review. (P2.317)
Conclusions:This is the first case of SAL presenting with medullary PML in an African-American patient not on immunosuppressive therapy. The role of SAL in PML pathogenesis or Sarcoidosis Associated Immunodeficiency is unclear. No guidelines for CD4/CD8 monitoring are available and needs further investigation. We suggest an aggressive diagnostic approach in evaluating Sarcoidosis with atypical neurologic manifestations and neuroimaging to reduce morbidity-mortality.Study Supported by: Not applicable.Disclosure: Dr. Rathore has nothing to disclose. Dr. Sweiss has nothing to disclose. Dr. Campanella has nothing to disclose. ...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Rathore, J., Sweiss, N., Campanella, F., Andreoni, J., Wichter, M. Tags: HIV, HTLV-I, PML, Other Viral Infections, and CJD Source Type: research

Teaching NeuroImages: Posterior reversible encephalopathy syndrome resulting in hydrocephalus
A woman with prior lung transplantation presented with headaches, seizure, and obtundation. Head MRI (figure) revealed obstructive hydrocephalus and hyperintensity on T2-weighted imaging in the bilateral thalami and brainstem. Management included antiepileptic medications, ventriculostomy placement, and cessation of tacrolimus for concern of atypical posterior reversible encephalopathy syndrome (PRES). Infectious and paraneoplastic etiologies were ruled out. An autoimmune process was unlikely due to immunosuppression. There was rapid clinical improvement with repeat MRI revealing resolution of hydrocephalus and T2 changes....
Source: Neurology - June 5, 2016 Category: Neurology Authors: Paolini, S., Jadhav, A. P. Tags: Hydrocephalus, Secondary headache disorders, Other cerebrovascular disease/ Stroke RESIDENT AND FELLOW SECTION Source Type: research

Paraneoplastic Progressive Vasculopathy as the Presenting Manifestation of Polyneuropathy, Organomegaly, Endocrinopathy or Edema, M-Spike, and Skin Manifestations: A Case Report
We report a patient with ischemic stroke due to an underlying vasculopathy as the initial presentation of POEMS. This case highlights the importance of recognizing ischemic stroke as a presenting sign for POEMS as early diagnosis and treatment in patients with POEMS may prevent progression of multisystem involvement and may potentially stabilize the vasculopathy associated with it.
Source: Journal of Stroke and Cerebrovascular Diseases - May 9, 2016 Category: Neurology Authors: Shadi Yaghi, Mitchell S.V. Elkind Tags: Case Studies Source Type: research

The Evaluation and Management of Alternative Diagnoses in Amyotrophic Lateral Sclerosis (P5.091)
Conclusions: Treatment with intravenous steroids, immunoglobulin and surgical interventions prior to diagnosis of ALS is associated with a significantly prolonged mean ODI.Disclosure: Dr. Kannan has nothing to disclose. Dr. Glass has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Kannan, M., Glass, J. Tags: Neuroepidemiology: Neuro-oncology and ALS Source Type: research

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