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SMART Syndrome Identification and Successful Treatment
We report a 41-year-old male patient admitted to our emergency room with a reduced level of consciousness and global aphasia. One month prior to admission, he started with frequent headache attacks of moderate intensity and paroxysmal behavioral alterations, advancing to confusion, gait instability, language impairment, and somnolence. He had a history of medulloblastoma treated with surgical resection followed by craniospinal irradiation 21 years before symptom onset. After excluding more frequent causes for the patient ’s symptoms along with a suggestive image pattern, we started treatment for SMART syndrome with high-...
Source: Case Reports in Neurology - January 25, 2021 Category: Neurology Source Type: research

Recurrent Vertebrobasilar Strokes Associated With Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE)
Conclusions: This case illustrates the importance of careful evaluation and high clinical suspicion for this entity when dealing with patients with new-onset headache or stroke associated with visual impairment. Proper ophthalmologic evaluation is important so that adequate therapy is established.
Source: The Neurologist - September 1, 2020 Category: Neurology Tags: Case Report/Case Series Source Type: research

A Case of Multiple Sclerosis —Like Relapsing Remitting Encephalomyelitis Following Allogeneic Hematopoietic Stem Cell Transplantation and a Review of the Published Literature
Complications involving the central nervous system (CNS) occur in 9–14% of patients following allogeneic hematopoietic stem cell transplantation (HSCT), including stroke-like episodes, demyelination, encephalitis, and nonspecific neurological symptoms. Here we report a case of multiple sclerosis (MS) like relapsing remitting encephalomyelitis following allogeneic HSCT, which did not respond to disease modifying therapies (DMTs) and “domino” autologous HSCT. A 53-year-old male was treated with allogeneic HSCT for lymphoid blast transformation of chronic myeloid leukemia. Ten months later he presented with confusion, s...
Source: Frontiers in Immunology - May 4, 2020 Category: Allergy & Immunology 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

What Causes Hyperammonemia?
Discussion Reye’s syndrome (RS)is named for Dr. Douglas Reye who along with Drs. G. Morgan and J. Baral described encephalopathy and fatty accumulation and degeneration in children in a 1963 Lancet article. RS usually affects children but can occur at all ages. All organs can be affected but the liver and brain are primarily affected causing liver failure and encephalopathy as toxic metabolites (especially ammonia) accumulate, and intracranial hypertension and cerebral edema occurs. As the ammonia levels begin to rise (> 100 mg/dL) patients lose their appetite, have nausea and emesis and mental status changes whic...
Source: PediatricEducation.org - February 20, 2017 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

Fatal antiphospholipid syndrome following endoscopic transnasal-transsphenoidal surgery for a pituitary tumor: A case report
Conclusion: If patients have a history of cerebral stroke in their early life, such as a young stroke, the APS and higher risk of developing fatal APS after major surgery should be considered. The optimal management of APS remains controversial. The best treatment strategies are only early diagnosis and aggressive therapies combing of anticoagulant, corticosteroid, and plasma exchange. The intravenous immunoglobulin is prescribed for patients with refractory APS.
Source: Medicine - January 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Case report: acute demyelinating encephalomyelitis following viper bite
We present a rarely seen central nervous system complication, acute demyelinating encephalomyelitis, after a treated Deinagkistrodon's viper bite. On April 5, 2015, a 50-year-old male farmer was bitten on his right leg by a Deinagkistrodon's viper. The bite rendered the victim unconscious for 14 days, during which he was treated with tetanus toxoid and polyvalent antisnake venom. Acute demyelinating encephalomyelitis (ADEM) was suspected after magnetic resonance imaging of the brain. After a high dose of methylprednisolone was used as diagnostic treatment, the patient started recovering fast. ADEM is a rare complication ...
Source: Medicine - November 1, 2016 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Recurrent Hemorrhagic Venous Infarctions Caused by Thrombosis of a Pontine Developmental Venous Anomaly and Protein S Mutation
A 34-year-old man presented with an acute onset of upbeat nystagmus, slurred speech, and limb and truncal ataxias. The patient had a history of limb ataxia and gait disturbance previously treated as brainstem encephalitis with corticosteroids 3 years previously. Brain magnetic resonance imaging showed pontine developmental venous anomaly (DVA) and hemorrhagic infarction within the drainage territory of the DVA. Three months later, the patient exhibited recurrent limb ataxia, double vision, and numbness of the left side of the body.
Source: Journal of Stroke and Cerebrovascular Diseases - September 18, 2016 Category: Neurology Authors: Yuri Nakamura, Kei-ichiro Takase, Takuya Matsushita, Satoshi Yoshimura, Ryo Yamasaki, Hiroyuki Murai, Kazufumi Kikuchi, Jun-ichi Kira Tags: Case Studies Source Type: research

Can Quantitative Muscle Strength and Functional Motor Ability Differentiate the Influence of Age and Corticosteroids in Ambulatory Boys with Duchenne Muscular Dystrophy?
Conclusion The baseline data analysis of this natural history study indicates that the outcomes measures utilized in this study were sensitive to the age related differences in strength and motor function that are characteristic of disease progression boys with DMD; however treatment effects were less likely to be identified. These findings reflect the difficulty inherent in obtaining the statistical power needed to substantiate intervention efficacy in the small, heterogeneous samples sizes that are characteristic of DMD clinical studies. Isokinetic dynamometry revealed variability in the muscles affected, which has been ...
Source: PLOS Currents Muscular Dystrophy - July 8, 2016 Category: Neurology Authors: cbuckon Source Type: research

Isolated Central Nervous System Vasculitis as a Manifestation of Neurosarcoidosis
A 62-year-old male presented to our clinic with recurrent fever, skin lesions (petechiae), scleral wounds, and hilar adenomegaly. A diagnosis of sarcoidosis was established, which resolved with corticosteroid treatment. After a few months, the patient developed confusion and behavioral changes, with few objective neurological deficits. Brain magnetic resonance imaging showed slight focal meningeal enhancement (prepontine region). The level of angiotensin-converting enzymes was normal in the serum and increased in the cerebrospinal fluid.
Source: Journal of Stroke and Cerebrovascular Diseases - April 11, 2016 Category: Neurology Authors: Philippe Joaquim Oliveira Menezes Macêdo, Victor Calil da Silveira, Luíza Tavares Ramos, Felipe Resende Nóbrega, Luiz Felipe Rocha Vasconcellos Tags: Case Studies Source Type: research

Report of cold agglutinins in a patient with acute ischemic stroke
Conclusion: We report here the first case of cerebral infarction probably due to the cold agglutinin disease. The underlying mechanism of cold agglutinins in the pathogenesis of acute ischemic stroke needs to be investigated further.
Source: BMC Neurology - October 30, 2015 Category: Neurology Authors: Haiqiang JinWei SunYongan SunYining HuangYunchuang Sun Source Type: research

Spinal Cord Infarction as the Initial Presentation of Systemic Lupus Erythematosus (P2.077)
CONCLUSIONS:Aggressive therapy with high dose corticosteroids and intravenous cyclophosphamide followed by oral therapy may be a successful therapeutic approach to spinal cord infarcts secondary to systemic lupus erythematosus. Study Supported by: N/ADisclosure: Dr. Michael has nothing to disclose. Dr. Hayat has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Michael, A., Hayat, G. Tags: Neurological Consequences of Autoimmune Disease Source Type: research

Twenty-year brain magnetic resonance imaging follow-up study in Systemic Lupus Erythematosus: Factors associated with accrual of damage and central nervous system involvement
Conclusion This study shows that MRI brain damage in SLE patients progresses independently from NP involvement as an effect of potentially modifiable risk factors and it is associated with increased risk of new NP events.
Source: Autoimmunity Reviews - January 27, 2015 Category: Allergy & Immunology Source Type: research

Listeria monocytogenes Meningoencephalitis Mimicking Stroke in a Patient with Chronic Lymphocytic Leukemia
Conclusion The supratentorial focal lesions secondary to Listeria meningoencephalitis are rare. The cases with focal neurological signs without fever at onset can resemble stroke.
Source: Neurology and Therapy - December 1, 2013 Category: Neurology Source Type: research

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