scholarly journals Stroke as an Unusual First Presentation of Lyme Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Mohamad Almoussa ◽  
Angelika Goertzen ◽  
Barbara Fauser ◽  
Christoph W. Zimmermann
Keyword(s):  
Case Reports ◽  
Brain Magnetic Resonance Imaging ◽  
Neurological Complications ◽  
Cognitive Disorder ◽  
Lyme Neuroborreliosis ◽  
Resonance Imaging ◽  
Radiological Findings ◽  
Case Presentation ◽  
Cerebrovascular Events ◽  
Thalamic Infarct

Introduction. Lyme neuroborreliosis is a nervous system infection caused by spirocheteBorrelia burgdorferiwith diverse neurological complications. Stroke due to cerebral vasculitis is a rare consequence of neuroborreliosis and has been described in just a few case reports.Case Presentation. Here, we report the case of a 43-year-old patient who presented with discrete left-sided hemiparesis and amnestic cognitive impairment. Brain magnetic resonance imaging showed a thalamic infarct, and serological and cerebrospinal fluid (CSF) tests confirmed the diagnosis of active neuroborreliosis. The antibiotic treatment with intravenous ceftriaxone for three weeks led to an improvement of the symptoms and remarkable regression of radiological findings, but not to full recovery of the amnestic cognitive disorder.Conclusion. Lyme neuroborreliosis should be suspected in patients with cerebrovascular events without obvious risk factors, especially those living in endemic areas such as northern Europe or those who have been exposed to ticks and those with clinical or radiological findings suggesting Lyme neuroborreliosis, in order to establish the diagnosis and start a proper antibiotic therapy.

scholarly journals Paroxysmal hemicrania masquerading as a stroke in an elderly gentleman: case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Boon Hian Tan ◽  
Astrid Melani Suantio ◽  
Yeow Hoay Koh
Keyword(s):  
Brain Magnetic Resonance Imaging ◽  
The Elderly ◽  
Severe Headache ◽  
Paroxysmal Hemicrania ◽  
Horner’S Syndrome ◽  
Conjunctival Injection ◽  
Resonance Imaging ◽  
Horner's Syndrome ◽  
Case Presentation ◽  
Chinese Male

Abstract Background Paroxysmal hemicrania has not been associated with ipsilateral weakness, loss of sensation and Horner’s syndrome. This report is the first of its kind documented in literature. Case presentation This was an elderly, sixty-five-year-old Chinese male who presented with a headache fulfilling criteria of paroxysmal hemicrania and was found to have signs of ipsilateral conjunctival injection, Horner’s syndrome, weakness and loss of sensation; with resolution of the patient’s physical signs after relief of the headache. Brain magnetic resonance imaging did not show any strokes or other headache mimics. The patient had a marked response to indomethacin and a decrease of headache intensity and frequency with indomethacin prophylaxis. Conclusions Paroxysmal hemicrania has joined the list of stroke chameleons and that it would be one of the differentials in a patient with hemiplegia, hemisensory loss, autonomic signs and severe headache. It suggests that paroxysmal hemicrania in the elderly present atypically.

scholarly journals A patient with McLeod syndrome showing involvement of the central sensorimotor tracts for the legs

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Takenobu Murakami ◽  
Dan Abe ◽  
Hideyuki Matsumoto ◽  
Ryo Tokimura ◽  
Mitsunari Abe ◽  
...  
Keyword(s):  
Lower Limb ◽  
Blood Cells ◽  
Magnetic Stimulation ◽  
Evoked Potential ◽  
Brain Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Caudate Nuclei ◽  
Case Presentation ◽  
Axonal Polyneuropathy ◽  
Psychiatric Disturbances

Abstract Background McLeod syndrome is a rare X-linked recessive acanthocytosis associated with neurological manifestations including progressive chorea, cognitive impairment, psychiatric disturbances, seizures, and sensorimotor axonal polyneuropathy. However, no studies have investigated the functioning of central sensorimotor tracts in patients with McLeod syndrome. Case presentation A 66-year-old man had experienced slowly progressive chorea and gait disturbance due to lower limb muscle weakness since his early fifties. Blood examinations showed erythrocyte acanthocytosis and the reduction of Kell antigens in red blood cells. Brain magnetic resonance imaging showed atrophy of the bilateral caudate nuclei and putamen. The diagnosis of McLeod syndrome was confirmed by the presence of a mutation of the XK gene on the X chromosome. Somatosensory-evoked potential and transcranial magnetic stimulation studies demonstrated that the central sensory and motor conduction times were abnormally prolonged for the lower extremity but normal for the upper extremity. Conclusions This is the first report of the involvement of the central sensorimotor tracts for the legs in a patient with McLeod syndrome. The clinical neurophysiological technique revealed the central sensorimotor tracts involvements clinically masked by neuropathy.

scholarly journals Pituitary abscess: two case reports

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Yaotse Elikplim Nordjoe ◽  
Suzanne Rita Aubin Igombe ◽  
Fatima Zahra Laamrani ◽  
Laila Jroundi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Case Reports ◽  
Brain Magnetic Resonance Imaging ◽  
Accurate Diagnosis ◽  
Differential Diagnoses ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Pituitary Abscess ◽  
Hormone Substitution

Abstract Background Pituitary abscess is a rare condition with nonspecific symptoms that can be delayed. Proper diagnosis needs to occur preoperatively so that the management can be set up accordingly. Accurate diagnosis is challenging because many differential diagnoses can exhibit the same magnetic resonance imaging features. Case presentation We report two cases of pituitary abscess. The first patient was a 66-year-old Arab woman who underwent a surgical procedure for a pituitary macroadenoma and presented 3 months later with chronic headaches and panhypopituitarism. A pituitary abscess was found on the follow-up magnetic resonance imaging. The second patient was a 64-year-old Arab man with no medical history who presented with a chiasmal syndrome with headaches and panhypopituitarism. Brain magnetic resonance imaging showed a heterogeneous pituitary mass that turned out to be a pituitary abscess intraoperatively. These two patients were treated with hormone substitution, endoscopic transsphenoidal drainage, and antibiotherapy, with excellent outcomes. Conclusions Pituitary abscess is a rare and serious condition. Preoperative diagnosis can be challenging because of the many existing differential diagnoses upon imaging. Magnetic resonance imaging is the mainstay technique of imaging due to its multimodal nature. These cases demonstrate the variable patterns of a pituitary abscess seen on magnetic resonance imaging and the potential difficulties in achieving an accurate diagnosis preoperatively due to many other conditions potentially exhibiting the same magnetic resonance imaging features.

scholarly journals Resolution of pituitary microadenoma after coronavirus disease 2019: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Salah Raishan ◽  
Mohammed Alsabri ◽  
Ann Mary Hanna ◽  
Matthew Brett
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Brain Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Blood Oxygen Saturation ◽  
Case Presentation ◽  
Pituitary Microadenoma ◽  
Viral Illness ◽  
The Relationship ◽  
Tumor Remission

Abstract Background This report describes the case of a patient whose pituitary microadenoma resolved after he contracted coronavirus disease 2019. To our knowledge, this is one of the first reported cases of pituitary tumor resolution due to viral illness. We present this case to further investigate the relationship between inflammatory response and tumor remission. Case presentation A 32-year-old man in Yemen presented to the hospital with fever, low blood oxygen saturation, and shortness of breath. The patient was diagnosed with coronavirus disease 2019. Past medical history included pituitary microadenoma that was diagnosed using magnetic resonance imaging and secondary adrenal insufficiency, which was treated with steroids. Due to the severity of coronavirus disease 2019, he was treated with steroids and supportive care. Three months after his initial presentation to the hospital, brain magnetic resonance imaging was performed and compared with past scans. Magnetic resonance imaging revealed changes in the microadenoma, including the disappearance of the hypointense lesion and hyperintense enhancement observed on the previous scan. Conclusions Pituitary adenomas rarely undergo spontaneous resolution. Therefore, we hypothesized that tumor resolution was secondary to an immune response to coronavirus disease 2019.

Neurological complications during treatment of liver abscess: think of metronidazole toxicity

2020 ◽  
Vol 50 (2) ◽  
pp. 165-166 ◽  
Author(s):  
Navneet Arora ◽  
Kushal P Wasti ◽  
Navida Babbar ◽  
Atul Saroch ◽  
Ashok K Pannu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Clinical Practice ◽  
Magnetic Resonance ◽  
Adverse Effects ◽  
Liver Abscess ◽  
Brain Magnetic Resonance Imaging ◽  
Neurological Complications ◽  
Amoebic Liver Abscess ◽  
Resonance Imaging ◽  
Dose Dependent

Related neurological adverse effects to metronidazole are rarely encountered in clinical practice despite its wide use as an antibacterial or antiparasitic agent. The neurotoxicity is not dose-dependent and is fully reversible with discontinuation of the drug. We describe a young man who was receiving metronidazole for an amoebic liver abscess and developed encephalopathy and seizures. Brain magnetic resonance imaging showed characteristic bilateral symmetrical cerebellar dentate hyperintensities.

scholarly journals An unusual Neuronal Intranuclear Inclusion Disease with Chief Complaint of Autonomic Dysfunction

2019 ◽  
Author(s):  
Xiaoyun Liu ◽  
Xiaohui Liu ◽  
Yifeng Du ◽  
Chunxia Li ◽  
Cuicui liu ◽  
...  
Keyword(s):  
Brain Magnetic Resonance Imaging ◽  
Intranuclear Inclusions ◽  
Resonance Imaging ◽  
Dominant Group ◽  
Intranuclear Inclusion ◽  
Case Presentation ◽  
Level Of Consciousness ◽  
Recurrent Vomiting ◽  
Neuronal Intranuclear Inclusion ◽  
Magnetic Resonance Imaging Mri

Abstract Background Neuronal intranuclear inclusion disease (NIID) is a recently defined disease entity of progressive neurodegenerative disease with characterizations of eosinophilic hyaline intranuclear inclusions in neuronal and somatic cells. The sporadic adult-onset NIID cases were previous described as ‘dementia dominant group’. Here we present a NIID case manifested prominently with recurrent vomiting. Case presentation A 60-year-old women present with paroxysmal vomiting, hypertention and decreased level of consciousness for 3 years. She was diagnosed with NIID based on history, clinical features, brain magnetic resonance imaging(MRI), skin biopsy. Conclusion Autonomic symptoms may manifest as the initial and predominant presentation of NIID. This case presentation may extend the spectrum of NIID and may give new insights in exploring the pathogenic mechanisms of NIID.

scholarly journals Ischemic Stroke of the Artery of Percheron with Normal Initial MRI: A Case Report

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Guillaume Cassourret ◽  
Bertrand Prunet ◽  
Fabrice Sbardella ◽  
Julien Bordes ◽  
Olga Maurin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Brain Magnetic Resonance Imaging ◽  
Symptomatic Patient ◽  
Resonance Imaging ◽  
Complex Anatomy ◽  
Artery Of Percheron ◽  
Thalamic Infarct ◽  
Head Computed Tomography

The artery of Percheron is a solitary trunk representing an uncommon anatomic variant that provides bilateral arterial supply to the paramedian thalami and the rostral midbrain. Occlusion of this artery results in bilateral thalamic and mesencephalic infarctions. The clinical diagnosis is difficult because the complex anatomy causes large clinical variability. We report a case of a comatose patient with normal early head-computed tomography and magnetic resonance imaging. A bilateral paramedian thalamic infarct due to an occlusion of the artery of Percheron was revealed two days later by a new head computed tomography. To our knowledge, this is the first report in the literature of a symptomatic patient presenting an acute Percheron stroke with normal early brain magnetic resonance imaging. Our case indicates that a normal initial magnetic resonance imaging cannot formally eliminate the diagnosis of acute stroke of the artery of Percheron. We discuss the causes of noncontributive brain magnetic resonance imaging at the onset of this acute Percheron stroke and the alternative diagnosis and therapy methods.

scholarly journals Role of Advanced MRI Brain Sequences in Diagnosing Neurological Complications of Scrub Typhus

2015 ◽  
Vol 5 ◽  
pp. 11 ◽  
Author(s):  
Shikha Sood ◽  
Sanjeev Sharma ◽  
Shweta Khanna
Keyword(s):  
Scrub Typhus ◽  
Case Reports ◽  
Neurological Complications ◽  
Review Of Literature ◽  
Resonance Imaging ◽  
Cranial Nerve Involvement ◽  
Routine Magnetic Resonance Imaging ◽  
Mri Sequences ◽  
Magnetic Resonance Imaging Mri

Scrub typhus is a rare disease affecting many organs and causing vasculitis by affecting the endothelium of blood vessels. Review of literature shows that there are only a few case reports describing the neuroradiological manifestations of scrub typhus. This case report describes how newer and advanced MRI sequences are able to diagnose neurological complications of scrub typhus, such as hemorrhages, meningoencephalitis, infarctions, cranial nerve involvement, thrombosis, and hypoperfusion, that are not picked up on routine magnetic resonance imaging (MRI) sequences.

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