scholarly journals Importance of Rapid Clinical Recognition of the Anterior Opercular Syndrome (Foix-Chavany-Marie Syndrome): A Case Report

2021 ◽  
pp. 166-170
Author(s):  
Hafed Amin Saidane ◽  
Helle Klingenberg Iversen ◽  
Hanne Søndergaard ◽  
Faisal Mohammad Amin
Keyword(s):  
Case Report ◽  
Facial Palsy ◽  
Clinical Presentation ◽  
Intravenous Thrombolysis ◽  
Acute Onset ◽  
Common Reason ◽  
Acute Ischemia ◽  
Opercular Syndrome ◽  
The Right ◽  
The Brain

We have described a 55-year-old woman with the anterior opercular syndrome (Foix-Chavany-Marie syndrome). The clinical presentation included acute onset of bilateral facial palsy and anarthria. Immediate MRI of the brain revealed acute ischemia in the right opercular region and sequelae after a previous infarction involving the left opercular region. The patient was treated with intravenous thrombolysis resulting in full recovery. The anterior opercular syndrome is rare, and the most common reason is sequential stroke. We emphasize the importance of recognizing this syndrome early, and in all cases, consulting a revascularization center immediately.

Left hemispheric cortical watershed infarcts triggered by carotid sinus self-massage

2021 ◽  
Vol 14 (12) ◽  
pp. e244926
Author(s):  
Georg Haber ◽  
Miriam Loffeld ◽  
Magret Braumiller ◽  
Stefan Lorenzl
Keyword(s):  
Ischaemic Stroke ◽  
Carotid Sinus ◽  
Intravenous Thrombolysis ◽  
Visual Field Loss ◽  
Acute Onset ◽  
Neurological Deficits ◽  
Artery Dissection ◽  
The Right ◽  
The Brain ◽  
Watershed Infarcts

A 69-year-old man was presented to our emergency department with acute onset of hemianopsia, aphasia and dizziness. He reported that while he was sitting in front of his computer at home, he had performed a bilateral self-massage of his carotid arteries when suddenly the symptoms occurred. A neurological examination revealed a hemianopsia with a visual field loss on the right side. In addition, a mild aphasic syndrome with agraphia and a word-finding disorder (National Institutes of Health Stroke Scale (NIHSS): 3 points) was diagnosed. The initial brain CT scan with CT angiography showed neither an intracerebral haemorrhage nor a cerebral infarction. Also, no occlusion or any signs of artery dissection or a flow relevant stenosis of the brain supplying arteries were found. After excluding other contraindications, an intravenous thrombolysis with weight-adapted alteplase was performed. The symptoms of the patient significantly improved in the short-term follow-up. Three days after admission no neurological deficits remained. The MRI of the brain revealed multifocal, small, left hemispherical strokes in the middle cerebral artery territory. In general, watershed infarcts after carotid sinus self-massage follow a rare ischaemic stroke mechanism. This case emphasises the importance of a detailed anamnestic evaluation to determine the aetiological classification of ischaemic stroke as well as educating patients’ (poststroke) behaviour.

scholarly journals Temporal gliosarcoma: case report and review of literature

2015 ◽  
Vol 22 (1) ◽  
pp. 112-116
Author(s):  
Amit Agrawal ◽  
Vissa Shanthi ◽  
Baddukonda Appala Ramakrishna ◽  
Kuppili Venkata Murali Mohan
Keyword(s):  
Case Report ◽  
Median Survival ◽  
Glial Cells ◽  
Primary Tumor ◽  
Clinical Presentation ◽  
Spindle Cell ◽  
Review Of Literature ◽  
Future Studies ◽  
Aggressive Tumor ◽  
The Brain

Abstract First characterized by Stroebe, the gliosarcomas are highly malignant and rare primary tumor of the brain composed of neoplastic glial cells in association with spindle cell sarcomatous elements (biphasic tissue patterns). In spite of being recognized as two different pathologies studies have not shown any significant differences between gliosarcoma and glioblastoma with regard to age, sex, size, clinical presentation, and median survival. In summary, gliosarcoma is an aggressive tumor with a propensity to recur and re-grow with poor outcome. Future studies are needed to understand the true pathology of these biphasic tumors.

Surviving a Self-inflicted Transorbital Pen Intrusion to the Cerebellum: Case Report

2021 ◽  
Author(s):  
David Breuskin ◽  
Ralf Ketter ◽  
Joachim Oertel
Keyword(s):  
Case Report ◽  
Ct Scan ◽  
Foreign Bodies ◽  
Routine Procedure ◽  
Low Velocity ◽  
Foreign Objects ◽  
Surgical Exposure ◽  
The Right ◽  
The Brain ◽  
Do So

Abstract Background Although intracranial traumas by penetrating foreign objects are not absolute rarities, the nature of trauma, the kind of object, and its trajectory make them a one of a kind case every time they occur. Whereas high-velocity traumas mostly result in fatalities, it is the low-velocity traumas that demand an individualized surgical strategy. Methods We present a case report of a 33-year-old patient who was admitted to our department with a self-inflicted transorbital pen injury to the brain. The authors recall the incident and the technique of the pen removal. Results Large surgical exposure of the pen trajectory was considered too traumatic. Therefore, we opted to remove the pen and have an immediate postoperative computed tomography (CT) scan. Due to its fragility, the pen case could only be removed with a screwdriver, inserted into the case. Post-op CT scan showed a small bleeding in the right peduncular region, which was treated conservatively. The patient was transferred back to intensive care unit and woken up the next day. She lost visual function on her right eye, but suffered from no further neurologic deficit. Conclusion Surgical management of removal of intracranial foreign bodies is no routine procedure. Although some would favor a large surgical exposure, we could not think of an approach to do so without maximum surgical efforts. We opted for a minimal surgical procedure with immediate CT scan and achieved an optimal result. We find this case to be worth considering when deciding on a strategy in the future.

scholarly journals Penetrating wound of the heart manifested with periphery embolism: Case report

2012 ◽  
Vol 69 (9) ◽  
pp. 803-805 ◽  
Author(s):  
Milos Velinovic ◽  
Mile Vranes ◽  
Biljana Obrenovic-Kircanski ◽  
Svetozar Putnik ◽  
Aleksandar Mikic ◽  
...  
Keyword(s):  
Case Report ◽  
Atrial Septal Defect ◽  
Femoral Artery ◽  
Septal Defect ◽  
Common Femoral Artery ◽  
Acute Ischemia ◽  
Rare Type ◽  
Penetrating Wound ◽  
Event Reconstruction ◽  
The Right

Introduction. Heart injuries can be classified as penetrating and non-penetrating (blunt). Penetrating wounds are usually caused by stabbing with a piercing object, weapon or projectiles - missiles. The right atrium is damaged in most cases, because of its anatomical position - making the most of the anterior side of the heart. Morbidity caused by stabbing injuries to the heart is 20%-30%, while piercing wounds cause 30%-60% of deaths. Case report. A 28-year-old patient was admitted to our clinic with acute ischemia of the extremities. Angiography revealed a bullet in the right common femoral artery, occluding it. The patient denied having any piercing or shooting wound to his leg, but he said that four years before he had been shot to his chest. Echocardiography revealed an atrial septal defect of secondary type. An event reconstruction revealed that, four years after shooting, the bullet was displaced from the heart to the right common femoral artery. Conclusion. This case report is unique because of the rare type of injury, time that passed from the injury, the way bullet entered the artery (via atrial septal defect) and especially the success of both surgical procedures (embolectomy and repair of atrial septal defect).

scholarly journals Microemboli monitoring by trans-cranial doppler in patient with acute cardioemboliogenic stroke due to atrial myxoma

2010 ◽  
Vol 2 (1) ◽  
pp. 5 ◽  
Author(s):  
Gregory Telman ◽  
Orit Mesica ◽  
Efim Kouperberg ◽  
Oved Cohen ◽  
Gil Bolotin ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Cardiac Myxoma ◽  
Surgical Excision ◽  
Interatrial Septum ◽  
Acute Onset ◽  
Atrial Myxoma ◽  
Clonic Seizures ◽  
The Right ◽  
The Brain ◽  
Trans Cranial Doppler

This is the first reported attempt to examine the emboliogenic potential of cardiac myxoma in patients with acute stroke through the monitoring of microembolic signals (MES) by transcranial doppler. A 43-year old woman was brought to the emergency department because of acute onset of generalized tonic-clonic seizures and left hemiplegia. A CT scan of the brain demonstrated a large acute infraction in the territory of the right middle cerebral artery (MCA) and another smaller one in the territory of the posterior cerebral artery on the same side. Trans-cranial doppler (TCD) microemboli monitoring did not reveal MES. Transesophagial echocardiography (TEE) identified a 5 cm left atrial mass, which was highly suspected to be an atrial myxoma attached to the interatrial septum and prolapsed through the mitral valve. After the TEE results were obtained, another TCD monitoring was performed. Again, there were no MES found in either of the MCAs. Our findings showed the absence of MES on two consecutive TCD examinations, suggesting a spontaneous occurrence, rather than the permanent presence, of embolization, even in the most acute phase of stroke. Thus, the tendency of myxomas to spontaneously produce multiple emboli emphasizes the need for the surgical excision of myxomas.

scholarly journals A Rare Case of Unilateral Foix-Chavany-Marie Syndrome

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Courtney Raab ◽  
Farrukh Chaudhry, MD
Keyword(s):  
Ischemic Stroke ◽  
Case Report ◽  
Rare Case ◽  
Speech Therapy ◽  
Case Reports ◽  
Intravenous Thrombolysis ◽  
White Matter Lesions ◽  
African American Female ◽  
Presenting Symptoms ◽  
Opercular Syndrome

Background: Bilateral anterior opercular syndrome, or Foix-Chavany-Marie Syndrome (FCMS), is a neurological condition characterized by bilateral anterior opercular lesions. Common presenting symptoms of this rare suprabublar palsy include dysarthria, or slurred speech, as well as paralysis of facial, pharyngeal, lingual, and masticatory voluntary muscles while autonomic function is preserved.1 Most cases of FCMS are bilateral, yet some rare cases have been reported with unilateral opercular lesions with preexisting contralateral white matter lesions.2 In this case report we present a rare case of unilateral FCMS in a patient who had an acute anterior left opercular infarct, as well as a residual right parietal subcortical stroke. Project Methods: The patient we present is a 49 year old African American female with a history of hypertension and previous stroke with residual spastic right hemiplegia who presented to the ED for evaluation of right sided facial droop, right sided weakness, and slurred speech. Patient was evaluated by acute stroke team and was treated with intravenous thrombolysis (Alteplase). On hospital day 2, the patient developed complete disarticulation, unable to produce any speech but able to communicate by appropriate gestures and writing. The patient’s symptoms included anarthria, weakness of bilateral masseters, and lateral/medial pterygoids without dysphagia. Results: The MRI brain showed left insular region/frontal opercular ischemic stroke and a small right parietal subcortical ischemic stroke, likely embolic in nature. Over the hospital stay, the patient’s motor function improved but her anarthria persisted. These radiologic findings along with the symptomology proved consistent with FCMS. She was discharged to home with an NIH stroke scale of 5 and recommended outpatient speech therapy. Conclusion: In this case report, we describe a patient that presents with an extremely rare case of unilateral FCMS, with a preexisting contralateral parietal infarct that could have collectively caused anarthria and masseter weakness.   Works Cited 1. Milanlioglu A, Aydın MN, Gökgül A, Hamamcı M, Erkuzu MA, Tombul T. Ischemic Bilateral Opercular Syndrome. Case Reports in Medicine. 2013;2013:1-3. doi:10.1155/2013/513572. 2. Sa F, Cordeiro IM, Mestre S, Nzwalo H. Unilateral opercular infarction presenting with FoixChavany-Marie syndrome. Case Reports. 2014;2014. doi:10.1136/bcr-2014-206439.

scholarly journals Idiopathic Omental Infarction Mimic Acute Appendicitis: A Case Report

2020 ◽  
pp. 1-3
Author(s):  
Hamad Almakinzy ◽  
Bandar Idress ◽  
Hamad Almakinzy
Keyword(s):  
Case Report ◽  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Inflammatory Markers ◽  
Iliac Fossa ◽  
Young Patients ◽  
Acute Onset ◽  
First Case ◽  
Laparoscopy Surgery ◽  
The Right

Idiopathic Omental Infarct (IOI) is a rare cause of an acute abdomen that arises from an interruption of blood supply to the omentum. Since first case was described by Elitelin 1899, more than 300 cases have been published [1]. It can mimic serious surgical pathology. It occurs in <1% of appendicitis cases [2]. It’s challenge to diagnose, as features may mimic acute appendicitis and therefore in young patients, may only be discovered intra-operative. Here, we present a case of omental infarct in 26-year-old gentleman with no significant medical or surgical background who present with acute onset of right iliac fossa (RIF) pain. Examination revealed tenderness over the right iliac fossa and was having localized rebound. His inflammatory markers were high. He was successfully treated with laparoscopy surgery and he was subsequently discharged the following day.

scholarly journals Crossed renal ectopia with an unusual form of fusion (inverted U shape) managed by novel approach - laparoscopic ureterocalicostomy. A case report

2021 ◽  
Vol 6 (1) ◽  
pp. 71-75
Author(s):  
Osama Bani Hani ◽  
Omar Halalsheh ◽  
Yazeed Mohammad ◽  
Anas Bani Yaseen ◽  
Ruba Khasawneh ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Presentation ◽  
The Body ◽  
Published Data ◽  
Renal Ectopia ◽  
Novel Approach ◽  
Crossed Renal Ectopia ◽  
The Right ◽  
Tract Infections ◽  
Unusual Type

Herein we present a case of crossed renal ectopia with an unusual type of fusion, discovered incidentally in a 11-year-old girl presented with recurrent urinary tract infections. Both kidneys were located on the right side of the body fused in their upper poles only, forming an inverted U shape. After reviewing the published data on this topic, we found that most of the described anomalies were within the six well-known types of fusion anomalies. This child had an unusual clinical presentation of severe hydronephrosis of the orthotopic kidney. A unique surgical technique to correct the pathology to be able to preserve the residual mass of that kidney was performed.

scholarly journals A rare case of acquired infantile Bell’s palsy

2021 ◽  
Vol 8 (7) ◽  
pp. 1316
Author(s):  
Lakshmi Mulinja ◽  
Thanzir Mohammed ◽  
Varun Govindarajan ◽  
Mallesh Kariyappa
Keyword(s):  
Case Report ◽  
Facial Palsy ◽  
Rare Case ◽  
Bell’S Palsy ◽  
Acute Onset ◽  
Spontaneous Resolution ◽  
Bell's Palsy ◽  
Peripheral Facial Palsy ◽  
Oral Corticosteroids ◽  
Viral Illness

Bell’s palsy, an acute onset, acquired, isolated peripheral facial palsy, usually follows a viral illness, is common disorder post infancy to adolescence. It has a favourable prognosis with spontaneous resolution, or with use of oral corticosteroids. Its presentation in early infancy is very unusual, as in our case report of 3 month old infant with an ovoid mass lesion in parotid, which disappeared after therapy with corticosteroids with no residual deficit.

scholarly journals Vaping-associated lung injury: a case report and literature review

2021 ◽  
Vol 5 (2) ◽  
pp. 1-4
Author(s):  
Dewansh Goel ◽  
Kenneth Iyamu
Keyword(s):  
Case Report ◽  
Respiratory Failure ◽  
Lung Injury ◽  
Clinical Presentation ◽  
Clinical Course ◽  
Electronic Cigarettes ◽  
Invasive Mechanical Ventilation ◽  
Young Male ◽  
Acute Onset ◽  
Current Evidence

Usage of vaping and electronic cigarettes products is a growing trend among young adults, with rising rates worldwide. Such products are gaining popularity for many reasons including an alternative to smoking cigarettes, trying something new, or as a means to relax. While users may feel that these products are less harmful or a safer substitute to smoking traditional products, the side effect profile of vape inhalation has the potential for profound injury to the lung tissue and significant respiratory failure. We would like to present a case in which a young male who was evaluated at our Emergency department for acute onset respiratory failure subsequently requiring invasive mechanical ventilation in the setting of vaping associated lung injury (VALI). In the case report, we will highlight the patient’s clinical course as well as a summary of the current evidence surrounding evaluation, diagnosis and management of this emerging pathology. We want to emphasize the importance of a detailed history which should include the use of vaping products when a young patient presents with acute respiratory failure, allowing VALI to be in the differential diagnosis. Additionally, we want to compare the clinical presentation of VALI to that of COVID-19 pneumonia as they both have many similar attributes including symptoms and findings on lung imaging studies.

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