scholarly journals About pathognomonic images: an infrequent case of acute encephalopathy

2013 ◽  
pp. 39-41
Author(s):  
Alessandro Grasso ◽  
Pietro Nurra ◽  
Luigia Cavallo ◽  
Giorgio Menardo
Keyword(s):  
Cerebrospinal Fluid ◽  
Third Ventricle ◽  
Brain Mri ◽  
Acute Diarrhoea ◽  
Complete Recovery ◽  
Diagnostic Techniques ◽  
Clinical Event ◽  
Acute Encephalopathy ◽  
Wernicke Encephalopathy ◽  
Cerebral Mri

BACKGROUND The occurrence of acute encephalopathy is a dramatic clinical dilemma when usual diagnostic techniques (blood tests, cerebral CT and cerebrospinal fluid analysis) show no abnormalities. CLINICAL CASE We describe a case of a 73 years old man admitted in our Internal Medicine Unit for acute diarrhoea with vomiting and fever who developed a prolonged gastrointestinal dysmotility syndrome with poor nutritional intake. Although a parenteral support was provided, he developed acute encephalopathy followed by hypotension and lactic acidosis without evidence of renal and hepatic disease or glycemic alterations. Likewise, no cerebral CT and cerebrospinal fluid alterations were found. Conversely, cerebral MRI showed marked and diffuse DP-2 and FLAIR hyperintensity of the mesencephalic tectal plate, of the periaqueductal area, and of the periventricular region of the third ventricle including the median thalamic area. These MRI descriptions were considered pathognomonic of Wernicke encephalopathy. Thus, the immediate use of ev thiamine was followed by a prompt and complete recovery of neurological, hemodinamic and metabolic conditions. CONCLUSIONS Non-alcoholic Wernicke encephalopathy is a rare and dramatic clinical event with high mortality. In this context, brain MRI is the best diagnostic tool providing a typical picture.

scholarly journals Rapid detection of Listeria monocytogenes rhombencephalitis in an immunocompetent patient by multiplexed PCR

2018 ◽  
pp. bcr-2018-225575 ◽  
Author(s):  
Rocco J Richards ◽  
Matthew S Simon ◽  
C Douglas Phillips ◽  
Lindsay Lief ◽  
Stephen G Jenkins ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Listeria Monocytogenes ◽  
Cranial Nerve ◽  
Rapid Detection ◽  
Brain Mri ◽  
Complete Recovery ◽  
Immunocompetent Patient ◽  
Brainstem Encephalitis ◽  
Mri Findings ◽  
Multiplexed Pcr

A 46-year-old previously healthy man presented with 1 week of headache, nausea, vomiting and dizziness. He was found to have cranial nerve deficits, his cerebrospinal fluid (CSF) demonstrated a lymphocytic pleocytosis and brain MRI suggested rhombencephalitis. Although Gram stains and cultures of his CSF did not identify a pathogen, Listeria monocytogenes DNA was detected by the FilmArray Meningitis/Encephalitis panel within 2 hours of performing a lumbar puncture. He was treated with ampicillin and gentamicin and had a near-complete recovery. This case highlights the importance of recognising L. monocytogenes infection as a cause of acute cranial nerve impairment with MRI findings suggestive of brainstem encephalitis. It also highlights the frequently atypical CSF profile and low yield of culture in L. monocytogenes rhombencephalitis and the value of multiplex PCR testing of CSF to rapidly identify this pathogen and permit targeted therapy.

Cerebrospinal fluid rhinorrhea and acquired anterior basal encephalocoele in a patient with colloid cyst of the third ventricle

2010 ◽  
Vol 58 (1) ◽  
pp. 156 ◽  
Author(s):  
Chandrasekharan Kesavadas ◽  
TirurRaman Kapilamoorthy ◽  
Gireesh Menon ◽  
KythasandraShivakumar Deepak
Keyword(s):  
Cerebrospinal Fluid ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
The Third

scholarly journals Isolated velopalatine paralysis associated with parvovirus B19 infection

2006 ◽  
Vol 64 (3a) ◽  
pp. 603-605 ◽  
Author(s):  
João P. Soares-Fernandes ◽  
Ricardo Maré
Keyword(s):  
Cerebrospinal Fluid ◽  
Nerve Palsy ◽  
Parvovirus B19 ◽  
Brain Mri ◽  
Sudden Onset ◽  
Recent Infection ◽  
Positive Data ◽  
Cerebrospinal Fluid Examination ◽  
Parvovirus B19 Infection

A case of isolated velopalatine paralysis in an 8-year-old boy is presented. The symptoms were sudden-onset of nasal speech, regurgitation of liquids into the nose and dysphagia. Brain MRI and cerebrospinal fluid examination were normal. Infectious serologies disclosed an antibody arrangement towards parvovirus B19 that was typical of recent infection. In the absence of other positive data, the possibility of a correlation between the tenth nerve palsy and parvovirus infection is discussed.

scholarly journals Endoscopic monoportal removal of a choroid plexus papilloma in the posterior third ventricle in a child

2015 ◽  
Vol 16 (1) ◽  
pp. 107-111 ◽  
Author(s):  
Albert A. Sufianov ◽  
Saidi S. K. Gaibov ◽  
Rinat A. Sufianov
Keyword(s):  
Choroid Plexus ◽  
Tumor Recurrence ◽  
Third Ventricle ◽  
Brain Mri ◽  
Choroid Plexus Papilloma ◽  
Male Infant ◽  
Invasive Technique ◽  
Endoscopic Removal ◽  
Who Grade

Currently, only a few reports describe the minimally invasive removal of choroid plexus papillomas (CPPs) and, to the best of the authors' knowledge, no reports detail the resection of such a papilloma through an endoscopic approach in infants. The authors here describe the endoscopic removal of a third ventricle CPP in a child. A 5-month-old male infant presented with progressive macrocephaly, vomiting, and convulsions. A lesion in the posterior third ventricle was detected on brain MRI. Because of the patient's very young age, neuroendoscopy was used as the least invasive technique. The tumor was completely resected through a monoportal neuroendoscopic approach. Histologically, the tumor was classified as a WHO Grade I CPP. After surgery, the patient's condition improved, with no complications during his recovery. Ten-month follow-up neuroimaging revealed no evidence of tumor recurrence or progressive hydrocephaly. In view of the successful neuroendoscopic excision of this posterior third ventricle CPP, the authors believe that this method seems promising in the treatment of young children with intraventricular lesions.

scholarly journals A ten-year follow-up of human leptospirosis in Uruguay: an unresolved health problem

2012 ◽  
Vol 54 (2) ◽  
pp. 69-76 ◽  
Author(s):  
Felipe Schelotto ◽  
Elba Hernández ◽  
Sabina González ◽  
Alicia Del Monte ◽  
Silvana Ifran ◽  
...  
Keyword(s):  
Young Male ◽  
Standard Technique ◽  
Signs And Symptoms ◽  
Complete Recovery ◽  
Laboratory Diagnosis ◽  
Diagnostic Techniques ◽  
Clinical Feature ◽  
Serum Samples ◽  
Microbiological Methods ◽  
Major Factors

Leptospira spp. are delicate bacteria that cannot be studied by usual microbiological methods. They cause leptospirosis, a zoonotic disease transmitted to humans through infected urine of wild or domestic animals. We studied the incidence of this disease in the Uruguayan population, its epidemiologic and clinical features, and compared diagnostic techniques. After examining 6,778 suspect cases, we estimated that about 15 infections/100,000 inhabitants occurred yearly, affecting mainly young male rural workers. Awareness about leptospirosis has grown among health professionals, and its lethality has consequently decreased. Bovine infections were probably the principal source of human disease. Rainfall volumes and floods were major factors of varying incidence. Most patients had fever, asthenia, myalgias or cephalalgia, with at least one additional abnormal clinical feature. 30-40% of confirmed cases presented abdominal signs and symptoms, conjunctival suffusion and altered renal or urinary function. Jaundice was more frequent in patients aged > 40 years. Clinical infections followed an acute pattern and their usual outcome was complete recovery. Laboratory diagnosis was based on indirect micro-agglutination standard technique (MAT). Second serum samples were difficult to obtain, often impairing completion of diagnosis. Immunofluorescence was useful as a screening test and for early detection of probable infections.

scholarly journals Acute childhood encephalopathy with prolonged fever, pleocytosis and elevated inflammatory cytokines in the cerebrospinal fluid and transient splenial lesion

2019 ◽  
Author(s):  
Rena Okada ◽  
Yuri Sakaguchi ◽  
Takeshi Matsushige ◽  
Isamu Kamimaki ◽  
Toshiki Takenouchi ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Mental Status ◽  
Nationwide Survey ◽  
Altered Mental Status ◽  
Acute Encephalopathy ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Prolonged Fever ◽  
Splenial Lesion ◽  
Male Patients

Background: Acute encephalopathy during childhood represents a highly heterogeneous group of infectious and non-infectious pathologies. According to a recent nationwide survey on acute childhood encephalopathy in Japan, the combination of clinical and radiographic features left approximately half of the affected children unclassified, mainly because of the lack of disease-specific biomarkers. Case: Herein, we document a school-aged boy who manifested with acute encephalopathy that was characterized by a prolonged fever, altered mental status, urinary retention, and intention tremor lasting for more than a month. Accompanying features included syndrome of inappropriate secretion of antidiuretic hormone, pleocytosis with elevated interleukin-6 and interferon-gamma levels in the cerebrospinal fluid, and a transient splenial lesion on neuroimaging. No pathogens were identified, and C-reactive protein was negative throughout his clinical course. This constellation of clinical features was not compatible with any of the existing entities of acute pediatric encephalopathy. Discussion: Our retrospective literature review identified two additional school-aged male patients who exhibited highly similar clinical courses. The prolonged altered mental status with pleocytosis in the cerebrospinal fluid and a transient splenial lesion in the absence of serum inflammatory markers suggest a primary central nervous system pathology. Conclusion: This combination of features defines this presumably new group of acute childhood febrile encephalopathy with prolonged fever and ataxia in school-aged boys.

scholarly journals Genetic Overlap Between Alzheimer’s Disease and Depression Mapped Onto the Brain

2021 ◽  
Vol 15 ◽  
Author(s):  
Jennifer Monereo-Sánchez ◽  
Miranda T. Schram ◽  
Oleksandr Frei ◽  
Kevin O’Connell ◽  
Alexey A. Shadrin ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Genome Wide Association Study ◽  
Third Ventricle ◽  
Brain Mri ◽  
Genetic Correlations ◽  
Gaussian Mixture ◽  
Brain Morphology ◽  
Genetic Overlap ◽  
Ventricle Volume

Background: Alzheimer’s disease (AD) and depression are debilitating brain disorders that are often comorbid. Shared brain mechanisms have been implicated, yet findings are inconsistent, reflecting the complexity of the underlying pathophysiology. As both disorders are (partly) heritable, characterising their genetic overlap may provide aetiological clues. While previous studies have indicated negligible genetic correlations, this study aims to expose the genetic overlap that may remain hidden due to mixed directions of effects.Methods: We applied Gaussian mixture modelling, through MiXeR, and conjunctional false discovery rate (cFDR) analysis, through pleioFDR, to genome-wide association study (GWAS) summary statistics of AD (n = 79,145) and depression (n = 450,619). The effects of identified overlapping loci on AD and depression were tested in 403,029 participants of the UK Biobank (UKB) (mean age 57.21, 52.0% female), and mapped onto brain morphology in 30,699 individuals with brain MRI data.Results: MiXer estimated 98 causal genetic variants overlapping between the 2 disorders, with 0.44 concordant directions of effects. Through pleioFDR, we identified a SNP in the TMEM106B gene, which was significantly associated with AD (B = −0.002, p = 9.1 × 10–4) and depression (B = 0.007, p = 3.2 × 10–9) in the UKB. This SNP was also associated with several regions of the corpus callosum volume anterior (B > 0.024, p < 8.6 × 10–4), third ventricle volume ventricle (B = −0.025, p = 5.0 × 10–6), and inferior temporal gyrus surface area (B = 0.017, p = 5.3 × 10–4).Discussion: Our results indicate there is substantial genetic overlap, with mixed directions of effects, between AD and depression. These findings illustrate the value of biostatistical tools that capture such overlap, providing insight into the genetic architectures of these disorders.

scholarly journals CLINICAL-EPIDEMIOLOGICAL CHARACTERISTICS OF ASEPTIC MENINGITIS IN CHILDREN OF KHMELNITSKYI REGION (PODILSKYI REGION, UKRAINE): FOURTEEN-YEAR EPIDEMIOLOGICAL OBSERVATION

2019 ◽  
Vol 11 (1) ◽  
pp. 41-45
Author(s):  
L. V. Pypa ◽  
R. V. Svistilnik ◽  
Yu. N. Lysytsia ◽  
K. Yu. Romanchuk ◽  
I. V. Odarchuk
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Aseptic Meningitis ◽  
Clinical Picture ◽  
Epileptic Seizures ◽  
Complete Recovery ◽  
The Central Nervous System ◽  
Meningitis In Children ◽  
Epidemiological Characteristics

Aim of work – to analyze the etiological structure, epidemiological structure, social-demographic features and the nature of the development of complications of the central nervous system in aseptic meningitis in children in Khmelnitskyi region for the period 2004-2017.Materials and methods. It was conducted a prospective analysis of 208 cases of aseptic meningitis in children of whom 138 people were boys and 70 people were girls. The etiology of the disease was determined by studying cerebrospinal fluid using PCR method. Complications of the central nervous system were diagnosed on the basis of the clinical picture and CT or MRI scans. The analytical method was used to conduct the analysis of the received data.Results. The highest seasonal increase of the incidence was from August to October and it was 65.6% with its peak in September (24.0%). The clinical picture was characterized by a moderate trend in 71.2% of cases and in 28.8% by a severe course. In 100% of cases the disease began with a fever, headache (83.6%), vomiting (76.9%), abdominal pain with diarrhea (6.2%), epileptic seizures (0.9%). The average level of cytosis was 269.4±196.7 cells/mm3with a predominance of lymphocytes and the average protein level in cerebrospinal fluid was 73 ± 36 mg/dl. The etiological factor was established in 18 (8.6%) patients.Conclusions. Enterovirus remains to be the main pathogen which was determined in 72.2% of cases. The second place was taken by herpes viruses (22.2% of cases), the third place was given to the mumps virus (5.6% of cases) (in etiologically verified cases). In most cases the disease ended in complete recovery but in 47 (22.6%) patients the complications were observed. The prevalence of aseptic meningitis among children in Khmelnitskyi region was 6.2 per 100,000 children, and males outnumbered females by a 2:1 ratio.

scholarly journals Listeria monocytogenes meningitis in an immunocompetent 18-year old patient as a possible diagnostic and therapeutical problem

2013 ◽  
Vol 70 (10) ◽  
pp. 976-978
Author(s):  
Miodrag Vrbic ◽  
Marina Dinic ◽  
Maja Jovanovic ◽  
Aleksandar Rankovic ◽  
Lidija Popovic-Dragonjic ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Listeria Monocytogenes ◽  
Bacterial Meningitis ◽  
Initial Treatment ◽  
Clinical Effect ◽  
Complete Recovery ◽  
Cell Mediated Immunity ◽  
The Third ◽  
Appropriate Treatment

Introduction. Listeria monocytogenes is the third most frequent cause of bacterial meningitis in adults. It commonly affects persons with defective cell-mediated immunity or advanced age, and only a few patients with no underlying predisposition have been reported. Case report. We presented an previously healthy, 18-year-old man with typical clinical features of meningitis. On the account of earlier treatment with ceftriaxone and cerebrospinal fluid finding, an assumption of partially treated bacterial meningitis was made. The initial treatment with vancomycin and ceftriaxone, substituted on day 4 with meropenem, did not produce any clinical effect. On day 6 Listeria monocytogenes was isolated and, even as late as that, the administration of ampicillin was followed by complete recovery of the patient. Conclusion. In younger, immunocompetent individuals, in spite of the existent diagnostic and therapeutic problems, the subacute course of Listeria monocytogenes meningitis provides enough time for appropriate treatment and favorable disease outcome.

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