M. Cappellari, C. Zivelonghi, N. Micheletti, L. Mezzetto, Raffaelle Augelli
A 82‐year‐old male presented with right‐sided hemiplegia and aphasia. CT‐scan showed hyperdensity of the left middle cerebral artery (MCA). CT‐angiography revealed occlusion of the left MCA and intra‐cranial internal carotid artery (ICA) in combination with occlusion of the left extra‐cranial ICA. Complete recanalization of intra‐cranial vessels was obtained after thrombectomy within 6 h from symptom onset, but residual significant extra‐cranial stenosis remained. Non‐contrast CT‐scan after thrombectomy revealed large hyperdensities secondary to contrast extravasation in the left MCA territory. Residual extra‐cranial ICA stenosis was not treated with emergent stenting. At 24 h, NIHSS score was 0, but follow‐up CT‐scan showed an ischemic lesion with spontaneous hemorrhagic transformation. A single antiplatelet treatment was reintroduced after 24 h and carotid endarterectomy was done without complications after 2 weeks.
{"title":"Carotid artery stenting or carotid endarterectomy for residual significant stenosis after thrombectomy in acute tandem occlusion stroke?","authors":"M. Cappellari, C. Zivelonghi, N. Micheletti, L. Mezzetto, Raffaelle Augelli","doi":"10.1111/ncn3.12725","DOIUrl":"https://doi.org/10.1111/ncn3.12725","url":null,"abstract":"A 82‐year‐old male presented with right‐sided hemiplegia and aphasia. CT‐scan showed hyperdensity of the left middle cerebral artery (MCA). CT‐angiography revealed occlusion of the left MCA and intra‐cranial internal carotid artery (ICA) in combination with occlusion of the left extra‐cranial ICA. Complete recanalization of intra‐cranial vessels was obtained after thrombectomy within 6 h from symptom onset, but residual significant extra‐cranial stenosis remained. Non‐contrast CT‐scan after thrombectomy revealed large hyperdensities secondary to contrast extravasation in the left MCA territory. Residual extra‐cranial ICA stenosis was not treated with emergent stenting. At 24 h, NIHSS score was 0, but follow‐up CT‐scan showed an ischemic lesion with spontaneous hemorrhagic transformation. A single antiplatelet treatment was reintroduced after 24 h and carotid endarterectomy was done without complications after 2 weeks.","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"11 1","pages":"283 - 285"},"PeriodicalIF":0.4,"publicationDate":"2023-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46090916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Landman, Z. Chaudhry, Jorge L. Morales, Rupindra Singh, Michelle Nunes, Roberta Santos, Paola Colon‐Figueroa, F. Rossi, Afra Janarious
1Department of Neurology, UCF/HCA Healthcare Graduate Medical Education Consortium Neurology Residency Program of Greater Orlando, Orlando, Florida, USA 2Osceola Regional Medical Center, Kissimmee, Florida, USA 3Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA 4Department of Neurology, University of Florida, Jacksonville, Florida, USA 5Department of Neurology, Orlando Veteran Affairs Healthcare System, Orlando, Florida, USA
{"title":"A case of acute disseminated encephalomyelitis precipitated by Venetoclax","authors":"A. Landman, Z. Chaudhry, Jorge L. Morales, Rupindra Singh, Michelle Nunes, Roberta Santos, Paola Colon‐Figueroa, F. Rossi, Afra Janarious","doi":"10.1111/ncn3.12722","DOIUrl":"https://doi.org/10.1111/ncn3.12722","url":null,"abstract":"1Department of Neurology, UCF/HCA Healthcare Graduate Medical Education Consortium Neurology Residency Program of Greater Orlando, Orlando, Florida, USA 2Osceola Regional Medical Center, Kissimmee, Florida, USA 3Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA 4Department of Neurology, University of Florida, Jacksonville, Florida, USA 5Department of Neurology, Orlando Veteran Affairs Healthcare System, Orlando, Florida, USA","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"11 1","pages":"294 - 295"},"PeriodicalIF":0.4,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42441408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yoya Ono, K. Higashida, A. Takekoshi, A. Kimura, T. Shimohata
An 81‐year‐old man developed axial rigidity, bradykinesia, and cognitive impairment within 6 weeks. On initial examination, he was misdiagnosed with progressive supranuclear palsy (PSP). Brain magnetic resonance imaging showed hyperintensities in the bilateral mesial temporal lobes and basal ganglia. Neuronal antibodies previously reported in autoimmune encephalitis mimicking PSP were negative. Immunohistochemical and immunocytochemical analysis revealed the autoantibodies recognized neuronal surface and intracellular antigens. The diagnostic criteria for probable autoimmune encephalitis were fulfilled. We diagnosed him with autoimmune encephalitis. Intravenous immunoglobulin and steroid therapy improved his symptoms. The presence of novel autoantibodies causing autoimmune encephalitis presenting with atypical parkinsonism was suggested.
{"title":"Autoimmune encephalitis presenting with atypical parkinsonism: A case report and review of the literature","authors":"Yoya Ono, K. Higashida, A. Takekoshi, A. Kimura, T. Shimohata","doi":"10.1111/ncn3.12721","DOIUrl":"https://doi.org/10.1111/ncn3.12721","url":null,"abstract":"An 81‐year‐old man developed axial rigidity, bradykinesia, and cognitive impairment within 6 weeks. On initial examination, he was misdiagnosed with progressive supranuclear palsy (PSP). Brain magnetic resonance imaging showed hyperintensities in the bilateral mesial temporal lobes and basal ganglia. Neuronal antibodies previously reported in autoimmune encephalitis mimicking PSP were negative. Immunohistochemical and immunocytochemical analysis revealed the autoantibodies recognized neuronal surface and intracellular antigens. The diagnostic criteria for probable autoimmune encephalitis were fulfilled. We diagnosed him with autoimmune encephalitis. Intravenous immunoglobulin and steroid therapy improved his symptoms. The presence of novel autoantibodies causing autoimmune encephalitis presenting with atypical parkinsonism was suggested.","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"11 1","pages":"271 - 275"},"PeriodicalIF":0.4,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45214367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 69‐year‐old man suddenly developed bilateral hearing impairment and dizziness. Magnetic resonance imaging showed multiple infarctions in the area of the bilateral posterior circulation, and magnetic resonance angiography showed a completely occluded right vertebral artery (VA) and severe stenosis of the left VA. Pearl and string sign was detected in the left VA by cerebral angiography, leading to the diagnosis of arterial dissection. The infarctions in the anterior inferior cerebellar artery area were considered a result of artery‐to‐artery embolism. He regained his hearing gradually and was discharged in 2 weeks. Acute ischemic stroke with bilateral hearing loss is generally accompanied by proximal severe vascular legions, with poor outcome. Prognosis may depend on the underlying vascular pathology.
{"title":"Sudden bilateral hearing loss due to vertebral artery dissection","authors":"Mai Marumori, K. Sakuta, S. Miyagawa, H. Yaguchi","doi":"10.1111/ncn3.12719","DOIUrl":"https://doi.org/10.1111/ncn3.12719","url":null,"abstract":"A 69‐year‐old man suddenly developed bilateral hearing impairment and dizziness. Magnetic resonance imaging showed multiple infarctions in the area of the bilateral posterior circulation, and magnetic resonance angiography showed a completely occluded right vertebral artery (VA) and severe stenosis of the left VA. Pearl and string sign was detected in the left VA by cerebral angiography, leading to the diagnosis of arterial dissection. The infarctions in the anterior inferior cerebellar artery area were considered a result of artery‐to‐artery embolism. He regained his hearing gradually and was discharged in 2 weeks. Acute ischemic stroke with bilateral hearing loss is generally accompanied by proximal severe vascular legions, with poor outcome. Prognosis may depend on the underlying vascular pathology.","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"11 1","pages":"268 - 270"},"PeriodicalIF":0.4,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45014079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Zaboli, G. Turcato, B. Nucera, S. Sibilio, F. Rinaldi, Laura D’Acunto, P. Manganotti, R. Nardone, N. Pfeifer, F. Brigo
The Manchester Triage System (MTS) is one of the most widely used and studied triage systems in emergency departments (ED). MTS does not have a specific presentational flow chart for patients with transient global amnesia (TGA). The goal of this study was to determine the adequacy of priority code assignment for patients with TGA presenting at the ED and triaged using the MTS.
{"title":"Validity of the Manchester triage system in the prioritization of patients with transient global amnesia in the emergency department","authors":"A. Zaboli, G. Turcato, B. Nucera, S. Sibilio, F. Rinaldi, Laura D’Acunto, P. Manganotti, R. Nardone, N. Pfeifer, F. Brigo","doi":"10.1111/ncn3.12720","DOIUrl":"https://doi.org/10.1111/ncn3.12720","url":null,"abstract":"The Manchester Triage System (MTS) is one of the most widely used and studied triage systems in emergency departments (ED). MTS does not have a specific presentational flow chart for patients with transient global amnesia (TGA). The goal of this study was to determine the adequacy of priority code assignment for patients with TGA presenting at the ED and triaged using the MTS.","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"11 1","pages":"262 - 267"},"PeriodicalIF":0.4,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44708498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Natsuko Togawa, Masahiro Mitsuhashi, H. Yamashita, S. Minamiguchi, Y. Arakawa, T. Ayaki, A. Kuzuya, A. Ikeda, Ryosuke Takahashi
H3K27M‐mutant diffuse midline glioma is a malignant glioma that was newly added to the World Health Organization classification in 2016. In diffuse midline glioma, the H3K27M‐mutant sometimes develops sub‐acutely and requires a differential diagnosis from encephalomyelitis. Here, we report a case of adult‐onset diffuse midline glioma that was diagnosed by immunostaining for histone H3K27M after death. The present case required a differential diagnosis of autoimmune cervical myelitis and brainstem encephalitis.
{"title":"A case of adult‐onset diffuse midline glioma diagnosed by histone H3K27M immunostaining after death, which required differentiation from brainstem encephalitis and myelitis","authors":"Natsuko Togawa, Masahiro Mitsuhashi, H. Yamashita, S. Minamiguchi, Y. Arakawa, T. Ayaki, A. Kuzuya, A. Ikeda, Ryosuke Takahashi","doi":"10.1111/ncn3.12718","DOIUrl":"https://doi.org/10.1111/ncn3.12718","url":null,"abstract":"H3K27M‐mutant diffuse midline glioma is a malignant glioma that was newly added to the World Health Organization classification in 2016. In diffuse midline glioma, the H3K27M‐mutant sometimes develops sub‐acutely and requires a differential diagnosis from encephalomyelitis. Here, we report a case of adult‐onset diffuse midline glioma that was diagnosed by immunostaining for histone H3K27M after death. The present case required a differential diagnosis of autoimmune cervical myelitis and brainstem encephalitis.","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"11 1","pages":"239 - 241"},"PeriodicalIF":0.4,"publicationDate":"2023-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45235057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 48yearold male with a history of hypertension presented to the emergency department with acute onset leftsided weakness, dysarthria, and blood pressure of 196/113 mm Hg. Head computed tomography (CT) revealed a right basal ganglia and subarachnoid hemorrhage. (Figure 1A) Head CT angiogram showed a 2.9 mm aneurysm in the medial distal lenticulostriate artery (LSA) within the area of hematoma suggestive of aneurysm rupture. (Figure 1B– D). Aneurysms of LSA are a rare finding with an average diameter of 3.88 mm (ranging from 1– 19 mm) and are usually missed by CT angiogram.1,2 These aneurysms can be located either proximally near
{"title":"Computed tomography angiography evidence of distal lenticulostriate artery aneurysm","authors":"Riwaj Bhagat, Alexis Clay, Ava Bakhtyari","doi":"10.1111/ncn3.12717","DOIUrl":"https://doi.org/10.1111/ncn3.12717","url":null,"abstract":"A 48yearold male with a history of hypertension presented to the emergency department with acute onset leftsided weakness, dysarthria, and blood pressure of 196/113 mm Hg. Head computed tomography (CT) revealed a right basal ganglia and subarachnoid hemorrhage. (Figure 1A) Head CT angiogram showed a 2.9 mm aneurysm in the medial distal lenticulostriate artery (LSA) within the area of hematoma suggestive of aneurysm rupture. (Figure 1B– D). Aneurysms of LSA are a rare finding with an average diameter of 3.88 mm (ranging from 1– 19 mm) and are usually missed by CT angiogram.1,2 These aneurysms can be located either proximally near","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"11 1","pages":"292 - 293"},"PeriodicalIF":0.4,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42540425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Takuma Maeda, M. Okawara, Manabu Osakabe, Hiroyuki Yamaguchi, Takahiro Maeda, S. Maeshima
Reports of stroke‐related catalepsy and other catatonia syndromes are rare. A 68‐year‐old man was admitted to a local hospital 10 days prior for heart failure. He subsequently developed multiple cerebral infarctions and was referred to our hospital for emergency care. He spontaneously opened his eyes but did not speak. He had hemiparesis on the right side. Diffusion‐weighted imaging revealed high‐intensity areas in the left frontal and parietal lobes and right cerebellar hemisphere. Rehabilitation therapy was initiated in the acute stage. When he was instructed to raise his left upper limb 90°, he maintained the posture for more than 5 min. We hypothesized that catatonia syndromes, including catalepsy, were caused by damage to the orbitofrontal, premotor, supplementary motor cortices, and basal forebrain. These abnormalities disappeared after 4 months. Catalepsy may also be observed in organic central nervous system diseases, such as stroke, and should be considered in stroke care.
{"title":"A case of catalepsy after multiple cerebral infarctions","authors":"Takuma Maeda, M. Okawara, Manabu Osakabe, Hiroyuki Yamaguchi, Takahiro Maeda, S. Maeshima","doi":"10.1111/ncn3.12716","DOIUrl":"https://doi.org/10.1111/ncn3.12716","url":null,"abstract":"Reports of stroke‐related catalepsy and other catatonia syndromes are rare. A 68‐year‐old man was admitted to a local hospital 10 days prior for heart failure. He subsequently developed multiple cerebral infarctions and was referred to our hospital for emergency care. He spontaneously opened his eyes but did not speak. He had hemiparesis on the right side. Diffusion‐weighted imaging revealed high‐intensity areas in the left frontal and parietal lobes and right cerebellar hemisphere. Rehabilitation therapy was initiated in the acute stage. When he was instructed to raise his left upper limb 90°, he maintained the posture for more than 5 min. We hypothesized that catatonia syndromes, including catalepsy, were caused by damage to the orbitofrontal, premotor, supplementary motor cortices, and basal forebrain. These abnormalities disappeared after 4 months. Catalepsy may also be observed in organic central nervous system diseases, such as stroke, and should be considered in stroke care.","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"11 1","pages":"248 - 250"},"PeriodicalIF":0.4,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43814582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Yoshizaki, Shinobu Minatani, Hiroto Namba, Akitoshi Takeda, J. Kawabe, Hideko Mizuta, Yasuhiro Wada, A. Mawatari, Yasuyoshi Watanabe, H. Shimada, Makoto Higuchi, Y. Itoh
Heterogeneity in Alzheimer's disease (AD) has been reported on the basis of clinical, neuropathological, and neuroimaging data. However, most of the indices, including cerebral atrophy evaluated using magnetic resonance imaging and amyloid β (Aβ) accumulation detected using positron emission tomography (PET), lack sensitivity, and specificity for categorization.
{"title":"Tau accumulates differently in four subtypes of Alzheimer's disease","authors":"T. Yoshizaki, Shinobu Minatani, Hiroto Namba, Akitoshi Takeda, J. Kawabe, Hideko Mizuta, Yasuhiro Wada, A. Mawatari, Yasuyoshi Watanabe, H. Shimada, Makoto Higuchi, Y. Itoh","doi":"10.1111/ncn3.12715","DOIUrl":"https://doi.org/10.1111/ncn3.12715","url":null,"abstract":"Heterogeneity in Alzheimer's disease (AD) has been reported on the basis of clinical, neuropathological, and neuroimaging data. However, most of the indices, including cerebral atrophy evaluated using magnetic resonance imaging and amyloid β (Aβ) accumulation detected using positron emission tomography (PET), lack sensitivity, and specificity for categorization.","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"204 1","pages":"231 - 238"},"PeriodicalIF":0.4,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41264771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Montalvan, Walter R Duarte-Celada, T. Bueso, Jeannie Lee, K. Rivas, Gabriel Neves, Yuanyuan Tan, Jannatul Ferdous
Isolated cortical venous thrombosis (ICVT) is an uncommon subtype of cerebral venous thrombosis that only affects the cortical veins on the cerebral convexities. Its clinical presentation is variable and may mimic other neurological conditions.
{"title":"Isolated cortical venous thrombosis: A systematic review","authors":"V. Montalvan, Walter R Duarte-Celada, T. Bueso, Jeannie Lee, K. Rivas, Gabriel Neves, Yuanyuan Tan, Jannatul Ferdous","doi":"10.1111/ncn3.12714","DOIUrl":"https://doi.org/10.1111/ncn3.12714","url":null,"abstract":"Isolated cortical venous thrombosis (ICVT) is an uncommon subtype of cerebral venous thrombosis that only affects the cortical veins on the cerebral convexities. Its clinical presentation is variable and may mimic other neurological conditions.","PeriodicalId":19154,"journal":{"name":"Neurology and Clinical Neuroscience","volume":"11 1","pages":"119 - 126"},"PeriodicalIF":0.4,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47005734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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