T. Pedro, Pedro Pereira, A. Costa, Fábio Almeida, M. Loureiro, T. Alfaiate, Abílio Gonçalves
Background: Blood pressure variability (BPV) is a predictor of short- and long-term disability in patients with acute ischemic stroke (AIS). Its effect on more immediate functional outcomes has been seldom studied, and the results are inconsistent. We aimed to determine the role of BPV during the first 5 days of hospitalization in functional status at the time of discharge of patients with AIS. Methods: We enrolled 134 patients diagnosed with AIS and BPV using standard deviation and coefficient of variation (CV %). These were associated with the dichotomized modified Rankin Scale at discharge using logistic regression. Results: Patients with unfavorable outcomes were significantly older ( P =0.014), had a lower body mass index ( P =0.001), were less likely to present with dyslipidemia ( P =0.001), had lower serum triglyceride levels ( P =0.012), had a longer hospitalization period ( P <0.001), and had a higher mean National Institutes of Health Stroke Scale score at admission ( P <0.001). After adjusting for multiple confounders, the CV % of systolic blood pressure (SBP) in the first 120 hours after admission had a significant effect on functional disability at discharge. Conclusion: Variability in SBP in the first 5 days of hospitalization had a deleterious effect on the functional outcomes at discharge of patients with AIS. The role of diastolic BPV seems to be significant only in the first 24 hours of admission; however, further research is required.
{"title":"Systolic blood pressure variability within 120 hours of admission predicts the functional outcomes at discharge of patients with acute ischemic stroke","authors":"T. Pedro, Pedro Pereira, A. Costa, Fábio Almeida, M. Loureiro, T. Alfaiate, Abílio Gonçalves","doi":"10.18700/jnc.210038","DOIUrl":"https://doi.org/10.18700/jnc.210038","url":null,"abstract":"Background: Blood pressure variability (BPV) is a predictor of short- and long-term disability in patients with acute ischemic stroke (AIS). Its effect on more immediate functional outcomes has been seldom studied, and the results are inconsistent. We aimed to determine the role of BPV during the first 5 days of hospitalization in functional status at the time of discharge of patients with AIS. Methods: We enrolled 134 patients diagnosed with AIS and BPV using standard deviation and coefficient of variation (CV %). These were associated with the dichotomized modified Rankin Scale at discharge using logistic regression. Results: Patients with unfavorable outcomes were significantly older ( P =0.014), had a lower body mass index ( P =0.001), were less likely to present with dyslipidemia ( P =0.001), had lower serum triglyceride levels ( P =0.012), had a longer hospitalization period ( P <0.001), and had a higher mean National Institutes of Health Stroke Scale score at admission ( P <0.001). After adjusting for multiple confounders, the CV % of systolic blood pressure (SBP) in the first 120 hours after admission had a significant effect on functional disability at discharge. Conclusion: Variability in SBP in the first 5 days of hospitalization had a deleterious effect on the functional outcomes at discharge of patients with AIS. The role of diastolic BPV seems to be significant only in the first 24 hours of admission; however, further research is required.","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44356663","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}
Background: Takotsubo syndrome and myasthenic crisis can be triggered by physical stress. We present the case of a woman who developed Takotsubo syndrome and myasthenic crisis following radiocontrast media-induced anaphylaxis. Case Report: A 39-year-old woman presented with diplopia and ptosis. After chest computed tomography scan, her consciousness was stupor and her oxygen saturation decreased. Electrocardiography showed ST elevation, and cardiac enzyme levels increased. Echocardiography revealed severe left ventricular dysfunction. Myasthenia gravis was diagnosed based on anti-acetylcholine receptor antibody and repetitive nerve stimulation test. Extubation failed, and her weakness worsened. Her neurological condition gradually improved after steroid therapy. Repeat echocardiography demonstrated complete recovery of left ventricular dysfunction. Conclusion: Takotsubo syndrome can be triggered by anaphylaxis and can occur in patients with neurological disorders; therefore, neurologists need to know about this disorder. The combination of Takotsubo syndrome and myasthenic crisis is rare but may be associated with a poor prognosis.
{"title":"Takotsubo syndrome and myasthenic crisis after radiocontrast media-induced anaphylaxis","authors":"J. Cho, Hyeongsoo Kim, J. Yum","doi":"10.18700/jnc.210032","DOIUrl":"https://doi.org/10.18700/jnc.210032","url":null,"abstract":"Background: Takotsubo syndrome and myasthenic crisis can be triggered by physical stress. We present the case of a woman who developed Takotsubo syndrome and myasthenic crisis following radiocontrast media-induced anaphylaxis. Case Report: A 39-year-old woman presented with diplopia and ptosis. After chest computed tomography scan, her consciousness was stupor and her oxygen saturation decreased. Electrocardiography showed ST elevation, and cardiac enzyme levels increased. Echocardiography revealed severe left ventricular dysfunction. Myasthenia gravis was diagnosed based on anti-acetylcholine receptor antibody and repetitive nerve stimulation test. Extubation failed, and her weakness worsened. Her neurological condition gradually improved after steroid therapy. Repeat echocardiography demonstrated complete recovery of left ventricular dysfunction. Conclusion: Takotsubo syndrome can be triggered by anaphylaxis and can occur in patients with neurological disorders; therefore, neurologists need to know about this disorder. The combination of Takotsubo syndrome and myasthenic crisis is rare but may be associated with a poor prognosis.","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43334439","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}
Han Kyu Na, Taewon Kim, Jung-Yoon Yum, W. Park, Joonho Kim, Seok-joo Kim, Jong Hun Kim, K. Seo
Early neurologic deterioration (END) is a common complication occurring in up to one-third of patients with acute ischemic stroke [1]. Proximal arterial occlusion is a risk factor for predicting END [2]. Pharmacologically induced hypertensive therapy (PIHT) is a therapeutic option for END, which acts by increasing collateral flow, thereby preventing the expansion of the infarct core [3,4]. Phenylephrine is mainly used for PIHT because it selectively binds to alpha-1 receptors and causes peripheral vasoconstriction Recanalization of the middle cerebral artery after prolonged induced hypertensive therapy to rescue early neurologic deterioration Han Kyu Na, MD; Taewon Kim, MD; Jung Yon Yum, MD; Woohyun Park, MD; Joonho Kim, MD; Seokhyun Kim, MD; Jong Hun Kim, MD; Kwon-Duk Seo, MD Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, Korea 2 Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea CASE REPORT
{"title":"Recanalization of the middle cerebral artery after prolonged induced hypertensive therapy to rescue early neurologic deterioration","authors":"Han Kyu Na, Taewon Kim, Jung-Yoon Yum, W. Park, Joonho Kim, Seok-joo Kim, Jong Hun Kim, K. Seo","doi":"10.18700/jnc.210036","DOIUrl":"https://doi.org/10.18700/jnc.210036","url":null,"abstract":"Early neurologic deterioration (END) is a common complication occurring in up to one-third of patients with acute ischemic stroke [1]. Proximal arterial occlusion is a risk factor for predicting END [2]. Pharmacologically induced hypertensive therapy (PIHT) is a therapeutic option for END, which acts by increasing collateral flow, thereby preventing the expansion of the infarct core [3,4]. Phenylephrine is mainly used for PIHT because it selectively binds to alpha-1 receptors and causes peripheral vasoconstriction Recanalization of the middle cerebral artery after prolonged induced hypertensive therapy to rescue early neurologic deterioration Han Kyu Na, MD; Taewon Kim, MD; Jung Yon Yum, MD; Woohyun Park, MD; Joonho Kim, MD; Seokhyun Kim, MD; Jong Hun Kim, MD; Kwon-Duk Seo, MD Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, Korea 2 Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea CASE REPORT","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45503462","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}
eral anterior or central cord lesions. However, unilateral hemicord lesions were rarely reported [1]. A 94-year-old woman visited our institution due to sudden right hemiplegia. Neurological examination findings were consistent with Brown-Sequard syndrome. The motor functions of the right arm and leg were given Medical Research Council scale grades of 1 and 2, respectively. Touch sensation was decreased in the right arm, trunk, and leg. Pain and temperature sensations were decreased on the left side. Magnetic resonance imaging showed diffusion restriction and T2-hyperintensity of the spinal cord between C2 and C5 level (Fig. 1). Cerebral angiography revealed a right vertebral artery occlusion (Fig. 2). The ischemia of separated anterior spinal arteries or sulco-commissural arteries can provoke partial Brown-Sequard syndrome [2]. However, under the above conditions, posterior spinal artery territories remain spared. The radiculomedullary arteries are branches of radicular arteries arising from the vertebral artery. They form a Y-shaped branch in the cervical region supplying both anterior and posterior spinal artery territories [3,4]. Ischemia of the unilateral radiculomedullary artery could provoke hemicord infarction [4]. In our case, occlusion of the right vertebral artery might have caused an ischemia A case of Brown-Sequard syndrome caused by spinal cord infarction
{"title":"A case of Brown-Sequard syndrome caused by spinal cord infarction","authors":"S. Kim, Keun Lee, S. Sohn","doi":"10.18700/jnc.210041","DOIUrl":"https://doi.org/10.18700/jnc.210041","url":null,"abstract":"eral anterior or central cord lesions. However, unilateral hemicord lesions were rarely reported [1]. A 94-year-old woman visited our institution due to sudden right hemiplegia. Neurological examination findings were consistent with Brown-Sequard syndrome. The motor functions of the right arm and leg were given Medical Research Council scale grades of 1 and 2, respectively. Touch sensation was decreased in the right arm, trunk, and leg. Pain and temperature sensations were decreased on the left side. Magnetic resonance imaging showed diffusion restriction and T2-hyperintensity of the spinal cord between C2 and C5 level (Fig. 1). Cerebral angiography revealed a right vertebral artery occlusion (Fig. 2). The ischemia of separated anterior spinal arteries or sulco-commissural arteries can provoke partial Brown-Sequard syndrome [2]. However, under the above conditions, posterior spinal artery territories remain spared. The radiculomedullary arteries are branches of radicular arteries arising from the vertebral artery. They form a Y-shaped branch in the cervical region supplying both anterior and posterior spinal artery territories [3,4]. Ischemia of the unilateral radiculomedullary artery could provoke hemicord infarction [4]. In our case, occlusion of the right vertebral artery might have caused an ischemia A case of Brown-Sequard syndrome caused by spinal cord infarction","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43697265","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}
{"title":"Utility of transoral and transcranial ultrasonography in the diagnosis of internal carotid dissection: a case report","authors":"Issac Cheong, Victoria Otero Castro, F. Tamagnone","doi":"10.18700/jnc.210033","DOIUrl":"https://doi.org/10.18700/jnc.210033","url":null,"abstract":"","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46386774","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}
Background: Although there are common risk factors for acute ischemic stroke and myocardial infarction, simultaneous onset of both diseases is uncommon. Here, we present a case of acute cerebral infarction with concurrent fatal myocardial infarction. Case Report: A 54-year-old man presented with left hemiparesis, gaze preponderance to the right side, and visual and tactile extinction. Computed tomography angiography showed occlusion of the right middle cerebral artery. ST-elevation myocardial infarction was suspected on electrocardiography. After the injection of intravenous tissue plasminogen activator, thrombectomy was attempted first, and the coronary angiogram was planned after recanalization of the cerebral artery. However, thrombectomy was discontinued because of cardiac arrest. Despite extracorporeal membrane oxygenation and emergency percutaneous coronary intervention, the patient died of multiorgan failure.Conclusion: Double primary acute ischemic stroke and myocardial infarction are rare but may be fatal due to the narrow therapeutic time window for both diseases. Careful consideration of the urgency of cardiac status is essential.
{"title":"Which one to do first?: a case report of simultaneous acute ischemic stroke and myocardial infarction","authors":"Kijeong Lee, W. Park, K. Seo, Hyeongsoo Kim","doi":"10.18700/jnc.210030","DOIUrl":"https://doi.org/10.18700/jnc.210030","url":null,"abstract":"Background: Although there are common risk factors for acute ischemic stroke and myocardial infarction, simultaneous onset of both diseases is uncommon. Here, we present a case of acute cerebral infarction with concurrent fatal myocardial infarction. Case Report: A 54-year-old man presented with left hemiparesis, gaze preponderance to the right side, and visual and tactile extinction. Computed tomography angiography showed occlusion of the right middle cerebral artery. ST-elevation myocardial infarction was suspected on electrocardiography. After the injection of intravenous tissue plasminogen activator, thrombectomy was attempted first, and the coronary angiogram was planned after recanalization of the cerebral artery. However, thrombectomy was discontinued because of cardiac arrest. Despite extracorporeal membrane oxygenation and emergency percutaneous coronary intervention, the patient died of multiorgan failure.Conclusion: Double primary acute ischemic stroke and myocardial infarction are rare but may be fatal due to the narrow therapeutic time window for both diseases. Careful consideration of the urgency of cardiac status is essential.","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45714081","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}
S. Touzani, Mohammed Hamdouni, Nawfal Houari, Youssef Yaakoubi Khbiza, A. Elbouazzaoui, B. Boukatta, N. Kanjaa
Background: Neuroleptic malignant syndrome (NMS) is a rare but potentially life-threatening neuropsychiatric emergency. The aim of our study was to update our bedside procedures by investigating NMS cases managed in the intensive care unit (ICU).Methods: This retrospective study included all NMS patients admitted to our hospital between January 2012 and December 2019. The variables analyzed included demographics, diagnosis, therapeutics, and outcomes.Results: This study included 20 patients, with an average age of 36.6 years. The male to female ratio was 1:4. No patient had a history of NMS, and 60% of the patients had schizophrenia. First-generation neuroleptics (NLs) were the most commonly prescribed drugs (80%). The mean time between the introduction of NLs and onset of symptoms was 7.6 days. Rigidity was observed in 90% of the patients, hyperthermia and neuropsychic syndrome in 65%, and dysautonomia in 50%. The creatine phosphokinase level in all patients was four times the normal value. Mechanical ventilation was required in 20% of the patients and hemodialysis in one patient. None of the patients received specific therapy. The mean duration of ICU stay was 10 days. The mortality rate was 10%,, mainly associated with renal failure. The analysis of the predictors of mortality was limited by the size of our cohort.Conclusion: NMS is a rare condition requiring multidisciplinary implementation of contextualized and updated procedures. Early detection and supportive treatment could improve the prognosis in resource-limited settings, where specific treatments are not available. Predictive risk factors should be investigated in larger multicenter cohorts.
{"title":"Neuroleptic malignant syndrome cases in a Moroccan intensive care unit: a retrospective analysis and literature review","authors":"S. Touzani, Mohammed Hamdouni, Nawfal Houari, Youssef Yaakoubi Khbiza, A. Elbouazzaoui, B. Boukatta, N. Kanjaa","doi":"10.18700/jnc.210019","DOIUrl":"https://doi.org/10.18700/jnc.210019","url":null,"abstract":"Background: Neuroleptic malignant syndrome (NMS) is a rare but potentially life-threatening neuropsychiatric emergency. The aim of our study was to update our bedside procedures by investigating NMS cases managed in the intensive care unit (ICU).Methods: This retrospective study included all NMS patients admitted to our hospital between January 2012 and December 2019. The variables analyzed included demographics, diagnosis, therapeutics, and outcomes.Results: This study included 20 patients, with an average age of 36.6 years. The male to female ratio was 1:4. No patient had a history of NMS, and 60% of the patients had schizophrenia. First-generation neuroleptics (NLs) were the most commonly prescribed drugs (80%). The mean time between the introduction of NLs and onset of symptoms was 7.6 days. Rigidity was observed in 90% of the patients, hyperthermia and neuropsychic syndrome in 65%, and dysautonomia in 50%. The creatine phosphokinase level in all patients was four times the normal value. Mechanical ventilation was required in 20% of the patients and hemodialysis in one patient. None of the patients received specific therapy. The mean duration of ICU stay was 10 days. The mortality rate was 10%,, mainly associated with renal failure. The analysis of the predictors of mortality was limited by the size of our cohort.Conclusion: NMS is a rare condition requiring multidisciplinary implementation of contextualized and updated procedures. Early detection and supportive treatment could improve the prognosis in resource-limited settings, where specific treatments are not available. Predictive risk factors should be investigated in larger multicenter cohorts.","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42616855","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}
acute carbon monoxide (CO) poisoning. Neurological examinations were normal except for confusion. Initial brain images showed no acute lesions (Fig. 1A) on the next day of admission. Twelve days after CO intoxication, severe headache, choreic movement of both upper extremities, and impaired visual acuity with optic ataxia, oculomotor apraxia, and simultanagnosia were observed. Cerebrospinal fluid findings showed pleocytosis (white blood cell, 135/mm) with elevated protein level (134.8 mg/dL). From the follow-up brain magnetic resonance imaging, she was diagnosed with posterior reversible encephalopathy syndrome (PRES) as delayed neurologic sequelae (DNS) after CO intoxication (Fig. 1B). With steroid pulse therapy, she had clinical improvement (Fig. 1C). During the acute phase of CO poisoning, brain MRI shows signal changes in the bilateral globus pallidus (GP) with cytotoxic edema [1]. PRES shows distinctive MRI findings of the parieto-occipital lesions with either vasogenic or cytotoxic edema or both [2]. A patient with DNS with PRES was reported without GP involvement [3]. However, in this case, DNS after CO intoxication affected not only the basal ganglia but also the parieto-occipital regions as PRES. Therefore, it is the reason that the patient presented with both chorea and Balint’s syndrome simultaneously. ARTICLE INFORMATION
{"title":"Posterior reversible encephalopathy syndrome as delayed neurological sequelae after carbon monoxide intoxication","authors":"H. Lee, Jin-Su Park","doi":"10.18700/jnc.210027","DOIUrl":"https://doi.org/10.18700/jnc.210027","url":null,"abstract":"acute carbon monoxide (CO) poisoning. Neurological examinations were normal except for confusion. Initial brain images showed no acute lesions (Fig. 1A) on the next day of admission. Twelve days after CO intoxication, severe headache, choreic movement of both upper extremities, and impaired visual acuity with optic ataxia, oculomotor apraxia, and simultanagnosia were observed. Cerebrospinal fluid findings showed pleocytosis (white blood cell, 135/mm) with elevated protein level (134.8 mg/dL). From the follow-up brain magnetic resonance imaging, she was diagnosed with posterior reversible encephalopathy syndrome (PRES) as delayed neurologic sequelae (DNS) after CO intoxication (Fig. 1B). With steroid pulse therapy, she had clinical improvement (Fig. 1C). During the acute phase of CO poisoning, brain MRI shows signal changes in the bilateral globus pallidus (GP) with cytotoxic edema [1]. PRES shows distinctive MRI findings of the parieto-occipital lesions with either vasogenic or cytotoxic edema or both [2]. A patient with DNS with PRES was reported without GP involvement [3]. However, in this case, DNS after CO intoxication affected not only the basal ganglia but also the parieto-occipital regions as PRES. Therefore, it is the reason that the patient presented with both chorea and Balint’s syndrome simultaneously. ARTICLE INFORMATION","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42860966","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}
Joong-Goo Kim, J. Choi, H. Kim, J. Rhim, T. Jung, C. Hyun, J. Joo
Tuberous sclerosis complex (TSC) is an autosomal dominant multisystem disorder, first described by Bourneville [1]. TSC patients present with three distinct intracranial lesions: subcortical tubers, subependymal nodules, and subependymal giant cell astrocytomas (SEGA) [1,2]. Despite its benign histopathology, SEGA can result in a variety of severe events that may substantially increase the mortality and morbidity of TSC patients [3]. This is due to their preferential proximity to the foramen of Monro, Bilateral posterior cerebral artery stroke following transtentorial herniation caused by a subependymal giant cell astrocytoma in a patient with tuberous sclerosis: a case report Joong-Goo Kim, MD; Jay Chol Choi, MD, PhD; Hong Jun Kim, MD; Jong Kook Rhim, MD; Tae Jun Jung; Chang-Lim Hyun, MD, PhD; Jin Deok Joo, MD
{"title":"Bilateral posterior cerebral artery stroke following transtentorial herniation caused by a subependymal giant cell astrocytoma in a patient with tuberous sclerosis: a case report","authors":"Joong-Goo Kim, J. Choi, H. Kim, J. Rhim, T. Jung, C. Hyun, J. Joo","doi":"10.18700/jnc.210034","DOIUrl":"https://doi.org/10.18700/jnc.210034","url":null,"abstract":"Tuberous sclerosis complex (TSC) is an autosomal dominant multisystem disorder, first described by Bourneville [1]. TSC patients present with three distinct intracranial lesions: subcortical tubers, subependymal nodules, and subependymal giant cell astrocytomas (SEGA) [1,2]. Despite its benign histopathology, SEGA can result in a variety of severe events that may substantially increase the mortality and morbidity of TSC patients [3]. This is due to their preferential proximity to the foramen of Monro, Bilateral posterior cerebral artery stroke following transtentorial herniation caused by a subependymal giant cell astrocytoma in a patient with tuberous sclerosis: a case report Joong-Goo Kim, MD; Jay Chol Choi, MD, PhD; Hong Jun Kim, MD; Jong Kook Rhim, MD; Tae Jun Jung; Chang-Lim Hyun, MD, PhD; Jin Deok Joo, MD","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47139069","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}
K. Bismaya, S. Pattanayak, A. Dixit, A. Pathak, R. Chaurasia, V. Singh
Various eyelid and eye movement abnormalities have been attributed to different central nervous system lesions. Apraxia of eyelid closure (AEC), which is less common than apraxia of eyelid opening, is reported to occur in progressive supranuclear palsy, Creutzfeldt-Jakob disease, Huntington disease, amyotrophic lateral sclerosis, and acquired frontal and parietal lobe diseases such as Supranuclear oculomotor palsy in cerebral venous sinus thrombosis: a case report
{"title":"Supranuclear oculomotor palsy in cerebral venous sinus thrombosis: a case report","authors":"K. Bismaya, S. Pattanayak, A. Dixit, A. Pathak, R. Chaurasia, V. Singh","doi":"10.18700/jnc.210025","DOIUrl":"https://doi.org/10.18700/jnc.210025","url":null,"abstract":"Various eyelid and eye movement abnormalities have been attributed to different central nervous system lesions. Apraxia of eyelid closure (AEC), which is less common than apraxia of eyelid opening, is reported to occur in progressive supranuclear palsy, Creutzfeldt-Jakob disease, Huntington disease, amyotrophic lateral sclerosis, and acquired frontal and parietal lobe diseases such as Supranuclear oculomotor palsy in cerebral venous sinus thrombosis: a case report","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67504319","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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