Brain and Development Case Reports最新文献

{"title":"A female patient with paramyotonia congenita. Part 2: Contribution of SCN4A to the developing brain","authors":"Yoshie Kurokawa ,&nbsp;Karin Kojima ,&nbsp;Tomoyuki Ishii ,&nbsp;Eriko Jimbo ,&nbsp;Hirokazu Yamagishi ,&nbsp;Akihiko Miyauchi ,&nbsp;Hiroko Wakabayashi ,&nbsp;Kazuhiro Muramatsu ,&nbsp;Hitoshi Osaka ,&nbsp;Takanori Yamagata","doi":"10.1016/j.bdcasr.2024.100042","DOIUrl":"10.1016/j.bdcasr.2024.100042","url":null,"abstract":"<div><h3>Background</h3><div><em>SCN4A</em> encodes the α-subunit of the voltage-gated sodium channel Na_V1.4, which is responsible for the generation of action potentials and excitation of skeletal muscle fibers. Paramyotonia congenita (PMC) is a congenital disorder characterized by non-dystrophic myotonia due to variants of <em>SCN4A</em>. <em>SCN4A</em> has been considered to be exclusively expressed in muscles, and the brain phenotype has not been reported until recently, including descriptions of essential tremor and epilepsy.</div></div><div><h3>Patient</h3><div>The patient is a 20-year-old woman with PMC by detecting a c.3917G&gt;A, p.(Gly1306Glu) variant in <em>SCN4A</em>. The patient also showed neurological symptoms, such as epilepsy, from 1 year old and intellectual disability (intelligence quotient 48).</div></div><div><h3>Mouse brain</h3><div>We confirmed the Na_V 1.4 expression in the brain of developing mice, 10 days after birth, immunohistochemically, in the entire cerebral cortex, the olfactory bulb and the midbrain but not in the hippocampus or cerebellum. However, the Na_V 1.4 expression was not detected in adult mouse cortex.</div></div><div><h3>Discussion</h3><div>Na_V1.4 was shown to be expressed in the cerebral cortex of young mice but not in adults. Since our patient had shown intellectual disability and epilepsy from infancy, Na_V1.4 was considered to be involved in the developing brain and cause central nervous system symptom in some situations.</div></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"2 4","pages":"Article 100042"},"PeriodicalIF":0.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemorrhagic shock and encephalopathy syndrome occurring in the setting of dual pathogenesis of cerebral cavernous malformation 1 and Houge-Janssens syndrome 2","authors":"Haruna Yoshikawa ,&nbsp;Kenichiro Hayashi ,&nbsp;Mamiko Yamada ,&nbsp;Fuyuki Miya ,&nbsp;Kenjiro Kosaki ,&nbsp;Toshiki Takenouchi","doi":"10.1016/j.bdcasr.2024.100038","DOIUrl":"10.1016/j.bdcasr.2024.100038","url":null,"abstract":"<div><h3>Background</h3><div>Hemorrhagic shock and encephalopathy syndrome is a lethal form of acute childhood encephalopathy that occurs in the setting of various neurodevelopmental conditions. In undiagnosed patients, exome sequencing identifies dual genetic diagnoses in 5% of affected individuals.</div></div><div><h3>Clinical Report</h3><div>A male infant with a family history of cavernous malformation syndrome with profound developmental delay and hypotonia was brought to our clinic. A trio-based exome analysis identified dual genetic diagnoses: cerebral cavernous malformation 1 (OMIM#<span><span>116860</span><svg><path></path></svg></span>) due to a maternally inherited heterozygous frameshift mutation in <em>KRIT1</em> and Houge-Janssens syndrome 2 (OMIM#<span><span>616362</span><svg><path></path></svg></span>) due to a de novo heterozygous mutation in <em>PPP2R1A</em>. At the age of two years, the child developed hemorrhagic shock and encephalopathy syndrome and died.</div></div><div><h3>Discussion</h3><div>The dual genetic diagnoses well explained the patient's overall clinical and neuroradiographic phenotype. The differential risk of recurrence of two independent disorders was informative from a genetic counseling standpoint. Known underlying neurological comorbidities in cases developing hemorrhagic shock and encephalopathy syndrome do not appear to have a shared molecular mechanism, but perhaps have perturbations in the basal neuronal activity, predisposing to acute lethal encephalopathy.</div></div><div><h3>Conclusion</h3><div>A thorough genetic investigation to search for multiple genetic causes to fully explain a patient's overall phenotype is critical. Multiplicity of the underlying genetic conditions may increase the risk of development of acute childhood encephalopathy.</div></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"2 4","pages":"Article 100038"},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950221724000345/pdfft?md5=d203e515451163ff7a3d57c63a15abf3&pid=1-s2.0-S2950221724000345-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A female patient with paramyotonia congenita. Part 1: Combination therapy of lacosamide and topiramate","authors":"Yoshie Kurokawa ,&nbsp;Karin Kojima ,&nbsp;Tomoyuki Ishii ,&nbsp;Eriko Jimbo ,&nbsp;Hirokazu Yamagishi ,&nbsp;Akihiko Miyauchi ,&nbsp;Hiroko Wakabayashi ,&nbsp;Kazuhiro Muramatsu ,&nbsp;Hitoshi Osaka ,&nbsp;Takanori Yamagata","doi":"10.1016/j.bdcasr.2024.100041","DOIUrl":"10.1016/j.bdcasr.2024.100041","url":null,"abstract":"<div><h3>Background</h3><div>Paramyotonia congenita (PMC) is a congenital disorder characterized by non-dystrophic myotonia due to variants of <em>SCN4A</em>. <em>SCN4A</em> encodes the α-subunit of the voltage-gated sodium channel Na_V1.4, which is responsible for the generation of action potentials and excitation of skeletal muscle fibers. Despite some reduction of myotonia by sodium channel blockers, a more effective treatment is still being sought. We herein report a patient whose myotonia was ameliorated by combination therapy with topiramate, mexiletine and lacosamide.</div></div><div><h3>Patient</h3><div>The patient was a 20-year-old woman. A few days after birth, laryngospasm and cyanosis had appeared repeatedly on crying, gradually followed by local myotonia in various parts of the body. Exposure to both hot and cold, exercise, and mental stress induced myotonia in her fingers, orbicularis oculi, neck, trunk, and limbs, lasting for several minutes to hours, several times a day. We diagnosed her with PMC by detecting a c.3917G &gt; A, p.(Gly1306Glu) variant in <em>SCN4A.</em> She also had epilepsy with tonic-clonic seizure since 1 year old. Combination therapy of topiramate and lacosamide in addition to mexiletine reduced the myotonia markedly.</div></div><div><h3>Discussion</h3><div>A sodium channel blocker, the combination of fast inactivation by topiramate and mexiletine, and slow inactivation by lacosamide may be effective in reducing myotonia in PMC. The further accumulation of data concerning this treatment is required.</div></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"2 4","pages":"Article 100041"},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950221724000370/pdfft?md5=7158e566f41a2f8e280c0cce0c476595&pid=1-s2.0-S2950221724000370-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequential MRI of the brain in a patient with Leigh syndrome revealed extensive changes and the development of posterior reversible encephalopathy syndrome","authors":"Tatsuya Fukasawa ,&nbsp;Tetsuo Kubota ,&nbsp;Toshiki Takeo ,&nbsp;Takeshi Suzuki ,&nbsp;Hiroyuki Kidokoro ,&nbsp;Tamiko Negoro ,&nbsp;Kei Murayama ,&nbsp;Akira Ohtake ,&nbsp;Jun Natsume","doi":"10.1016/j.bdcasr.2024.100040","DOIUrl":"10.1016/j.bdcasr.2024.100040","url":null,"abstract":"<div><p>Background: The majority of Leigh syndrome cases exhibit fulminant clinical courses, and magnetic resonance imaging (MRI) typically reveals evolutionary changes. We present a case of Leigh syndrome in which MRI of the brain revealed extensive changes along with the development of posterior reversible encephalopathy syndrome (PRES).</p><p>Patient: An 8-year-old Japanese girl presented with gait disturbance. MRI revealed high-intensity areas in the bilateral basal ganglia and the ventral midbrain in T2-weighted images (T2WIs) and fluid attenuated inversion recovery (FLAIR). We identified the mitochondrial DNA homozygous mutation 9176 T &gt; C. The patient gradually recovered. One month after symptom onset, she developed respiratory and circulatory failure accompanied by lactic acidosis and disturbances of consciousness. A repeat MRI did not reveal any new lesions. Subsequently, 1 month later, she presented with disturbances of consciousness, headache, and vision disturbances. Her blood pressure was 210/140 mmHg; MRI revealed many spotty high-intensity areas, predominantly located in the parietal and occipital lobes in T2WIs and FLAIR. She was treated with hypotensive drugs and gradually recovered with improved MRI findings. This episode was diagnosed as PRES.</p><p>Conclusion: This case revealed extensive changes in MRI findings of the brain, as well as disturbances of consciousness due to respiratory and circulatory failure and PRES. Sequential brain MRI is useful for the evaluation of patients with Leigh syndrome and for the detection of unexpected complications, such as PRES.</p></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"2 4","pages":"Article 100040"},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950221724000369/pdfft?md5=a91eabdb445cbf7572b141218d7d13d7&pid=1-s2.0-S2950221724000369-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequent breath-hold while awakening in SATB1 missense variant: A case report","authors":"Yu Aihara ,&nbsp;Takashi Saito ,&nbsp;Yuta Suenaga ,&nbsp;Kaori Miyana ,&nbsp;Toshiyuki Itai ,&nbsp;Satoko Miyatake ,&nbsp;Kaoru Yamamoto ,&nbsp;Noriko Sumitomo ,&nbsp;Shimpei Baba ,&nbsp;Eri Takeshita ,&nbsp;Yuko Shimizu-Motohashi ,&nbsp;Yuji Takahashi ,&nbsp;Hidehiro Mizusawa ,&nbsp;Naomichi Matsumoto ,&nbsp;Masayuki Sasaki","doi":"10.1016/j.bdcasr.2024.100036","DOIUrl":"10.1016/j.bdcasr.2024.100036","url":null,"abstract":"<div><p><em>Introduction: SATB1</em> encodes a protein of the same name, and its genetic alteration causes SATB1 (special AT-rich sequence-binding protein 1) dysfunction, which clinically presents as developmental delay, intellectual disability, facial features, and epilepsy. However, detailed clinical information, especially regarding respiratory disorders, has not yet been fully described.</p><p><em>Case Presentation:</em> We report the case of a 3-year-old Japanese girl with a <em>de novo</em> variant of <em>SATB1</em>, c.1588G &gt; A:p.(Glu530Lys), who presented with a frequent breath-holding and hyperventilation while awake, in addition to typical phenotype. The long-term EEG showed no corresponding epileptiform changes, and breath-holding was considered non-epileptic rather than epilepsy, such as ictal central apneas. Valproic acid and acetazolamide alleviated breath-holding; however, it was intractable.</p><p><em>Conclusion:</em> Respiratory disorders were thought to be non-epileptic, not reported in <em>SATB1</em> disorders, and were resistant to treatment. The case was considered critical and may provide new research clues to this severe and not yet fully understood phenomenon.</p></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"2 4","pages":"Article 100036"},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950221724000321/pdfft?md5=7b06a36254beacba17e0007f42f80e1b&pid=1-s2.0-S2950221724000321-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrathecal nusinersen treatment in a Chinese patient with spinal muscular atrophy type 3 after ventriculo-peritoneal shunt placement: A case report and review of literature","authors":"Kai Ma ,&nbsp;Yi Lu ,&nbsp;Dong Wang ,&nbsp;Xiao Han ,&nbsp;Lei Liang ,&nbsp;Yuanyuan Zhang","doi":"10.1016/j.bdcasr.2024.100039","DOIUrl":"10.1016/j.bdcasr.2024.100039","url":null,"abstract":"<div><h3>Background</h3><p>There is a risk of secondary communicating hydrocephalus in patients with 5q spinal muscular atrophy (SMA) treated with intrathecal nusinersen. The benefits and risks of intrathecal nusinersen treatment in SMA type 3 patients with ventriculoperitoneal shunt (VPS) due to hydrocephalus are unknown.</p></div><div><h3>Case report</h3><p>A female patient was diagnosed with hydrocephalus at 6 months owing to a progressive increase in head circumference and underwent VPS treatment at 7 months. Motor function development was delayed, and she was diagnosed with SMA type 3 at 41 months. Intrathecal nusinersen treatment was initiated when the patient was 51 months old. The results of the motor function rating scales showed significant improvement after 28 months of follow-up, and a CT scan of the head showed relief of the hydrocephalus. Serious adverse reactions were not observed.</p></div><div><h3>Conclusion</h3><p>Intrathecal nusinersen treatment is effective and safe after VPS surgery in SMA type 3 patients. Hydrocephalus is not a contraindication for intrathecal nusinersen treatment in SMA patients.</p></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"2 4","pages":"Article 100039"},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950221724000357/pdfft?md5=a43000bcbdca06f80a06e7fc3860978e&pid=1-s2.0-S2950221724000357-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Opsoclonus myoclonus syndrome with improvement of symptoms and decrease in cerebrospinal fluid B cell percentage after Rituxmab administration: Case report","authors":"Eri Inoue ,&nbsp;Sae Nishisho ,&nbsp;Noriko Fuke ,&nbsp;Takayuki Wakabayashi ,&nbsp;Yukihiko Konishi ,&nbsp;Takashi Kusaka","doi":"10.1016/j.bdcasr.2024.100037","DOIUrl":"10.1016/j.bdcasr.2024.100037","url":null,"abstract":"<div><h3>Introduction</h3><p>Opsoclonus myoclonus syndrome (OMS) is a rare neurological disorder that presents with opsoclonus, ataxia or myoclonus, behavioral changes, or sleep disturbances. Cognitive and behavioral deficits are the most problematic sequelae in pediatric patients with OMS. Patients with OMS often have increased cerebrospinal fluid (CSF) B cell counts, which are considered a biomarker of disease activity and may be an important indicator in selecting optimal treatment.</p></div><div><h3>Case report</h3><p>A 1-year-and-5-month-old boy diagnosed with paraneoplastic OMS was started on immunotherapy with intravenous immunoglobulin and dexamethasone (DEX) pulse therapy 3 months after disease onset. After one course of DEX pulse therapy, rituximab (RTX) was added due to a worsening of symptoms, resulting in an OMS Rating Scale score of 13. Two weeks after starting RTX therapy, the patient's symptoms started to improve, and he was able to walk 5 months later. The percentage of B cells in the CSF was 10.7 % before the introduction of RTX therapy but decreased to 0.16 % 3 months after starting RTX therapy. The patient achieved remission 12 months after the disease onset and had no recurrence.</p></div><div><h3>Conclusion</h3><p>The high percentage of B-cells in the patient's CSF indicated severe disease activity. Remission could have been achieved sooner if RTX had been administered earlier. CSF lymphocyte subset analysis should be performed aggressively in OMS as it is a potential indicator for RTX introduction.</p></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"2 4","pages":"Article 100037"},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950221724000333/pdfft?md5=7d9f9ef0bdf7851f1dc683fc7ae070c9&pid=1-s2.0-S2950221724000333-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cranial polyneuropathy secondary to retropharyngeal abscess in an adolescent: Multidisciplinary management and clinical resolution","authors":"Timothy Mathieson ,&nbsp;Alexandre Piletta-Zanin ,&nbsp;Serge Daniel Le Bon ,&nbsp;Basile Nicolas Landis ,&nbsp;Hélène Cao Van ,&nbsp;Christian Korff","doi":"10.1016/j.bdcasr.2024.100035","DOIUrl":"10.1016/j.bdcasr.2024.100035","url":null,"abstract":"<div><h3>Introduction</h3><p>Cranial nerve deficits are a rare but described complication of infection in the deep spaces of the neck and their optimal management remains unclear.</p></div><div><h3>Case report</h3><p>We present the case and clinical resolution of a fifteen-year-old male with multiple cranial nerve deficits in the setting of a retropharyngeal abscess. Cranial nerve IX involvement was postulated based on gustatory testing and clinical resolution was achieved after surgical management.</p></div><div><h3>Conclusion</h3><p>We believe that this case underscores that cranial polyneuropathy associated with deep neck space infections should warrant a comprehensive approach with specific consideration for surgical decompression if maximal medical treatments fails.</p></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"2 4","pages":"Article 100035"},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S295022172400031X/pdfft?md5=a5cbe70c4a48df44f7453c45b9f1ef41&pid=1-s2.0-S295022172400031X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial comments on “Two cases of cerebrospinal fluid hypovolemia that had been interpreted as orthostatic dysregulation”","authors":"Tomoyuki Akiyama ,&nbsp;Shinji Saitoh","doi":"10.1016/j.bdcasr.2024.100033","DOIUrl":"10.1016/j.bdcasr.2024.100033","url":null,"abstract":"","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"2 3","pages":"Article 100033"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950221724000291/pdfft?md5=677a53890654d6ddeae288c7d700dc8a&pid=1-s2.0-S2950221724000291-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two cases of cerebrospinal fluid hypovolemia that had been interpreted as orthostatic dysregulation","authors":"Yuko Ohashi ,&nbsp;Tatsuo Fuchigami ,&nbsp;Koichi Takahashi","doi":"10.1016/j.bdcasr.2024.100031","DOIUrl":"10.1016/j.bdcasr.2024.100031","url":null,"abstract":"<div><h3>Background</h3><p>Children with cerebrospinal fluid (CSF) hypovolemia can exhibit various symptoms, with the most common ones being headache and vertigo; further, it is often misdiagnosed as orthostatic dysregulation (OD). This article describes two cases of CSF hypovolemia that were interpreted as OD.</p></div><div><h3>Case presentation</h3><p>Both patients, including a previously healthy 13-year-old boy and an 11-year-old girl, presented with orthostatic headaches and participated in sports activities, such as tennis and basketball. Both patients were considered to have OD given their diagnosis of postural orthostatic tachycardia syndrome using a new orthostatic test. However, the symptoms did not improve after OD treatment; they were diagnosed with CSF hypovolemia based on radioisotope cisternography and computed tomography myelography. Both patients were treated with epidural blood patches (EBPs), which significantly improved their prognoses.</p></div><div><h3>Discussion and conclusion</h3><p>We report two cases of cerebrospinal fluid hypovolemia that improved with treatment with EBP. When a patient is diagnosed with OD and shows no response to lifestyle guidance and medication, considering cerebrospinal fluid hypovolemia as one of the differential diseases is essential.</p></div>","PeriodicalId":100196,"journal":{"name":"Brain and Development Case Reports","volume":"2 3","pages":"Article 100031"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950221724000278/pdfft?md5=4cc686da4c5a4541d7e74a97c25e65f3&pid=1-s2.0-S2950221724000278-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}