NMC case report journal最新文献_第8页

A Case of Bilateral Lambdoid and Sagittal Synostosis Diagnosed with Skull Fracture after Vacuum-assisted Delivery: A Case Report and Literature Review. 一例真空辅助分娩后诊断为颅骨骨折的双侧蝶鞍和矢状突合：病例报告与文献综述

NMC case report journal Pub Date : 2024-06-13 eCollection Date: 2024-01-01 DOI: 10.2176/jns-nmc.2023-0279

Natsuki Nakamura, Atsuko Harada, Kazushige Maeno, Shigeo Kyutoku, Koichi Ueda

{"title":"A Case of Bilateral Lambdoid and Sagittal Synostosis Diagnosed with Skull Fracture after Vacuum-assisted Delivery: A Case Report and Literature Review.","authors":"Natsuki Nakamura, Atsuko Harada, Kazushige Maeno, Shigeo Kyutoku, Koichi Ueda","doi":"10.2176/jns-nmc.2023-0279","DOIUrl":"10.2176/jns-nmc.2023-0279","url":null,"abstract":"Craniosynostosis (CS) can develop in the fetal period, but it is difficult to diagnose prenatally. In this case, a 3-month-old female baby developed extensive subgaleal hematoma and severe anemia after vacuum-assisted delivery. Her computed tomography showed bilateral lambdoid and sagittal synostosis (BLSS) with a depressed fracture of the right parietal bone. She was referred to our hospital for treatment of the CS. At 4 months of age, she underwent bilateral lambda and sagittal suturectomy and foramen magnum decompression. CS may result in trauma at delivery, because CS disturbs fetal head molding during delivery and disrupts passage through the birth canal. In particular, the risk of severe peripartum trauma is thought to increase in cases of CS with multiple suture fusions, such as those observed in BLSS, due to the strong inhibition of this process of passage through the birth canal. Therefore, if the delivery is abnormally prolonged or if the infant has a massive subgaleal hematoma, it is important to perform evaluations for CS after birth.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"11 ","pages":"157-161"},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11224651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556436","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}

引用次数: 0

A Case of Multiple Intracranial Hemorrhages due to a Ruptured Neoplastic Cerebral Aneurysm Secondary to Metastasis of Poorly Differentiated Parotid Gland Carcinoma. 分化不良的腮腺癌转移导致的肿瘤性脑动脉瘤破裂引发多发性颅内出血病例。

NMC case report journal Pub Date : 2024-06-13 eCollection Date: 2024-01-01 DOI: 10.2176/jns-nmc.2023-0250

Naoki Irizato, Syogo Fukuya, Hidekazu Nakata, Tomofumi Takenaka, Akihiro Tateishi, Kazumi Yamamoto, Akatsuki Wakayama, Masaaki Taniguchi

{"title":"A Case of Multiple Intracranial Hemorrhages due to a Ruptured Neoplastic Cerebral Aneurysm Secondary to Metastasis of Poorly Differentiated Parotid Gland Carcinoma.","authors":"Naoki Irizato, Syogo Fukuya, Hidekazu Nakata, Tomofumi Takenaka, Akihiro Tateishi, Kazumi Yamamoto, Akatsuki Wakayama, Masaaki Taniguchi","doi":"10.2176/jns-nmc.2023-0250","DOIUrl":"10.2176/jns-nmc.2023-0250","url":null,"abstract":"Neoplastic cerebral aneurysms (NCAs) are rare. This study reported a case of an NCA secondary to a poorly differentiated carcinoma of the parotid gland. An 84-year-old Japanese woman undergoing treatment for parotid gland cancer was admitted to our hospital with headache and progressive loss of consciousness. Based on computed tomography (CT) and CT angiography (CTA), a diagnosis of subarachnoid hemorrhage due to rupture of a left posterior inferior cerebellar artery aneurysm was made, and emergency aneurysmectomy was performed. Pathological examination of the resected aneurysm showed an NCA secondary to parotid carcinoma. After the aneurysmectomy, her condition stabilized; however, 33 days later, the patient developed an intracerebral hemorrhage, and a new aneurysm was confirmed in the right middle cerebral artery. To the best of our knowledge, there have been no previous reports on cases of NCAs secondary to parotid carcinoma. The pathology and clinical course strongly suggest that NCAs derived from malignant tumors may have an aggressive course.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"11 ","pages":"181-186"},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11223887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536344","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}

引用次数: 0

Endoscopic Cerebellar Necrosectomy for Space-occupying Cerebellar Infarction: A Case Report. 内窥镜小脑坏死切除术治疗空间占位性小脑梗塞：病例报告。

NMC case report journal Pub Date : 2024-05-28 eCollection Date: 2024-01-01 DOI: 10.2176/jns-nmc.2023-0301

Yu Naruse, Mio Endo, Dai Uzuki, Kiyoshi Saito

{"title":"Endoscopic Cerebellar Necrosectomy for Space-occupying Cerebellar Infarction: A Case Report.","authors":"Yu Naruse, Mio Endo, Dai Uzuki, Kiyoshi Saito","doi":"10.2176/jns-nmc.2023-0301","DOIUrl":"10.2176/jns-nmc.2023-0301","url":null,"abstract":"Suboccipital decompressive craniectomy with or without resection of necrosis is the preferred treatment for space-occupying cerebellar infarctions with neurological deterioration due to brainstem compression and obstructive hydrocephalus. We herein present our experience with treating space-occupying cerebellar infarctions successfully using endoscopic necrosectomy. A total of 27 patients were admitted to our hospital due to cerebellar infarctions between April 2021 and November 2023. Four patients required surgical interventions due to a drop in consciousness level or compression of the fourth ventricle and brainstem with acute hydrocephalus confirmed by a computed tomography (CT) scan. Three patients were performed endoscopic necrosectomy through a burr hole in a supine-lateral position. Removing most of the necrotic tissue was possible, resulting in early decompression of the fourth ventricle and brainstem. Endoscopic necrosectomy is less invasive than suboccipital decompressive craniectomy. An endoscopic necrosectomy can be performed for patients with unstable health conditions in a supine-lateral position. Therefore, endoscopic necrosectomy might be an effective method for treating patients with space-occupying cerebellar infarctions and poor general condition, although an objective evaluation of the extent and degree of removal is needed.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"11 ","pages":"141-144"},"PeriodicalIF":0.0,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11190657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444019","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}

引用次数: 0

A Case of Superficial Siderosis with Elevated Anti-Ro/SSA Antibody. 一例抗 Ro/SSA 抗体升高的表层蚕豆病病例

NMC case report journal Pub Date : 2024-05-28 eCollection Date: 2024-01-01 DOI: 10.2176/jns-nmc.2023-0214

Shoji Watanabe, Maulidina Amalia Putri, Hitoshi Yamahata, Ryosuke Hanaya

{"title":"A Case of Superficial Siderosis with Elevated Anti-Ro/SSA Antibody.","authors":"Shoji Watanabe, Maulidina Amalia Putri, Hitoshi Yamahata, Ryosuke Hanaya","doi":"10.2176/jns-nmc.2023-0214","DOIUrl":"10.2176/jns-nmc.2023-0214","url":null,"abstract":"Superficial siderosis (SS) of the central nervous system is a rare disorder that is caused by chronic or recurrent hemorrhage in the subarachnoid space via a dural defect at the spinal level. The most common clinical features of SS include slow-progressive sensorineural deafness, cerebellar symptoms, and pyramidal tract signs. Considering that SS can present with broad clinical manifestations, for precise diagnosis, this disease must be understood. Anti-Ro/SSA antibodies are commonly detected in patients with Sjögren's syndrome and are utilized as markers for autoimmune diseases. In this report, we present a unique pathological condition in which SS coincided with a positive anti-Ro/SSA antibody test result. During the diagnosis of gait disturbance, an elevation in anti-Ro/SSA antibody was detected, and steroid pulse therapy was initiated as the initial treatment for autoimmune diseases. Head magnetic resonance imaging (MRI) revealed extensive hypointensity as a dark band that surrounded the intracranial basal structures and cerebellar hemispheres. Spinal MRI indicated ventral longitudinal intraspinal fluid collection extending from C7 to T5 as well as a defect in the ventral T2-3 dura mater. Intraoperative visualization revealed that the intradural venous plexus was the source of bleeding that caused the SS. To our knowledge, this report is the first to discuss the presence of anti-Ro/SSA antibodies in patients with SS. The role of anti-Ro/SSA antibodies in the pathophysiology of SS remains unclear; therefore, to confirm a possible association, further research and accumulation of cases are required.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"11 ","pages":"151-155"},"PeriodicalIF":0.0,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11190658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444018","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}

引用次数: 0

A Case of Pontine Infarction due to Subclavian Steal Phenomenon Enhanced by an Arteriovenous Shunt for Hemodialysis. 一例因血液透析动静脉分流术导致锁骨下盗血现象而引发的桥脑梗死病例。

NMC case report journal Pub Date : 2024-05-28 eCollection Date: 2024-01-01 DOI: 10.2176/jns-nmc.2024-0004

Motohide Takahara, Tomoaki Murakami, Shingo Toyota, Shuki Okuhara, Kazuhiro Touhara, Yuhei Hoshikuma, Takamune Achiha, Shuhei Yamada, Maki Kobayashi, Haruhiko Kishima

{"title":"A Case of Pontine Infarction due to Subclavian Steal Phenomenon Enhanced by an Arteriovenous Shunt for Hemodialysis.","authors":"Motohide Takahara, Tomoaki Murakami, Shingo Toyota, Shuki Okuhara, Kazuhiro Touhara, Yuhei Hoshikuma, Takamune Achiha, Shuhei Yamada, Maki Kobayashi, Haruhiko Kishima","doi":"10.2176/jns-nmc.2024-0004","DOIUrl":"10.2176/jns-nmc.2024-0004","url":null,"abstract":"We present a case of pontine infarction caused by subclavian steal phenomenon (SSP) due to subclavian artery stenosis (SAS) and an arteriovenous shunt in the forearm in a 74-year-old man with hemodialysis and stenting for SAS with improvement of SSP. He developed dysarthria during dialysis. He was admitted to our hospital and diagnosed with a pontine infarction. As the basilar artery appeared to be occluded on magnetic resonance angiography, an emergency diagnostic angiography was performed. Aortagram showed severe stenosis of the left subclavian artery. Right vertebral artery (VA) angiogram revealed retrograde arterial blood flow from the right VA to the left VA via the VA union, which suggested SSP. In addition, the steal was augmented by an ipsilateral hemodialysis arteriovenous shunt. Percutaneous subclavian artery stenting was performed 12 days later, and there was no recurrence of symptoms in the follow-up period. To our knowledge, this study is the first to report a patient with SSP who developed a pontine infarction due to SAS and an arteriovenous shunt during hemodialysis and who underwent subclavian artery stenting and had a good outcome.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"11 ","pages":"145-150"},"PeriodicalIF":0.0,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11190656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444017","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}

引用次数: 0

A Patient with Tarsal Tunnel Syndrome Associated with the Flexor Digitorum Accessorius Longus Muscle. 一名患有跗骨隧道综合征的患者，其病因与屈指肌有关。

NMC case report journal Pub Date : 2024-05-17 eCollection Date: 2024-01-01 DOI: 10.2176/jns-nmc.2023-0136

Kosuke Miwa, Kyongsong Kim, Rinko Kokubo, Hiroyuki Dan, Kenta Koketsu, Yasuo Murai

{"title":"A Patient with Tarsal Tunnel Syndrome Associated with the Flexor Digitorum Accessorius Longus Muscle.","authors":"Kosuke Miwa, Kyongsong Kim, Rinko Kokubo, Hiroyuki Dan, Kenta Koketsu, Yasuo Murai","doi":"10.2176/jns-nmc.2023-0136","DOIUrl":"10.2176/jns-nmc.2023-0136","url":null,"abstract":"The flexor digitorum accessorius longus muscle (ALM) can be overlooked as the eliciting factor in patients with tarsal tunnel syndrome (TTS), an entrapment neuropathy of the posterior tibial nerve that elicits sole numbness and pain. Most elicitations are idiopathic, however, mass lesions within the tarsal tunnel can be also implicated. We report an 80-year-old woman whose flexor digitorum ALM led to the onset of bilateral TTS. She had suffered numbness in both soles for 3 years. Magnetic resonance imaging (MRI) of the bilateral tarsal tunnel showed that the posterior tibial nerve was compressed by the arteriovenous complex and in contact with the flexor digitorum ALM. We diagnosed bilateral TTS based on her symptoms and imaging findings, and performed bilateral decompression surgery of the posterior tibial nerve under local anesthesia. The artery on both sides was dislocated for nerve decompression. Because the posterior tibial nerve on the right side was strongly compressed in ankle plantar flexion we excised a portion of the tendon compressing the nerve. Postoperatively her symptoms gradually improved and she reported surgical satisfaction 6 months after the operation. In patients with flexor digitorum ALM-related TTS, the effect of dynamic factors on MRI findings and on surgical treatment decisions must be considered. Intraoperatively, not only the flexor digitorum ALM, but also other potential etiologic factors eliciting TTS must be kept in mind.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"11 ","pages":"125-129"},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11165262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307779","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}

引用次数: 0

Unexpected Cerebral Hyperperfusion after Transient Hypoperfusion Associated with Stroke-like Migraine Attacks after Radiation Therapy Syndrome. 放疗后中风样偏头痛发作综合征与一过性低灌注后的意外脑过度灌注有关

NMC case report journal Pub Date : 2024-05-17 eCollection Date: 2024-01-01 DOI: 10.2176/jns-nmc.2024-0037

Naoki Irizato, Hiroaki Hashimoto, Yasuyoshi Chiba

{"title":"Unexpected Cerebral Hyperperfusion after Transient Hypoperfusion Associated with Stroke-like Migraine Attacks after Radiation Therapy Syndrome.","authors":"Naoki Irizato, Hiroaki Hashimoto, Yasuyoshi Chiba","doi":"10.2176/jns-nmc.2024-0037","DOIUrl":"10.2176/jns-nmc.2024-0037","url":null,"abstract":"Stroke-like migraine attacks after radiation therapy (SMART) syndrome, a delayed sequela of cranial radiotherapy encountered rarely, occurs due to transient neurological deficits coupled with migraine episodes. This case report describes an occurrence of SMART syndrome in an individual 8 years after receiving medulloblastoma treatment. The subject, a 21-year-old male, experienced abrupt aphasia and right-sided hemiparesis. Arterial spin labeling (ASL) revealed initial cerebral hypoperfusion in the left temporal and parietal regions, with no tumor resurgence or notable ischemic alterations. Two days later, the symptoms disappeared completely; nevertheless, at that time, ASL presented cerebral hyperperfusion in the same lobule. The subject experienced a pulsating headache and nausea the next day. In the context of SMART syndrome, this fluctuation in cerebral blood flow indicated by ASL is a unique finding. The significance of this case lies in the documentation of the dynamic evolution of cerebral perfusion in SMART syndrome via ASL, thereby elucidating its underlying pathophysiology. As hemiplegic migraine shows a similar cerebral perfusion pattern to SMART syndrome, we inferred an unexplored but shared pathophysiology among hemiplegic migraine and SMART syndrome. Through this successful capture of these distinct cerebral blood flow alterations, from hypoperfusion to hyperperfusion, our understanding of the pathophysiological intricacies inherent to SMART syndrome will be enhanced.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"11 ","pages":"135-140"},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11165263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307781","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}

引用次数: 0

Surgical Removal of Foramen Ovale Osteophyte Completely Relieved Atypical Trigeminal Neuralgia: A Case Report and Literature Review. 手术切除大孔骨赘可完全缓解非典型三叉神经痛：病例报告与文献综述

NMC case report journal Pub Date : 2024-05-17 eCollection Date: 2024-01-01 DOI: 10.2176/jns-nmc.2023-0194

Haopeng Wang, Xuhui Wang, Shiting Li, Yinda Tang

引用次数: 0

Endoscopic Endonasal Approach for Optic Canal Dural Metastasis in a Patient with Progressive Visual Dysfunction: A Case Report. 视功能进行性障碍患者视神经硬膜外转移的内窥镜手术：病例报告。

NMC case report journal Pub Date : 2024-04-24 eCollection Date: 2024-01-01 DOI: 10.2176/jns-nmc.2023-0203

Takamitsu Saito, Ryo Hiruta, Yu Naruse, Masao Tanbara, Kenichiro Nagai, Shinya Jinguji, Masazumi Fujii

{"title":"Endoscopic Endonasal Approach for Optic Canal Dural Metastasis in a Patient with Progressive Visual Dysfunction: A Case Report.","authors":"Takamitsu Saito, Ryo Hiruta, Yu Naruse, Masao Tanbara, Kenichiro Nagai, Shinya Jinguji, Masazumi Fujii","doi":"10.2176/jns-nmc.2023-0203","DOIUrl":"https://doi.org/10.2176/jns-nmc.2023-0203","url":null,"abstract":"To improve optic nerve function in a patient with progressive visual dysfunction, performing early decompressive and debulking surgery for a metastatic tumor located in the optic canal is essential. The endoscopic endonasal approach could be a practical and effective alternative for lesions in the inferomedial part of the optic canal. A 66-year-old man with a right visual eye field deficit had multiple lesions in the pineal gland, occipital lobe, and right inferomedial optic canal. The optic nerve was distorted by a tumor compressing against the falciform ligament. Although a systemic examination suggested the presence of primary lung cancer, the patient only complained of progressive visual impairment in the right eye. We planned surgery with endoscopic transethmoidal and transsphenoidal approaches to restore visual function and make a pathological diagnosis. During the procedure, we drilled the sella floor, tuberculum sellae, and optic canal and successfully removed the tumor underneath the dura mater. The patient's visual function improved rapidly following surgery, and no complications were observed, such as cerebrospinal fluid leakage. After confirming the pathological diagnosis, the patient subsequently received whole-brain radiotherapy. The endoscopic endonasal skull base approach to the optic canal region could be a practical alternative for treating symptomatic metastatic tumors.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"11 ","pages":"113-117"},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961447","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}

引用次数: 0

A Case of Rheumatoid Meningitis Diagnosed with FLAIR Images and Anti-cyclic Citrullinated Peptide Antibodies Levels. 一例通过 FLAIR 图像和抗环瓜氨酸肽抗体水平确诊的类风湿性脑膜炎病例

NMC case report journal Pub Date : 2024-04-24 eCollection Date: 2024-01-01 DOI: 10.2176/jns-nmc.2023-0289

Taro Suzuki, Yosuke Akamatsu, Sotaro Oshida, Shinpei Sato

{"title":"A Case of Rheumatoid Meningitis Diagnosed with FLAIR Images and Anti-cyclic Citrullinated Peptide Antibodies Levels.","authors":"Taro Suzuki, Yosuke Akamatsu, Sotaro Oshida, Shinpei Sato","doi":"10.2176/jns-nmc.2023-0289","DOIUrl":"https://doi.org/10.2176/jns-nmc.2023-0289","url":null,"abstract":"Rheumatoid meningitis (RM) is a rare but serious extra-articular manifestation of rheumatoid arthritis. Due to the absence of specific biomarkers, imaging findings, or guidelines for its detection, the diagnosis of RM is difficult. This report describes a patient of RM diagnosed with an open biopsy and discusses the utility of anticyclic citrullinated peptide antibodies (ACPA) levels in the serum and cerebrospinal fluid (CSF), and contrast-enhanced (CE) fluid-attenuated inversion recovery (FLAIR) images for screening and monitoring RM. A 65-year-old woman presented with a 2-month history of headaches. Imaging studies showed asymmetric meningeal and leptomeningeal involvement seen on brain magnetic resonance imaging (MRI). An open biopsy of the meninges and leptomeninges depicted palisaded and necrotizing granulomatous inflammation, which suggests rheumatoid nodules. Treatment with prednisolone and tocilizumab led to symptom improvement and reduced lesion intensity on follow-up MRI. Throughout the treatment, the ACPA index in her serum and CSF, and the findings of CE-FLAIR images, rather than the CE T1WI, reflected disease activity. For 6 months, the patient has been stable without symptom recurrence. The ACPA index and the CE-FLAIR images were useful for the diagnosis and monitoring of RM. To validate these findings, further studies are necessary.","PeriodicalId":101331,"journal":{"name":"NMC case report journal","volume":"11 ","pages":"119-123"},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961445","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}

引用次数: 0