Neurohospitalist最新文献

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Who Obtains Informed Consent for Endovascular Thrombectomy in Acute Stroke? A Survey of Clinicians. 急性脑卒中血管内血栓切除术谁获得知情同意?临床医生调查。
IF 0.7
Neurohospitalist Pub Date : 2025-09-06 DOI: 10.1177/19418744251377576
Amir A Mbonde, Ali A Alsarah, Bart M Demaerschalk, Adam A Dmytriw, Quentin J Moyer, Joshua A Hirsch, Aneesh B Singhal, Thabele M Leslie-Mazwi, Natalia S Rost, Aman B Patel, Michael J Young, Robert W Regenhardt
{"title":"Who Obtains Informed Consent for Endovascular Thrombectomy in Acute Stroke? A Survey of Clinicians.","authors":"Amir A Mbonde, Ali A Alsarah, Bart M Demaerschalk, Adam A Dmytriw, Quentin J Moyer, Joshua A Hirsch, Aneesh B Singhal, Thabele M Leslie-Mazwi, Natalia S Rost, Aman B Patel, Michael J Young, Robert W Regenhardt","doi":"10.1177/19418744251377576","DOIUrl":"10.1177/19418744251377576","url":null,"abstract":"<p><strong>Background and purpose: </strong>Informed consent (IC) practices for endovascular thrombectomy (EVT) in acute stroke are not well elucidated. We investigated the roles and specialties of those obtaining EVT IC, aiming to provide insights for enhancing the process.</p><p><strong>Methods: </strong>We conducted a survey from July- December 2023 among acute stroke care clinicians. Utilizing Qualtrics, we disseminated a questionnaire through various national and international online platforms. This analysis summarizes the characteristics of individuals who obtain IC at respondents' institution.</p><p><strong>Results: </strong>Among 168 respondents, 71% were staff physicians, 70% practiced in the US and 70% worked at academic centers. Neurology (77%) was the most common specialty obtaining EVT IC, followed by neurosurgery (41%), radiology (30%) and emergency medicine (EM) (10%). Staff physicians were the most frequently involved (61%), followed by fellows (43%), residents (48%) and advanced practice providers (APPs) (36%). Comparatvely, non-US institutions were more likely to utilize neurologists alone (50% vs 31%, <i>P</i> = 0.016) and staff physicians (76% vs 54%, <i>P</i> = 0.008), while US institutions more often utilized neurosurgeons (51% vs 18%, <i>P</i> < 0.001), APPs (43% vs 18%, <i>P</i> = 0.002) and residents (56% vs 28%, <i>P</i> = 0.001). Non-academic institutions used EM (25% vs 5%, <i>P</i> < 0.001) and APPs (50% vs 31%, <i>P</i> = 0.031), while academic institutions commonly utilized neurosurgeons (48% vs 18%, <i>P</i> = 0.001), residents (59% vs 13%, <i>P</i> < 0.001) and fellows (52% vs 18%, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Neurologists and staff physicians are the primary providers obtaining EVT IC, with variations based on region and institution type. Future efforts to optimize the IC process should integrate various specialties and be widely adaptable.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251377576"},"PeriodicalIF":0.7,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024338","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
Cardiac Arrest: A Rare Complication of Intrathecal Baclofen Withdrawal. 心脏骤停:鞘内巴氯芬停药的一种罕见并发症。
IF 0.7
Neurohospitalist Pub Date : 2025-08-23 DOI: 10.1177/19418744251370410
Singh Karminder, Arora Niraj, Nattanmai Chandershekran Prem, Merchant Rameez
{"title":"Cardiac Arrest: A Rare Complication of Intrathecal Baclofen Withdrawal.","authors":"Singh Karminder, Arora Niraj, Nattanmai Chandershekran Prem, Merchant Rameez","doi":"10.1177/19418744251370410","DOIUrl":"https://doi.org/10.1177/19418744251370410","url":null,"abstract":"<p><p>Baclofen, a GABA agonist, is used for the management of spasticity. Intrathecal route is indicated in cases of severe spasticity associated with spinal cord injury. Baclofen withdrawal symptoms can happen after IT pump removal which can present as anxiety, paranoia, psychosis, seizures, hallucinations, severe spasticity and dyskinesia. Cardiac arrest after baclofen withdrawal is rare with only 2 cases in literature so far however in both cases IT-pump was replaced. We present a case of PEA arrest after baclofen IT-pump removal which was managed without replacing. 33 year-old male with history of paraplegia from cervical spinal cord injury (C-6) level, chronic spasticity, fibular osteomyelitis and chronic sacral ulcers presented with wound dehiscence and exposed baclofen pump which was replaced 4 weeks ago due to the end of the pump's life. After 24-48 h of removal of the baclofen pump, cardiovascular instability in the form of supra ventricular tachycardia with hypotension and altered mentation was noted. It evolved to progressive clinical worsening with stiffness of body, loss of responsiveness, and up-rolling of eyes. Patient underwent PEA, and ROSC after 3 rounds of CPR. He was subsequently intubated, mechanically ventilated and sedated with midazolam intravenously. Baclofen and clonazepam were started through the feeding tube. Over a period of 10 days, midazolam was weaned, and baseline clinical stability was achieved without IT-baclofen pump. Though rare, cardiac arrest can happen after baclofen withdrawal. High index of clinical suspicion is advised for long term baclofen pump patients after pump explant to prevent withdrawal symptoms and complications.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251370410"},"PeriodicalIF":0.7,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973756","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
Myelitis in a Young Patient With Testing Supportive for Both Angiostrongylus and Schistosoma Infection. 年轻患者的脊髓炎与血管圆线虫和血吸虫感染检测支持。
IF 0.7
Neurohospitalist Pub Date : 2025-08-20 DOI: 10.1177/19418744251370935
Kristen Murray, Noriko Salamon, Doojin Kim, Michael G Ho
{"title":"Myelitis in a Young Patient With Testing Supportive for Both Angiostrongylus and Schistosoma Infection.","authors":"Kristen Murray, Noriko Salamon, Doojin Kim, Michael G Ho","doi":"10.1177/19418744251370935","DOIUrl":"https://doi.org/10.1177/19418744251370935","url":null,"abstract":"<p><p>Schistosoma and Angiostrongylus are both parasites which can cause central nervous system manifestations in humans. These parasites live in several overlapping geographic areas as well as share several clinical features. Diagnosis and treatment can be difficult given these infections are rare, have non-specific symptoms, and have definitive testing that takes days to weeks to result. We present a case of myelitis secondary to Angiostrongylus cantonensis infection with false-positive Schistosoma serologies complicating the diagnostic process in which the patient had an excellent clinical response to treatment with steroids and antiparasitic agents.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251370935"},"PeriodicalIF":0.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973802","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
Myelin Oligodendrocyte Glycoprotein Optic Neuritis Presenting in Late Pregnancy. 妊娠晚期出现髓磷脂少突胶质细胞糖蛋白视神经炎。
IF 0.7
Neurohospitalist Pub Date : 2025-08-09 DOI: 10.1177/19418744251367172
Kelsey M Donovan, Marielle Mahan, Narmien Murdock, Martin P Kolsky, Benjamin Osborne
{"title":"Myelin Oligodendrocyte Glycoprotein Optic Neuritis Presenting in Late Pregnancy.","authors":"Kelsey M Donovan, Marielle Mahan, Narmien Murdock, Martin P Kolsky, Benjamin Osborne","doi":"10.1177/19418744251367172","DOIUrl":"10.1177/19418744251367172","url":null,"abstract":"<p><p>Myelin oligodendrocyte glycoprotein (MOG) antibody-associated optic neuritis is a demyelinating disease that shares clinical overlap with Neuromyelitis Optica Spectrum Disorder (NMOSD) and Multiple Sclerosis (MS). The immunosuppressive effects of pregnancy followed by a rebound in the immune system postpartum are thought to affect presentation and relapse rates of NMOSD and MS. Few studies exist describing pregnancy affecting MOG antibody-associated disease. In this case, a 29-year-old female from Ethiopia presented on postpartum day 8 with 4 weeks of progressive, painful bilateral vision loss that had acutely worsened over the past 6 days. Her visual acuity was light perception in the right eye and hand motion in the left eye with a right afferent pupillary defect. Dilated exam revealed bilateral optic nerve head elevation, vascular tortuosity, and macular folds. MRI of the brain and orbits with contrast revealed long segment bilateral optic nerve enhancement and nonspecific white matter changes. Serum MOG IgG was positive (1:160). Her vision rapidly improved with intravenous methylprednisolone 1000 mg daily for 5 days, followed by an oral prednisone taper. After 6 months, the patient's vision returned to 20/20 in each eye, and she has had no further clinical relapse. This case suggests that initial presentation of MOG optic neuritis may be affected by pregnancy. Physicians must appropriately triage patients with postpartum vision changes to ensure prompt treatment.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251367172"},"PeriodicalIF":0.7,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822779","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
Isolated Pancerebellar Syndrome With anti-GQ1b IgG Positivity: A Case Report. 抗gq1b IgG阳性分离性胰腺小脑综合征1例
IF 0.7
Neurohospitalist Pub Date : 2025-08-06 DOI: 10.1177/19418744251367176
Iyas Daghlas, Liza Solovey, Vanja C Douglas
{"title":"Isolated Pancerebellar Syndrome With anti-GQ1b IgG Positivity: A Case Report.","authors":"Iyas Daghlas, Liza Solovey, Vanja C Douglas","doi":"10.1177/19418744251367176","DOIUrl":"10.1177/19418744251367176","url":null,"abstract":"<p><strong>Background: </strong>Ataxia is a hallmark of the anti-GQ1b antibody syndrome, though it is unclear whether this symptom arises primarily from sensory nerve injury or from cerebellar involvement. We report a case of a patient with a clinically isolated post-infectious pancerebellar syndrome with anti-GQ1b antibody positivity.</p><p><strong>Case presentation: </strong>A 22-year-old previously healthy woman presented with acute-onset, progressive imbalance, limb ataxia, and dysarthria following an upper respiratory tract infection. She had no paresthesias, numbness, or diplopia. Neurological examination revealed an isolated pancerebellar syndrome including ocular and limb dysmetria, intention tremor, and gait ataxia. All sensory modalities were unaffected, reflex testing was normal, and there was no ophthalmoplegia. In-hospital serum and CSF testing was unremarkable, and brain magnetic resonance imaging was normal. The patient was empirically treated with intravenous immunoglobulin. Her symptoms were moderately improved by discharge (hospital day 5), and fully resolved several months later. Serological testing sent during the hospitalization subsequently revealed anti-GQ1b IgG positivity.</p><p><strong>Conclusions: </strong>This case expands the spectrum of anti-GQ1b syndrome to include isolated cerebellar ataxia, suggesting that ataxia in this syndrome can have cerebellar origin. Clinicians should consider anti-GQ1b testing in cases of acute cerebellar ataxia following infection.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251367176"},"PeriodicalIF":0.7,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817868","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
Reversible Diffusion-Restricting White Matter Lesions in Sickle Cell Disease During Pain Crises: A Case Report. 镰状细胞病疼痛危象中可逆性限制扩散的白质病变1例报告。
IF 0.7
Neurohospitalist Pub Date : 2025-08-05 DOI: 10.1177/19418744251367181
Sangharsha Thapa, Meyer Herzog, Esewi Aifuwa, Joseph Quintas, Amir Steinberg, Sana Ali, Tomoko Kitago
{"title":"Reversible Diffusion-Restricting White Matter Lesions in Sickle Cell Disease During Pain Crises: A Case Report.","authors":"Sangharsha Thapa, Meyer Herzog, Esewi Aifuwa, Joseph Quintas, Amir Steinberg, Sana Ali, Tomoko Kitago","doi":"10.1177/19418744251367181","DOIUrl":"10.1177/19418744251367181","url":null,"abstract":"<p><p>Sickle cell disease (SCD) is a chronic hemoglobinopathy characterized by recurrent vaso-occlusive events and significant neurological morbidity. While ischemic and hemorrhagic strokes are well-known complications, reversible diffusion-restricting white matter lesions are exceedingly rare and underreported. We present the case of an 18-year-old male with homozygous SCD (HbSS) who developed acute neurological deterioration during a vaso-occlusive pain crisis. MRI revealed symmetric areas of restricted diffusion and FLAIR hyperintensities in the splenium of the corpus callosum and periventricular white matter, typically associated with cytotoxic edema and irreversible injury. Remarkably, the patient experienced near-complete neurological recovery with aggressive disease-targeted therapy, including hydroxyurea, voxelotor, and serial exchange transfusions. Follow-up MRI at 4 months showed complete resolution of the prior abnormalities. This case underscores the importance of recognizing potentially reversible diffusion-restricting lesions in SCD and challenges the conventional interpretation of restricted diffusion as a marker of permanent injury. Early recognition, comprehensive management, and serial neuroimaging may improve neurological outcomes in similar cases. Clinicians should maintain a high index of suspicion for reversible white matter injury when evaluating patients with sickle cell disease presenting with acute neurological symptoms. Incorporating serial neuroimaging and a multidisciplinary treatment approach is essential for timely diagnosis and optimizing neurological recovery in this vulnerable population.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251367181"},"PeriodicalIF":0.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800522","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 56-year-Old Woman With Initial Severe Electrolyte Imbalance Who Developed Altered Mental Status, Psychosis and Catatonia. 一位56岁女性,最初出现严重的电解质失衡,后来出现精神状态改变、精神错乱和紧张症。
IF 0.7
Neurohospitalist Pub Date : 2025-08-01 DOI: 10.1177/19418744251364125
Mariana Peschard-Franco, Enrique Piña-Rosales, Anwar García-Santos
{"title":"A 56-year-Old Woman With Initial Severe Electrolyte Imbalance Who Developed Altered Mental Status, Psychosis and Catatonia.","authors":"Mariana Peschard-Franco, Enrique Piña-Rosales, Anwar García-Santos","doi":"10.1177/19418744251364125","DOIUrl":"10.1177/19418744251364125","url":null,"abstract":"<p><p>Patients with acute psychiatric and cognitive symptoms can be challenging to evaluate, particularly in the context of renal or metabolic alterations. A 56-year-old woman initially presented with abdominal pain and vomiting, with no findings on physical examination. A severe chronic hypovolemic hypotonic hyponatremia was acknowledged in the lab work, leading to admission for sodium replacement and electrolyte imbalance correction. Two weeks later the patient developed altered mental status, agitation, psychosis and catatonia. This case highlights the diagnostic approach to patients with encephalopathy. Readers are guided through this stepwise approach, considering a wide range of differential diagnosis, including metabolic, infectious, autoimmune and paraneoplastic etiologies, with an extensive workup, ultimately arriving at the leading diagnosis.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251364125"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776513","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
Continuous Intrathecal Milrinone Administration via IRRAflow Intraventricular Catheter for Refractory Cerebral Vasospasm in Subarachnoid Hemorrhage: A Case Report. 经脑室导管持续鞘内注射米力农治疗蛛网膜下腔出血难治性脑血管痉挛1例。
IF 0.7
Neurohospitalist Pub Date : 2025-07-30 DOI: 10.1177/19418744251362522
Hayley G Williams, Christine Ahrens, Joao A Gomes, Mark Bain, Catherine Hassett
{"title":"Continuous Intrathecal Milrinone Administration via IRRA<i>flow</i> Intraventricular Catheter for Refractory Cerebral Vasospasm in Subarachnoid Hemorrhage: A Case Report.","authors":"Hayley G Williams, Christine Ahrens, Joao A Gomes, Mark Bain, Catherine Hassett","doi":"10.1177/19418744251362522","DOIUrl":"10.1177/19418744251362522","url":null,"abstract":"<p><strong>Background/objective: </strong>The IRRA<i>flow</i> device combines intracerebroventricular (ICV) medication infusion, cerebrospinal fluid (CSF) irrigation, and continuous intracranial pressure (ICP) monitoring. While ICV milrinone is conventionally given as a bolus to manage vasospasm after aneurysmal subarachnoid hemorrhage (aSAH), this case presents the use of continuous ICV milrinone infusion via IRRA<i>flow</i> in a patient with refractory cerebral vasospasm following aSAH.</p><p><strong>Results: </strong>A 47-year-old female with aSAH (Hunt Hess 2, Modified Fisher Grade 4) underwent coil embolization for a ruptured left PICA aneurysm. Despite standard management, severe vasospasm was detected in the bilateral middle cerebral arteries and basilar arteries on hospital day 6. Following initiation of systemic milrinone IV and intra-arterial verapamil treatment, subsequent transcranial Doppler (TCD) and CT angiogram revealed persistent vasospasm. Elevated ICPs precluded further angiography or ICV bolus therapy through the existing external ventricular drain (EVD). An IRRA<i>flow</i> catheter was inserted intraventricularly for continuous CSF drainage and ICV milrinone administration (2.6 mg/kg/day). Over days 8 to 12, vasospasm improved significantly, ICP normalized, and neurologic examination permitted extubation. Continuous ICV milrinone therapy was tapered over 5 days, and the IRRA<i>flow</i> system removed on day 14 without complications, leading to discharge for acute rehabilitation. Patient consent for case publication was documented per institutional protocol.</p><p><strong>Conclusions: </strong>Continuous intrathecal milrinone infusion via IRRA<i>flow</i> may be a feasible adjunct for treating refractory vasospasm after aSAH. After the combined use of ICV milrinone via the IRRA<i>flow</i> catheter with standard-of-care therapies for severe vasospasm, the patient demonstrated favorable clinical and radiographic improvement without complications.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251362522"},"PeriodicalIF":0.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776514","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 Young Man with Altered Mental Status, Rigidity, and Hyperthermia. 一位精神状态改变、僵硬和体温过高的年轻人。
IF 0.7
Neurohospitalist Pub Date : 2025-07-29 DOI: 10.1177/19418744251364117
Ahmed Alsakha, Daniella Giardina, Nicholas Cochran-Caggiano, Andrew Curtin, Devin J Burke, Sarah G Burke
{"title":"A Young Man with Altered Mental Status, Rigidity, and Hyperthermia.","authors":"Ahmed Alsakha, Daniella Giardina, Nicholas Cochran-Caggiano, Andrew Curtin, Devin J Burke, Sarah G Burke","doi":"10.1177/19418744251364117","DOIUrl":"10.1177/19418744251364117","url":null,"abstract":"<p><p><b>Background</b>: We present a case report of a 24 year-old male who presented with encephalopathy, rigidity, and hyperthermia after receiving his medication. In this report, we guide you through the approach, differential diagnosis, investigation, and treatment modalities for similar presentations.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251364117"},"PeriodicalIF":0.7,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12307332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761761","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
Subarachnoid Hemorrhage, CNS Vasculitis and Stroke as a Sequela of Q Fever Infection. Q热感染的后遗症:蛛网膜下腔出血、中枢神经系统血管炎和中风。
IF 0.9
Neurohospitalist Pub Date : 2025-07-18 DOI: 10.1177/19418744251361313
Melinda C Arthur, Christopher S Medina, Erin Penn, Hector Ojeda-Martinez, Elie Dancour, Paul Wright
{"title":"Subarachnoid Hemorrhage, CNS Vasculitis and Stroke as a Sequela of Q Fever Infection.","authors":"Melinda C Arthur, Christopher S Medina, Erin Penn, Hector Ojeda-Martinez, Elie Dancour, Paul Wright","doi":"10.1177/19418744251361313","DOIUrl":"10.1177/19418744251361313","url":null,"abstract":"<p><p>A 64-year-old female with a history of Subarachnoid Hemorrhage (SAH) of non-aneurysmal origin underwent 4 cerebral Digital Subtraction Angiography (cDSA) studies to investigate the cause of the SAH. All angiograms were unrevealing. Two years and 3 months following her SAH, she presented to the emergency department with ataxia and aphasia. Magnetic Resonance Imaging (MRI) of the brain without contrast showed a right posterior parietal lobe stroke with a watershed appearance and a chronic right cerebellar infarct with encephalomalacia. Repeat cDSA showed stenosis in the right A3 of the Anterior Cerebral Artery (ACA) and right M2 of the Middle Cerebral Artery (MCA) suggesting CNS vasculitis. Known reversible and secondary causes of CNS vasculitis were tested and found to be negative. However, Indirect Immunofluorescence Assay (IFA) testing revealed a high titer of IgG phase II Coxiella indicating acute Q fever. CDC lab findings from 10 years earlier also showed a high titer IgG phase II Coxiella, indicating untreated Q fever prior to the SAH event. A whole-body Positron Emission Tomography (PET) scan was negative for systemic or CNS vasculitis. The patient was treated for Q fever and CNS vasculitis with 1 year of doxycycline and hydroxychloroquine. There was no recurrence of symptoms 15 months after treatment. We conclude that Q fever can present with SAH in addition to CNS vasculitis and stroke.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251361313"},"PeriodicalIF":0.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676076","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
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