{"title":"\"Sentinel Oculomotor Nerve Palsy\": A Harbinger of Subarachnoid Hemorrhage.","authors":"Vijay Renga","doi":"10.1155/crnm/6786272","DOIUrl":"10.1155/crnm/6786272","url":null,"abstract":"<p><p>Subarachnoid hemorrhage (SAH) is a life-threatening condition most commonly caused by aneurysmal rupture. Sentinel headaches, often described as the \"worst headache of life\" or a \"thunderclap headache,\" are critical warning signs that may precede SAH. However, atypical headaches can complicate early diagnosis. Oculomotor nerve palsy, though rare, may occur as a complication of both aneurysmal and nonaneurysmal SAH. We report a unique case of a 64-year-old woman who initially presented with atypical headache followed by isolated oculomotor nerve palsy, preceding the onset of a nonaneurysmal SAH. This case highlights isolated oculomotor palsy as a potential unrecognized sentinel sign of SAH.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"6786272"},"PeriodicalIF":0.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109502","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}
Thomas Zeyen, Thomas Klockgether, Christina Schaub, Daniel Paech, Timo Vogt, Delia Kurzwelly
{"title":"Cerebellar Hemorrhage Masquerading as Unilateral Vestibulopathy: A Case Report.","authors":"Thomas Zeyen, Thomas Klockgether, Christina Schaub, Daniel Paech, Timo Vogt, Delia Kurzwelly","doi":"10.1155/crnm/9611619","DOIUrl":"https://doi.org/10.1155/crnm/9611619","url":null,"abstract":"<p><p>Pseudovestibular syndrome refers to central pathologies that mimic acute unilateral peripheral vestibulopathy, often posing a diagnostic challenge, particularly when key symptoms indicating a central origin are absent. The most common etiology is brain ischemia resulting from posterior inferior cerebellar artery occlusion. This article presents a rare case of a left paramedian cerebellar hemorrhage initially misdiagnosed as right-sided vestibular neuritis. Cerebellar hemorrhage can induce pseudovestibular syndrome by disrupting the connective fibers from the flocculus to the ipsilateral vestibular nucleus in the pons. Additionally, central pathologies affecting the vestibular system may occasionally manifest a pathological vestibulo-ocular reflex. This case report underscores the importance of considering potentially severe central-origin conditions in the differential diagnosis of seemingly benign unilateral peripheral vestibulopathy.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"9611619"},"PeriodicalIF":0.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076234","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":"Chronic Inflammatory Demyelinating Polyneuropathy Following Natural Influenza A Infection in a Pediatric Patient: A Case Report and Literature Review.","authors":"Emily Grew, Garrett Gianneschi, Janet Elgallab","doi":"10.1155/crnm/8840308","DOIUrl":"10.1155/crnm/8840308","url":null,"abstract":"<p><p>Chronic inflammatory demyelinating polyneuropathy (CIDP) following viral infections and influenza vaccination has been well documented. However, there have been no confirmed natural influenza A infections leading to development of CIDP. Therefore, we present the case of a 6-year-old male who developed CIDP following a confirmed influenza A infection. Initially presenting with typical flu-like symptoms, the patient experienced a gradual onset of gait instability and leg weakness approximately 1 month later. Despite initial improvement with intravenous immunoglobulin therapy following a diagnosis of Guillain-Barré syndrome, his symptoms relapsed, including lower extremity weakness, incontinence, and sensory loss. Electromyography confirmed a demyelinating polyneuropathy, leading to a diagnosis of CIDP.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"8840308"},"PeriodicalIF":0.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977577","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":"Atypical Presentation of Susac Syndrome in 55-Year-Old: From Unremarkable Stroke Workup to Rapid Diagnosis of \"Snowball Strokes\" and Successful Immunosuppressive Treatment.","authors":"Yasaman Pirahanchi","doi":"10.1155/crnm/3178952","DOIUrl":"https://doi.org/10.1155/crnm/3178952","url":null,"abstract":"<p><p>We report the case of a 55-year-old right-handed female with a medical history of hypothyroidism and gastric bypass surgery. The patient initially presented with cognitive impairment, dizziness, and unsteady gait. Despite an unremarkable stroke workup, her symptoms progressed rapidly within 2 days, leading to subsequent admissions and a complex diagnostic journey revealing Susac syndrome-a rare autoimmune disorder affecting the brain's microvasculature, retina, and cochlea. The patient's treatment involved aggressive immunosuppression with corticosteroids, IVIG, mycophenolate, and cyclophosphamide. The patient responded well and had progressive improvement, with discharge to home. This case highlights the diagnostic challenges and management strategies for Susac syndrome.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"3178952"},"PeriodicalIF":0.9,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977574","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}
Linda Angela Mbah, Parvinder Kaur, Dakshin Meenashi Sundaram, Shubh Mehta, Zenia Elavia, Seyi Olaniyi, Jubran Al Balushi, Jeffrin John Varghese, Archit Kumar Nigam, Mansi Singh
{"title":"Exploring Central Venous Thrombosis as a Rare Postinfectious Complication of Dengue: A Case Report.","authors":"Linda Angela Mbah, Parvinder Kaur, Dakshin Meenashi Sundaram, Shubh Mehta, Zenia Elavia, Seyi Olaniyi, Jubran Al Balushi, Jeffrin John Varghese, Archit Kumar Nigam, Mansi Singh","doi":"10.1155/crnm/5368634","DOIUrl":"10.1155/crnm/5368634","url":null,"abstract":"<p><p>Dengue fever, caused by a flavivirus transmitted through Aedes mosquitoes, presents a spectrum of clinical manifestations ranging from mild to severe. Several neurological complications, including encephalopathy and encephalitis, have been increasingly recognized. Here, we report a case of central venous thrombosis (CVT) as a postinfectious complication of dengue fever. A 38-year-old previously healthy male presented with classic dengue symptoms and later developed persistent headaches and visual disturbances. Neurological examination revealed papilledema, and imaging confirmed CVT involving the superior straight sinus. Prompt initiation of anticoagulant therapy led to gradual improvement in neurological symptoms and partial recanalization of the thrombosed sinus. Our case underscores the importance of considering thrombotic complications in dengue infections, despite the predominance of hemorrhagic manifestations. Understanding pathophysiology and appropriate management of thrombotic events in dengue fever is crucial for favorable patient outcomes.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"5368634"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810531","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}
Abir Zioudi, Hanene Benrhouma, Maha Jamoussi, Thouraya Ben Younes, Zouhour Miladi, Hedia Klaa, Sonia Nagi, Brahim Tabarki, Ilhem Ben Youssef Turki, Ichraf Kraoua
{"title":"Biotinidase Deficiency: Report of a Tunisian Case With Neuromyelitis Optica-Like Presentation and Review of the Literature.","authors":"Abir Zioudi, Hanene Benrhouma, Maha Jamoussi, Thouraya Ben Younes, Zouhour Miladi, Hedia Klaa, Sonia Nagi, Brahim Tabarki, Ilhem Ben Youssef Turki, Ichraf Kraoua","doi":"10.1155/crnm/7003370","DOIUrl":"10.1155/crnm/7003370","url":null,"abstract":"<p><p>Biotinidase deficiency is a rare treatable metabolic disorder caused by biallelic mutations in the <i>BTD</i> gene. In the absence of neonatal screening and treatment, affected children develop typically optic atrophy, hypotonia, early onset seizures, developmental delay, and cutaneous manifestations. Some patients may have atypical presentations mimicking a demyelinating disorder of the central nervous system. We report on the first genetically confirmed Tunisian patient with biotinidase deficiency who presented initially with cutaneous manifestations misdiagnosed as dermatophytosis and subsequently with an opticospinal syndrome leading to the diagnosis of seronegative neuromyelitis optica spectrum disorder that was dramatically improved under biotin. We carry on a review of the literature of the previously reported pediatric cases with an opticospinal syndrome revealing biotinidase deficiency.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"7003370"},"PeriodicalIF":0.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763166","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}
Pacôme Constant Dit Beaufils, Benoît Guillon, Hugues Chabriat, Solène de Gaalon
{"title":"Familial Reversible Cerebral Vasoconstriction Syndrome: Insights From Two Families.","authors":"Pacôme Constant Dit Beaufils, Benoît Guillon, Hugues Chabriat, Solène de Gaalon","doi":"10.1155/crnm/3126513","DOIUrl":"https://doi.org/10.1155/crnm/3126513","url":null,"abstract":"<p><p>Reversible cerebral vasoconstriction syndrome (RCVS) is a rare condition whose exact underlying mechanisms remain undetermined. Herein, we report two exceptional family cases suggesting that a potential genetic factor might be involved in this condition. A mother and her daughter presented with recurrent thunderclap headaches and reversible vasoconstriction of the right middle cerebral artery in the first family. Clinical features suggestive of RCVS associated with a discrete subdural hemorrhage was observed in a mother and her daughter in a second family. These familial observations of RCVS suggest the existence of a genetic factor promoting the emergence of this condition.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"3126513"},"PeriodicalIF":0.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965169","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}
Kyle N Kaneko, Pablo Read, John M Eaton, Yoshie Umemura, Justin L Hoskin
{"title":"Resolution of Refractory Status Epilepticus With Ketamine Without Intubation in a Patient With Stroke-Like Migraine Attacks After Radiation Therapy (SMART) Syndrome.","authors":"Kyle N Kaneko, Pablo Read, John M Eaton, Yoshie Umemura, Justin L Hoskin","doi":"10.1155/crnm/3203322","DOIUrl":"10.1155/crnm/3203322","url":null,"abstract":"<p><p>Stroke-like migraine attacks after radiation therapy (SMART) syndrome is an infrequently reported complication arising years after radiation therapy that manifests as a reversible syndrome marked by migraine-like headaches, focal neurologic signs, and/or seizures. Refractory status epilepticus (RSE) associated with SMART syndrome is rare and can be challenging to treat. Valproic acid has been reported to improve seizures in RSE in SMART syndrome in a few case reports and may be ideal for SMART syndrome, given its use in the treatment of migraines and seizures. Ketamine has been used in RSE and a few instances in SMART syndrome. Here, we present a case of refractory focal status epilepticus in a patient with SMART syndrome who was treated with ketamine, which resolved seizures without the need for intubation.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"3203322"},"PeriodicalIF":0.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11824791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413469","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":"Parietal Meningocele Under the Scalp of a Fetus Diagnosed Based on Volume Contrast Imaging of Prenatal Three-Dimensional Ultrasound Data.","authors":"Akihiro Hasegawa, Masami Kono, Tokumasa Suemitsu, Yuki Ito, Tatsuya Hirotsu, Yuichiro Nonaka, Osamu Samura, Aikou Okamoto","doi":"10.1155/crnm/7401673","DOIUrl":"10.1155/crnm/7401673","url":null,"abstract":"<p><p>Determining the differential diagnosis of small scalp cysts identified on a fetus is difficult. In particular, many physicians have difficulty differentiating small meningoceles from small scalp cysts during the prenatal period. Volume contrast imaging increases contrast between tissues, thereby allowing an enhanced view of target structures. A 15 × 5 mm scalp cyst was identified on a fetus during a prenatal ultrasonography examination performed at 20 weeks of gestation. The cyst was not connected to the blood flow, and did not include the tissue of the brain parenchyma. Ventriculomegaly and other structural abnormalities were not observed. Based on these findings, we suspected a sinus pericranii or fetal epidermal cyst. The size of the fetal scalp cyst was stable, and the growth of the fetus remained normal until birth. The diagnosis of a small meningocele was confirmed postnatally, based on the results of a magnetic resonance imaging examination. Postnatal evaluation of offline volume contrast imaging of prenatal three-dimensional ultrasound data at 22 weeks of gestation revealed a skull bone defect beneath the cyst. Volume contrast imaging can facilitate the prenatal diagnosis of small meningoceles by detecting bone defects on the fetal head.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"7401673"},"PeriodicalIF":0.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000980","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}
Sameen Ejaz, Rabia Nawaz, Fakeha Tariq, Ahmad Nawaz, Safia Bano, Ayesha Aslam, Fawad Khan, Zeeshan Ahmed, Aaqib Rashid, Sana Saqib
{"title":"Chronic Myeloid Leukemia Presenting With Bilateral Optic Neuropathy and Sensorineural Hearing Loss as the First Clinical Presentation: A Case Report.","authors":"Sameen Ejaz, Rabia Nawaz, Fakeha Tariq, Ahmad Nawaz, Safia Bano, Ayesha Aslam, Fawad Khan, Zeeshan Ahmed, Aaqib Rashid, Sana Saqib","doi":"10.1155/crnm/9371576","DOIUrl":"10.1155/crnm/9371576","url":null,"abstract":"<p><p>Chronic myeloid leukemia (CML) is a myeloproliferative disorder that commonly manifests in chronic, accelerated, or blast phase. Typically observed in individuals aged 60-65 years, CML is infrequently diagnosed in adolescents. The usual presentation in late adulthood involves nonspecific symptoms such as fever, fatigue, and weight loss, with rare reports of initial neurological involvement. A 17-year-old male presented with bilateral vision loss and profound hearing loss, alongside a medical history marked by fever, night sweats, and weight loss. A positive tuberculosis contact raised suspicions of tuberculous meningitis, while cervical and inguinal lymphadenopathy suggested the possibility of neurosarcoidosis. Despite clinical signs pointing toward a neurological cause, elevated white blood cell (WBC) count, a bone marrow biopsy, and the identification of BCR-ABL translocation through chromosomal analysis surprisingly revealed a diagnosis of CML in the chronic phase. This case underscores the importance of considering hematological malignancy as a differential in cases of multiple cranial neuropathies, especially if supported by systemic symptoms. Understanding the diverse presentations of CML is essential for clinicians to provide timely and appropriate interventions particularly in young patients where it could mimic other neurological disorders leading to diagnostic challenges and delay in treatment initiation.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"9371576"},"PeriodicalIF":0.9,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969603","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}