Case Reports in Neurology最新文献_第9页

Multiple Dural Arteriovenous Fistulas as the Mystery of Rapidly Progressive Dementia with Bilateral Thalamic Lesions. 多发性硬脑膜动静脉瘘是伴有双侧丘脑病变的快速进展性痴呆的奥秘。

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Case Reports in Neurology Pub Date : 2022-09-01 DOI: 10.1159/000527076

Yu Zhan, Murad Al-Nusaif, Chang Xu, Jiahao Li, Li Zhao, Feng Wang, Chunbo Dong

{"title":"Multiple Dural Arteriovenous Fistulas as the Mystery of Rapidly Progressive Dementia with Bilateral Thalamic Lesions.","authors":"Yu Zhan, Murad Al-Nusaif, Chang Xu, Jiahao Li, Li Zhao, Feng Wang, Chunbo Dong","doi":"10.1159/000527076","DOIUrl":"https://doi.org/10.1159/000527076","url":null,"abstract":"Dementia is a gradual and irreversible loss of higher mental function, particularly memory. Dural arteriovenous fistulas (DAVFs) are one of the rare causes of a rapid decline in cognitive function, which can be curable. DAVFs are pathological shunts between the dural artery and the dural venous sinus, dural vein, or cortical vein. Here, we present a case that initially manifested nausea and dizziness and developed rapidly progressive dementia caused by DAVFs in the left transverse sinus-sigmoid sinus junction area and the sinus confluence area, combined with cerebral venous sinus thrombosis. Moreover, our case has multiple DAVFs that cause bilateral thalamic lesions and rapidly progressive dementia called thalamic dementia, which is infrequent and often misdiagnosed. His symptoms have improved after receiving endovascular embolization treatment. In addition to presenting our case, we conducted a systemic literature review to summarize how familiarity with the manifestation and early diagnosis of bilateral thalamic lesions caused by DAVFs can lead to earlier and more effective therapy.","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"14 3","pages":"404-412"},"PeriodicalIF":0.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/08/48/crn-0014-0404.PMC9830287.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10532560","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 Masks May Hide Neurological Diagnoses. 外科口罩可能隐藏神经学诊断。

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Case Reports in Neurology Pub Date : 2022-09-01 DOI: 10.1159/000526716

Martin S Gizzi, Ryan J Mason, Andrew Amaranto

{"title":"Surgical Masks May Hide Neurological Diagnoses.","authors":"Martin S Gizzi, Ryan J Mason, Andrew Amaranto","doi":"10.1159/000526716","DOIUrl":"https://doi.org/10.1159/000526716","url":null,"abstract":"COVID-19 has disrupted the routine flow of patients through emergency departments (EDs) across the globe, including the need to consider COVID-19 for nearly all presenting complaints. The constraints of mask wearing and isolation have created inherent barriers to timely stroke care. We present a case that highlights one of the many ways in which the pandemic has negatively impacted the care of the non-COVID patient. A patient presented to the ED with a chief complaint of diffuse weakness and a new-onset cough on awakening. His daughter noted that he was slurring his words. An emergency medicine resident evaluated him, ordered laboratory studies, and decided to monitor the patient. The same resident later noted the patient veering to the left when walking, prompting a more detailed neurological examination. On removing the patient's facemask, a left lower facial weakness was evident. The resident called a Code Stroke roughly 50 min after the patient initially presented to the ED. The patient proved to have an acute infarct at the right thalamocapsular junction. Universal masking policies during the COVID-19 pandemic should not prevent the routine assessment of cranial nerve function for all patients presenting to an ED.","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"14 3","pages":"377-380"},"PeriodicalIF":0.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d0/69/crn-0014-0377.PMC9941768.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9321535","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: 1

The Usefulness of Swallowing Pressure Assessment in the Identification of Mild Pharyngeal Weakness of Myasthenia Gravis: A Case Report. 吞咽压力评估在重症肌无力轻度咽部无力诊断中的价值1例。

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Case Reports in Neurology Pub Date : 2022-09-01 DOI: 10.1159/000526399

Kenjiro Kunieda, Yuichi Hayashi, Nobuaki Yoshikura, Tomohisa Ohno, Akio Kimura, Ichiro Fujishima, Takayoshi Shimohata

{"title":"The Usefulness of Swallowing Pressure Assessment in the Identification of Mild Pharyngeal Weakness of Myasthenia Gravis: A Case Report.","authors":"Kenjiro Kunieda, Yuichi Hayashi, Nobuaki Yoshikura, Tomohisa Ohno, Akio Kimura, Ichiro Fujishima, Takayoshi Shimohata","doi":"10.1159/000526399","DOIUrl":"https://doi.org/10.1159/000526399","url":null,"abstract":"Despite the clinical impact of dysphagia in myasthenia gravis (MG), a standard protocol for diagnosing dysphagia reliably has not yet been established. High-resolution manometry (HRM) provides precise information on pharyngeal pressure. We hypothesized that swallowing pressure assessment using HRM during the edrophonium chloride (EC) test could identify mild bulbar symptoms with no abnormalities on videoendoscopic (VE) and videofluorographic (VF) examination of swallowing, and we tested this hypothesis on a 72-year-old female patient diagnosed with ocular MG who developed slight pharyngeal discomfort over 3 months. The patient's ocular symptoms were stable with pyridostigmine medication. VE and VF revealed no abnormalities. The swallowing pressure along the pharynx was measured using HRM during the EC test. HRM parameters, including velopharyngeal contractile integral and meso-hypopharyngeal contractile integral, were evaluated. These parameters were assessed for three swallows using 3 mL of water. After EC injection, the values of the velopharyngeal contractile integral (78.0 ± 5.4 vs. 134.7 ± 1.3 mm Hg cm·s) and the meso-hypopharyngeal contractile integral were both higher (130.6 ± 1.5 vs. 284.2 ± 11.9 mm Hg cm·s) than those observed before EC injection. Chest computed tomography revealed a thymoma that had not been observed in previous examinations. The patient was diagnosed with thymoma-associated MG. Intravenous immunoglobulin therapy improved the mild dysphagia. We concluded that swallowing pressure assessment during the EC test may be helpful in identifying mild bulbar symptoms in patients with MG.","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"14 3","pages":"372-376"},"PeriodicalIF":0.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/2d/crn-0014-0372.PMC9941770.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9321536","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

The Development of Pulmonary Edema after Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke Patient; Neurogenic or Non-Neurogenic? 重组组织型纤溶酶原激活剂对急性缺血性脑卒中患者肺水肿的影响神经源性还是非神经源性?

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Case Reports in Neurology Pub Date : 2022-08-30 eCollection Date: 2022-05-01 DOI: 10.1159/000526250

Ahmad Sulaiman Alwahdy, Ika Yulieta Margaretha Sihombing, Fitria Tahta Alfina, Niken Syahdian, Putri Nurbaeti, Annisa Futihandayani, Allifka Ramadhanti

引用次数: 0

Clinical Reasoning: Wilbrand's Knee, Scotoma of Traquair, and Normal Tension Glaucoma. 临床推论:Wilbrand’s Knee, Traquair暗点，和Normal Tension青光眼。

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Case Reports in Neurology Pub Date : 2022-08-30 eCollection Date: 2022-05-01 DOI: 10.1159/000525799

Francesco Pellegrini, Alessandra Cuna, Daniele Cirone, Cristina Ciabattoni, Ettore Caruso, Emanuela Interlandi, Antonio Zappacosta

引用次数: 0

Neurosarcoidosis Presenting with Prominent Periventricular White-Matter Lesions during Steroid Treatment for Autoimmune Hepatitis. 自身免疫性肝炎类固醇治疗期间出现显著脑室周围白质病变的神经结节病。

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Case Reports in Neurology Pub Date : 2022-08-19 eCollection Date: 2022-05-01 DOI: 10.1159/000526223

Tomoya Shibahara, Fumitaka Yoshino, Mikiaki Matsuoka, Masaki Tachibana, Kuniyuki Nakamura, Tetsuro Ago, Junya Kuroda, Hiroshi Nakane

{"title":"Neurosarcoidosis Presenting with Prominent Periventricular White-Matter Lesions during Steroid Treatment for Autoimmune Hepatitis.","authors":"Tomoya Shibahara, Fumitaka Yoshino, Mikiaki Matsuoka, Masaki Tachibana, Kuniyuki Nakamura, Tetsuro Ago, Junya Kuroda, Hiroshi Nakane","doi":"10.1159/000526223","DOIUrl":"https://doi.org/10.1159/000526223","url":null,"abstract":"A 63-year-old woman under treatment of autoimmune hepatitis presented with headache, memory loss, and somnolence. Three months before admission, the patient experienced liver inflammation relapse after prednisolone (PSL) cessation. Consequently, PSL was resumed and then tapered. Cerebrospinal fluid (CSF) examination showed lymphocytic pleocytosis with remarkably reduced glucose and elevated angiotensin-converting enzyme and soluble interleukin-2 receptor levels. Magnetic resonance imaging (MRI) revealed prominent bilateral periventricular white-matter lesions, hydrocephalus, ischemic stroke with gadolinium enhancement of frontoparietal and basilar meninges on contrast-enhanced fluid-attenuated inversion recovery. Magnetic resonance angiography (MRA) showed narrowing of the bilateral middle cerebral arteries. Based on these findings, we diagnosed the patient with neurosarcoidosis. Re-increment of PSL improved the neurological symptoms, CSF findings, and abnormalities found on MRI and MRA. This case suggests that neurosarcoidosis may occur as a complication of some autoimmune diseases during immunotherapy administration.","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"14 2","pages":"334-340"},"PeriodicalIF":0.7,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/41/d0/crn-0014-0334.PMC9459521.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33486648","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

Immunocompetence after SARS-CoV-2 Infection in a Patient with Multiple Sclerosis Treated with Ofatumumab: A Case Report. Ofatumumab治疗多发性硬化症患者感染SARS-CoV-2后的免疫能力:1例报告

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Case Reports in Neurology Pub Date : 2022-08-16 eCollection Date: 2022-05-01 DOI: 10.1159/000524946

Elżbieta Jasińska

{"title":"Immunocompetence after SARS-CoV-2 Infection in a Patient with Multiple Sclerosis Treated with Ofatumumab: A Case Report.","authors":"Elżbieta Jasińska","doi":"10.1159/000524946","DOIUrl":"https://doi.org/10.1159/000524946","url":null,"abstract":"Ofatumumab is the first fully human anti-CD20 monoclonal antibody that, on March 26, 2021, was approved by the EMA to treat patients with relapsing multiple sclerosis. This paper aimed to present a case confirming the ability to produce and maintain anti-SARS-CoV-2 antibodies in a patient treated with ofatumumab for over 4 years. The course of the infection was moderate, and the patient did not require hospitalization. Antibody measurements were performed five times post-COVID-19 infection. The first test was performed in the fourth month (131 days), and the last, over 1 year after the infection. To date, only 2 cases have been published describing the ability of a patient treated with the same drug to produce antibodies against SARS-CoV-2, although the observation was conducted over a shorter period. In our case study, we have 15-month follow-up data. The patient was not vaccinated and additionally received suppressive steroid therapy due to the relapse. We observed an increase in antibodies up to 10 months from the infection. The case under analysis suggests that patients treated with ofatumumab, despite complete peripheral B-cell depletion, can produce and maintain a long-lasting immune response.","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"14 2","pages":"320-325"},"PeriodicalIF":0.7,"publicationDate":"2022-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/06/crn-0014-0320.PMC9459643.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33486653","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: 1

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Case Reports in Neurology Pub Date : 2022-08-16 eCollection Date: 2022-05-01 DOI: 10.1159/000525908

Monami Tarisawa, Takahiro Kano, Daiki Tanaka, Masanao Yoshino, Hideki Houzen

引用次数: 0

Myasthenia Gravis Complicated by Eosinophilic Granulomatosis with Polyangiitis: A Case Report. 重症肌无力合并嗜酸性肉芽肿病合并多血管炎1例。

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Case Reports in Neurology Pub Date : 2022-07-11 eCollection Date: 2022-05-01 DOI: 10.1159/000525702

Takahumi Uchi, Shingo Konno, Hideo Kihara, Mari Matsushima, Hideki Sugimoto, Toshiaki Oharaseki, Kei Takahashi, Toshiki Fujioka

引用次数: 0

A Case of Perimesencephalic Subarachnoid Hemorrhage with Cerebral Venous Sinus Thrombosis due to Stenosis of the Junction of the Vein of Galen and Rectus Sinus. 脑实质周围蛛网膜下腔出血合并脑静脉窦血栓形成1例，原因是盖伦静脉与直静脉窦交界处狭窄。

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Case Reports in Neurology Pub Date : 2022-07-08 eCollection Date: 2022-05-01 DOI: 10.1159/000525506

Kyoya Sakashita, Kei Miyata, Ryohei Saito, Ryota Sato, Sangnyon Kim, Nobuhiro Mikuni

{"title":"A Case of Perimesencephalic Subarachnoid Hemorrhage with Cerebral Venous Sinus Thrombosis due to Stenosis of the Junction of the Vein of Galen and Rectus Sinus.","authors":"Kyoya Sakashita, Kei Miyata, Ryohei Saito, Ryota Sato, Sangnyon Kim, Nobuhiro Mikuni","doi":"10.1159/000525506","DOIUrl":"https://doi.org/10.1159/000525506","url":null,"abstract":"Perimesencephalic subarachnoid hemorrhage (PMSAH) is a group of diseases characterized by bleeding around the brainstem. In recent years, it has been suggested that PMSAH is associated with the venous system. We report a case of PMSAH caused by stenosis of the junction of the vein of Galen (VG) and the rectus sinus (RS). A 39-year-old man presented with restlessness at work. He was administered diazepam, and a few minutes later, his consciousness became clear. Imaging showed subarachnoid hemorrhage (SAH) around the right midbrain, occlusion of the right sigmoid sinus and the right transverse sinus, stenosis of the junction of the VG and RS, T2 hyperintensity in the right middle temporal gyrus, and obstruction of the right vein of Labbe. The location of the SAH coincided with stenosis of the junction of the VG and RS. PMSAH was diagnosed due to the increase in intracranial venous pressure caused by the patient's sinus obstruction in addition to the stenosis of the junction of the VG and RS. It is necessary to pay attention to venous return when PMSAH is observed.","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"14 2","pages":"307-313"},"PeriodicalIF":0.7,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8e/32/crn-0014-0307.PMC9386415.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33486601","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