Marchiafava-Bignami Disease in Crohn's Disease

No abstract available.

Asymmetric and Upper Body Parkinsonism in Patients with Idiopathic Normal-Pressure Hydrocephalus

BACKGROUND AND PURPOSE: Our aims were to analyze the characteristics of parkinsonian features and to characterize changes in parkinsonian motor symptoms before and after the cerebrospinal fluid tap test (CSFTT) in idiopathic normal-pressure hydrocephalus (INPH) patients. METHODS: INPH subjects were selected in consecutive order from a prospectively enrolled INPH registry. Fifty-five INPH patients (37 males) having a positive response to the CSFTT constituted the final sample for analysis. The mean age was 73.7±4.7 years. The pre-tap mean Unified Parkinson's Disease Rating Scale motor (UPDRS-III) score was 24.5±10.2. RESULTS: There was no significant difference between the upper and lower body UPDRS-III scores (p=0.174). The parkinsonian signs were asymmetrical in 32 of 55 patients (58.2%). At baseline, the Timed Up and Go Test and 10-meter walking test scores were positively correlated with the total motor score, global bradykinesia score, global rigidity score, upper body score, lower body score, and postural instability/gait difficulties score of UPDRS-III. After the CSFTT, the total motor score, global bradykinesia score, upper body score, and lower body score of UPDRS-III significantly improved (p<0.01). There was a significant decrease in the number of patients with asymmetric parkinsonism (p<0.05). CONCLUSIONS: In the differential diagnosis of elderly patients presenting with asymmetric and upper body parkinsonism, we need to consider a diagnosis of INPH. The association between gait function and parkinsonism severity suggests the involvement of similar circuits producing gait and parkinsonian symptoms in INPH.

Concomitant Small Intracerebral Hemorrhage in a Patient with Cerebral Amyloid Angiopathy Mimicking Transient Ischemic Attack

No abstract available.

Cerebrospinal Fluid Tap Test in Idiopathic Hydrocephalus Patient with an Evans' Index Less Than 0.3

A 73-year-old man presented with progressive gait impairment. He exhibited slow, shuffling, and unstable gait. A formal neuropsychological evaluation revealed memory deficits with frontal dysfunction. Brain MRI revealed communicating hydrocephalus with an Evans' index of 0.27. After cerebrospinal fluid (CSF) removal by lumbar puncture, the patient exhibited a marked improvement in gait. A CSF tap test after careful clinical examination may need to be considered in the diagnosis of idiopathic hydrocephalus with an Evans' index of <0.3.

Forced Arterial Suction Thrombectomy of Septic Embolic Middle Cerebral Artery Occlusion Due to Infective Endocarditis: an Illustrative Case and Review of the Literature / 신경중재치료의학

In acute ischemic stroke patients with major intracranial vessel occlusion due to infective endocarditis, treatment modalities are not well established. A 40-year-old woman presented with acute stroke due to left middle cerebral artery occlusion. She was successfully treated with intra-arterial mechanical thrombectomy, and the subsequent clinical outcome was favorable. Pathological analysis of the retrieved clots showed septic thrombi containing gram-positive cocci. Based on literature review and the present case regarding treatment strategies for patients with septic embolic stroke, pharmacological thrombolysis might increase the risk of hemorrhagic complications, which might alter clinical outcome. Therefore, we can consider intra-arterial mechanical thrombectomy as a first-line treatment option in patients with acute stroke resulting from infective endocarditis.