RESUMEN
Spontaneous cervical epidural hematoma (SCEH) is a rare condition that causes paraparesis or quadriparesis. As spontaneous resolution is seldom expected, it usually requires surgical treatment for relieve symptoms. Even if spontaneous resolution occurs, relief from symptoms usually requires several hours to days. In contrast, hemiparesis is the most common symptom of a transient ischemic attack (TIA), and usually resolves over minutes to hours. We report here two patients with SCEH who presented with hemiparesis with severe neck pain. Both patients were taking antiplatelet drugs. Their neurological symptoms recovered spontaneously over a very short time. They were initially misdiagnosed as TIA. These cases show that patients with transient hemiparesis may have SCEH if there is severe neck pain and no cranial nerve involvement.
RESUMEN
Cilostazol is a phosphodiesterase inhibitor that has been shown to have similar efficacy in stroke prevention but fewer hemorrhagic events compared with aspirin. We report a case of spontaneous spinal epidural hematoma (SSEH) in a 67-year-old woman who has been treated with cilostazol for cerebral infarction. The patient was presented with sudden neck pain and right hemiparesis. Thirteen days after the onset, she recovered completely. Even cilostazol, which is a relatively safer drug in terms of bleeding risk compared to other antiplatelet agents, may cause SSEH. Therefore, physicians should keep in mind rare, but potentially fatal, bleeding complications such as SSEH when prescribing antiplatelet agents.
Asunto(s)
Femenino , Humanos , Aspirina , Infarto Cerebral , Hematoma Espinal Epidural , Hemorragia , Dolor de Cuello , Paresia , Inhibidores de Agregación Plaquetaria , Accidente Cerebrovascular , TetrazolesRESUMEN
A severe, but reversible encephalitis associated with antibodies to the N-methyl-D-aspartate receptor (NMDAR) was identified recently in young women with ovarian teratoma. This condition has not been reported previously in Korea. A 31-year-old woman presented with fever and behavioral disturbances; she became comatose several days later, and dyskinesia and dysautonomia developed thereafter. Antibodies to the NMDAR were positive and abdominal computed tomography detected a large ovarian teratoma. The patient improved dramatically after the removal of the teratoma and administration of corticosteroid therapy.
Asunto(s)
Adulto , Femenino , Humanos , Encefalitis Antirreceptor N-Metil-D-Aspartato , Anticuerpos , Coma , Discinesias , Encefalitis , Fiebre , Corea (Geográfico) , N-Metilaspartato , Disautonomías Primarias , TeratomaRESUMEN
Listeria myelitis is known to be very rare and not reported yet in Korea. A 78-year-old man with diabetes mellitus and hepatocellular carcinoma presented altered mentality, paraparesis, and fever. His spinal cord MRI, cerebrospinal fluid study, and blood culture demonstrated thoracic myelitis caused by Listeria monocytogenes. This case suggests that listeria myelitis should be considered as one of the causes of non-tumorous myelopathy especially in immunocompromised patients.