RESUMO
Herpes simplex encephalitis (HSE) is the most common type of viral encephalitis and a fourteen day administration of acyclovir is well-known as the treatment of choice for HSE. Occasionally HSE relapses, but rarely with acyclovir treatment. We report a case of relapsing HSE after treatment with acyclovir for 14 days. Our case suggests that patients with progressive high signal intensities in diffusion-weighted brain MRIs might need longer antiviral therapy over 14 days for preventing the relapse of herpes simplex encephalitis.
Assuntos
Humanos , Aciclovir , Encéfalo , Encefalite por Herpes Simples , Encefalite Viral , Herpes Simples , Imageamento por Ressonância Magnética , RecidivaRESUMO
Taste disorder is not rare in patients with acute stroke is not usually evaluated. There is also controversy about central gustatory pathways. We report one case of ipsilateral hemiaguesia induced by a right middle cerebral artery infarction. A right-handed 70-year-old woman presented with headache. She had a history of hypertension and diabetes mellitus. The systemic examination revealed no abnormalities. Neurologic examination revealed left side hemispatial neglect and right side hemiageusia. Brain MRI showed high signal intensity in the right middle cerebral artery territory including the temporal lobe and parietal lobe with sparing insular cortex on T2 and diffusion weighted image (DWI). This case is suggestive of the existence of an uncrossed ascending gustatory pathway, explaining the ipsilateral hemiageusia above the midbrain lesion.
Assuntos
Idoso , Feminino , Humanos , Encéfalo , Diabetes Mellitus , Difusão , Disgeusia , Cefaleia , Hipertensão , Infarto da Artéria Cerebral Média , Imageamento por Ressonância Magnética , Mesencéfalo , Artéria Cerebral Média , Exame Neurológico , Lobo Parietal , Transtornos da Percepção , Acidente Vascular Cerebral , Distúrbios do Paladar , Lobo TemporalRESUMO
Antiphospholipid syndrome may be associated with various neurologic conditions. Pseudotumor cerebri is a rare complication of the disease and is often attributed to venous thrombosis. We report a 18-year-old woman with pseudotumor cerebri due to primary antiphospholipid syndrome. She has normal findings on MR venography. Antiphospholipid syndrome should be considered in the differential diagnosis of pseudotumor cerebri, even in the patients without evidence of venous thrombosis on MR angiography.
Assuntos
Adolescente , Feminino , Humanos , Angiografia , Síndrome Antifosfolipídica , Diagnóstico Diferencial , Flebografia , Pseudotumor Cerebral , Trombose VenosaRESUMO
A case was presented of a 41-year-old male with progressive claudication and numbness in the lower extremities. A MRI showed swelling of the spinal cord with an intramedullary high signal intensity on a T2-weighted image. The patient was diagnosed with transverse myelitis and was started on intravenous steroids. However, there were no significant effects with the steroid treatment. An angiography showed a spinal dural arteriovenous fistula fed by a T11 radicular artery. An endovascular embolization was performed and the claudication and numbness were improved. We report a case of spinal dural arteriovenous fistula misdiagnosed as transverse myelitis.