RESUMO
Japanese-B virus encephalitis (JE), the most common human endemic and epidemic encephalitis, usually has a uniphasic illness with a variable outcome. A 49-year-old woman with cognitive dysfunction from JE had improved over 3 weeks. Brain MRI revealed multiple lesions in the bilateral thalamus, caudate nuclei and medial temporal lobe. Two weeks after discharge, the patient showed re-aggravation of the cognitive dysfunction and lapsed into coma. We report a patient with JE having showed biphasic illness pattern.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Encéfalo , Coma , Encefalite , Encefalite por Arbovirus , Lobo Temporal , Tálamo , VírusRESUMO
An anaphylactoid reaction to recombinant tissue plasminogen activator (rt-PA) is an uncommon but fatal complication. A 39-year-old man was admitted within 1 hour of the onset of a right hemispheric stroke. He was not taking any specific medication, including angiotensin-converting enzyme (ACE) inhibitors. A systemic anaphylactoid reaction developed immediately after rt-PA infusion. However, the symptoms were improved after treatment with a steroid and antihistamine. Subsequent intra-arterial thrombolytic therapy resulted in complete recanalization and clinical improvement. To our knowledge, this is the first report of a life-threatening anaphylactoid reaction after rt-PA treatment followed by successful intra-arterial thrombolytic therapy in a patient who had not taken an ACE inhibitor.
Assuntos
Adulto , Humanos , Acidente Vascular Cerebral , Terapia Trombolítica , Ativador de Plasminogênio TecidualRESUMO
Thyrotoxicosis autoimmune encephalopathy (TAE) and Hashimoto's encephalopathy (HE) are steroid responsive disorders of persistent or relapsing neurological or neuropsychological deficits associated with elevated serum concentrations of an antithyroid antibody. Most patients with TAE or HE are reported to have normal brain imaging findings at the time of presentation. We report here a rare case of TAE in whom brain MRI abnormalities were associated with clinical manifestations of thyroid storm.