Propriospinal Myoclonus Induced by a Herniated Lumbar Intervertebral Disc at a Young Age: A Case Report

The cause of propriospinal myoclonus (PSM) is idiopathic. Cervical trauma, ischemic myelopathy secondary to a spinal dural arteriovenous fistula, syringomyelia, Lyme neuroborreliosis, human immunodeficiency virus central nervous system infection, and cervical disc herniation can be the cause of PSM, but lumbar herniated intervertebral disc (HIVD) induced PSM has not been reported. We describe a patient who presented with PSM induced by HIVD and was treated with an epidural steroid injection using a transforaminal approach.

Short-term Coexisting Intracerebral Hemorrhage and Cerebral Infarctions

OBJECTIVE: Short-term coexisting intracerebral hemorrhage and cerebral infarctions defined as the recurrent stroke presented with different type within three weeks. Despite the high recurrence rate of stroke, little attention and insufficient clinical data had been given to short-term coexisting intracerebral hemorrhage and cerebral infarction's features. This study aims to estimate the risk factors and present the clinical features of short-term coexisting intracerebral hemorrhage and cerebral infarctions. METHODS: We investigated 18 patients with short-term coexisting intracerebral hemorrhage and cerebral infarctions who were admitted to our hospital between January 1995 and January 2005. They were subdivided by the recurrence interval such as a group of within one week and another of between one and three weeks as hyperacute and acute respectively. RESULTS: The mean interval between strokes was 6.64 days. Lesional analysis showed that short-term coexisting intracerebral hemorrhage and cerebral infarctions in this study occurred at the other side in 12 cases (66.7%). The abnormality on the electrocardiographic feature (23.5%) and long-term history of hypertension (20.5%) were the most common risk factors. However, short-term history of diabetes was more common in hyperacute group than in acute group (P<0.05). The mean number of risk factors was three in acute group. It is larger than that of hyperacute group (P<0.05). CONCLUSION: If the patients who experienced cerebrovascular attack have many risk factors, they tend to be the cases of acute coexisting intracerebral hemorrhage and cerebral infarctions than hyperacute. Therefore, that cases are required to be vigilant to the change of patients' state up to three weeks in the treatment.

Simultaneous Occurrence of Aneurysmal Subarachnoid Hemorrhage and Hypertensive Intracerebral Hemorrhage

Intracerebral hemorrhage(ICH) following aneurysmal rupture is found in 34% of the previous literature. However, hypertensive ICH concurrent with subarachnoid hemorrhage(SAH) due to an aneurysm rupture is very unusual with only four cases, to our knowledge, having been previously reported in the literature. We describe a patient who presented with aneurysmal SAH concurrent with hypertensive ICH and review of the literature.