Subject(s)
Brain Neoplasms/psychology , Glioma/psychology , Hallucinations/psychology , Music/psychology , Brain Neoplasms/physiopathology , Brain Neoplasms/surgery , Electroencephalography , Epilepsy/etiology , Epilepsy/psychology , Glioma/physiopathology , Glioma/surgery , Humans , Male , Middle Aged , Temporal Lobe/physiopathology , Temporal Lobe/surgerySubject(s)
Corpus Callosum/pathology , Hypernatremia/etiology , Marchiafava-Bignami Disease/blood , Acute Disease , Alcoholism/complications , Combined Modality Therapy , Emergencies , Female , Fluid Therapy , Humans , Magnetic Resonance Imaging/methods , Marchiafava-Bignami Disease/diagnosis , Marchiafava-Bignami Disease/rehabilitation , Marchiafava-Bignami Disease/therapy , Methylprednisolone/therapeutic use , Middle Aged , Parenteral Nutrition , Thiamine/therapeutic use , Torticollis/etiologyABSTRACT
The antiphospholipid syndrome (APS) is defined by the association of high titers of antiphospholipid antibodies (aPLs) with thrombotic events and/or obstetrical problems. APS can be isolated or associated with immune system diseases. Several central nervous system (CNS) manifestations have been reported in APS, but are still not included in the international diagnostic criteria. We present here three cases of APS revealed by CNS manifestations. The first patient had a primary APS with stroke, dementia, epilepsy and the "so-called" Liebman-Sacks disease, a subacute thrombotic non-bacterial valvulopathy. The second one developed a primary APS with a Sneddon syndrome, while the third case is a neurolupus-associated APS with subacute encephalopathy, chorea, stroke, and epilepsy. The pathogenesis of the APS is related to both prothrombotic and immunologic effects of the aPLs. Long-term anticoagulation by low-weight heparin or warfarin is currently recommended in APS. We propose to search the presence of aPLs in any case of young adults' stroke, unexplained dementia, and acquired chorea.
Subject(s)
Antiphospholipid Syndrome/complications , Nervous System Diseases/etiology , Adult , Blood Sedimentation , Central Nervous System/pathology , Diffusion Magnetic Resonance Imaging , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Nervous System Diseases/diagnosis , Young AdultSubject(s)
Cough/complications , Mediastinal Emphysema/etiology , Pneumorrhachis/etiology , Chest Pain/etiology , Cough/physiopathology , Evoked Potentials, Somatosensory , Humans , Magnetic Resonance Imaging , Male , Mediastinal Emphysema/diagnostic imaging , Neural Conduction , Nonverbal Communication , Paresthesia/etiology , Pneumorrhachis/diagnostic imaging , Pulmonary Alveoli/injuries , Rupture, Spontaneous , Subcutaneous Emphysema/etiology , Tomography, X-Ray Computed , Young AdultABSTRACT
We report a patient with a Guillain-Barré syndrome (GBS) revealed by a posterior reversible encephalopathy syndrome (PRES). The PRES is typically associated with bilateral parieto-occipital T2 and FLAIR hyperintense MRI lesions and observed in various etiologic conditions leading to acute arterial hypertension. PRES results from a breakdown of the circulatory autoregulation, many in the posterior cerebral territories. GBS can be considered as an independent risk factor of PRES, due to acute dysautonomia and pain with consecutive arterial hypertension, as well as to cytokine production changing capillary permability. Such patients with PRES-revealed GBS may be treated with intravenous immunoglobulin therapy only after exclusion of any ischemic or hemorrhagic cerebral complications, and after control of the blood pressure and of the encephalopathic signs and symptoms.
Subject(s)
Guillain-Barre Syndrome/complications , Posterior Leukoencephalopathy Syndrome/etiology , Aged , Confusion/etiology , Electromyography , Female , Gangliosides/immunology , Guillain-Barre Syndrome/diagnosis , Guillain-Barre Syndrome/pathology , Homeostasis/physiology , Humans , Immunoglobulins, Intravenous/therapeutic use , Magnetic Resonance Imaging , Neurologic Examination , Occipital Lobe/pathology , Pain/etiology , Parietal Lobe/pathology , Posterior Leukoencephalopathy Syndrome/pathology , Primary Dysautonomias/etiologySubject(s)
Abducens Nerve Diseases/chemically induced , Cerebellar Diseases/chemically induced , Metronidazole/adverse effects , Nystagmus, Pathologic/chemically induced , Peripheral Nervous System Diseases/chemically induced , Abducens Nerve Diseases/complications , Abducens Nerve Diseases/diagnostic imaging , Accommodation, Ocular/drug effects , Accommodation, Ocular/physiology , Aged, 80 and over , Anti-Infective Agents/adverse effects , Cerebellar Diseases/complications , Cerebellar Diseases/diagnostic imaging , Eye Movements/drug effects , Eye Movements/physiology , Humans , Magnetic Resonance Imaging , Male , Nystagmus, Pathologic/complications , Nystagmus, Pathologic/diagnostic imaging , Peripheral Nervous System Diseases/complications , Peripheral Nervous System Diseases/diagnostic imaging , Radiography , Vision Disorders/chemically induced , Vision Disorders/complications , Vision Disorders/diagnostic imagingABSTRACT
BACKGROUND: Intravenous thrombolysis (IVT) for stroke seems to be beneficial independent of the underlying etiology. Recent observations raised concern that IVT might cause harm in patients with strokes attributable to small artery occlusion (SAO). OBJECTIVE: The safety of IVT in SAO-patients is addressed in this study. METHODS: We used the Swiss IVT databank to compare outcome and complications of IVT-treated SAO-patients with IVT-treated patients with other etiologies (non-SAO-patients). Main outcome and complication measures were independence (modified Rankin scale