The Unique Relationship between Neuro-Critical Care and Critical Illness-Related Corticosteroid Insufficiency : Implications for Neurosurgeons in Neuro-Critical Care

The brain houses vital hormonal regulatory structures such as the hypothalamus and pituitary gland, which may confer unique susceptibilities to critical illness-related corticosteroid insufficiency (CIRCI) in patients with neurological disorders. In addition, the frequent use of steroids for therapeutic purposes in various neurological conditions may lead to the development of steroid insufficiency. This abstract aims to highlight the significance of understanding these relationships in the context of patient care and management for physicians. Neurological disorders may predispose patients to CIRCI due to the role of the brain in hormonal regulation. Early recognition of CIRCI in the context of neurological diseases is essential to ensure prompt and appropriate intervention. Moreover, the frequent use of steroids for treating neurological conditions can contribute to the development of steroid insufficiency, further complicating the clinical picture. Physicians must be aware of these unique interactions and be prepared to evaluate and manage patients with CIRCI and steroid insufficiency in the context of neurological disorders. This includes timely diagnosis, appropriate steroid administration, and careful monitoring for potential adverse effects. A comprehensive understanding of the interplay between neurological disease, CIRCI, and steroid insufficiency is critical for optimizing patient care and outcomes in this complex patient population.

Neurosyphilis Presenting with Non-Convulsive Status Epilepticus

Neurosyphilis is an infectious disease of the central nervous system caused by Treponema pallidum spirochete. There are several case reports on atypical manifestations of neurosyphilis, involving progressive cognitive dysfunction and seizures similar to those in herpes encephalitis. Seizures are common in patients with neurosyphilis, but they are usually associated with a positive Jarisch-Herxheimer reaction and status epilepticus is atypical as an initial manifestation of neurosyphilis. Here, we report on neurosyphilis patient whose initial symptom was nonconversive status epilepticus.

Swallow Syncope following Chemoradiotherapy in a Patient with Lung Cancer

Swallow or deglutition syncope is a rare cause of syncope. It occurs due to a vagal reflex while swallowing. We present here a patient with recurrent loss of consciousness after swallowing liquid. He had a 1-month history of concurrent chemoradiotherapy due to non-small cell lung cancer. Electrocardiogram monitoring revealed atrioventricular block with swallowing of beverages. The details of this case suggest that chemoradiotherapy to mediastinum may cause neurogenic swallow syncope.

A Case of Linear Focal Elastosis / 대한피부과학회지

Linear focal elastosis was first described by Burket et al. in 1989 in three elderly men with palpable striae-like yellow bands on their backs. Microscopic examination revealed many fine wavy bundles of elastic fibers separating the collagen in the mid to reticular dermis. The patients' ages range a from 17 to 87 years but this disease seems to be more common in younger age; men are more commonly affected. The cause of this disease has been suggested to be hereditary predisposition, unusual form of striae distensae or keloidal repair of striae distensae. We report linear focal elatosis with typical clinical and pathological features in a 15-year-old boy.