scholarly journals Pseudoephedrine-induced Hemorrhage Associated with a Cerebral Vascular Malformation

Author(s):  
Steven K. Baker ◽  
Jamie E. Silva ◽  
Ken K.S. Lam ◽  
Steven K. Baker

ABSTRACT:Background:Sympathomimetic-related intracerebral hemorrhage is well-documented. Most cases are associated with phenylpropanolamine use.Case Report:We report a case of intracerebral hemorrhage occurring in a middle-aged man who suffered from chronic sinusitis and had been ingesting pseudoephedrine daily for one year. This patient was previously well with no known cardiovascular risk factors. Clinical examination revealed no evidence of vasculitis nor coagulopathy and initial neuroimaging (i.e., computed tomography, angiography, magnetic resonance imaging) demonstrated no features consistent with aneurysm, arteriovenous malformation (AVM), cavernoma, nor cerebral metastases. A follow-up cerebral angiogram demonstrated a small AVM arising off a branch of the pericallosal artery and a small arteriovenous fistula arising off the costal marginal branch. The AVM was embolized without incident, however, the AVF was not accessible.Conclusions:Sympathomimetics have long been associated with intracerebral hemorrhage. Since 1979, over 30 published case reports have documented the relationship between phenylpropanolamine and stroke. Only one report links phenylpropanolamine consumption to an intracerebral hemorrhage in a patient with an AVM. There is a paucity of literature etiologically inculpating other ephedra alkaloids in the causation of intracerebral hemorrhage. This is a case of pseudoephedrine-induced intracerebral hemorrhage in a patient with an underlying vascular malformation.

Author(s):  
Ida Sofie Grønningsæter ◽  
Aymen Bushra Ahmed ◽  
Nils Vetti ◽  
Silje Johansen ◽  
Øystein Bruserud ◽  
...  

The increasing use of radiological examination, especially magnetic resonance imaging (MRI), will probably increase the risk of unintended discovery of bone marrow abnormalities in patients where a hematologic disease would not be expected. In this paper we present four patients with different hematologic malignancies of nonplasma cell types. In all patients the MRI bone marrow abnormalities represent an initial presentation of the disease. These case reports illustrate the importance of a careful diagnostic follow-up without delay of patients with MRI bone marrow abnormalities, because such abnormalities can represent the first sign of both acute promyelocytic leukemia as well as other variants of acute leukemia.


2015 ◽  
Vol 14 (2) ◽  
pp. 134-137
Author(s):  
Pedro Luis Bazán

<sec><title>OBJECTIVE:</title><p> Recognizing the importance of SCIWORA in adult age; analyze the usefulness of complementary studies; evaluating therapeutic options; learn about the evolution of the treated patients.</p></sec><sec><title>METHODS:</title><p> A prospective evaluation with a minimum follow-up of 5 years, eight elderly patients with cervical arthrosis and diagnosis of SCIWORA. The Japanese Orthopaedic Association (JOA) scale and ASIA were used on admission and at 6, 12, 24, 36, 48 and 60 months.</p></sec><sec><title>RESULTS:</title><p> The central cord syndrome (CCS) was the neurological condition at admission. One patient recovered after corticosteroid therapy, but later, his disability worsened, and he was operated at 18 months, another patient recovered and a third died. The other patients underwent laminoplasty in the first 72 hours; patients with partial severity condition had a minimum improvement of five points in JAO scale and those with severe conditions died.</p></sec><sec><title>CONCLUSIONS:</title><p> The low-energy trauma can decompensate the relationship between container and content in the spine with asymptomatic arthrosis, and can be devastating to the patient. The diagnosis of intramedullary lesion is made by magnetic resonance imaging. Patients with incomplete deficit undergoing laminoplasty reached at least one level in ASIA score. The potential postoperative complications can be serious.</p></sec>


Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1267
Author(s):  
Claudia Brogna ◽  
Lara Cristiano ◽  
Tommaso Verdolotti ◽  
Giulia Norcia ◽  
Luana Ficociello ◽  
...  

Background and Objectives: The aim of this study was to evaluate longitudinal changes using both upper limb muscle Magnetic Resonance Imaging (MRI) at shoulder, arm and forearm levels and Performance of upper limb (PUL) in ambulant and non-ambulant Duchenne Muscular Dystrophy (DMD) patients. We also wished to define whether baseline muscle MRI could help to predict functional changes after one year. Materials and Methods: Twenty-seven patients had both baseline and 12month muscle MRI and PUL assessments one year later. Results: Ten were ambulant (age range 5–16 years), and 17 non ambulant (age range 10–30 years). Increased abnormalities equal or more than 1.5 point on muscle MRI at follow up were found on all domains: at shoulder level 12/27 patients (44%), at arm level 4/27 (15%) and at forearm level 6/27 (22%). Lower follow up PUL score were found in 8/27 patients (30%) at shoulder level, in 9/27 patients (33%) at mid-level whereas no functional changes were found at distal level. There was no constant association between baseline MRI scores and follow up PUL scores at arm and forearm levels but at shoulder level patients with moderate impairment on the baseline MRI scores between 16 and 34 had the highest risk of decreased function on PUL over a year. Conclusions: Our results confirmed that the integrated use of functional scales and imaging can help to monitor functional and MRI changes over time.


2019 ◽  
Vol 7 (28) ◽  
pp. 33-37
Author(s):  
Dongkwan Jin ◽  
Juliana Gomez

Coccidioides meningoencephalitis is a central nervous system (CNS) fungal infection withCoccidioides species which can lead to various CNS complications, such as hydrocephalus,vasculitis, and stroke. Most cases reported with Coccidioides meningoencephalitis were inimmunocompromised patients, and the radiologic characteristics on this condition are not wellestablished. Here we report a case of Coccidioides meningoencephalitis in an immunocompetentpatient with one-year follow-up brain magnetic resonance image (MRI) studies after successfultreatment with antifungal drugs. The MRI demonstrated subcortical parenchymal lesions,selectively involving the white matter, and persistent meningeal enhancement.


2021 ◽  
Author(s):  
Chiyi Jiang ◽  
Xiao Xu ◽  
Binglin Jian ◽  
Xue Zhang ◽  
Zhixia Yue ◽  
...  

Abstract Background Neuroblastoma (NB) is the most common extracranial solid tumor in children with high heterogeneity and concealed onset. The mechanism for its occurrence and development has not been revealed. The purpose of this study was to summarize the clinical characteristics of children with NB and abnormal chromosome 10. To investigate the relationship between the number and structure of chromosome 10 abnormality and NB prognosis.MethodsWe used chromosome G-banding in the first diagnosis to evaluate the genetics of chromosomes in patients with NB, and follow up their clinical characteristics and prognosis. All participants were diagnosed with NB in Hematology Oncology Center, Beijing Children’s Hospital from May 2015 to December 2018, and were followed up for at least one year. ResultsOf all 150 patients with bone marrow metastases, 42 were clearly diagnosed with chromosomal abnormalities. There were 13 patients with chromosome 10 abnormalities definitely, and the loss of chromosome 10 was the most common decrease in the number of chromosomes. These 13 patient had higher LDH, lower OS and EFS than that of children in abnormal group without chromosome 10 abnormality. Eight patients both had MYCN amplification and 1p36 deletion. Two of them had optic nerve damage and no vision, and 1 had left supraorbital metastases five months after treatment. Among the 16 children with suspected chromosome 10 abnormalities, 3 also had orbital metastases. ConclusionsThe above results showed that chromosome 10 might be a new prognostic marker. MYCN amplification and 1p36 deletion may be related with chromosome 10 abnormalities in NB. And NB patients with abnormal chromosome 10 were prone to have orbital metastases.


2016 ◽  
Vol 55 (203) ◽  
pp. 29-32
Author(s):  
Mahesh Prakash ◽  
Pankaj Gupta ◽  
Ajay Gulati ◽  
Niranjan Khandelwal

Cysticercus, the larval form of Taenia Solium, a tapeworm, can infest various tissues in the human body. Though central nervous system involvement is the most dramatic form of infestation, several other uncommon sites of has been reported in the literature. One such involvement is that of the musculature. The most easily recalled manifestation of myocysticercus is that in the orbit where the patients present with painful proptosis. However, other less common muscular sites of involvement are documented in case reports. To the best of our knowledge, there are no documented cases of pyriformis muscle infestation with cysticercus. We came across two interesting cases, where imaging established the diagnosis of isolated pyriformis cysticercosis. Follow up after one month of anti-elminthic treatment imaging revealed disappearance of the lesions. Keywords: magnetic resonance imaging,myocysticercosis; pyriformis; ultrasound. | PubMed


1991 ◽  
Vol 21 (3) ◽  
pp. 675-685 ◽  
Author(s):  
John Stirling ◽  
Digby Tantam ◽  
Philip Thomas ◽  
David Newby ◽  
Linda Montague ◽  
...  

SYNOPSISKey relatives of 33 first or early admission psychotic patients (mainly schizophrenics) were interviewed to determine household levels of expressed emotion (EE). The patients were followed up for 12 months from index admission, during which time 13 (39%) experienced psychotic relapse. There was no association between relapse rate and household EE, but correlations between individual components of EE and pre-morbid measures suggest that level of criticism may be related to less acute onset of index episode, greater elapsed time since first signs of illness, and poor adjustment in the realm of work/study. The results are discussed in the context of continuing uncertainties about the precise nature of the relationship between EE and relapse.


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