Spontaneous subdural hematoma associated with microcystic meningioma: first case report in the literature

Background: Binasal Occlusion (BNO) is a clinical technique used by many neurorehabilitative optometrists in patients with mild traumatic brain injury (mTBI) and increased visual motion sensitivity (VMS) or visual vertigo. BNO is a technique in which partial occluders are added to the spectacle lenses to suppress the abnormal peripheral visual motion information. This technique helps in reducing VMS symptoms (i.e., nausea, dizziness, balance difficulty, visual confusion). Case Report: A 44-year-old AA female presented for a routine eye exam with a history of mTBI approximately 33 years ago. She was suffering from severe dizziness for the last two years that was adversely impacting her ADLs. The dizziness occurred in all body positions and all environments throughout the day. She was diagnosed with vestibular hypofunction and had undergone vestibular therapy but reported little improvement. Neurological exam revealed dizziness with both OKN drum and hand movement, especially in the left visual field. BNO technique resulted in immediate relief of her dizziness symptoms. Conclusion: To our knowledge, this is the first case that illustrates how the BNO technique in isolation can be beneficial for patients with mTBI and vestibular hypofunction. It demonstrates the success that BNO has in filtering abnormal peripheral visual motion in these patients.

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Anesthesia in Carvajal syndrome; the first case report

Anaesthesia, Pain & Intensive Care ◽

10.35975/apic.v24i1.1233 ◽

2020 ◽

Vol 24 (1) ◽

pp. 105-107

Author(s):

Sedighe Shahhosseini ◽

Reza Aminnejad ◽

Amir Shafa ◽

Mehrdad Memarzade

Keyword(s):

Intensive Care ◽

Case Report ◽

Surgical Resection ◽

Genetic Disorder ◽

Anesthetic Technique ◽

Close Monitoring ◽

Anesthesia Management ◽

Rare Genetic Disorder ◽

First Case ◽

Anesthetic Considerations

Carvajal syndrome is a rare genetic disorder. Patients reporting for surgery pose some difficulties in anesthesia management. In this case report we present the case of a 12-year-old boy, who was a known case of Carvajal syndrome, referred for surgical resection of perianal condyloma. Close monitoring of hemodynamic status is the mainstay of anesthetic considerations in such patients. As in any other challenging scenario, it should be kept in mind that ‘there is no safest anesthetic agent, nor the safest anesthetic technique; there is only the safest anesthesiologist’. Citation: Shahhosseini S, Aminnejad R, Shafa A, Memarzadeh M. Anesthesia in Carvajal syndrome; the first case report. Anaesth pain intensive care 2020;24(1):___ DOI: https://doi.org/10.35975/apic.v24i1.

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Meningeal Carcinomatosis for Prostate Adenocarcinoma Mimicking Chronic Subdural Hematoma: Case Report and Literature Review

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0040-1713092 ◽

2021 ◽

Author(s):

Tiago Silva Holanda Ferreira ◽

Gilnard Caminha de Menezes Aguiar ◽

Daniel Gurgel Fernandes Távora ◽

Lucas Alverne Freitas de Albuquerque ◽

Stélio da Conceição Araújo Filho

Keyword(s):

Case Report ◽

Subdural Hematoma ◽

Specific Antigen ◽

Chronic Subdural Hematoma ◽

Radical Resection ◽

Prostate Adenocarcinoma ◽

Meningeal Carcinomatosis ◽

Motor Deficits ◽

Friable Material ◽

The Central Nervous System

Abstract Introduction Cerebral metastases are the most common cancer of the central nervous system (CNS). Meningeal infiltration by neoplasms that did not originate in the CNS is a rare fact that is present in 0.02% of the autopsies.Epidemiologically, the radiological presentation mimicking a subdural hematoma is even more uncommon. We report a case of meningeal carcinomatosis by an adenocarcinoma of the prostate mimicking a chronic subdural hematoma. Case Report A 60-year-old male patient was diagnosed with prostate cancer in 2011. He underwent radical resection of the prostate, as well as adjuvant hormonal therapy and chemotherapy.Five years later, the patient presented peripheral facial paralysis that evolved with vomiting and mental confusion. Tomography and magnetic resonance imaging scans confirmed the subdural collection.At surgery, the dura was infiltrated by friable material of difficult hemostasis. The anatomicopathological examination showed atypical epithelial cells. The immunohistochemistry was positive for prostate-specific antigen (PSA) and other key markers, and it was conclusive for meningeal carcinomatosis by a prostate adenocarcinoma. Discussion Meningeal carcinomatosis presents clinically with headache, motor deficits, vomiting, changes in consciousness and seizures.The two most discussed mechanisms of neoplastic infiltration are the hematogenous route and retrograde drainage by the vertebral venous plexus. Conclusion Variable clinical presentations may occur in dural metastases; however, the radiological presentation as subdural hematoma is rare. There are few descriptions of cases like this one in the literature.To support the diagnosis, the previous medical history is as important as the complementary exams and the radiological findings, because the symptoms are common at the neurological emergency. To our knowledge, this is the first report of a prostate neoplasm mimicking chronic subdural hematoma in Brazil.

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Isolated Dysphagia in a Patient with Medial Medullary Infarction – Effects of Evidence-Based Dysphagia Therapy: A Case Report

Case Reports in Neurology ◽

10.1159/000513676 ◽

2021 ◽

pp. 190-199

Author(s):

Samra Hamzic ◽

Patrick Schramm ◽

Hassan Khilan ◽

Tibo Gerriets ◽

Martin Juenemann

Keyword(s):

Case Report ◽

Vascular Occlusion ◽

Evidence Based ◽

Severe Dysphagia ◽

First Case ◽

Jaw Opening ◽

Medial Medullary Infarction ◽

Dysphagia Therapy ◽

Evidence Based Therapy ◽

Medullary Infarction

Medial medullary infarction (MMI) is a vascular occlusion in the medulla oblongata leading to certain constellations of neurological symptoms and seriously affecting the patient. Effective evidence-based treatment of severe dysphagia as sole symptom of MMI has not yet been reported. This case study aims to report successful effects of evidence-based therapy based on findings of dysphagia symptoms and pathophysiology of swallowing by flexible endoscopic evaluation of swallowing (FEES) in severe isolated dysphagia after MMI. FEES was performed to evaluate swallowing pathophysiology and dysphagia symptoms in a 57-year-old male with severe dysphagia after MMI. On the basis of FEES findings, simple and high-frequent evidence-based exercises for improvement of swallowing were implemented: thermal stimulation of faucial arches, Jaw Opening Exercise, and Jaw Opening Against Resistance. After 7 weeks of high-frequent evidence-based therapy and regular FEES evaluation the patient was set on full oral diet with no evidence of aspiration risk. In a first case report of isolated dysphagia in MMI our case illustrates that high-frequent evidence-based dysphagia therapy in combination with FEES as the method to evaluate and monitor swallowing pathophysiology can lead to successful and quick rehabilitation of severely affected dysphagic patients.

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