Importance of medical interpretation in guiding emergent stroke treatment: a case report

Basilar invagination is a type of craniovertebral junction anomaly which occurs when the tip of odontoid process migrates upward into the intracranial space through foramen magnum and most commonly present as progressive neurological deficit implicating the high cervical cord, lower brainstem and cranial nerves. It can rarely present as vertebro-basilar territory insufficiency and occlusion, leading to stroke. Treatment is typically surgical and continues to centre on varying combinations of anterior or posterior decompression with or without traction or fusion. We present a 13-year-old boy with basilar invagination diagnosed on MRI with angiogram, which was missed on initial presentation, leading to recurrent posterior circulation stroke progressed to Locked-in syndrome. This case report emphasis the need of screening for craniovertebral junction anomalies in young patients presenting with posterior circulation stroke.

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Rapid Multiorgan Dissemination of Low-Grade Myxofibrosarcoma: A Case Report

Case Reports in Medicine ◽

10.1155/2012/310805 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Yasutaka Murahashi ◽

Mitsunori Kaya ◽

Tamotsu Soma ◽

Mikito Sasaki ◽

Satoshi Nagoya ◽

...

Keyword(s):

Case Report ◽

High Frequency ◽

Distant Metastases ◽

Low Grade ◽

Growth Property ◽

Diffuse Infiltration ◽

Medical Interpretation ◽

Paravertebral Muscles ◽

Clinical Conditions ◽

Skeletal Bone

Myxofibrosarcoma is one of the most common sarcomas in the extremities of elderly people. It is characterized by a high frequency of local recurrence due to an infiltrative growth property. In contrast, the overall risk of distant metastases is generally low. This makes the prognosis for the patients with myxofibrosarcoma definitely good. In this paper, we will report the case of a 79-year-old female with very aggressive metastatic low-grade myxofibrosarcoma. The disease progression was really unexpected and misled every possible medical interpretation, leading to rapid worsening of the patient's clinical conditions and no chance for therapy. The tumor developed diffuse infiltration in lung, spine, skeletal bone, abdomen, paravertebral muscles, and liver. The patient died 8 months after the diagnosis of remote metastases due to rapid tumor progression.

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Medium cerebral artery thrombosis – radiological fing: hyperdense MCA sign – case report

10.5327/1516-3180.244 ◽

2021 ◽

Author(s):

Bruno Custódio Silva ◽

Vivianne Amanda do Nascimento ◽

Maria Isabelle Nakano Vieira ◽

Guilherme Rocha Spiller ◽

Celso David Lago

Keyword(s):

Ischemic Stroke ◽

Case Report ◽

Cerebral Artery ◽

Radiological Finding ◽

Vascular Diseases ◽

Left Middle Cerebral Artery ◽

Stroke Treatment ◽

Temporal Lobes ◽

Common Etiology ◽

Treatment Prognosis

Introduction: Vascular diseases are the leading cause of death in the world. Although major advances in neuroimaging and stroke treatment have contributed to a decrease in mortality, strokes occupy second place in the list. Case report: A 75-year-old man is admitted to emergency with an altered neurological examination: right hemiplegia, Broca’s aphasia and dysphagia. Conscience was preserved. Computed tomography (CT) was performed, which showed the radiological finding of hyperdense MCA sign, confirming the diagnosis of ischemic stroke with involvement of the left middle cerebral artery branch. The treatment, in this case, was outside the criteria for thrombolytics. Discussion: Irrigation of the brain is done by Willis polygon. One of the essential branches is the medium cerebral artery (MCA), the most important termination of the internal carotid arteries, responsible for blood supply of the dorsolateral hemifacial of both cerebral hemispheres, irrigating the frontal, parietal and temporal lobes. The imaging exam in suspected cases of stroke focuses on confirming its diagnosis and etiology, location of the lesion, extent of ischemic evolution, therapeutic treatment and prognosis. CT is the main modality of neuroimaging for stroke and an important radiological finding is the hyperdense artery sign, which is more common in MCA and demonstrates an evolving or impending infarction and is secondary to a plunger housed in this vessel. Therefore, it is an important early tomographic sign of ischemic stroke found on non-contrast blood CT. Conclusion: Ischemic stroke is the most common etiology among strokes. The diagnosis must be based mainly on anamnesis and image exam, such as a CT scan. The CT performed helps to guide treatment, prognosis and clinical evolution. Finally, the recognition of the hyperdense MCA sign, found in the first 6 hours, is also extremely helpful for stroke classification.

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5-year Progression of CADASIL: A Case Report

Progress in Drug Discovery & Biomedical Science ◽

10.36877/pddbs.a0000200 ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Hong Chuan Loh ◽

Kah Hay Yuen ◽

Irene Looi

Keyword(s):

Case Report ◽

Specific Treatment ◽

Symptomatic Treatment ◽

Acute Encephalopathy ◽

Moderate Severity ◽

Stroke Treatment ◽

Full Remission ◽

Neurology Clinic ◽

Normal Cognitive Function ◽

Lowering Drug

A female patient in her 40’s of mixed Chinese-Indian ancestry was referred to our neurology clinic for frequent migraine with aura and CADASIL. She had been treated for acute encephalopathy in 2014. The incident led to her CADASIL diagnosis and later retinitis pigmentosa, both rare conditions. Initial clinical assessment showed moderate severity of migraine and normal cognitive function. As there is no specific treatment recommended for CADASIL, the patient was maintained on pharmacological therapies for secondary prevention of ischaemic stroke, treatment of seizure, symptomatic treatment for migraine and a cholesterol-lowering drug. A supplement containing Vitamin E (tocotrienols) was recommended. During the ensuing 5-years, there were no further neurovascular incidents and her migraine went into full remission.

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Misophonia: An Evidence-Based Case Report

American Journal of Audiology ◽

10.1044/2020_aja-19-00111 ◽

2020 ◽

Vol 29 (4) ◽

pp. 685-690

Author(s):

C. S. Vanaja ◽

Miriam Soni Abigail

Keyword(s):

Quality Of Life ◽

Case Report ◽

Case History ◽

Pure Tone ◽

Physiological Responses ◽

Evidence Based ◽

Management Option ◽

Pure Tone Audiogram

Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.

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Intensive Stuttering Therapy With Telepractice Follow-up: A Case Study

Perspectives on Fluency and Fluency Disorders ◽

10.1044/ffd21.1.11 ◽

2011 ◽

Vol 21 (1) ◽

pp. 11-21 ◽

Cited By ~ 2

Author(s):

Farzan Irani ◽

Rodney Gabel

Keyword(s):

Case Report ◽

Therapeutic Intervention ◽

Intensive Therapy ◽

Positive Outcome ◽

Eclectic Approach

This case report describes the positive outcome of a therapeutic intervention that integrated an intensive, residential component with follow-up telepractice for a 21 year old male who stutters. This therapy utilized an eclectic approach to intensive therapy in conjunction with a 12-month follow-up via video telepractice. The results indicated that the client benefited from the program as demonstrated by a reduction in percent stuttered syllables, a reduction in stuttering severity, and a change in attitudes and feelings related to stuttering and speaking.

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A Tape-Recorded Therapy Method for Stutterers: A Case Report

Journal of Speech and Hearing Disorders ◽

10.1044/jshd.3502.188 ◽

1970 ◽

Vol 35 (2) ◽

pp. 188-193 ◽

Cited By ~ 4

Author(s):

Maryann Peins ◽

Bernard S. Lee ◽

W. Edward McGough

Keyword(s):

Case Report

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The Use of Real-Time Visual Displays of Speech in the Training of a Profoundly Deaf, Nonspeaking Child: A Case Report

Journal of Speech and Hearing Disorders ◽

10.1044/jshd.3603.397 ◽

1971 ◽

Vol 36 (3) ◽

pp. 397-409 ◽

Cited By ~ 10

Author(s):

Rachel E. Stark

Keyword(s):

Case Report ◽

Real Time ◽

Speech Production ◽

Behavior Problem ◽

Deaf Children ◽

Developmental Sequence ◽

Visual Displays ◽

Individual Instruction ◽

Academic Record ◽

Extract Information

Real-time amplitude contour and spectral displays were used in teaching speech production skills to a profoundly deaf, nonspeaking boy. This child had a visual attention problem, a behavior problem, and a poor academic record. In individual instruction, he was first taught to produce features of speech, for example, friction, nasal, and stop, which are present in vocalizations of 6- to 9-month-old infants, and then to combine these features in syllables and words. He made progress in speech, although sign language and finger spelling were taught at the same time. Speech production skills were retained after instruction was terminated. The results suggest that deaf children are able to extract information about the features of speech from visual displays, and that a developmental sequence should be followed as far as possible in teaching speech production skills to them.

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Erratum: Recurrent Laryngeal Nerve Dissection

Journal of Speech and Hearing Disorders ◽

10.1044/jshd.4503.427b ◽

1980 ◽

Vol 45 (3) ◽

Author(s):

Frank B. Wilson ◽

D. J. Oldring ◽

Kathleen Mueller

Keyword(s):

Case Report ◽

Recurrent Laryngeal Nerve ◽

Laryngeal Nerve ◽

Long Period ◽

Initial Surgery

On page 112 of the report by Wilson, Oldring, and Mueller ("Recurrent Laryngeal Nerve Dissection: A Case Report Involving Return of Spastic Dysphonia after Initial Surgery," pp. 112-118), the paraphrase from Cooper (1971), "if the patients are carefully selected and are willing to remain in therapy for a long period of time," was inadvertantly put in quotation marks.

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