scholarly journals Recurrent transient heading disorientation heralding acute posterior cerebral artery (PCA) infarction

2019 ◽  
Vol 1 (1) ◽  
pp. e000009
Author(s):  
Yong Chuan Chee ◽  
Beng Hooi Ong
Keyword(s):  
Case Report ◽  
Cerebral Infarction ◽  
Cerebral Artery ◽  
Transient Ischaemic Attack ◽  
Posterior Cerebral Artery ◽  
Underlying Mechanism ◽  
Unusual Presentation ◽  
Topographical Disorientation ◽  
Ischaemic Attack ◽  
The Right

ObjectiveHeading disorientation is a type of pure topographical disorientation. Reported cases have been very few and its underlying mechanism remains unclear. We report an unusual presentation of a 60-year-old man with recurrent transient heading disorientation heralding an acute posterior cerebral artery infarction.DesignCase report.ConclusionAcquired injury to the right retro-splenial region can result in a specific variant of topographical disorientation known as heading disorientation that may present as an atypical transient ischaemic attack-like symptom heralding acute cerebral infarction.

scholarly journals Visual Agnosia for Line Drawings and Silhouettes without Apparent Impairment of Real-Object Recognition: A Case Report

2009 ◽  
Vol 21 (3-4) ◽  
pp. 187-192 ◽  
Author(s):  
Kotaro Hiraoka ◽  
Kyoko Suzuki ◽  
Kazumi Hirayama ◽  
Etsuro Mori
Keyword(s):  
Case Report ◽  
Object Recognition ◽  
Cerebral Infarction ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Real Object ◽  
Visual Agnosia ◽  
Line Drawings ◽  
Real Objects ◽  
The Right

We report on a patient with visual agnosia for line drawings and silhouette pictures following cerebral infarction in the region of the right posterior cerebral artery. The patient retained the ability to recognize real objects and their photographs, and could precisely copy line drawings of objects that she could not name. This case report highlights the importance of clinicians and researchers paying special attention to avoid overlooking agnosia in such cases. The factors that lead to problems in the identification of stimuli other than real objects in agnosic cases are discussed.

scholarly journals Microsurgical Treatment of Posterior Cerebral Artery Aneurysm (P2P Segment): Case Report and Review of the Literature

2018 ◽  
Vol 37 (04) ◽  
pp. 343-348
Author(s):  
Lucas Meguins ◽  
Antônio Spotti ◽  
Jean de Oliveira ◽  
Carlos Pereira ◽  
Ronaldo Fernandes ◽  
...  
Keyword(s):  
Case Report ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Saccular Aneurysm ◽  
Neurological Deficits ◽  
Uneventful Recovery ◽  
Cerebral Peduncle ◽  
Vast Number ◽  
The Right

Introduction Aneurysms of the posterior cerebral artery (PCA) represent ∼ 1% of all intracranial aneurysms and usually present with subarachnoid hemorrhage. Objective The aim of the present study is to describe the case of an adult man presenting a saccular aneurysm of the right PCA at the posterior half of the postcommunicating (P2P) segment, and to discuss the technical nuances of the approach and of the clipping process. Case Report An investigation of a chronic headache in a 55-year-old man found a saccular aneurysm located just posterior to the most lateral portion of the right cerebral peduncle. A digital subtraction arteriography revealed a 7.8 mm × 5.6 mm × 4.8 mm posterior-medial projecting aneurysm of the right PCA at the P2P segment. A subtemporal approach was performed with partial aspiration of the right parahippocampal gyrus for a better exposure of the vascular structures. A proximal temporary occlusion of the PCA was performed at the anterior half of the postcommunicating P2A segment. The aneurysm was clipped with two semi-curved clips. The patient presented an uneventful recovery and was discharged from the hospital on the third postoperative day without any additional neurological deficits. Conclusion Aneurysms of the PCA are an uncommon vascular disease that challenges the ability of the neurosurgeons due to their many anatomical nuances, to their vast number of perforators, and to the risk of bleeding. However, the operative management of aneurysms of the PCA is technically feasible, safe and effective when performed respecting microsurgical principles.

scholarly journals Cerebral infarction in the territory of the right anterior cerebral artery presenting with alien hand sign and mirror writing-A case report.

Nosotchu ◽  
1993 ◽  
Vol 15 (4) ◽  
pp. 317-322 ◽  
Author(s):  
Kazuhiro Takamatsu ◽  
Takaaki Takizawa ◽  
Shoju Sato ◽  
Akira Sano ◽  
Tsutomu Miyamoto
Keyword(s):  
Case Report ◽  
Cerebral Infarction ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Alien Hand ◽  
The Right ◽  
Mirror Writing

Cerebral Infarction Related to Neck Position

PEDIATRICS ◽  
1984 ◽  
Vol 73 (4) ◽  
pp. 573-573
Author(s):  
JOHN B. BODENSTEINER
Keyword(s):  
Cerebral Infarction ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
Posterior Cerebral Artery ◽  
Vascular Supply ◽  
Posterior Communicating Artery ◽  
Vascular Pattern ◽  
Neck Position ◽  
Vertebral Arteries ◽  
The Right

In Reply.— Adventitial tears of the vertebral arteries during a breach or otherwise difficult delivery may well result in hypoplasia of the vertebral arteries as suggested by Yates.1 It is doubtful, however, that such an injury would result in the anomalous cerebral vascular supply demonstrated in our patient.2 It seems more likely that the origin of the right posterior cerebral artery from the right internal carotid may represent persistance of the fetal vascular pattern. This concept might be supported by the absence of the posterior communicating artery.

scholarly journals A case report of unilateral conductive hearing loss as a consequence of malignant sinonasal melanoma: the importance of completing a full clinical history and examination

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Victoria Blackabey ◽  
Olivia Kenyon ◽  
Rishi Talwar
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Clinical Symptoms ◽  
Symptomatic Relief ◽  
Clinical History ◽  
Histological Diagnosis ◽  
Unusual Presentation ◽  
Sinus Surgery ◽  
Cancer Management ◽  
The Right

Abstract Background Sinonasal melanoma is a rare head and neck tumour. It is associated with a poor prognosis, high rates of loco-regional recurrence and distant metastasis. Treatment of the disease is therefore complicated, and because of limited data regarding the cancer, management is frequently tailored to the individual patient. We describe an unusual presentation of sinonasal melanoma with relevant histology, radiology and clinical photography. Case presentation The case report describes the presentation of a 64-year-old man to the Ear, Nose and Throat department with progressive right-sided hearing loss. A thorough history highlighted other clinical symptoms including unilateral nasal obstruction and epistaxis. Clinical examination showed a right middle ear effusion with a polypoidal lesion in the right nasal cavity. Relevant imaging demonstrated a destructive process that required further assessment. An endoscopic sinus procedure was performed to obtain histological diagnosis as well as providing symptomatic relief. Histology confirmed malignant mucosal melanoma. The patient underwent maxillectomy and orbital exenteration (due to further progression of disease) at a tertiary centre with a plan for subsequent immunotherapy. This however has been delayed due to further surgery to excise a metastatic lesion to the right femur. Conclusions This case report highlights the importance of a thorough clinical history and examination. An unusual presentation of a sinonasal tumour can easily be missed leading to a significant delay in treatment. The case report also describes the use of functional endoscopic sinus surgery in order to obtain histological diagnosis and to debulk the tumour, providing symptomatic relief. The current literature regarding management will be discussed as well as current developments guiding future treatment.

Neuropsychiatric Derangement by Polycythemia Vera: A Case Report of an Unexpected Disease Presentation and Review of the Literature

2021 ◽  
pp. 1-6
Author(s):  
Heleen De Lil ◽  
Michelle van Beek ◽  
Alexandra Herbers ◽  
Ellen van der Holst ◽  
Karen Keijsers
Keyword(s):  
Case Report ◽  
Chronic Disease ◽  
Cerebral Infarction ◽  
Polycythemia Vera ◽  
Neuropsychiatric Symptoms ◽  
Unusual Presentation ◽  
Review Of The Literature ◽  
Remarkable Recovery ◽  
Visual Complaints ◽  
Underlying Pathophysiology

Cerebral infarction as well as other thromboses, headaches, and visual complaints are well-known symptoms of polycythemia vera. However, chorea and neuropsychiatric disturbances are less recognized consequences of this chronic disease. Whereas chorea is a rare but acknowledged symptom of polycythemia vera, neuropsychiatric symptoms have only sporadically been reported. We depict 2 patients with an unusual presentation of polycythemia vera. Our first patient presented with right-sided hemiballism and psychosis, and the second patient had a long diagnostic trajectory of unexplained chorea. In both cases diagnosis of JAK2 positive polycythemia vera was established, and in both cases remarkable recovery occurred after the initiation of phlebotomies. The underlying pathophysiology of these symptoms has not been clearly elucidated. Because of the unfamiliarity of the link between especially neuropsychiatric symptoms and polycythemia, current reported numbers are probably an underestimation. Benefit of treatment appears to be large. We seek to create more awareness among physicians about this phenomenon.

scholarly journals Early Recognition of Stroke by Confrontation Visual Field Test – Is It Possible?

2020 ◽  
Keyword(s):  
Case Report ◽  
Visual Field ◽  
Cerebral Artery ◽  
Vision Loss ◽  
Posterior Cerebral Artery ◽  
Early Recognition ◽  
Past History ◽  
Neurological Deficits ◽  
Visual Field Defects ◽  
Axial Tomography

Introduction: Visual field loss is often the first sign of lesion of the anterior or posterior visual pathways. Screening for visual field defects should be a part of all routine eye examinations, mainly when neurological lesions are suspected. A confrontation visual field (CVF) test provide a rapid and practical method of visual field assessment, allowing the recognition of major neurological deficits. Materials and Research Methods: To report a case of posterior cerebral artery (PCA) stroke early suspected by CVF test. Case-Report: A 77 year-old male presented to our emergency department with vision blurring complaints and a strange sensation of a vision loss on one side on the left eye (OS), for the previous 15 days. He explained that symptoms initiated after an episode of dizziness followed by lipothymia. He denied diplopia or headaches. Past history revealed hypertension and diabetes as cardiovascular risk factors. The best corrected visual acuity was 20/25 on right eye (OD) and 20/60 on OS and pupillary reflexes were normal. CVF test was performed and showed a decrease on left hemicampus of OS. The biomicroscopy was normal and the fundus examination showed optic nerve edema bilaterally, also documented by Optical Coherence Tomography. Considering the findings and the history, neuroimaging and a neurological observation were requested. Computerized axial tomography revealed a hypodense lesion in right occipital posterior region, with hematic density. He was hospitalized for proper treatment with the diagnosis of posterior cerebral artery ischemic stroke, with further hemorrhagic transformation. Discussion: In acute stroke, visual disorders may form all or part of the initial presentation. Homonymous visual field deficits are well-known almost universal characteristics of PCA ischemia, however, due to the absent of cognitive impairment or speech problems associated to many cases, the diagnosis can be challenging at early stages. Our case-report highlights the importance of using CVF test to an immediate inspection of the peripheral visual field, in order to detect acute major defects, including homonymous deficits, to understand if a further prompt neurological examination is mandatory.

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