scholarly journals Reversible Cortical Blindness as a Prominent Manifestation of Cerebral Embolism due to Infective Endocarditis

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Georgios P. Kranidiotis ◽  
Alexandra N. Gougoutsi ◽  
Theodoros A. Retsas ◽  
Maria I. Anastasiou-Nana
Keyword(s):  
Infective Endocarditis ◽  
Visual Loss ◽  
Cerebral Arteries ◽  
Multiple Organ ◽  
Cortical Blindness ◽  
Multiple Organ Dysfunction ◽  
Case Presentation ◽  
History Of ◽  
Occipital Lobes ◽  
The Brain

Introduction. Infective endocarditis in the left heart may be complicated by stroke, due to embolisation from infectious valvular vegetations. Infarction of both occipital lobes, which are supplied by the posterior cerebral arteries, is infrequent, and is the cause of cortical blindness from lesion of the visual cortex. Cortical blindness is characterized by intact pupillary reflexes, a normal fundoscopy, and, rarely, denial of visual loss.Case Presentation. We report the case of a 58-year-old woman, recipient of a mechanical aortic valve, who presented with fever, multiple organ dysfunction, and cortical blindness. Transesophageal echocardiography and blood cultures confirmed the diagnosis of infective endocarditis caused by methicillin-sensitiveStaphylococcus aureus. Computed tomography of the brain without contrast revealed the presence of infarctions in both occipital lobes. It is noteworthy that the visual loss resolved after treatment of endocarditis.Conclusions. A stroke occurring in a patient presenting with fever and a history of valvular heart disease strongly suggests the presence of infective endocarditis. Bilateral thromboembolic infarcts of the occipital lobes cause cortical blindness, that can resolve after treatment of endocarditis.

scholarly journals A history of the path towards imaging of the brain: From skull radiography through cerebral angiography

2021 ◽  
Author(s):  
Haris Kamal ◽  
Edward J. Fine ◽  
Banafsheh Shakibajahromi ◽  
Ashkan Mowla
Keyword(s):  
Contrast Agent ◽  
Carotid Arteries ◽  
Cerebral Arteries ◽  
X Ray ◽  
Spinal Subarachnoid Space ◽  
Frontal Horn ◽  
History Of ◽  
The Right ◽  
Occipital Lobes ◽  
The Brain

This publication reviews the steps in the path towards obtaining a complete image of the brain. Up to the 1920s, plain X-ray films could demonstrate only calcified tumors, shifts in midline position of a calcified pineal gland due to a mass in the cranium, or foreign metallic objects within the skull. Walter Dandy reported in 1918 that he visualized cerebral ventricles by introducing air as a contrast agent through a trocar into one of the occipital lobes or the right frontal horn of the ventricular system. Dandy localized lesions that distorted or shifted the ventricles. In 1920, Dandy placed air by lumbar puncture into the spinal subarachnoid space that could visualize the brain and entire ventricles. Antonio Egas Moniz with the assistance of his neurosurgeon colleague, Almeida Lima, obtained X-ray images of cerebral arteries of dogs and decapitated human heads from corpses after injecting strontium bromide into their carotid arteries. Satisfied by these experiments, Moniz injected strontium bromide directly into carotid arteries of five patients which failed to show intracranial vessels. In the sixth patient, intracranial arteries were outlined but that patient died of cerebral thrombosis presumably due to the hyper- osmolality of that contrast agent. Finally, on June 18, 1927, Moniz injected 22% sodium iodine into a 20-year-old man and obtained clear visualization of his carotid artery and intracerebral branches after temporarily occluding the artery with a ligature. 

scholarly journals Diagnosing RCVS Without the CV

2015 ◽  
Vol 6 (3) ◽  
pp. NP1-NP4 ◽  
Author(s):  
Nuri Jacoby ◽  
Ulrike Kaunzner ◽  
Marc Dinkin ◽  
Joseph Safdieh
Keyword(s):  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Multiple Risk Factors ◽  
Mri Brain ◽  
Cerebral Vasoconstriction ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
Occipital Lobes ◽  
The Brain

This is a case of a 52-year-old man with a past medical history of 2 episodes of coital thunderclap headaches as well as recent cocaine, marijuana, and pseudoephedrine use, who presented with sudden, sharp, posterior headache associated with photophobia and phonophobia. His initial magnetic resonance imaging (MRI) of the brain, magnetic resonance angiography (MRA) of the head, and magnetic resonance venography (MRV) of the head were all normal as well as a normal lumbar puncture. Given the multiple risk factors for reversible cerebral vasoconstriction syndrome (RCVS), the patient was treated for suspected RCVS, despite the normal imaging. Repeat MRI brain 3 days after hospital admission demonstrated confluent white matter T2 hyperintensities most prominent in the occipital lobes, typical of posterior reversible encephalopathy syndrome (PRES). Repeat MRA of the head 1 day after discharge and 4 days after the abnormal MRI brain showed multisegment narrowing of multiple arteries. This case demonstrates that RCVS may present with PRES on MRI brain and also exemplifies the need to treat suspected RCVS even if imaging is normal, as abnormalities in both the MRI and the MRA may be delayed.

scholarly journals Transient Cortical Blindness after Coronary Angiography

2009 ◽  
Vol 37 (4) ◽  
pp. 1246-1251 ◽  
Author(s):  
BN Alp ◽  
N Bozbuğa ◽  
MA Tuncer ◽  
C Yakut
Keyword(s):  
Coronary Angiography ◽  
Cerebral Haemorrhage ◽  
Cortical Blindness ◽  
Focal Neurological Deficit ◽  
Computed Tomographic ◽  
Contrast Enhanced ◽  
Computed Tomographic Scan ◽  
Transient Cortical Blindness ◽  
Occipital Lobes ◽  
The Brain

Transient cortical blindness is rarely encountered after angiography of native coronary arteries or bypass grafts. This paper reports a case of transient cortical blindness that occurred 72 h after coronary angiography in a 56-year old patient. This was the patient's fourth exposure to contrast medium. Neurological examination demonstrated cortical blindness and the absence of any focal neurological deficit. A non-contrast-enhanced computed tomographic scan of the brain revealed bilateral contrast enhancement in the occipital lobes and no evidence of cerebral haemorrhage, and magnetic resonance imaging of the brain showed no pathology. Sight returned spontaneously within 4 days and his vision gradually improved. A search of the current literature for reported cases of transient cortical blindness suggested that this is a rarely encountered complication of coronary angiography.

POSTERIOR REVERSBLE ENCEPHALOPATHY SYNDROME IN ECLAMPSIA: A RARE PHENOMENON

2021 ◽  
pp. 69-70
Author(s):  
Neelu Khanna Suri ◽  
Kanika Kinra ◽  
Pawan Suri
Keyword(s):  
Endothelial Dysfunction ◽  
Effective Treatment ◽  
Similar Case ◽  
Multiple Organ ◽  
Cortical Blindness ◽  
Vascular Changes ◽  
Organ Systems ◽  
Ocular Changes ◽  
The Brain ◽  
Risk Of Preeclampsia

preeclampsia can affect multiple organ systems due to hypertension and systemic endothelial dysfunction, one of the more delicate maternal systems impacted is the brain It is not always the acute risk of preeclampsia and eclampsia on the brain that impacts maternal outcome. Cortical blindness is generally reversible, and permanent blindness from retinal vascular changes is rare [8].Other than effective treatment of preeclampsia/eclampsia and termination of pregnancy, no specic therapy is indicated in pre- eclamptic women who experience ocular changes. A Similar case with Eclampsia and blindness is presented here.

scholarly journals A case presentation of patient from northern China with endomyocardial fibrosis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yonggang Yuan ◽  
Yingkai Li ◽  
Zesheng Xu
Keyword(s):  
Enzyme Inhibitor ◽  
Beta Blockers ◽  
Specific Treatment ◽  
Rare Condition ◽  
Northern China ◽  
Multiple Organ ◽  
Chinese Patient ◽  
Endomyocardial Fibrosis ◽  
Case Presentation ◽  
History Of

Abstract Background Endomyocardial fibrosis (EMF) is a rare condition and a major cause of death in tropical countries. The etiology of EMF remains elusive, and no specific treatment has been developed yet, therefore it carries poor prognosis. Case presentation An 81-year-old male Chinese patient with a history of long-standing exertional breathlessness, presented with worsening symptoms rapidly evolving to orthopnea. A proper specific treatment was prescribed to the patient in the following days, including diuretics, angiotensin-converting-enzyme inhibitor and beta blockers. The patient died of progressive multiple organ failure. Conclusion Echocardiography is technically limited due to the acoustic shadowing as a result of the calcification. Chest computed tomography is a more accurate diagnostic tool to examine the anatomic distribution and extent of endomyocardial calcification in this rare case.

scholarly journals Case Report: Organic Hallucinosis in Viral Encephalitis

2021 ◽  
Vol 2 (1) ◽  
pp. 61-64
Author(s):  
Andrian Fajar Kusumadewi
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Mental Disorders ◽  
Viral Encephalitis ◽  
Case Presentation ◽  
The Family ◽  
Organic Mental Disorders ◽  
History Of ◽  
The Brain

Introduction : Organic mental disorders are diseases we need to put more attentionon because they are related to systemic disorders or disorders of the brain and cancause high mortality. Organic mental disorders often manifest in the form ofpsychiatric symptoms so that they can be treated too late because the physician isnot able to recognize the symptoms which can be fatal. Sequelae can be found inorganic mental disorders and may affect the patient’s quality of life, so a fast andproper management is needed to get a better outcome. Case presentation: A caseof organic hallucinosis in viral encephalitis had been reported in a 18 year-old malewith a history of sudden changes in behaviour. The symptoms appeared after thepatient had problems during OSPEK and was threatened by someone. The patientwas the only child in the family and often spoiled by his parents. Laboratory andimaging studies showed that there was a cerebritis in the CT scan result, a decreasein CD4 count, and an increase in anti-Rubella IgG titers in which the patient wasfinally diagnosed with viral encephalitis. Conclusion: The diagnosis of organicmental disorders can easily be overlooked in daily clinical practice so that patientsdo not receive proper management

scholarly journals Reversible Cerebral Vasoconstriction Syndrome Associated with Infundibular Dilation

2020 ◽  
Author(s):  
Héctor Montenegro-Rosales ◽  
Blanca Karina González-Alonso ◽  
Omar Cárdenas-Sáenz ◽  
Alonso Gutierrez-Romero
Keyword(s):  
Cerebral Arteries ◽  
Imaging Study ◽  
Sudden Onset ◽  
Severe Headache ◽  
Reversible Cerebral Vasoconstriction Syndrome ◽  
Initial Image ◽  
Case Presentation ◽  
Cerebral Vasoconstriction ◽  
History Of ◽  
Visual Disturbances

Background: Reversible cerebral vasoconstriction syndrome (RCVS) is defined as a clinical and radiological syndrome that comprises a group of disorders characterized by sudden-onset severe headache and segmental vasoconstriction of the cerebral arteries with resolution within 3 months. Case presentation: A 51-year-old female patient with a 2-week history of sudden-onset severe headache, visual disturbances and cerebellum; no relevant imaging findings, except for an infundibular dilation at the origin of the posterior communicating artery, and so, angiography was performed. When symptoms persisted, a new imaging study was carried out with findings of RCVS as the cause of the symptoms from the beginning. Conclusions: Findings of RCVS can be obtained in various vasculopathies of the nervous system and vasculitis, being misdiagnosed, and so, clinical suspicion is essential; if vasoconstriction is not demonstrated on the initial image and other diagnoses have been excluded, the patient should be managed as having possible or probable RCVS.

scholarly journals Multiple Organ Dysfunction and Acute Pancreatitis Following Wasp Stings

2020 ◽  
Vol 18 (3) ◽  
pp. 566-568
Author(s):  
Olita Shilpakar ◽  
Bibek Rajbhandari ◽  
Bipin Karki ◽  
Umesh Bogati
Keyword(s):  
Acute Kidney Injury ◽  
Acute Pancreatitis ◽  
Organ Dysfunction ◽  
Kidney Injury ◽  
Complete Recovery ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Wasp Sting ◽  
History Of ◽  
Wasp Stings

Wasp stings are common in our part of the world and may cause complications ranging from mild local reactions to fatal anaphylaxis. Severe cases may present with multisystem involvement causing acute kidney injury, hepatic dysfunction, clotting abnormalities, rhabdomyolysis or even death. However, cases with acute pancreatitis as a complication of wasp sting is not usual and have been very rarely reported. We present a case of a fifty-two-year-old lady with the history of multiple wasp stings followed by multiple organ dysfunction and acute pancreatitis with complete recovery following immediate conservative measures. Keywords: Acute kidney injury; multiple organ dysfunction; pancreatitis; wasp; sting

scholarly journals IgM, IgA, IgG, and complement components as pre-operative markers for the development of multiple organ dysfunction syndrome in patients with infective endocarditis in early postoperative period

2021 ◽  
Vol 6 (3) ◽  
pp. 35-45
Author(s):  
A. V. Ponasenko ◽  
M. V. Khutornaya ◽  
A. V. Tsepokina ◽  
Yu. A. Kudryavtseva
Keyword(s):  
Infective Endocarditis ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Postoperative Period ◽  
Postoperative Outcome ◽  
Multiple Organ ◽  
Early Postoperative Period ◽  
Multiple Organ Dysfunction ◽  
Complement Components ◽  
Native Valve

Aim. Here, we studied whether the immunoreactivity in pre-operative period defines early postoperative complications in patients with infective endocarditis (IE).Materials and Methods. We consecutively enrolled 110 patients with subacute IE (80 with native-valve IE and 30 with prosthetic valve IE) who underwent a heart valve replacement, then measuring the levels of IgM, IgA, IgG, and complement components in their serum and evaluating their correlation with an adverse early postoperative outcome.Results. Compared with patients< 50 years of age, those ≥ 50 years of age had 2-foldand 3-foldhigher prevalence of systemic inflammatory response syndrome and multiple organ dysfunction syndrome in the early postoperative period. Notably, these numbers correlated with increased С3d and С5а along with reduced Ig М and IgG. IgМ below 9.5 mg/mL and IgG below 2.0mg/mL indicated a 3-foldhigher risk of multiple organ dysfunction syndrome (OR = 3.07, 95% CI = 1.96-4.04, р=0,001).Conclusion. Serum IgM, IgG, and complements factors C3d and C5a may be used as prognostic markers of multiple organ dysfunction syndrome in the early postoperative period.

scholarly journals An uncommon manifestation of Streptococcus gallolyticus infective endocarditis with cerebral septic emboli

2017 ◽  
Vol 4 (4) ◽  
pp. 16
Author(s):  
Wan Tin Lim ◽  
Chiara Jiamin Chong ◽  
Robert Chen ◽  
Tharmmambal Balakrishnan
Keyword(s):  
Infective Endocarditis ◽  
Intracranial Hemorrhage ◽  
Cerebral Arteries ◽  
Neurological Manifestations ◽  
Septic Emboli ◽  
Streptococcus Gallolyticus ◽  
Uncommon Presentation ◽  
Magnetic Resonance Imaging Mri ◽  
Occipital Lobes ◽  
High Degree

Infective endocarditis (IE) can often present with neurological manifestations, due to embolization from valvular vegetation, but the presentation is often variable and unpredictable. Septic emboli to both occipital lobes supplied by the posterior cerebral arteries, resulting in visual disturbances are also an uncommon presentation of IE reported in the literature. While S. gallolyticus is a classical cause of IE, it is less common and usually occurs in a less suspecting group of patients with no predisposing cardiac conditions. We report the case of a 48-year-old man, who presented with predominant complaints of blurring of vision and temporal headache, without any other infective symptoms. The procalcitonin level was also normal even in the setting of bacteremia with septic embolism. The initial magnetic resonance imaging (MRI) showed multifocal enhancing lesions in cerebral hemispheres, cerebellum, and brainstem, with leptomeningeal enhancement. Transesophageal echocardiography and blood cultures subsequently confirmed diagnosis of S. gallolyticus IE of the mitral valve. The patient was treated with antibiotics upon diagnosis of IE. However, he developed intracranial hemorrhage secondary to mycotic aneurysms, and partial seizures. He eventually succumbed to the intracranial hemorrhage. This case serves to highlight that neurological manifestations can precede symptoms or signs of IE and the presentation are often variable. A high degree of clinical suspicion is needed to suspect neurological manifestations of IE, especially in patients without risk factors.

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