scholarly journals Delayed-Onset Post-Stroke Delusional Disorder: A Case Report

2013 ◽  
Vol 27 (3) ◽  
pp. 287-291 ◽  
Author(s):  
Raíssa B. Barboza ◽  
Gabriel R. De Freitas ◽  
Fernanda Tovar-Moll ◽  
Leonardo F. Fontenelle
Keyword(s):  
Cerebrovascular Accident ◽  
Case Reports ◽  
Delusional Disorder ◽  
Psychotic Symptoms ◽  
Parietal Region ◽  
Post Stroke ◽  
Delayed Onset ◽  
Long Period ◽  
One Year ◽  
The Right

Although the prevalence of neuropsychiatric disorders among patients with cerebrovascular illness is relatively high, there are only few case reports describing post-stroke psychotic symptoms. In general, post-stroke psychoses have been reported to emerge few days after the vascular event and to vanish soon afterwards. In this report, we describe delayed-onset post-stroke delusional disorder, persecutory type. A middle-aged female patient developed a persistent delusional disorder with homicidal behavior about one year after a cerebrovascular accident affecting the right fronto-temporo-parietal region and a long period of chronic post-stroke mixed anxiety and depressive symptoms. Our case suggests that there might be long intervals between stroke and the appearance of psychotic symptoms.

scholarly journals Post-stroke psychosis: how long should we treat?

2017 ◽  
Vol 39 (2) ◽  
pp. 144-146 ◽  
Author(s):  
Maria do Céu Ferreira ◽  
Célia Machado ◽  
Beatriz Santos ◽  
Álvaro Machado
Keyword(s):  
Low Dose ◽  
Rare Complication ◽  
Acute Onset ◽  
Psychotic Symptoms ◽  
Antipsychotic Treatment ◽  
Antipsychotic Therapy ◽  
Post Stroke ◽  
History Of ◽  
One Year

Abstract Objective: To describe a rare case of a patient who developed psychotic symptoms after a right stroke that disappeared with antipsychotic treatment, but appears to need low-dose maintenance antipsychotic therapy. Case description: A 65-year-old man presented at the psychiatric emergency service with a history of persistent delusional jealousy, visual illusions and agitation with onset about 1 month after a right posterior cerebral artery ischemic stroke. These symptoms only disappeared with therapeutic dosages of an antipsychotic drug (3 mg/day of risperidone). At 2-year follow-up, he no longer had delusional activity and the antipsychotic treatment was gradually discontinued over the following year. However, 1 week after full cessation, the patient once more became agitated and suspicious and was put back on risperidone at 0.25 mg/day, resulting in rapid clinical remission. One year after the return to low-dose risperidone, the patient's psychopathology is still under control and he is free from psychotic symptoms. Comments: Psychosis is a relatively rare complication after stroke. To our knowledge, no cases of post-stroke psychosis that apparently require continuous low-dose antipsychotic treatment have been reported to date. Our case suggests that low-dose maintenance antipsychotic therapy may be needed for certain patients with post-stroke psychosis, especially for those with risk factors and non-acute onset.

scholarly journals Central ossifying fibroma, periapical cemento-osseous dysplasia and complex odontoma occurring in the same jaw

2011 ◽  
Vol 1 (2) ◽  
pp. 36 ◽  
Author(s):  
Farzaneh Agha Hosseini ◽  
Elham Moslemi
Keyword(s):  
Case Reports ◽  
Ossifying Fibroma ◽  
Pulp Tissue ◽  
Osseous Lesion ◽  
Osseous Dysplasia ◽  
Complex Odontoma ◽  
School Of Dentistry ◽  
One Year ◽  
The Right ◽  
The Relationship

Central ossifying fibroma is a rare, benign fibro-osseous lesion that arises from the periodontal ligament. Periapical cemento-osseous dysplasia is another variant of fibro-osseous lesion which occurs in the anterior region of the mandible of females. Odontoma is a benign odontogenic tumor that contains enamel, dentine cement and pulp tissue. A 46-year-old woman was referred to the Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, with two nonpainful swellings on both sides of the mandible, which had been slowly growing over a period of one year. Our differential diagnosis was florid cemento-osseous dysplasia, focal cemento-osseous dysplasia for the right side, complex odontoma for the left side and periapical cement-osseous dysplasia for the anterior side. The historical feature revealed ossifying fibroma, complex odontoma and periapical cemento-osseous dysplasia. The occurrence of these three lesions in the same jaw has been rarely reported in the literature. The relationship between the occurrence of these three lesions is not obvious it could be coincidental. It seems that more case reports are needed to establish the relationship between them.

A case of delusional disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. s828-s828
Author(s):  
O. Porta Olivares ◽  
M. Juncal Ruiz ◽  
B. Fernández Abascal Puente ◽  
M. Gómez Revuelta ◽  
M. Pérez Herrera ◽  
...  
Keyword(s):  
Therapeutic Relationship ◽  
Psychiatric Treatment ◽  
Delusional Disorder ◽  
Psychotic Symptoms ◽  
First Line ◽  
Behavioral Disturbances ◽  
Competing Interest ◽  
Long Acting ◽  
The Right ◽  
First Line Treatment

IntroductionFunctioning of patients with delusional disorder may be impaired, particularly if the delusional thinking is chronic rather than episodic. They refuse to characterize their beliefs as false and view opposing views with surprise, if not hostility and disdain, dismissing or ignoring them, and continuing their struggle to find resolution or restitution for the wrongs they have endured or the illnesses from which they suffer. They typically reject and often resent the suggestion that they are mentally compromised. They are a difficult group to engage clinically, often refusing to meet with a clinician about their delusions and/or to take medication. The first-line treatment of delusional disorder is antipsychotic medication rather than other clinical interventions. Patients with the disorder often reject psychiatric treatment, it is particularly important that medication be prescribed in the context of a therapeutic relationship that includes support, education, encouragement of healthier pursuits, and discouragement of damaging, delusion-inspired actions.MethodsWe describe a case of a 55-year-old woman with a delusional disorder that was diagnosed 4 years before. The supervision of the right take of the treatment was not possible and the intensity of behavioral disturbances increased. Then we started the treatment with long-acting injectable aripiprazole.ResultsWithin the 4 months following the start of treatment, her mental state improved by attenuation of psychotic symptoms.ConclusionsLong-acting aripiprazole could be an effective tool for treatment of psychotic symptoms in patients with no insight and difficulties to check the proper treatment take.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Lingual Schwannoma Involving The Posterior Lateral Border Of The Tongue In A Young Individual: Case Report

2008 ◽  
Vol 33 (1) ◽  
pp. 59-62 ◽  
Author(s):  
Luciano José Pereira ◽  
Patrícia Peres Iucif Pereira ◽  
João de Paula dos Santos ◽  
Viator Ferreira Reis Filho ◽  
Paulo Roberto Dominguete ◽  
...  
Keyword(s):  
Case Reports ◽  
Neck Region ◽  
Excisional Biopsy ◽  
Individual Case ◽  
Autonomic Nerves ◽  
Current Case ◽  
Lateral Border ◽  
Individual Case Report ◽  
One Year ◽  
The Right

A schwannoma, also called neurilemmoma, is a benign, encapsulated, slow growing tumor, arising from the neural sheath's Schwann cells of the peripheral, cranial or autonomic nerves. The etiology is unknown, there is no gender preference and the tumors occur most commonly between the ages of 20 and 50 years. Approximately 25–48 % of these tumors occur in the head and neck region, with only 1% occurring in the mouth. The current case reports a schwannoma of the tongue, found in a 12 year-old boy. The lesion was present for 6 months. The clinical examination revealed a 1.5x1.0 cm, sessile, rubbery, non-tender, non-ulcerated mass on the right posterior lateral border of the tongue. An excisional biopsy was performed under local anesthesia. The histological sections showed a circumscribed submucosal nodule composed of spindle cells with thin wavy nuclei arranged as typical Antoni A (with Verocay bodies) and Antoni B areas. Nuclear palisading distribution (typical of a schwannoma) was readily identifiable. The patient was recurrence free after one year.

scholarly journals Chylopericardium as a complication of cardiac surgery: Report of two cases and review of the literature

2007 ◽  
Vol 135 (1-2) ◽  
pp. 88-91 ◽  
Author(s):  
Milos Velinovic ◽  
Mile Vranes ◽  
Mladen Kocica ◽  
Petar Djukic ◽  
Aleksandar Mikic ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Case Reports ◽  
Lymphatic Vessels ◽  
Medium Chain Triglycerides ◽  
High Concentration ◽  
Ductus Thoracicus ◽  
Medium Chain ◽  
One Year ◽  
The Right

Chylopericardium refers to existing communication between the pericardial sac and the thoracic duct carrying the chyle. The objective of our report was to highlight the specificity of diagnosis and treatment of this rare but tedious condition through the analysis of two case reports. Male patient, aged 63 years, with chylopericardium was diagnosed perioperatively (implantation of artificial aortic - St. Jude No 21 and mitral valve - St. Jude No 29). Etiology of pericardial effusion was established by Sudan III staining of punctate specimen obtained by subxiphoid pericardial puncture. Probable cause of chylopericardium was the lesion of ductus thoracicus during cross-clamping of the superior caval vein with a Cooley clamp. Initial treatment included diet rich in medium-chain triglycerides which resulted in resolution of the effusion. During five-year follow-up, there were no recurrences of pericardial effusion. The second patient was female, 21 years old, with chylopericardium after partial pericardiectomy performed because of the chronic severely symptomatic pericardial effusion, resistant to other forms of treatment. Pericardiocentesis provided 650 ml of yellowish fluid with a high concentration of cholesterol (3.2 mmol/l), triglycerides (16.6 mmol/l), and proteins (64.7 g/l), which verified chylopericardium, most probably as a consequence of the lesion of ductus thoracicus during partial pericardiectomy. Diet rich in medium-chain triglycerides failed to decrease the effusion, after two weeks of treatment (daily secretion 250-350 ml). Lymphography revealed lesion of ductus thoracicus, most probably at Th9/Th10 level, with no direct visualization of extravasal accumulation of contrast media. Surgical ligation of ductus thoracicus was performed through the right thoracotomy. However, postoperative secretion increased to 1000 ml/day. Patient underwent redo surgery comprising the ligation of lymphatic vessels, guided by extravasation of intraoperatively iwected methylene-blue indicator. During one-year follow-up, there were no recurrences of pericardial effusion. In conclusion, intraoperative lymphography significantly contributed to successful surgical treatment of patients with chylopericardium.

scholarly journals Implant Placement in a Cemento-Osseous Dysplasia: A case report

2021 ◽  
Vol 8 (2) ◽  
pp. 6
Author(s):  
Alexandre Perez ◽  
Avigaïl Maman ◽  
Edouard Di Donna ◽  
Tommaso Lombardi
Keyword(s):  
Case Reports ◽  
Lower Quadrant ◽  
Implant Placement ◽  
Osseous Dysplasia ◽  
Step Procedure ◽  
Mandibular Region ◽  
One Year ◽  
The Right

We present a 45-year-old black woman diagnosed with a florid cemento-osseous dysplasia (FCOD) affecting the right lower quadrant and the anterior mandibular region. The patient requested dental implants to rehabilitate the edentulous central lower incisors area (teeth # 31 and # 41) corresponding to a periapical cemento-osseous dysplasia (PCOD). Successful osseointegration of the two implants was obtained using a two-step procedure in order to limit the risk of complications associated with implant placement. Follow-up at one year showed no recurrence and good implant stability. Due to the abnormal quality of the bone in cemento-osseous dysplasia (COD), implant placement is generally avoided, and no other case reports have been reported in the literature in patients affected by PCOD. The present case suggests that in an appropriate clinical setting, implant placement may be a successful procedure.

Moyamoya Syndrome in a Child with β-Thalassemia Major

2020 ◽  
Vol 18 (04) ◽  
pp. 214-216
Author(s):  
Soumya Roy
Keyword(s):  
Magnetic Resonance ◽  
Cerebrovascular Accident ◽  
Muscle Wasting ◽  
Thalassemia Major ◽  
Blood Transfusions ◽  
Moyamoya Syndrome ◽  
Magnetic Resonance Angiogram ◽  
Joint Contractures ◽  
Gradual Development ◽  
The Right

AbstractA 9-year-old girl patient presented with left-sided weakness and joint contractures developing over a period of 18 months. She was known to be suffering from β-thalassemia major and was on regular blood transfusions. Eighteen months ago, she had suffered from an episode of ischemic cerebrovascular accident affecting the right side of her brain. Magnetic resonance angiogram revealed vaso-occlusive disease affecting mainly the anterior cerebral circulation, resembling Moyamoya disease. She was advised to carry out regular physiotherapy but her parents discontinued it, which resulted in the gradual development of joint contractures and muscle wasting.

scholarly journals Cephalad misplacement of a pulmonary artery catheter in a patient with a preexisting Hickman catheter

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hoon Choi ◽  
Joon Pyo Jeon ◽  
Jaewon Huh ◽  
Youme Kim ◽  
Wonjung Hwang
Keyword(s):  
Mitral Valve ◽  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Case Reports ◽  
Mitral Valve Regurgitation ◽  
Catheter Insertion ◽  
Routine Practice ◽  
Hickman Catheter ◽  
Risk Patients ◽  
The Right

Abstract Background Pulmonary artery catheter insertion is a routine practice in high-risk patients undergoing cardiac surgery. However, pulmonary artery catheter insertion is associated with numerous complications that can be devastating to the patient. Incorrect placement is an overlooked complication with few case reports to date. Case presentation An 18-year-old male patient underwent elective mitral valve replacement due to severe mitral valve regurgitation. The patient had a history of synovial sarcoma, and Hickman catheter had been inserted in the right internal jugular vein for systemic chemotherapy. We made multiple attempts to position the pulmonary artery catheter in the correct position but failed. A chest radiography revealed that the pulmonary artery catheter was bent and pointed in the cephalad direction. Removal of the pulmonary artery catheter was successful, and the patient was discharged 10 days after the surgery without complications. Conclusions To prevent misplacement of the PAC, clinicians should be aware of multiple risk factors in difficult PAC placement, and be prepared to utilize adjunctive methods, such as TEE and fluoroscopy.

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