Limb Pain as Unusual Presentation of a Parietal Intraparenchymal Bleeding Associated with Crack Cocaine Use: A Case Report

Limb pain as a presenting feature of an ischemic or hemorrhagic stroke is extremely rare. Here we present a case of a 65-year-old male with complaints of left arm pain and allodynia (specifically light touch to any part of the left arm produced significant discomfort) who was found to have a right parietal lobe intraparenchymal bleed after smoking crack cocaine. Acute central pain is mainly associated with parietal, thalamic, and brainstem lesions. It has been proposed that acute limb pain from a parietal lobe stroke is due to the disconnection of the parietal cortex from the thalamus secondary to the interruption of the pathways between the hemisphere and thalamus/basal ganglia.

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A Thoracic Outlet Syndrome That Concealed a Glioblastoma. Findings from a Case Report

Medicina ◽

10.3390/medicina57090908 ◽

2021 ◽

Vol 57 (9) ◽

pp. 908

Author(s):

Lorenzo Storari ◽

Manuel Signorini ◽

Valerio Barbari ◽

Firas Mourad ◽

Mattia Bisconti ◽

...

Keyword(s):

Differential Diagnosis ◽

Brain Tumor ◽

Case Report ◽

Bone Fracture ◽

Thoracic Outlet Syndrome ◽

Parietal Lobe ◽

Clavicle Fracture ◽

Rare Presentation ◽

Arm Pain ◽

The Brain

Background: Glioblastoma is the most frequent and aggressive malignant brain tumor among adults. Unfortunately, its symptoms can vary considerably depending on the size, location and the anatomic structures of the involved brain. Case report: A 58-year-old male amateur cyclist who suffered from sharp arm pain was examined for a thoracic outlet syndrome due to a previous clavicle fracture. Because of ambiguous results of the neck and nerve plexus imaging, he was referred to a neurosurgeon who properly suspected a brain tumor. The neuroimaging of the brain shown a 3 cm disploriferative mass with a blood enhancement within the left parietal lobe. The mass was urgently removed, and its histologic analysis stated a grade 4 glioblastoma. Conclusion: This case report highlights the differential diagnosis process and the teamwork approach needed to diagnose a rare presentation of a brain glioblastoma, which started its symptoms mimicking a thoracic outlet syndrome caused by a previous bone fracture.

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Crack Cocaine Mimicking Pulmonary Embolism on Pulmonary Ventilation/Perfusion Lung Scan A Case Report

Clinical Nuclear Medicine ◽

10.1097/00003072-199501000-00016 ◽

1995 ◽

Vol 20 (1) ◽

pp. 65-68 ◽

Cited By ~ 9

Author(s):

GARY T. SMITH ◽

PATRICK L. McCLAUGHRY ◽

JANET PURKEY ◽

WARREN THOMPSON

Keyword(s):

Pulmonary Embolism ◽

Case Report ◽

Crack Cocaine ◽

Pulmonary Ventilation ◽

Lung Scan

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Mirror Writing after Thalamic Hemorrhagic Stroke: A Case Report

Brain & Neurorehabilitation ◽

10.12786/bn.2014.7.1.61 ◽

2014 ◽

Vol 7 (1) ◽

pp. 61

Author(s):

Jin Kyu Yang ◽

Jong Bum Park ◽

So Young Joo ◽

Deog Young Kim

Keyword(s):

Case Report ◽

Hemorrhagic Stroke ◽

Mirror Writing

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Complex phonic tic and disinhibition in Tourette syndrome: case report

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2001000400019 ◽

2001 ◽

Vol 59 (3A) ◽

pp. 587-589 ◽

Cited By ~ 2

Author(s):

Débora Palmini Maia ◽

Francisco Cardoso

Keyword(s):

Breast Cancer ◽

Case Report ◽

Basal Ganglia ◽

Obsessive Compulsive Disorder ◽

Tourette Syndrome ◽

Limbic Cortex ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Behavioral Abnormalities ◽

Motor Tics

Tourette syndrome (TS) is a neuropsychiatric disorder characterized by a combination of multiple motor tics and at least one phonic tic. TS patients often have associated behavioral abnormalities such as obsessive compulsive disorder, attention deficit and hyperactive disorder. Coprolalia, defined as emission of obscenities or swearing, is one type of complex vocal tic, present in 8% to 26% of patients. The pathophysiology of coprolalia and other complex phonic tics remains ill-defined. We report a patient whose complex phonic tic was characterized by repetitively saying "breast cancer" on seeing the son of aunt who suffered from this condition. The patient was unable to suppress the tic and did not meet criteria for obsessive compulsive disorder. The phenomenology herein described supports the theory that complex phonic tics result from disinhibition of the loop connecting the basal ganglia with the limbic cortex.

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Cathodal transcranial direct current stimulation of the posterior parietal cortex reduces steady-state postural stability during the effect of light touch

Neuroreport ◽

10.1097/wnr.0000000000000654 ◽

2016 ◽

Vol 27 (14) ◽

pp. 1050-1055 ◽

Cited By ~ 8

Author(s):

Tomoya Ishigaki ◽

Ryota Imai ◽

Shu Morioka

Keyword(s):

Steady State ◽

Parietal Cortex ◽

Direct Current ◽

Transcranial Direct Current Stimulation ◽

Postural Stability ◽

Posterior Parietal Cortex ◽

Light Touch ◽

Posterior Parietal ◽

Effect Of Light ◽

Stimulation Of

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THU0526 Acute paraspinal muscle necrosis with crack cocaine and heroin; a case report

10.1136/annrheumdis-2018-eular.2294 ◽

2018 ◽

Author(s):

A. Masood ◽

L. Attipoe ◽

D. D’Cruz ◽

S. Al-Saraj ◽

S. Williams ◽

...

Keyword(s):

Case Report ◽

Crack Cocaine ◽

Paraspinal Muscle ◽

Muscle Necrosis

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Case Report: Dacomitinib Overcomes Osimertinib Resistance in NSCLC Patient Harboring L718Q Mutation: A Case Report

Frontiers in Oncology ◽

10.3389/fonc.2021.760097 ◽

2021 ◽

Vol 11 ◽

Author(s):

Qian Shen ◽

Jingjing Qu ◽

Zhen Chen ◽

Jianying Zhou

Keyword(s):

Case Report ◽

Disease Progression ◽

Gamma Knife ◽

Parietal Lobe ◽

Brain Mri ◽

Gamma Knife Radiosurgery ◽

Small Cell ◽

Egfr Mutations ◽

Small Subset ◽

Small Cell Lung

BackgroundAdvanced non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations has been successfully treated with tyrosine kinase inhibitors (TKIs). However, resistance to osimertinib, a third-generation TKI, can be difficult to overcome in this small subset of patients and is attributed to secondary resistant mutations. Here, we report a case of acquired EGFR L858R/L718Q mutation with advanced NSCLC that resistant to osimertinib, which was successfully overcome using dacomitinib.Case PresentationA 64-year-old non-smoker woman was diagnosed with stage IV non-small cell lung adenocarcinoma with EGFR L858R mutation and brain metastasis in November 2018. Treatment with gefitinib and gamma knife radiosurgery was started as the first-line treatment. After 7 months, she experienced disease progression with increased primary lung lesions and switched to osimertinib based on an acquired EGFR T790M mutation. After another 4 months, the disease progressed, and she was switched to chemotherapy. During chemotherapy, brain MRI showed an increasing number of parietal lobe metastases. Hence, gamma knife radiosurgery was performed again. After 12 months, the disease progression resumed, and an EGFR L718Q mutation was found on biopsy. The patient was then challenged with dacomitinib, and the disease was partially responsive and under control for 6 months.ConclusionCurrently, there are no established guidelines for overcoming osimertinib resistance caused by the L718Q mutation. The acquired EGFR L718Q mutation in subsequent resistance to osimertinib could be overcome using dacomitinib, indicating a promising treatment option in the clinic.

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