Focal Neurological Deficit with Sudden Onset as the First Manifestation of Sarcoidosis: A Case Report with MRI Follow-Up

A 4-year follow-up study is reported on 10 infants whose minor motor seizures were treated intensively with cortisone and/or corticotropin. No correlation was found between the infants' initial clinical and electroencephalographic response to therapy and their follow-up intelligence quotients. The similar initial electroencephalographic findings, contrasted with the marked followup differences in levels of intellectual functioning, illustrate the limited prognostic value of the electroencephalogram in this syndrome. Similarly, no correlation was noted in the patients' initial response to therapy, and the presence or absence of microcephaly or focal neurological deficit. In the absence of any other rational treatment, and despite the dismal prospect suggested by this report and those of others, renewed efforts to treat patients earlier and more intensively with cortisone and corticotropin could be undertaken. However, in the light of 4 years' experience, such an approach might be a reflection more of therapeutic desperation than of rational expectation of good results.

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Posttraumatic C2-C3 spondyloptosis without focal neurological deficit, treated with anterior and posterior approaches: A case report

Surgical Neurology International ◽

10.25259/sni_462_2021 ◽

2021 ◽

Vol 12 ◽

pp. 332

Author(s):

Arash Fattahi ◽

Abdoulhadi Daneshi ◽

seyed Mohammad Reza Mohajeri

Keyword(s):

Case Report ◽

Vertebral Artery ◽

Postoperative Period ◽

Neurological Deficit ◽

Neurological Deficits ◽

Case Description ◽

Focal Neurological Deficit ◽

X Ray ◽

Neurologically Intact ◽

Ct Studies

Background: Cervical spondyloptosis is usually caused by trauma, and correlated with significant neurological deficits that can include quadriplegia, respiratory disorders, vertebral artery injury, and death. Case Description: A 34-year-old male presented with C2-C3 spondylolisthesis after a fall from a tree. Although he had no neurological deficits, CT and X-ray studies confirmed C2-C3 a spondyloptosis. He was treated with emergent anterior and posterior cervical reduction, decompression, and fixation, remaining neurologically intact in the postoperative period. Conclusion: Patients with C2-C3 spondyloptosis documented on X-ray/CT studies should be considered for circumferential decompression/fusion to preserve neurological function.

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Meningioangiomatosis in a patient with progressive focal neurological deficit-case report and review of literature

British Journal of Neurosurgery ◽

10.3109/02688697.2012.741737 ◽

2012 ◽

Vol 27 (2) ◽

pp. 253-255 ◽

Cited By ~ 6

Author(s):

A. Abdulazim ◽

M. A. Samis Zella ◽

M. Rapp ◽

K. Gierga ◽

K. J. Langen ◽

...

Keyword(s):

Case Report ◽

Neurological Deficit ◽

Review Of Literature ◽

Focal Neurological Deficit

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Natural history of brainstem cavernous malformations: prospective hemorrhage rate and adverse factors in a consecutive prospective cohort

Journal of Neurosurgery ◽

10.3171/2019.12.jns192856 ◽

2020 ◽

pp. 1-12

Author(s):

Da Li ◽

Ze-Yu Wu ◽

Pan-Pan Liu ◽

Jun-Peng Ma ◽

Xu-Lei Huo ◽

...

Keyword(s):

Risk Factor ◽

Natural History ◽

Neurological Deficit ◽

Cox Regression ◽

Developmental Venous Anomaly ◽

Focal Neurological Deficit ◽

Cavernous Malformations ◽

Cox Regression Analysis ◽

History Of

OBJECTIVEGiven the paucity of data on the natural history of brainstem cavernous malformations (CMs), the authors aimed to evaluate the annual hemorrhage rate and hemorrhagic risk of brainstem CMs.METHODSNine hundred seventy-nine patients diagnosed with brainstem CMs were referred to Beijing Tiantan Hospital from 2006 to 2015; 224 patients were excluded according to exclusion criteria, and 47 patients were lost to follow-up. Thus, this prospective observational cohort included 708 cases (324 females). All patients were registered, clinical data were recorded, and follow-up was completed.RESULTSSix hundred ninety (97.5%) of the 708 patients had a prior hemorrhage, 514 (72.6%) had hemorrhagic presentation, and developmental venous anomaly (DVA) was observed in 241 cases (34.0%). Two hundred thirty-seven prospective hemorrhages occurred in 175 patients (24.7%) during 3400.2 total patient-years, yielding a prospective annual hemorrhage rate of 7.0% (95% CI 6.2%–7.9%), which decreased to 4.7% after the 1st year. Multivariate Cox regression analysis after adjusting for sex and age identified hemorrhagic presentation (HR 1.574, p = 0.022), DVA (HR 1.678, p = 0.001), mRS score ≥ 2 on admission (HR 1.379, p = 0.044), lesion size > 1.5 cm (HR 1.458, p = 0.026), crossing the axial midpoint (HR 1.446, p = 0.029), and superficially seated location (HR 1.307, p = 0.025) as independent adverse factors for prospective hemorrhage, but history of prior hemorrhage was not significant. The annual hemorrhage rates were 8.3% and 4.3% in patients with and without hemorrhagic presentation, respectively; the rate was 9.9%, 6.0%, and 1.0% in patients with ≥ 2, only 1, and 0 prior hemorrhages, respectively; and the rate was 9.2% in patients with both hemorrhagic presentation and focal neurological deficit on admission.CONCLUSIONSThe study reported an annual hemorrhage rate of 7.0% exclusively for brainstem CMs, which significantly increased if patients presented with both hemorrhagic presentation and focal neurological deficit (9.2%), or any other risk factor. Patients with a risk factor for hemorrhage needed close follow-up regardless of the number of prior hemorrhages. It should be noted that the referral bias in this study could have overestimated the annual hemorrhage rate. This study improved the understanding of the natural history of brainstem CMs, and the results are important for helping patients and physicians choose a suitable treatment option based on the risk factors and stratified annual rates.Clinical trial registration no.: ChiCTR-POC-17011575 (http://www.chictr.org.cn/).

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Multiple cerebral tuberculomas without focal neurological deficit in an immunocompetent adult Nigerian: A case report

SANAMED ◽

10.5937/sanamed1603221o ◽

2016 ◽

Vol 11 (3) ◽

pp. 221-224

Author(s):

Okokhere Peter ◽

Akhuemokhan Kennedy ◽

Wahab Kolawole ◽

Akhigbe Theophilus ◽

Akpede George

Keyword(s):

Case Report ◽

Neurological Deficit ◽

Immunocompetent Adult ◽

Focal Neurological Deficit

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Rare case of basilar artery aneurysm in a young child

BMJ Case Reports ◽

10.1136/bcr-2019-233875 ◽

2020 ◽

Vol 13 (4) ◽

pp. e233875

Author(s):

Peter Mallett ◽

Sean Thomas O'Reilly ◽

Ian Rennie ◽

Mano Shanmuganathan ◽

Andrew James Thompson

Keyword(s):

Neurological Deficit ◽

Artery Aneurysm ◽

Anterior Circulation ◽

Focal Neurological Deficit ◽

Significant Family History ◽

Level Of Consciousness ◽

Basilar Artery Aneurysm ◽

History Of ◽

Basilar Tip Aneurysm

A previously well, 14-month-old girl presented with acute decreased level of consciousness. There was no history of trauma, systemic upset or significant family history. Blood pressure was within normal range and no focal neurological deficit was elicited on examination. Neuroimaging revealed a subarachnoid haemorrhage secondary to a basilar tip aneurysm. Patient underwent endovascular embolisation with good clinical outcome. Follow-up MRI revealed anterior circulation vasospasm, and although clinically asymptomatic, she was treated with a calcium channel antagonist. She was later discharged home with no neurological deficit. Follow-up MRI 3 months following presentation suggested recurrent formation of the aneurysmal sac. The patient then underwent elective endovascular repair 2 months later and was discharged home on antiplatelet therapy with planned close outpatient clinical and radiological surveillance.

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Spontaneous Distal Extrusion of Kuntscher Intramedullary Nail

Case Reports in Orthopedics ◽

10.1155/2021/5587325 ◽

2021 ◽

Vol 2021 ◽

pp. 1-3

Author(s):

W. B. Teh ◽

R. Kuharajan ◽

A. H. Noor Shafika ◽

I. G. Nur Azhani

Keyword(s):

Case Report ◽

Clinical Outcome ◽

Intramedullary Nail ◽

Rare Complication ◽

Sudden Onset ◽

Left Knee ◽

Good Clinical Outcome ◽

Kuntscher Nail ◽

Nail Removal

Migration of femoral Kuntscher intramedullary nail (K-nail) proximally or distally within the femoral medullary cavity is a well-known documented complication, but spontaneous extrusion of a distally migrated K-nail is a rare complication. This is a case report of a 33-year-old lady who complained of sudden onset left knee pain and presented with spontaneous extrusion of a Kuntscher nail 12 years postinsertion. She underwent a successful K-nail removal surgery and showed a good clinical outcome after 6 months of outpatient follow-up.

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A rare cause of acute tympanic membrane perforation: a case report

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20185325 ◽

2018 ◽

Vol 5 (1) ◽

pp. 181

Author(s):

C. J. Timna ◽

Abhijit Kumar

Keyword(s):

Case Report ◽

Tympanic Membrane ◽

Sudden Onset ◽

Tympanic Membrane Perforation ◽

Complete Healing ◽

Accident And Emergency ◽

Membrane Perforation ◽

Accident And Emergency Department ◽

Perforated Tympanic Membrane

<p class="abstract">This is a case report of 57yrs old gentleman who presented to accident and emergency department with complaints of sudden onset of left earache, tinnitus, feeling of fullness in the ear which he claimed to start following an episode of sudden sneezing, while he was trying to blow his nose by pinching it with 2 fingers. The tympanic membrane was ruptured. He was managed conservatively with analgesics. Spontaneous and complete healing of the perforated tympanic membrane occured within one month of follow up. It was shown that an episode of sneezing with nose closed can build up such a high pressure in the middle ear which can perforate a tympanic membrane.</p>

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A patient with diplopia and upper eyelid edema: a case report

Slovenian Medical Journal ◽

10.6016/zdravvestn.1488 ◽

2017 ◽

Vol 86 (9-10) ◽

Author(s):

Igor Šivec Trampuž ◽

Dragica Kosec

Keyword(s):

Case Report ◽

Health Problems ◽

Sudden Onset ◽

Oblique Muscle ◽

Upper Eyelid ◽

Orbital Mass ◽

Eyelid Swelling ◽

Superior Oblique Muscle ◽

Superior Oblique

Idiopathic orbital inﬂammatory disease, previously referred to as orbital pseudotumor, is a nonneoplastic, non-infective disease. The inﬂammatory process can involve one or more orbital sof tissues; extraocular muscles, tear gland, scleralorepiscleral tissue or orbital fat. Orbital myositis typically presents itself with a sudden onset of restricted ocular motility, diplopia, congestive proptosis, eyelid ptosis, periocular swelling and conjunctival hyperemia. A thorough workup is essential for ruling out other entities.This report presents a case of a 47-year old man with a sudden onset of right upper eyelid swelling and diplopia. Until then he had no health problems. Afer initial ophthalmologic workup and ultrasound an orbital mass was suspected. Te MRI and a biopsy of the mass confirmed an isolated superior oblique muscle myositis. We treated him with systemic steroids. A good response and fast regression were observed. In two years of follow-up visits no recurrence was noted.Isolated superior oblique muscle myositis is extremely rare. This is one of eleven cases documented between 1988 and 2015. This case report presents a 47-year old man with a sudden onset of right upper eyelid swelling and diplopia. Until then he had no health problems. After initial ophthalmologic workup and ultrasound an orbital mass was suspected. The MRI and a biopsy of the mass confirmed an isolated superior oblique muscle myositis. We treated him with systemic steroids. A good response and fast regression was observed. In two years of follow-up visits no recurrence was noted.Isolated superior oblique muscle myositis is extremely rare. This is one of eleven documented cases between 1988 and 2015.

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Chronic Encapsulated Intracerebral Hematoma Associated with Cavernous Angioma: A Case Report

Neurosurgery ◽

10.1227/00006123-199004000-00026 ◽

1990 ◽

Vol 26 (4) ◽

pp. 700-702 ◽

Cited By ~ 21

Author(s):

Shigeyuki Murakami ◽

Masahiro Sotsu ◽

Satoru Morooka ◽

Takashi Suzuki

Keyword(s):

Brain Tumor ◽

Case Report ◽

Frontal Lobe ◽

Neurological Deficit ◽

Clinical Picture ◽

Cavernous Angioma ◽

Intracerebral Hematoma ◽

Focal Neurological Deficit ◽

Capsule Formation ◽

Space Occupying Lesion

Abstract The case of a patient with a chronic encapsulated intracerebral hematoma associated with a cavernous angioma is reported. In spite of a huge space-occupying lesion in the frontal lobe, our patient showed no focal neurological deficit. The clinical picture suggested a slowly growing brain tumor. Intraoperative findings revealed a liquefied intracerebral hematoma with a thick capsule. Pathological investigations demonstrated a capsule rich in neovascularity with a cavernous angioma attached to it. It is presumed that initial bleeding from the cavernous angioma encouraged capsule formation similar to the membrane of chronic subdural hematomas and that repeated bleeding from the capillaries of the capsule allowed the expansion of the hematoma.

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