scholarly journals Visual Loss Induced by Adalimumab Used for Plaque Psoriasis

2017 ◽  
Vol 9 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Norman Saffra ◽  
Konstantin Astafurov

A 61-year-old Caucasian male with severe plaque psoriasis without joint involvement was initiated on adalimumab therapy. Shortly thereafter he presented to the emergency room with acute loss of vision in the right eye. A comprehensive systemic workup was instituted which included magnetic resonance imaging (MRI) with and without gadolinium of the brain and orbits. MRI revealed findings that were consistent with CNS demyelination and retrobulbar optic neuritis. Immediate cessation of adalimumab was instituted without any other systemic therapy. Complete return of vision occurred within 6 weeks. No additional psoriatic or neurologic treatment was instituted, and the patient has remained stable now for 14 months.

2007 ◽  
Vol 48 (6) ◽  
pp. 687-689 ◽  
Author(s):  
A. B. Larson Kolbe ◽  
A. M. McKinney ◽  
A. Tuba Karagulle Kendi ◽  
D. Misselt

We present a case of an immunocompetent patient who developed Aspergillus meningitis, subsequent to discitis, presumed to be from an epidural steroid injection. Magnetic resonance imaging (MRI) of the lumbar spine confirmed the diagnosis of discitis. Fluoroscopic-guided aspiration of the disc showed growth of Aspergillus fumigatus. MRI of the brain revealed involvement of the right third cranial nerve. Repeat MRIs demonstrated multiple leptomeningeal masses consistent with granulomatous meningitis. Meningitis is a rare complication of discitis, discogram, or epidural steroid injection. Aspergillus usually only infects immunocompromised patients, but rarely can affect immunocompetent patients.


2019 ◽  
Vol 39 (01) ◽  
pp. 016-017
Author(s):  
Benedito Jamilson Araújo Pereira ◽  
Radmila Agra Cariry Targino de Holanda ◽  
José Targino Neto ◽  
Luciano Ferreira de Holanda

AbstractA 79-year-old patient was admitted to the emergency room with transitory monoparesis in the left hand and dysphasia. The brain computed tomography (CT) and magnetic resonance imaging (MRI) showed a spontaneous right convexity subarachnoid hemorrhage (cSAH). Digital subtraction angiography (DSA) confirmed an asymptomatic occlusion of the right internal carotid artery (ICA) . Cases related to stenosis have already been described, but there is no similar report of a case related to occlusion, even though the pathophysiology of both entities is similar. Atraumatic SAH has been associated with intracranial and extracranial artery stenosis.


Author(s):  
Abdorreza Naser Moghadasi

: This study aimed to present a case of a clinically isolated syndrome (CIS) with a reported tumefactive demyelinating lesion (TDLs) in the cord. The patient was a 25-year-old woman who referred to MS Clinic complaining of walking impairment and a blurred vision in the right eye. In the magnetic resonance imaging (MRI) of the brain, there were several periventricular plaques, a significant portion of which had enhanced, but none of the lesions was tumefactive. In the cervical MRI, however, several tumefactive plaques appeared with a clear enhancement and expansion, which was central-based in the axial view. Concerning the involvement of the cervical cord, further examinations were conducted of anti-aquaporin and anti-myelin oligodendrocyte glycoprotein (MOG) antibodies, which were negative. The patient was treated with 1g methylprednisolone daily injection for five days; her symptoms recovered completely. Then, due to the extent of the involvement, rituximab was prescribed for her. Unlike the TDLs of the brain, little attention has been paid to these lesions in the cord. Here, firstly a case of CIS with a tumefactive lesion reported in the cord is investigated, and then, by examining similar cases, we try to find a definition for cord TDLs.


Author(s):  
J.P. Schoeman ◽  
M.F. Stidworthy ◽  
J. Penderis ◽  
U. Kafka

A 13-month-old, neutered, male Golden retriever presented with seizures and progressive depression. Clinical and neurological assessment was consistent with severe intracranial disease. The neurological condition progressively deteriorated and magnetic resonance imaging (MRI) revealed the presence of a large, contrast-enhancing, space-occupying mass in the right cerebral hemisphere. Therapy with corticosteroids, mannitol and furosemide ameliorated the signs of depression and ataxia, but the owner elected euthanasia after 1 week. Post mortem examination of the brain confirmed the presence of a large haemorrhagic lesion in the right olfactory lobe, the histopathological appearance of which was consistent with cerebral cavernous haemangioma. This is the 1st case describing the MRI appearance of a cavernous haemangioma of the cerebrum in the veterinary literature.


2012 ◽  
Vol 03 (03) ◽  
pp. 344-346 ◽  
Author(s):  
Murat Alemdar

ABSTRACTHemifacial Spasm (HS) occurs idiopathically or secondary to the lesions compressing the root exit zone of the facial nerve symptomatically. Symptomatic HS is generally due to vascular compression. We report on a 23-year-old male with right sided HS for a month. Magnetic resonance imaging (MRI) of the brain revealed a well-demarcated epidermoid cyst in the right cerebellopontine cistern. It was hypointense on T1-weighted imaging, hyperintense on T2-weighted imaging without contrast enhancement, hyperintense on DWI, and slightly hypointense on ADC relative to the brain. Although it caused shifting of the pons and medulla to the left side and compression of the right cerebellar peduncles and fourth ventricle, the sole symptom of the patient was HS. Clinicians are advised to request MRI/scan for brainstem lesions from the patients with HS. Epidermoid cysts in cerebellopontine cistern may present with HS as the sole symptom.


2012 ◽  
Vol 71 (2) ◽  
Author(s):  
S. O. Wajuihian

This paper forms part two of a review of the neurobiology of developmental dyslexia (DD) and here the focus is on magnetic resonance imaging (MRI)of the corpus callosum (CC) of dyslexic and non-dyslexic subjects. The CC is a bundle of nerve fibres connecting the left and the right hemisphere of the brain. Due to the role of this structure in inter-hemispheric transfer and integration between the hemispheres, the CC is significant in the search for the neurobiological basis of DD. (S Afr Optom 2012 71(1) 39-45)


2012 ◽  
Vol 71 (1) ◽  
Author(s):  
S. O. Wajuihian

This paper forms part two of a review of the neurobiology of developmental dyslexia (DD) and here the focus is on magnetic resonance imaging (MRI) of the corpus callosum (CC) of dyslexic and non-dyslexic subjects. The CC is a bundle of nerve fibres connecting the left and the right hemisphere of the brain. Due to the role of this structure in inter-hemispheric transfer and integration between thehemispheres, the CC is significant in the search for the neurobiological basis of DD. (S Afr Optom 2012 71(1) 39-45)


Author(s):  
Dominic Gascho ◽  
Michael J. Thali ◽  
Rosa M. Martinez ◽  
Stephan A. Bolliger

AbstractThe computed tomography (CT) scan of a 19-year-old man who died from an occipito-frontal gunshot wound presented an impressive radiating fracture line where the entire sagittal suture burst due to the high intracranial pressure that arose from a near-contact shot from a 9 mm bullet fired from a Glock 17 pistol. Photorealistic depictions of the radiating fracture lines along the cranial bones were created using three-dimensional reconstruction methods, such as the novel cinematic rendering technique that simulates the propagation and interaction of light when it passes through volumetric data. Since the brain had collapsed, depiction of soft tissue was insufficient on CT images. An additional magnetic resonance imaging (MRI) examination was performed, which enabled the diagnostic assessment of cerebral injuries.


Neurosurgery ◽  
1988 ◽  
Vol 23 (6) ◽  
pp. 770-773 ◽  
Author(s):  
Masahiko Udzura ◽  
Hiroo Kobayashi ◽  
Yoshio Taguchi ◽  
Hiroaki Sekino

Abstract A 54-year-old man with a right hemiparesis was found to have an intrasellar intercarotid communicating artery associated with agenesis of the right internal carotid artery. Magnetic resonance imaging (MRI) studies demonstrated the spatial relationship of the anomalous artery to the surrounding structures, thus suggesting an embryonic enlargement of the capsular artery as a source of this anomalous artery.


CNS Spectrums ◽  
2010 ◽  
Vol 15 (S4) ◽  
pp. 3-6 ◽  
Author(s):  
Andres M. Kanner ◽  
Andrew J. Cole

A 27-year-old woman presented to the emergency room after having witnessed generalized tonic clonic seizure while asleep. Birth and development were normal. She had suffered a single febrile seizure at 13 months of age, but had no other seizure risk factors. She was otherwise well except for a history of depression for which she was taking sertraline. Depressive symptoms had been well controlled over the past 3 months, but she had been under increased stress working to finish a doctoral thesis. Neurological examination was normal. Magnetic resonance imaging (MRI) showed modest asymmetry of the hippocampi, slightly smaller on the right, but no abnormal signal and well-preserved laminar anatomy. An electroencephalogram was negative. She was discharged from the emergency room with no treatment. Three weeks later, the patient's boyfriend witnessed an episode of behavioral arrest with lip smacking and swallowing automatisms lasting 45 seconds, after which the patient was confused for 20–30 minutes. The next morning she and her boyfriend kept a previously scheduled appointment with a neurologist.


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