Medullary infarction causing coexistent SUNCT and trigeminal neuralgia

Cephalalgia ◽  
2016 ◽  
Vol 37 (5) ◽  
pp. 486-490 ◽  
Author(s):  
Giorgio Lambru ◽  
Michele Trimboli ◽  
S Veronica Tan ◽  
Adnan Al-Kaisy
Keyword(s):  
Case Report ◽  
Trigeminal Neuralgia ◽  
Trigeminal Autonomic Cephalalgias ◽  
Conjunctival Injection ◽  
Neurovascular Conflict ◽  
First Case ◽  
Clinical Variants ◽  
Broad Variety ◽  
Medullary Infarction

Background Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) or with autonomic symptoms (SUNA) are grouped together within the trigeminal autonomic cephalalgias (TACs). However, the SUNCT and SUNA phenotype and management overlap with those of trigeminal neuralgia (TN). Additionally, a broad variety of cerebral pathologies are reportedly able to trigger either TN- or SUNCT-like pain, and emerging structural neuroimaging findings suggest the possible role of neurovascular conflict with the trigeminal nerve in SUNCT, further supporting aetiological and pathophysiological overlaps among SUNCT, SUNA and TN. Case report We present the first case of coexisting chronic SUNCT- and TN-like phenotypes caused by haemorrhagic infarct of the dorsolateral medulla. Discussion In light of our case, a perturbation of the dorsolateral medullary circuits may constitute an important pathophysiological component, supporting a unifying nosological hypothesis that considers SUNCT, SUNA and TN clinical variants of the same disorder.

scholarly journals Isolated Dysphagia in a Patient with Medial Medullary Infarction – Effects of Evidence-Based Dysphagia Therapy: A Case Report

2021 ◽  
pp. 190-199
Author(s):  
Samra Hamzic ◽  
Patrick Schramm ◽  
Hassan Khilan ◽  
Tibo Gerriets ◽  
Martin Juenemann
Keyword(s):  
Case Report ◽  
Vascular Occlusion ◽  
Evidence Based ◽  
Severe Dysphagia ◽  
First Case ◽  
Jaw Opening ◽  
Medial Medullary Infarction ◽  
Dysphagia Therapy ◽  
Evidence Based Therapy ◽  
Medullary Infarction

Medial medullary infarction (MMI) is a vascular occlusion in the medulla oblongata leading to certain constellations of neurological symptoms and seriously affecting the patient. Effective evidence-based treatment of severe dysphagia as sole symptom of MMI has not yet been reported. This case study aims to report successful effects of evidence-based therapy based on findings of dysphagia symptoms and pathophysiology of swallowing by flexible endoscopic evaluation of swallowing (FEES) in severe isolated dysphagia after MMI. FEES was performed to evaluate swallowing pathophysiology and dysphagia symptoms in a 57-year-old male with severe dysphagia after MMI. On the basis of FEES findings, simple and high-frequent evidence-based exercises for improvement of swallowing were implemented: thermal stimulation of faucial arches, Jaw Opening Exercise, and Jaw Opening Against Resistance. After 7 weeks of high-frequent evidence-based therapy and regular FEES evaluation the patient was set on full oral diet with no evidence of aspiration risk. In a first case report of isolated dysphagia in MMI our case illustrates that high-frequent evidence-based dysphagia therapy in combination with FEES as the method to evaluate and monitor swallowing pathophysiology can lead to successful and quick rehabilitation of severely affected dysphagic patients.

scholarly journals Role of Immunotherapy in Pulmonary Angiosarcoma: A Case Report

2021 ◽  
pp. 797-801
Author(s):  
Quang Tien Nguyen ◽  
Anh Tuan Pham ◽  
Thuy Thi Nguyen ◽  
Tam Thi Thanh Nguyen ◽  
Ky Van Le
Keyword(s):  
Case Report ◽  
Poor Prognosis ◽  
Checkpoint Inhibitor ◽  
Therapeutic Strategies ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
Excellent Response ◽  
First Case

Pulmonary angiosarcoma is a rare clinical entity with a poor prognosis and no established therapeutic strategies. We present the first case to our knowledge of metastatic pulmonary angiosarcoma, treated with checkpoint inhibitor immunotherapy, and have an excellent response. Until now, patient has been treated with immunotherapy for 1 year, and his disease is stable and well-tolerated.

scholarly journals Intraoperative Treatment of Duct of Luschka during Laparoscopic Cholecystectomy: A Case Report and Revision of Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Luigi Masoni ◽  
Leandro Landi ◽  
Riccardo Maglio
Keyword(s):  
Case Report ◽  
Bile Leak ◽  
Bile Leakage ◽  
Medical Systems ◽  
Invasive Treatment ◽  
Endoscopic Clip ◽  
First Case ◽  
Duct Of Luschka ◽  
Clinically Significant

Background. Bile leakage still remains a serious complication during cholecystectomies. In limited cases, this complication may occur from injury of the so-called ducts of Luschka. These rare ducts are usually discovered intraoperatively, and their presence poses the risk of bile injury and clinically significant bile leak. Presentation Case. We present a unique case of a 59-year-old male patient with acute cholecystitis. After removal of the gallbladder, thorough inspection of the hepatic bed was made and a little bile leak was identified from a duct of Luschka 1 cm away from the gallbladder hilum. We report on the use of endoscopic QuickClip Pro® clips (Olympus Medical Systems Corp., Tokyo, Japan) to avoid further more invasive treatment. Discussion. Endoscopic retrograde cholangiopancreatography with sphincterotomy played a crucial role for diagnosis and treatment of bile leaks with success rate near 94%. Many authors have argued the role of relaparoscopy, Diagnosis may be intraoperatively but this option does not seem to occur very often; in fact, there is a lack of data in literature. Conclusion. This is the first case report of bile leak from duct of Luschka treated during the cholecystectomies with endoscopic clip.

Idiopathic Trigeminal Neuralgia: A Case Report

2018 ◽  
Vol 31 (04) ◽  
pp. 254-258
Author(s):  
Shruti Jain ◽  
Chetna Lamba
Keyword(s):  
Case Report ◽  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Conventional Medicine ◽  
Positive Role ◽  
Idiopathic Trigeminal Neuralgia ◽  
Adequate Pain Relief ◽  
The Face

AbstractTrigeminal neuralgia (TN) is the most frequent type of neuropathic facial pain affecting one or more branches of trigeminal nerve. Here, a 51-year-old woman diagnosed with idiopathic trigeminal neuralgia (ITN) presented with complaints of pain over right side of the face with redness of the eyes and excessive lachrymation since 5 years with weekly acute episodes of shooting pain. Chelidonium was chiefly prescribed followed by few doses of Spigelia as per indications which provided adequate pain relief. The complaints flared up following stressful circumstances for which Pulsatilla was prescribed after detailed case taking. The frequency, duration and intensity of pain reduced after homoeopathic treatment. The need for conventional medicine was also reduced. This suggests positive role of individualised homoeopathy in the treatment of ITN. Further studies should be undertaken to evaluate the role of homoeopathy in ITN.

scholarly journals Vertebrobasilar dolichoectasia as a cause of trigeminal neuralgia: the role of microvascular decompression. Case report

2006 ◽  
Vol 64 (1) ◽  
pp. 128-131 ◽  
Author(s):  
Jorge Luiz Kraemer ◽  
Arthur de Azambuja Pereira Filho ◽  
Gustavo de David ◽  
Mario de Barros Faria
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
Facial Pain ◽  
Successful Outcome ◽  
Mechanical Compression ◽  
Suboccipital Craniotomy ◽  
Vertebrobasilar Dolichoectasia

Our purpose is to report a case of trigeminal neuralgia caused by vertebrobasilar dolichoectasia treated with microvascular decompression. A 63-year-old man sought treatment for a recurrent lancinating left facial pain in V2 and V3 trigeminal territories. The computed tomography angiography revealed a mechanical compression of the left trigeminal nerve due to vertebrobasilar dolichoectasia. The patient was submitted to a left suboccipital craniotomy. Shredded Teflon® was introduced in the conflicting neurovascular area, achieving a satisfactory decompression. The patient’s pain resolved immediately. Vertebrobasilar dolichoectasia is a rare cause of trigeminal neuralgia and a successful outcome can be achieved with microvascular decompression.

scholarly journals The role of neurovascular conflict in the pathogenesis of classical trigeminal neuralgia and the dynamics of approaches to its visualization

2021 ◽  
Vol 2 (1) ◽  
pp. 24-31
Author(s):  
E. V. Baliazina ◽  
O. M. Evusyak ◽  
V. A. Baliazin ◽  
N. G. Kadyan
Keyword(s):  
Trigeminal Neuralgia ◽  
Superior Cerebellar Artery ◽  
Neurovascular Conflict ◽  
Classical Trigeminal Neuralgia ◽  
Cerebellar Artery ◽  
X Ray Computed ◽  
Thematic Review ◽  
Points Of View ◽  
Diagnostic Capabilities

The thematic review discusses various points of view on the topographic and atomic features of the location of the root of the trigeminal nerve and the superior cerebellar artery that serve as the foundation for the development of classical trigeminal neuralgia. The diagnostic capabilities of magnetic resonance imaging in the recognition of neurovascular conflict as the pathogenetic basis of the disease are considered. The search for diagnostic criteria that distinguish neurovascular conflict from neurovascular contact by improving both the performance of MRI and the new technical possibilities of its interpretation is highlighted in the chronological aspect. The possibilities of multispiral X-ray computed angiography in 3D mode as an alternative method for diagnosing neurovascular conflict are described.

scholarly journals Successful Endovascular Treatment of Trigeminal Neuralgia Caused by a CarotidCavernous Fistula: Case Report

2020 ◽  
pp. 1-4
Author(s):  
Luciano Manzato ◽  
Luciano Manzato ◽  
Paulo M. Mesquita Filho ◽  
Octavio Karam ◽  
Victor E. Angeliero ◽  
...  
Keyword(s):  
Case Report ◽  
Trigeminal Neuralgia ◽  
Endovascular Treatment ◽  
World Literature ◽  
Cranial Nerves ◽  
Conjunctival Injection ◽  
Arteriovenous Fistulas ◽  
Fourth Report ◽  
The World ◽  
Dural Arteriovenous Fistulas

Dural arteriovenous fistulas (DAVFs) of the cavernous sinus are arteriovenous connections located in the dura mater leaflets of this region. The usual presentation of a DAVF is predominantly ocular, with symptoms such as diplopia, conjunctival injection, involvement of cranial nerves III/IV/VI, exophthalmos, and chemosis. Trigeminal neuralgia caused by a cavernous DAVF is extremely rare. To the best our knowledge, this is only the fourth report in the world literature. We describe the case of a patient treated by embolization in whom the only presenting symptom of DAVF was trigeminal neuralgia. After endovascular treatment, the patient became asymptomatic.

scholarly journals Cluster-Tic or Tic-Cluster? Trigeminal Neuralgia (Tic) Turning to Trigeminal Autonomic Cephalalgia (TAC) Following Venous Decompression of the Trigeminal Nerve: A Case Report and Review of the Literature

2019 ◽  
Author(s):  
Patrick M. Chen ◽  
Sharona Ben-Haim ◽  
Jason Handwerker ◽  
Hossein Ansari
Keyword(s):  
Case Report ◽  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
New Left ◽  
Trigeminal Autonomic Cephalalgia ◽  
Venous Compression ◽  
Clinical Presentations ◽  
Paroxysmal Pain

Abstract Objective: We present a rare case of Tic-cluster in the context of venous compression of the trigeminal nerve. Background: Cluster-Tic syndrome is a rare headache condition with features of both trigeminal neuralgia (Tic) and trigeminal autonomic cephalalgia symptom (TAC). Methods: Case report and review of literature. Results: A 75-year old man presents with left sided paroxysmal pain consistent with trigeminal neuralgia (Tic). Magnetic resonance demonstrated a venous compression of the posterior-medial aspect of the left trigeminal ganglion. He underwent microvascular decompression which confirmed petrosal vein compression with subsequent symptomatic resolution. After two years of remission, he had a new left unilateral throbbing headache consistent with International Classification of Headache Disorders (ICHD)- 3 cluster headache definition, which improved with steroids. Conclusion: Cluster-Tic syndrome has variable clinical presentations. Tic can precede cluster and the possible role of venous trigeminal compression in this headache remains unclear.

scholarly journals Sarcoidosis Developing During Secukinumab Therapy: Case Report

2017 ◽  
Vol 1 (2) ◽  
pp. 95
Author(s):  
Timothy Nyckowski ◽  
Roger Ceilley ◽  
Joshua Wilson
Keyword(s):  
Case Report ◽  
Psoriatic Arthritis ◽  
Side Effect ◽  
Pulmonary Involvement ◽  
Unknown Etiology ◽  
Systemic Involvement ◽  
First Case ◽  
Relationship Of ◽  
The Relationship

Introduction: Sarcoidosis is a systemic granulomatous inflammatory disease with an unknown etiology and complex pathogenesis. Existing literature supports the relationship of new-onset sarcoidosis with the use of a several biologic agents. Since the skin is the second most commonly involved organ in sarcoidosis and often precedes systemic involvement, dermatologists must be able to recognize its non-specific clinical presentation.Case Report: We present a 45 year old female with psoriatic arthritis who developed biopsy proven cutaneous sarcoidal granulomas with pulmonary involvement shortly after initiating secukinumab for treatment of psoriatic arthritis. Despite discontinuation of secukinumab, the sarcoidosis has persisted.Discussion: This is the first case report of secukinumab, or any IL-17 inhibitor related sarcoidosis that we are aware of in the literature. Dermatologists should be aware of this as a possible side effect of secukinumab use. As the research on the role of IL-17 in the pathogenesis of sarcoidosis continues to develop, the implications of this side effect of IL-17 inhibition may have important future implications.

scholarly journals Acetabular liner dissociation: A case report and review of the literature

SICOT-J ◽  
2019 ◽  
Vol 5 ◽  
pp. 31
Author(s):  
Asif A.H. Parkar ◽  
Mohamed Sukeik ◽  
Ahmed El-Bakoury ◽  
James Powell
Keyword(s):  
Case Report ◽  
Total Hip Arthroplasty ◽  
Polyethylene Liner ◽  
Review Of The Literature ◽  
Acetabular Liner ◽  
First Case ◽  
Ceramic Liner ◽  
Acetabular Shell ◽  
Acetabular Components

Dissociation of the polyethylene liner from the acetabular shell is a rare but catastrophic complication of total hip arthroplasty (THA). There have been reports of polyethylene liner dissociation (PLD) as well as ceramic liner dissociation (CLD) in the literature. Amongst the commonly used implants, liner dissociation has been reported with the Pinnacle (DePuy), Harris–Galante (Zimmer) and Trident (Stryker) acetabular components. To the best of our knowledge, this is the first case report of PLD in an R3 (Smith & Nephew) acetabular component. This case report highlights the implant choice for treatment of the liner dissociation and the role of constrained implants in such cases.

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