scholarly journals Intracerebral hemorrhage due to moyamoya syndrome as a rare presentation of cerebral rheumatoid vasculitis: a case report

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Ayman Hassan El-Sudany ◽  
Salah Hussein El-Halawany ◽  
Shady S. Georgy ◽  
Amr S. Zaki ◽  
Rady Y. Bedros ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Intracerebral Hemorrhage ◽  
Neurological Complications ◽  
Cord Compression ◽  
Moyamoya Syndrome ◽  
Rheumatoid Vasculitis ◽  
Rare Presentation ◽  
Early Management ◽  
Threatening Condition ◽  
Receptive Aphasia

Abstract Background Central nervous system affection in rheumatoid arthritis is rare. The most frequently encountered neurological complications with rheumatoid arthritis are peripheral neuropathy and atlantoaxial subluxation with subsequent spinal cord compression. Cerebral rheumatoid vasculitis is not a common complication. Case presentation A 60-year-old Egyptian female with history of rheumatoid arthritis for 15 years presented with headache and receptive aphasia. Computed tomography scan of the brain showed recent intracerebral hemorrhage. Digital subtraction cerebral angiography showed moyamoya syndrome angiographic pattern as sequelae of intracranial vasculitis. The patient did well with conservative management. Conclusion Cerebral rheumatoid vasculitis is rare, but can be a life-threatening condition. Early management of rheumatoid arthritis is essential to prevent such serious complication.

scholarly journals Case Report: Aortitis associated with rheumatoid arthritis: A challenging rheumatoid vasculitis presentation

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1370
Author(s):  
Zeineb Teyeb ◽  
Mohamed Ben Salah ◽  
Lobna Kharrat ◽  
Imen Abdellali ◽  
Taieb Jomni ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Chest Pain ◽  
Clinical Presentation ◽  
Rare Complication ◽  
Rheumatoid Vasculitis ◽  
Rare Presentation ◽  
Blood Tests ◽  
High Doses ◽  
Inflammatory Syndrome

Rheumatoid vasculitis (RV) is a rare but serious extra-articular manifestation of rheumatoid arthritis (RA). Its varied clinical presentation makes it hard to diagnose and treat. Hereby we describe a case of an aortitis revealing RV, which is a rare presentation of a rare complication of RA. A 56-year-old man with rheumatoid arthritis treated with methotrexate presented with fever, chest pain and arthritis. Blood tests revealed inflammatory syndrome associated with cholestasis. The diagnosis of pericarditis associated with aortitis was retained. Cholestasis was mostly due to methotrexate. The patient was treated with cyclophosphamide pulses and high doses of prednisolone. The patient was in complete remission of articular and extra-articular manifestations after two months of treatment.

Odontoid cervical gout causing atlantoaxial instability: case report

2019 ◽  
Vol 30 (4) ◽  
pp. 541-544
Author(s):  
Justin Slavin ◽  
Marcello DiStasio ◽  
Paul F. Dellaripa ◽  
Michael Groff
Keyword(s):  
Rheumatoid Arthritis ◽  
Spinal Cord ◽  
Case Report ◽  
Physical Examination ◽  
Odontoid Process ◽  
Signs And Symptoms ◽  
Cord Compression ◽  
Atlantoaxial Instability ◽  
Posterior Stabilization ◽  
Rotatory Subluxation

The authors present a case report of a patient discovered to have a rotatory subluxation of the C1–2 joint and a large retroodontoid pannus with an enhancing lesion in the odontoid process eventually proving to be caused by gout. This patient represented a diagnostic conundrum as she had known prior diagnoses of not only gout but also sarcoidosis and possible rheumatoid arthritis, and was in the demographic range where concern for an oncological process cannot fully be ruled out. Because she presented with signs and symptoms of atlantoaxial instability, she required posterior stabilization to reduce the rotatory subluxation and to stabilize the C1–2 instability. However, despite the presence of a large retroodontoid pannus, she had no evidence of spinal cord compression on physical examination or imaging and did not require an anterior procedure to decompress the pannus. To confirm the diagnosis but avoid additional procedures and morbidity, the authors proceeded with the fusion as well as a posterior biopsy to the retroodontoid pannus and confirmed a diagnosis of gout.

scholarly journals Significant Associations of Neurological Complications of Herpes Zoster With Stroke in Rheumatoid Arthritis Patients

2017 ◽  
Vol 6 (7) ◽  
Author(s):  
Tsai‐Ling Liao ◽  
Ching‐Heng Lin ◽  
Hsin‐Hua Chen ◽  
Yi‐Ming Chen ◽  
Che‐Chen Lin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Herpes Zoster ◽  
Neurological Complications

Neurological problems in advanced cancer

2021 ◽  
pp. 872-889
Author(s):  
Augusto Caraceni ◽  
Fabio Simonetti ◽  
Cinzia Martini
Keyword(s):  
Spinal Cord ◽  
Palliative Care ◽  
Advanced Cancer ◽  
Neurological Complications ◽  
Cord Compression ◽  
Pharmacological Therapy ◽  
Leptomeningeal Metastases ◽  
Clinical Aspects ◽  
Advanced Illness ◽  
Base Of The Skull

Neurological complications are frequent in patients with advanced cancer. This chapter discusses a variety of neurological problems found in advanced cancer together with their clinical aspects and management, including some suggested regimens for pharmacological therapy. Complications discussed include intracranial hypertension, seizures in patients with advanced illness (including a suggested algorithm for the management of status epilepticus), delirium, brain metastases, spinal cord compression (including an algorithm for the evaluation of back pain), leptomeningeal metastases, base of the skull and cranial nerve syndromes, neurological side effects of drugs used in oncology and palliative care, and paraneoplastic neurological syndromes.

scholarly journals Severe Mononeuritis Multiplex due to Rheumatoid Vasculitis in Rheumatoid Arthritis in Sustained Clinical Remission for Decades

2020 ◽  
Vol 59 (5) ◽  
pp. 705-710
Author(s):  
Masanobu Tanemoto ◽  
Shin Hisahara ◽  
Bungo Hirose ◽  
Kazuna Ikeda ◽  
Takashi Matsushita ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Remission ◽  
Rheumatoid Vasculitis ◽  
Mononeuritis Multiplex

Atlantoaxial stabilization in rheumatoid arthritis

1991 ◽  
Vol 74 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Stephen M. Papadopoulos ◽  
Curtis A. Dickman ◽  
Volker K. H. Sonntag
Keyword(s):  
Rheumatoid Arthritis ◽  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Atlantoaxial Subluxation ◽  
High Rate ◽  
Content Type ◽  
Operative Stabilization ◽  
Asymptomatic Patients ◽  
Fine Print

✓ Atlantoaxial subluxation in patients with rheumatoid arthritis is common. Operative stabilization is clearly indicated when signs and symptoms of spinal cord compression occur. However, many recommend early operative fusion before evidence of appreciable neural compression occurs because 1) the myelopathy in these patients may be irreversible; 2) the overall prognosis is poor once symptoms of cord compression are present; and 3) the risk of sudden death associated with atlantoaxial subluxation is increased even in asymptomatic patients. The authors believe that rheumatoid arthritis patients in relatively good health without advanced multisystem disease and less than 65 years of age should be considered for operative stabilization if mobile atlantoaxial subluxation is greater than 6 mm. Seventeen patients with severe rheumatoid arthritis and atlantoaxial subluxation treated with a posterior arthrodesis are presented. A new method of fusion, devised by the senior author (V.K.H.S.), was utilized in all cases. Indications for operative therapy in these patients included evidence of spinal cord compression in 11 patients (65%) and mobile atlantoaxial subluxation greater than 6 mm but no signs or symptoms of cord compression in six patients (35%). Thirteen patients developed a stable osseous fusion, two patients a well-aligned fibrous union, one patient a malaligned fibrous union, and one patient died prior to evaluation of fusion stability. The details of the operative technique and management strategies are presented. Several technical advantages of this method of fusion make this approach particularly useful in patients with rheumatoid arthritis. Because of multisystem involvement of this disease, a high rate of osseous fusion is often difficult to achieve.

Rheumatoid Arthritis

2013 ◽  
Author(s):  
Aaron E. Miller ◽  
Teresa M. DeAngelis
Keyword(s):  
Rheumatoid Arthritis ◽  
Nervous System ◽  
Peripheral Nervous System ◽  
Inflammatory Disease ◽  
Neurological Complications ◽  
Neurologic Complications ◽  
Neurological Sequelae ◽  
Systemic Inflammatory Disease

Rheumatoid arthritis (RA) is a systemic inflammatory disease that is characterized principally by a polyarthritis, but can result in several neurologic complications involving both the central and peripheral nervous system. In addition, several immunotherapies used to treat RA have been associated with neurological complications. In this chapter, we review the characteristic neurological sequelae of RA as well as the possible neurological consequences of its therapeutic regimens.

scholarly journals Behavioural change: a rare presentation of leptospirosis

2019 ◽  
Vol 12 (8) ◽  
pp. e230619 ◽  
Author(s):  
Isabelle Dominique Tomacruz ◽  
Joanne Carmela Sandejas ◽  
Regina Berba ◽  
Dennis Raymond Sacdalan
Keyword(s):  
Behavioural Change ◽  
Neurological Complications ◽  
Neurological Deficits ◽  
Empiric Antibiotic Therapy ◽  
Rare Presentation ◽  
Fourfold Increase ◽  
Microagglutination Test ◽  
Antibody Titres ◽  
Empiric Antibiotic ◽  
Cranial Mri

Neurological manifestations of leptospirosis without severe multiorgan involvement are a rare clinical entity. Despite the increasing prevalence of the disease in many tropical countries, its protean clinical presentations make its timely diagnosis challenging. We report the case of a 44-year-old Filipino man presenting with fever, myalgia, behavioural changes and altered sensorium. Neurological examination did not show any focal neurological deficits or clear signs of meningoencephalitis. Lumbar tap, cranial CT scan and cranial MRI were inconclusive. The diagnosis of leptospirosis with acute encephalitis relied heavily on the patient’s clinical clues, appropriate exposure history and patterns in ancillary laboratory tests. Empiric antibiotic therapy with ceftriaxone was initiated. Seroconversion and fourfold increase in serological antibody titres by leptospirosis microagglutination test later confirmed the diagnosis. The patient was successfully treated, and all neurological complications were reversed.

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