scholarly journals SAT-270 Priapism Secondary to Cabergoline

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Maryam Amir ◽  
Monica Flores ◽  
Jorge Calles-Escandon
Keyword(s):  
Side Effect ◽  
Penile Erection ◽  
Brain Mri ◽  
Sella Turcica ◽  
Underlying Mechanism ◽  
Recent Change ◽  
Low Flow ◽  
History Of ◽  
Long Acting ◽  
The Right

Abstract Background: Cabergoline and Bromocriptine are ergot derivative long-acting dopamine agonist that are very effective and well tolerated in patients with hyperprolactinemia. A rare and unwanted side effect of Bromocriptine is priapism, which has hardly ever been report in literature and it’s not cited under the medication insert. The underlying mechanism is not totally clear, but it is well known that dopaminergic pathways in the central nervous system are of importance for male sexual behavior and penile erection. Lesser is known about Cabergoline and priapism with only one case report in the literature (1). Clinical Case: A 65 yr old African American male with a past medical history significant for obesity, essential hypertension, and recent history of frontal headaches was found to have a pituitary macroadenoma. Brain MRI demonstrated 11 x 12 x 9 mm enhancing lesion within the right lateral sella turcica. The lesion extended laterally to abut the right cavernous ICA without vascular encasement or extension into the right temporal skull base. Prolactin level was 276.3 ng/mL (2.1-15.0 ng/mL). He was started on Cabergoline 0.5 mg weekly. 60 days after starting Cabergoline he presented to the ED with a painful penile erection lasting >12 hours. He did not take any Phosphodiesterase (PDE) inhibitors and had no other recent change in medications. He denied any history of sickle cell disease. His most recent dose of Carbergoline was the day prior to the ED visit. He was seen by a Urologist in the ED and confirmed to have a low flow Priapism and underwent aspiration of intracorporal bodies. He was discharged home on pseudoephedrine and pain medications. Carbergoline was discontinued. He has had no further episodes of Priapism since discontinuation of Cabergoline. Conclusion: The time between drug use and occurrence, absence of other offending medications or precipitating factors and no further priapism episodes once treatment was discontinued suggests a priapism as a rarely reported side effect of Cabergoline. (1) References: 1.E.de la Pena Zarzuelo, V. Hernandez Canas and C. Llorente Abarca, Department of Urology, Hospital Universitario Fundacion Alcorcon, Madrid, Spain

scholarly journals A Case of Priapism with Risperidone

2014 ◽  
Vol 2014 ◽  
pp. 1-2 ◽  
Author(s):  
Almari Ginory ◽  
Mathew Nguyen
Keyword(s):  
Side Effect ◽  
Penile Erection ◽  
Corpus Cavernosum ◽  
Psychotropic Medications ◽  
History Of ◽  
Future Risk ◽  
New Onset

Priapism is a urologic emergency defined as a prolonged, possibly painful, penile erection. There are several known causes of priapism including psychotropic medications. One of the mechanisms by which antipsychotics are believed to induce priapism is through alpha-1 antagonism. This is case of a 50-year-old male with a history of schizophrenia with previous priapism related to trazodone, who presents with new onset priapism associated with risperidone. In this case, the treatment of priapism includes discontinuation of the offending agent and drainage of the corpus cavernosum twice along with intracavernosal phenylephrine injections. It is important to educate patients on priapism as a possible side effect of medications. It is also important to consider previous episodes of medication-induced priapism when prescribing psychotropic medications as this may increase the patient’s future risk of priapism.

Primary cerebellar histiocytic sarcoma in a 17-month-old girl

2012 ◽  
Vol 10 (2) ◽  
pp. 126-129 ◽  
Author(s):  
Kiyoshi Gomi ◽  
Mio Tanaka ◽  
Mariko Yoshida ◽  
Susumu Ito ◽  
Masaki Sonoda ◽  
...  
Keyword(s):  
Right Hemisphere ◽  
Brain Mri ◽  
Histiocytic Sarcoma ◽  
Cerebellar Tumor ◽  
Pediatric Age Group ◽  
Old Japanese ◽  
History Of ◽  
Dural Attachment ◽  
The Right ◽  
Aggressive Clinical Course

The authors report on a case of histiocytic sarcoma (HS) in a pediatric patient presenting with a solitary tumor in the cerebellum, with the aim of providing insight into primary HS in the CNS, which is especially rare. A 17-month-old Japanese girl presented with a 2-week history of progressive gait disturbance. Brain MRI revealed a 4.7 × 4.3 × 4.3–cm well-demarcated solitary mass in the right hemisphere of the cerebellum, initially suggestive of medulloblastoma, ependymoma, or anaplastic astrocytoma. On intraoperative inspection the cerebellar tumor showed intensive dural attachment and was subtotally removed. Histological and immunohistochemical findings were consistent with HS. The patient subsequently received chemotherapy, and her preoperative neurological symptoms improved. Primary HS in the CNS usually demonstrates an aggressive clinical course and is currently considered to have a poor prognosis. The possibility of this rare tumor should be included in the differential diagnosis of localized cerebellar tumors in the pediatric age group.

The Sweating Anomaly in Cluster Headache: Further Observations on the Underlying Mechanism

Cephalalgia ◽  
1987 ◽  
Vol 7 (1) ◽  
pp. 77-81 ◽  
Author(s):  
Ottar Sjaastad ◽  
Rolf Salvesen ◽  
F Antonaci
Keyword(s):  
Cluster Headache ◽  
Underlying Mechanism ◽  
Interesting Case ◽  
Test Results ◽  
Sympathetic Dysfunction ◽  
Typical History ◽  
History Of ◽  
Heating Test ◽  
The Right ◽  
Autonomic Test

We describe a patient with a typical history of cluster headache for more than 18 years. During the first approximately 10 years of his disease, the pain was right-sided, and pupillometric and evaporimetric measurements indicated a sympathetic deficiency on this same side. However, for the next >6 years, his pain was consistently left-sided, although the signs of sympathetic dysfunction still were more marked on the right side. This was also true for the findings obtained during the interictal period and for the heating test performed within an attack. The implications of this interesting case are discussed. The view that two separate lines of symptom production lead to the pain and the autonomic phenomena seems to be supported by this case history. The cluster headache syndrome may also be a bilateral disorder, with only the weight of balance pointing one way or the other. Finally, the autonomic test results of this patient could reflect an autonomic “scar” in the previous headache side.

scholarly journals Bilateral Subdural Haematoma and CPAP Use: A Possible Association

2020 ◽  
Author(s):  
Beatrice Khater ◽  
Vicky Kassouf ◽  
Georges Haddad ◽  
Roula Hourany
Keyword(s):  
Subdural Haematoma ◽  
Brain Mri ◽  
Sleep Apnoea ◽  
Neurological Deficits ◽  
Angiotensin Ii Receptor Blocker ◽  
Angiotensin Ii Receptor ◽  
Acute Subdural Haematoma ◽  
Obstructive Sleep ◽  
History Of ◽  
The Right

Obstructive sleep apnoea (OSA) is a common condition usually treated with continuous positive airway pressure (CPAP). No reports have linked it to an acute subdural haematoma. A 54-year-old white man who had hypertension well controlled with an angiotensin II receptor blocker, presented with a 2-week history of occipital headache with no other focal neurological symptoms. The headache began 12 days after he had started using CPAP for OSA. A brain MRI performed 2 weeks later showed bilateral subdural haematomas which were chronic on the left and sub-acute/acute on the right. Since the patient was clinically stable with no focal neurological deficits, he received prednisone for 3 weeks and was followed up with consecutive CT scans demonstrating gradual regression of the haematomas. This is the first report showing that subdural haematomas could be linked to CPAP use.

Diagnosis and treatment of infraspinatus tendon-bursa ossification in a Eurasian Dog

2018 ◽  
Vol 46 (02) ◽  
pp. 126-132
Author(s):  
Stephan Hungerbühler ◽  
Wolfgang Henninger ◽  
Petra Klupiec ◽  
Julia Bödeker ◽  
Anna Langer ◽  
...  
Keyword(s):  
Radiographic Examination ◽  
Intralesional Injection ◽  
Veterinary Clinic ◽  
Imaging Results ◽  
Infraspinatus Muscle ◽  
Direct Pressure ◽  
History Of ◽  
Long Acting ◽  
The Right ◽  
Infraspinatus Tendon

SummaryA 4-year-old male Eurasian Dog presented at our veterinary clinic with a history of perpetual forelimb lameness in both thoracic limbs. In the clinical exploration, direct pressure over the infraspinatus tendon of insertion caused pain in both thoracic forelimbs and a firm band-like structure was palpable. No improvement was observed after treatment with rest, non-steroidal anti-inflammatory drugs and an intralesional injection of a long-acting glucocorticoid. Radiographic examination, ultrasonographic exploration and computed tomography were performed, identifying ossified structures lateral to the proximal humerus and an irregular roughened periosteum at the insertion and tendon of the infraspinatus muscle on both sides. There were more distinct alterations on the right thoracic limb. The imaging results led to a diagnosis of an infraspinatus tendon-bursa ossification accompanied by a chronic tendinopathy/tendovaginitis, accentuated on the right side. The dog was subjected to physiotherapy and autologous conditioned plasma (ACP) was injected into the insertion of the infraspinatus muscle of both thoracic limbs. After 5 months of physiotherapy and two injections of ACP with an interval of one week in both forelimbs, the dog showed no signs of lameness. This case report describes the diagnosis and management of infraspinatus tendon-bursa ossification in a Eurasian Dog. To the authors’ knowledge, this condition has previously not been described in this breed of dog.

A review of exercise pulmonary hypertension in systemic sclerosis

2019 ◽  
Vol 4 (3) ◽  
pp. 225-237
Author(s):  
Faisal Shaikh ◽  
Zafia Anklesaria ◽  
Tasneam Shagroni ◽  
Rajeev Saggar ◽  
Luna Gargani ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Systemic Sclerosis ◽  
Vascular Disease ◽  
Underlying Mechanism ◽  
Pulmonary Vascular Disease ◽  
Non Invasive ◽  
History Of ◽  
Prognostic Implications ◽  
Definition Of ◽  
The Right

In general, pulmonary vascular disease has important negative prognostic implications, regardless of the associated condition or underlying mechanism. In this regard, systemic sclerosis is of particular interest as it is the most common connective tissue disease associated with pulmonary hypertension, and a well-recognized at-risk population. In the setting of systemic sclerosis and unexplained dyspnea, the concept of using exercise to probe for underlying pulmonary vascular disease has acquired significant interest. In theory, a diagnosis of systemic sclerosis–associated exercise pulmonary hypertension may allow for earlier therapeutic intervention and a favorable alteration in the natural history of the pulmonary vascular disease. In the context of underlying systemic sclerosis, the purpose of this article is to provide a comprehensive review of the evolving definition of exercise pulmonary hypertension, the current role and methodologies for non-invasive and invasive exercise testing, and the importance of the right ventricle.

scholarly journals Gliosarcoma with Primary Skull Base Invasion

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Quoc-Bao D. Nguyen ◽  
Avital Perry ◽  
Christopher S. Graffeo ◽  
Cody L. Nesvick ◽  
Aditya Raghunathan ◽  
...  
Keyword(s):  
Skull Base ◽  
Brain Mri ◽  
Brain Parenchyma ◽  
Who Grade ◽  
Direct Invasion ◽  
Jaw Opening ◽  
History Of ◽  
Dural Attachment ◽  
The Right ◽  
Muscles Of Mastication

Gliosarcoma is an uncommon variant of glioblastoma, which commonly demonstrates dural attachment. However, skull base invasion is rarely seen with this entity. Herein, we report a 44-year-old female patient diagnosed with primary intracranial gliosarcoma extensively invading the skull base and muscles of mastication. She presented to our institution with a three-month history of difficult right jaw opening and retro-orbital pressure and one week of severe right-sided postauricular headache. Head CT demonstrated a 6 cm mass with marked bony erosion. Brain MRI at a one-week interval more clearly characterized tumor extension through the right orbit and muscles of mastication, with overall growth to 7 cm and worsening midline shift. The patient underwent a right frontotemporal craniotomy for gross total resection. Pathology confirmed the diagnosis of gliosarcoma, IDH-wildtype (WHO grade IV). Her postoperative course was uneventful and she was discharged at preoperative neurologic baseline. To our knowledge, this is the third reported case of a primary intracranial gliosarcoma with direct invasion of skull base, brain parenchyma, and extracranial compartment. However, this is the first report case of primary GS invading the surrounding musculature and orbit. This case report highlights the rapid aggressiveness of gliosarcomas and further a prior undescribed radiographic and anatomic finding of skull base invasion with this entity.

scholarly journals B.06 Two definite sudden unexpected deaths in epilepsy in a family with a DEPDC5 mutation

2016 ◽  
Vol 43 (S2) ◽  
pp. S10-S10
Author(s):  
FA Nascimento ◽  
F Borlot ◽  
P Cossette ◽  
B Minassian ◽  
D Andrade
Keyword(s):  
Risk Factor ◽  
Stop Codon ◽  
Brain Mri ◽  
Premature Stop Codon ◽  
Temporal Region ◽  
Unexpected Death ◽  
Increased Risk ◽  
History Of ◽  
Interictal Discharges ◽  
The Right

Background:DEPDC5 gene, mapped to 22q12.2-q12.3, has been associated with a variety of familial epilepsies, including FFEVF, autosomal dominant nocturnal frontal lobe epilepsy, and familial TLE. Notably, DEPDC5 has never been linked to increased risk of sudden unexpected death in epilepsy (SUDEP). Methods: Cases review. Results: We studied a three-generation, non-consanguineous, French-Canadian family with nine clinically affected individuals. The index case is a 39-year-old man who started having seizures (as 2rily GTCS) at the age of 13 years. EEGs showed interictal discharges over the right anterior-temporal region. Brain MRI was unremarkable. Two individuals in this family suffered definite autopsy-confirmed SUDEP, at the ages of 58 and 50 years, respectively. Overall, seizure-history in this family can be summarized by an onset before reaching adulthood followed by subsequent progressive decrease in seizure frequency. Seizures were predominantly nocturnal 2rily GTC. Genetic analysis revealed a pathogenic heterozygous variant in the DEDPC5 gene (p.Gln216, c.646C>T), which results in a premature stop codon, in all affected family members plus on heatlhy relative. Importantly, all the subjects were cognitively intact, and there was no history of cardiac symptomatology/cardiovascular risk factor. Conclusions: The finding in this family suggests that DEPDC5 mutations may be a risk factor for SUDEP.

scholarly journals Involvement of peripheral III nerve in multiple sclerosis patient: Report of a new case and discussion of the underlying mechanism

2017 ◽  
Vol 23 (5) ◽  
pp. 748-750 ◽  
Author(s):  
Natalia Shor ◽  
Maria del Mar Amador ◽  
Didier Dormont ◽  
Catherine Lubetzki ◽  
Anne Bertrand
Keyword(s):  
Multiple Sclerosis ◽  
Peripheral Nerve ◽  
Cranial Nerves ◽  
Underlying Mechanism ◽  
Secondary Process ◽  
Peripheral Nerve Damage ◽  
History Of ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Multiple sclerosis (MS) is a chronic disorder that affects the central nervous system myelin. However, a few radiological cases have documented an involvement of peripheral cranial nerves, within the subarachnoid space, in MS patients. We report the case of a 36-year-old female with a history of relapsing-remitting (RR) MS who consulted for a subacute complete paralysis of the right III nerve. Magnetic resonance imaging (MRI) examination showed enhancement and thickening of the cisternal right III nerve, in continuity with a linear, mesencephalic, acute demyelinating lesion. Radiological involvement of the cisternal part of III nerve has been reported only once in MS patients. Radiological involvement of the cisternal part of V nerve occurs more frequently, in almost 3% of MS patients. In both situations, the presence of a central demyelinating lesion, in continuity with the enhancement of the peripheral nerve, suggests that peripheral nerve damage is a secondary process, rather than a primary target of demyelination.

Microsurgical Treatment of Ruptured Spetzler-Martin Grade 3 Right Hippocampal Arteriovenous Malformation: 3-Dimensional Operative Video

2019 ◽  
Vol 18 (1) ◽  
pp. E17-E17
Author(s):  
Kléber González Echeverría ◽  
Marcos Devanir Silva da Costa ◽  
Bruno Lourenço Costa ◽  
Robert Zanabria Ortiz ◽  
Samantha Lorena Paganelli ◽  
...  
Keyword(s):  
Brain Mri ◽  
Venous Drainage ◽  
The Body ◽  
Temporal Region ◽  
3 Dimensional ◽  
Microsurgical Treatment ◽  
Generalized Seizures ◽  
History Of ◽  
Grade 3 ◽  
The Right

Abstract We present a 14-yr-old male with a history of traumatic brain injury in March 2016, secondary to clonic tonic generalized seizures. CT scan showed hemorrhage at mesial temporal region in the body of right hippocampus, intraventricular hemorrhage at the level of lateral ventricles (right and left side) and fourth ventricle. After this the patient presented with pulsating right temporal headache of high intensity (VAS 10/10) that improved with common analgesics, dizziness, and clonic tonic generalized seizures despite taking Phenobarbital 100 mg/24 h. Neuropsychological assessment reveal major deficits regarding executive functions: working memory, verbal fluency, and planning abilities. Brain MRI and angiography showed AVM at the right level of hippocampus body. An intranidal aneurysm was also observed. Venous drainage was through the basal vein of Rosenthal. We planned for surgery and resection of the hippocampal AVM through the trans-T2 approach. Postoperatively, the patient was without medical complications. We present a 3-dimensional video of the microsurgical treatment for right hippocampal AVM performed through a trans-T2 approach. The patient signed the Institutional Consent Form, which allows the use of his/her images and videos for any type of medical publications in conferences and/or scientific articles.

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