scholarly journals Unusual lesion in the splenium of the corpus callosum and coronavirus infectious disease-19

2020 ◽  
Vol 6 (3) ◽  
pp. 20200068
Author(s):  
Nivedita Agarwal ◽  
Rosella Martini ◽  
Giovanni Pedrotti ◽  
Sabino Walter Della Sala
Keyword(s):  
Infectious Disease ◽  
Corpus Callosum ◽  
Clinical Status ◽  
Altered Mental Status ◽  
Solitary Lesion ◽  
Viral Pathogen ◽  
Multiple Organs ◽  
The Central Nervous System ◽  
Unusual Lesion ◽  
Per Se

Coronavirus infectious diseases (COVID-19) is an emerging infectious disease that has taken a strong grip on the entire global community. The diagnosis per se is straightforward; however, the disease seems to affect multiple organs. Cytokine-storm, increased thromboembolic state, deranged overall homeostasis and aggressive medical treatment can cause a variety of lesions in the central nervous system. Interpretation of brain imaging findings will require a thorough understanding of the clinical status of the patient and treatment being offered, keeping in mind the several ways in which the viral pathogen, severe acute respiratory syndrome coronavirus-2 may interact with brain tissue. We present differential diagnosis of a MRI identified solitary lesion in the splenium of the corpus callosum, in a COVID-19 positive patient with altered mental status.

scholarly journals Unusual lesion in the splenium of the corpus callosum and coronavirus infectious disease-19

2020 ◽  
Author(s):  
Nivedita Agarwal ◽  
Rosella Martini ◽  
Giovanni Pedrotti ◽  
Sabino Walter Della Sala
Keyword(s):  
Infectious Disease ◽  
Corpus Callosum ◽  
Clinical Status ◽  
Altered Mental Status ◽  
Resonance Imaging ◽  
Solitary Lesion ◽  
Viral Pathogen ◽  
Multiple Organs ◽  
The Central Nervous System ◽  
Unusual Lesion

Abstract Coronavirus infectious diseases (COVID-19) is an emerging infectious disease that has taken a strong grip on the entire global community. The diagnosis per se is straightforward; however, the disease seems to affect multiple organs. Cytokine-storm, increased thromboembolic state, deranged overall homeostasis and aggressive medical treatment can cause a variety of lesions in the central nervous system. Interpretation of brain imaging findings will require a thorough understanding of the clinical status of the patient and treatment being offered, keeping in mind the several ways in which the viral pathogen, severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) may interact with brain tissue. We present differential diagnosis of a magnetic resonance imaging identified solitary lesion in the splenium of the corpus callosum, in a COVID-19 positive patient with altered mental status.

scholarly journals Infectious disease-associated encephalopathies

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Maria C. Barbosa-Silva ◽  
Maiara N. Lima ◽  
Denise Battaglini ◽  
Chiara Robba ◽  
Paolo Pelosi ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Cognitive Deficits ◽  
Brain Function ◽  
Cell Activation ◽  
Therapeutic Strategies ◽  
Barrier Dysfunction ◽  
Glial Cell Activation ◽  
The Central Nervous System ◽  
Underlying Mechanisms

AbstractInfectious diseases may affect brain function and cause encephalopathy even when the pathogen does not directly infect the central nervous system, known as infectious disease-associated encephalopathy. The systemic inflammatory process may result in neuroinflammation, with glial cell activation and increased levels of cytokines, reduced neurotrophic factors, blood–brain barrier dysfunction, neurotransmitter metabolism imbalances, and neurotoxicity, and behavioral and cognitive impairments often occur in the late course. Even though infectious disease-associated encephalopathies may cause devastating neurologic and cognitive deficits, the concept of infectious disease-associated encephalopathies is still under-investigated; knowledge of the underlying mechanisms, which may be distinct from those of encephalopathies of non-infectious cause, is still limited. In this review, we focus on the pathophysiology of encephalopathies associated with peripheral (sepsis, malaria, influenza, and COVID-19), emerging therapeutic strategies, and the role of neuroinflammation. Graphic abstract

Viral Encephalitis In Adults: A Narrative Review

2021 ◽  
Vol 16 ◽  
Author(s):  
Siciliano Valentina ◽  
Rosà Tommaso ◽  
Del Vecchio Pierluigi ◽  
D'Angelillo Anna ◽  
Brigida Mattia ◽  
...  
Keyword(s):  
Viral Encephalitis ◽  
Viral Infections ◽  
Direct Action ◽  
Ventilatory Support ◽  
Signs And Symptoms ◽  
Altered Mental Status ◽  
Poor Quality ◽  
Electrolyte Disorders ◽  
The Central Nervous System

: Viral infections of the central nervous system cause frequent hospitalization. The pathogenesis of viral encephalitis involves both the direct action of invading pathogens and the damage generated by the inflammatory reaction they trigger. The type of signs and symptoms presented by the patient depends on the severity and location of the ongoing inflammatory process. Most of the viral encephalitides are characterized by an acute development, fever, variable alterations in consciousness (confusion, lethargy, even coma), seizures (focal and generalized) and focal neurologic signs. The specific diagnosis of encephalitis is usually based on lumbar puncture. Cerebrospinal fluid examination should be performed in all patients unless absolutely contraindicated. Also, electroencephalogram and neuroimaging play a prominent role in diagnosis. Airway protection, ventilatory support, the management of raised intracranial pressure and correction of electrolyte disorders must be immediately considered in a patient with altered mental status. The only therapy strictly recommended is acyclovir in HSV encephalitis. The use of adjunctive glucocorticoids has poor-quality evidence in HSV, EBV, or VZV encephalitis. The role of antiviral therapy in other types of viral encephalitis is not well defined.

scholarly journals Fetal MRI vs. fetal ultrasound in the diagnosis of pathologies of the central nervous system

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Inês Pimentel ◽  
João Costa ◽  
Óscar Tavares
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Corpus Callosum ◽  
Fetal Mri ◽  
Fetal Ultrasound ◽  
Fetal Malformations ◽  
Fetal Us ◽  
The Central Nervous System ◽  
Common Group ◽  
Magnetic Resonance Imaging Mri

Abstract Background Malformations of the central nervous system (CNS) constitute the 2nd most common group of fetal pathologies, which can be reflected throughout the patient's life. Fetal ultrasound (US), together with fetal magnetic resonance imaging (MRI) are extremely important techniques for the diagnosis of CNS malformations. The objective of this work was to address fetal US and fetal MRI, as well as the benefits of its use in different CNS pathologies and to ascertain which of the techniques presents better results. Methods For this systematic literature review, a search was conducted using databases such as PubMed® and ScienceDirect®, Google Scholar, b-on digital library, in a 10-year period, 2010 to 2020. 60 references were used, which met the inclusion criteria, namely compliance with the defined timeframe and the theme of the work to be addressed. Results As for the results, fetal US is the first-line technique for fetal evaluation, and its objective is to detect possible fetal malformations early, while fetal MRI complements the information collected through fetal US. When there are cases of isolated ventriculomegaly and complete agenesis of the corpus callosum, fetal US can correctly assess the pathology. When it comes to pathologies such as dysgenesis of the corpus callosum and malformations of the posterior fossa, fetal MRI evaluates more effectively in comparison to fetal US. Conclusions In conclusions, to reduce the number of false positives, the techniques should be used together, thus providing a better diagnosis.

Fatal Parasitic Meningoencephalomyelitis Caused By Halicephalobus deletrix: A Case Report and Review of the Literature

2010 ◽  
Vol 134 (4) ◽  
pp. 625-629
Author(s):  
Sarah L. Ondrejka ◽  
Gary W. Procop ◽  
Keith K. Lai ◽  
Richard A. Prayson
Keyword(s):  
Fatal Case ◽  
Brain Biopsy ◽  
Altered Mental Status ◽  
Brain Parenchyma ◽  
Review Of The Literature ◽  
Inflammatory Infiltration ◽  
Granulomatous Vasculitis ◽  
Helminthic Infection ◽  
The Central Nervous System ◽  
The Brain

Abstract Infection with the saprophagous nematode Halicephalobus species is uncommon but has been reported in horses worldwide. Only 3 human cases have been previously described, all of which have been fatal. We report a fourth fatal case, which occurred in a 39-year-old woman who presented with meningeal signs, altered mental status, and a prodromal pruritic rash. Diagnostic evaluation included an open brain biopsy, which was diagnosed as granulomatous vasculitis. The patient subsequently died after a course of steroids and cyclophosphamide. At autopsy, a robust perivascular mixed inflammatory infiltration of the brain parenchyma, meninges, and ventricular system was present with larval forms and mature nematodes morphologically consistent with Halicephalobus deletrix. Although extremely rare, this organism needs to be considered in the differential diagnosis of human helminthic infection of the central nervous system.

Clinical Chemistry

2019 ◽  
Author(s):  
Dan Furmedge
Keyword(s):  
Fluid Balance ◽  
Clinical Chemistry ◽  
Clinical Status ◽  
Serum Biochemistry ◽  
Left Ventricular ◽  
Intravenous Fluids ◽  
Blood Tests ◽  
Large Numbers ◽  
Per Se ◽  
Level 2

With so many tests available and increasingly fast laboratory processors, there is a growing temptation to request large numbers of blood tests on each and every patient. What we should remember is that they should be used as an adjunct to the history and clinical examination. Test results should reinforce the likely diagnosis and rule out our differentials, rather than be used to try and make the diagnosis per se. What makes things easier is to know how serum biochemistry and homeostasis are regulated and then to consider a number of questions: ● Which hormones are involved in the control of this electrolyte? ● What happens when these are increased or decreased? ● Does the patient have any renal or hepatic impairment? ● Are they taking any drugs that might be affecting serum electrolyte levels? ● Have they taken an overdose? ● Is the patient dehydrated/ hypovolaemic/ hypoxic? It can seem daunting at first when results come back unexpectedly out of range. They must be considered in combination with the patient’s clinical status; if the numbers just do not fit, then repeat the test— they may not be right. However, there are a few ‘unmissable’ electrolyte derangements that need to be dealt with immediately. Once detected, they should trigger the thoughts shown in Table 12.1. Interpreting serum values is important, but to prevent iatrogenic derangement, careful use and prescription of intravenous fluids are also needed. Does a patient who looks hypovolaemic, has a low blood pres­sure, and is tachycardic need crystalloids or blood? Colloids, such as ‘Gelofusine®’ or ‘Volplex®’, are now largely out of date, with evidence not supporting their use. Are they frail or do they have cardiac failure and therefore require cautious replacement? Do they have liver failure? Is their fluid balance so critical that close fluid monitoring in a level 2 crit­ical care setting required? Gone are the days when central venous lines are used on the wards for fluid balance. This chapter will help consider­ation of the whole picture before putting pen to paper and (potentially) wrongly prescribing 4 L of fluids a day for a frail older man with left ventricular failure.

scholarly journals A Reversible Cytotoxic Lesion of the Corpus Callosum Developing after a Rapid Alteration in Cerebrospinal Fluid Pressure/Volume in a Patient with New Daily Persistent Headache

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Todd D. Rozen ◽  
Hector A. Robles
Keyword(s):  
Central Nervous System ◽  
Corpus Callosum ◽  
Fluid Pressure ◽  
New Daily Persistent Headache ◽  
Csf Pressure ◽  
Acute Withdrawal ◽  
History Of ◽  
The Central Nervous System ◽  
Head Pressure ◽  
Persistent Headache

A case is presented of a woman with a history of daily persistent head pressure and dizziness who developed a cytotoxic lesion of the splenium of the corpus callosum after an acute withdrawal of chronic acetazolamide treatment and then, in quick succession, a CSF pressure/volume drop with a lumbar puncture. This is the first documentation that rapid alterations of CSF pressure/volume may trigger cytotoxic lesions in the central nervous system.

N-terminal pro-B-type natriuretic peptide levels in children: comparison in cardiac and non-cardiac diseases

2020 ◽  
Vol 30 (4) ◽  
pp. 500-504
Author(s):  
Hyun Su Kim ◽  
Hee Joung Choi
Keyword(s):  
Infectious Disease ◽  
Natriuretic Peptide ◽  
Cardiac Disease ◽  
Clinical Status ◽  
Cardiac Diseases ◽  
Disease Group ◽  
Inflammatory Status ◽  
Acute Infections ◽  
Ventilation Support ◽  
Mechanical Ventilation Support

AbstractBackground:N-terminal pro-B-type natriuretic peptide (NT-proBNP), a well-known marker of cardiac disease, may be elevated in acute infections and other non-cardiac diseases. The aim of this study was to evaluate NT-proBNP levels in cardiac and non-cardiac diseases and found out the patient’s clinical status that affects the NT-proBNP levels.Methods:NT-proBNP levels were measured in three groups of children: a cardiac disease group, an infectious disease group, and a non-cardiac, non-infectious disease group.Result:In total, 348 children were enrolled, including 134 patients (38.5%) with cardiac disease, 170 patients (48.9%) with infectious disease, and 44 patients (12.6%) with non-cardiac, non-infectious disease. The NT-proBNP level of the cardiac disease group (median: 548 pg/mL; range: 5–35,000 pg/mL) was significantly higher than that of the infectious disease group (median: 193 pg/mL; range: 10–35,000 pg/mL) and the non-cardiac, non-infectious disease group (median: 280 pg/mL; range: 6–35,000 pg/mL). Regarding clinical status, the NT-proBNP levels were significantly higher in patients who needed mechanical ventilation support, oxygen therapy, or inotropic medication or had a change in mental status than in other patients. However, the systemic inflammatory response syndrome and mortality were not related to the NT-proBNP level.Conclusion:Among heterogeneous group of children, NT-proBNP level can be a useful marker of cardiac disease. Furthermore, the NT-proBNP levels were related to patients’ clinical deteriorations, such as shock rather than the inflammatory status of patients.

INSULIN STIMULATION TESTS IN PITUITARY DEPENDENT CUSHING'S SYNDROME AFTER COMPLETE ADRENALECTOMY

1977 ◽  
Vol 86 (3) ◽  
pp. 578-582 ◽  
Author(s):  
R. J. M. Croughs ◽  
H. Timmermans ◽  
A. C. M. Vingerhoeds ◽  
A. Vermeulen ◽  
A. Smals ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
Similar Magnitude ◽  
Insulin Stimulation ◽  
Plasma Acth ◽  
Stimulation Tests ◽  
The Central Nervous System ◽  
Previously Treated ◽  
Per Se ◽  
Adrenocortical System

ABSTRACT The present study shows that in a group of 6 euadrenal patients, previously treated by complete adrenalectomy for pituitary dependent Cushing's syndrome, the stress stimulus of insulin induced hypoglycaemia is followed by a plasma ACTH response which is of similar magnitude as the response obtained with lysin-vasopressin. Both observations indicate that the central nervous system-pituitary axis is basically normal in pituitary dependent Cushing's syndrome as assessed by insulin induced hypoglycaemia. It is concluded that non-responsiveness of the pituitary-adrenocortical system to insulin induced hypoglycaemia in untreated patients with pituitary dependent Cushing's syndrome does not represent a fundamental defect of the stress mechanism, but is due to hypercorticism per se.

scholarly journals A Late COVID-19 Complication: Male Sexual Dysfunction

2020 ◽  
Vol 35 (6) ◽  
pp. 688-689
Author(s):  
Saeed Shoar ◽  
Siamak Khavandi ◽  
Elsa Tabibzadeh ◽  
Aydin Vaez ◽  
Ali Khabbazi Oskouei ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Sexual Dysfunction ◽  
Clinical Course ◽  
Urogenital System ◽  
Multiple Organs ◽  
Clinical Presentations ◽  
Male Sexual Dysfunction ◽  
Male Patients ◽  
Novel Coronavirus

AbstractSince the beginning of the coronavirus infectious disease 2019 (COVID-19) pandemic, an exponentially large amount of data has been published to describe the pathology, clinical presentations, and outcomes in patients infected with the severe acute respiratory syndrome novel coronavirus 2 (SARS-CoV-2). Although COVID-19 has been shown to cause a systemic inflammation predisposing the involvement of multiple organs, its mechanism affecting the urogenital system has not been well-documented. This case report presents the clinical course of two male patients with COVID-19 who developed sexual dysfunction, as anorgasmia, following recovery from the infection. Although no evidence of viral replication or inflammatory involvement could be identified in these cases’ urogenital organs, a lack of other known risk factors for anorgasmia points to the role of COVID-19 as the contributing factor.

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