scholarly journals Benign Cerebral Edema and Increased Intracranial Pressure (ICP) as Manifestations of COVID-19 Reinfection; A Case Report

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Heidary AH ◽  
Elahi R ◽  
Nazari M
Keyword(s):  
Intracranial Hypertension ◽  
Cerebral Edema ◽  
Rare Case ◽  
Vaccine Development ◽  
Gastrointestinal Symptoms ◽  
First Episode ◽  
Neurological Manifestations ◽  
Imaging Studies ◽  
Increased Intracranial Pressure ◽  
Blurred Vision

Reinfection with COVID-19 is of great importance since it can substantially affect the future of disease control and vaccine development. COVID-19 can present with diverse neurological, as well as respiratory and gastrointestinal symptoms. Here, we present a rare case of COVID-19 reinfection with neurological manifestations. The patient was a healthy 26-year-old male that had experienced first episode of COVID-19 infection with mild respiratory and gastrointestinal symptoms. In his second episode of infection, he presented to the emergency department with vertigo, vomiting, metamorphopsia, blurred vision, headache, and gate disturbance. Based on the clinical data and imaging studies, the patient was diagnosed with benign cerebral edema and intracranial hypertension. Then, he was treated using intravenous/intramuscular corticosteroids in addition to the supplementary therapies. His symptoms dramatically improved during the next 2 days. No important neurologic or systemic adverse events in response to the treatment were noted. This case reveals that infection with COVID-19, despite positive IgG, does not protect the patient from reinfection. Moreover, COVID-19 reinfection can present with benign cerebral edema and intracranial hypertension, in which case, inflammatory suppression therapy should be considered.

scholarly journals Increased intracranial pressure in a case of spinal cervical glioblastoma multiforme: analysis of these two rare conditions

1994 ◽  
Vol 52 (1) ◽  
pp. 64-68 ◽  
Author(s):  
C.M. de Castro-Costa ◽  
R.W.B. de Araújo ◽  
M.A. de Arruda ◽  
P.M. de Araújo ◽  
E.G. de Figueiredo
Keyword(s):  
Glioblastoma Multiforme ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Young Patient ◽  
Rare Case ◽  
Spinal Tumors ◽  
Increased Intracranial Pressure

The authors describe a rare case of increased intracranial hypertension consequent to a spinal cervical glioblastoma multiforme in a young patient. They analyse the physiopathology of intracranial hypertension in spinal tumors and the rarity of such kind of tumor in this location, and its clinico-pathological aspects.

scholarly journals Cerebral edema: from the origins of the description to the modern understanding of the process

2021 ◽  
Vol 23 (2) ◽  
pp. 131-135
Author(s):  
Valentina V. Gudkova ◽  
◽  
Ekaterina I. Kimelfeld ◽  
Stanislav E. Belov ◽  
Evgeniia A. Koltsova ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Cerebral Edema ◽  
Biochemical Markers ◽  
Molecular Mechanisms ◽  
Symptomatic Treatment ◽  
Intracranial Volume ◽  
Increased Intracranial Pressure ◽  
Ancient Times

The article, which is a review-lecture, reflects the historical milestones in the description and study of cerebral edema (CE) from ancient times to the present. Great attention is paid to the Monroe–Kellie doctrine, without which it is impossible to understand the mechanism of development of a vitally significant complication of CE – intracranial hypertension. The importance of the Monroe–Kellie doctrine in substantiating the symptomatic treatment of increased intracranial pressure is emphasized. The possible involvement of the glymphatic system in both the decrease and the increase in increased intracranial pressure is discussed. The modern ideas about the blood-brain barrier (BBB), its role in the development of CE and an increase in intracranial volume are analyzed. With the study of the molecular mechanisms of BBB damage and the development of targeted therapy, the researchers associate future advances in the treatment of CE. The great interest of modern authors in the state of the BBB in various diseases, as well as in the violation of its integrity in COVID-19 is reflected. It is noted that the main and only, today, method for diagnosing CE is neuroimaging. Development has begun on the isolation of potential biochemical markers of CE from blood.

scholarly journals Increased Intracranial Pressure in the Setting ofEnterovirusand Other Viral Meningitides

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Jules C. Beal
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Rare Case ◽  
Case Reports ◽  
Viral Meningitis ◽  
Elevated Intracranial Pressure ◽  
Increased Intracranial Pressure ◽  
Cerebrospinal Fluid Analysis ◽  
Fluid Analysis

Increased intracranial pressure due to viral meningitis has not been widely discussed in the literature, although associations withVaricellaand rarelyEnterovirushave been described. Patients with increased intracranial pressure and cerebrospinal fluid analysis suggestive of a viral process are sometimes classified as having atypical idiopathic intracranial hypertension (IIH). However, a diagnosis of IIH requires normal cerebrospinal fluid, and therefore in these cases an infection with secondary intracranial hypertension may be a more likely diagnosis. Here seven patients are presented with elevated intracranial pressure and cerebrospinal fluid suggestive of viral or aseptic meningitis. Of these, 1 hadEnterovirusand the remainder were diagnosed with nonspecific viral meningitis. These data suggest that viral meningitis may be associated with elevated intracranial pressure more often than is commonly recognized.Enterovirushas previously been associated with increased intracranial pressure only in rare case reports.

scholarly journals Upbeat vertical nystagmus after brain stem cavernoma resection: a rare case of nucleus intercalatus/nucleus of roller injury

2020 ◽  
Vol 267 (10) ◽  
pp. 2865-2870
Author(s):  
Torstein R. Meling ◽  
Aria Nouri ◽  
Adrien May ◽  
Nils Guinand ◽  
Maria Isabel Vargas ◽  
...  
Keyword(s):  
Rare Case ◽  
Vascular Malformations ◽  
Clinical Manifestations ◽  
Neurological Injury ◽  
Medial Longitudinal Fasciculus ◽  
Blurred Vision ◽  
Complete Excision ◽  
First Case ◽  
Vertical Nystagmus ◽  
Upbeat Nystagmus

Abstract Introduction CNS cavernomas are a type of raspberry-shaped vascular malformations that are typically asymptomatic, but can result in haemorrhage, neurological injury, and seizures. Here, we present a rare case of a brainstem cavernoma that was surgically resected whereafter an upbeat nystagmus presented postoperatively. Case report A 42-year old man presented with sudden-onset nausea, vomiting, vertigo, blurred vision, marked imbalance and difficulty swallowing. Neurological evaluation showed bilateral ataxia, generalized hyperreflexia with left-sided predominance, predominantly horizontal gaze evoked nystagmus on right and left gaze, slight left labial asymmetry, uvula deviation to the right, and tongue deviation to the left. MRI demonstrated a 13-mm cavernoma with haemorrhage and oedema in the medulla oblongata. Surgery was performed via a minimal-invasive, midline approach. Complete excision was confirmed on postoperative MRI. The patient recovered well and became almost neurologically intact. However, he complained of mainly vertical oscillopsia. The videonystagmography revealed a new-onset spontaneous upbeat nystagmus in all gaze directions, not suppressed by fixation. An injury of the rarely described intercalatus nucleus/nucleus of Roller is thought to be the cause. Conclusion Upbeat nystagmus can be related to several lesions of the brainstem, including the medial longitudinal fasciculus, the pons, and the dorsal medulla. To our knowledge, this is the first case of an iatrogenic lesion of the nucleus intercalatus/nucleus of Roller resulting in an upbeat vertical nystagmus. For neurologists, it is important to be aware of the function of this nucleus for assessment of clinical manifestations due to lesions within this region.

scholarly journals Evaluation of cerebrovascular hemodynamics in patients with idiopathic intracranial hypertension using transcranial Doppler

2020 ◽  
Vol 56 (1) ◽  
Author(s):  
Mahmoud M. Allam ◽  
Hatem A. Almasry ◽  
Sandra M. Ahmed ◽  
Youssuf G. Taha ◽  
Mohammed I. Oraby
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Lumbar Puncture ◽  
Transcranial Doppler ◽  
Idiopathic Intracranial Hypertension ◽  
Pulsatility Index ◽  
Research Work ◽  
Increased Intracranial Pressure ◽  
Significant Relation ◽  
Before And After

Abstract Background Idiopathic intracranial hypertension (IIH) is a disorder of increased intracranial pressure without a clear cause and can have serious visual effects. Previous research work suggests that transcranial Doppler measurements of pulsatility index correlate accurately with elevated intracranial pressure. Objective To assess the cerebrovascular hemodynamic changes in patients with IIH using transcranial Doppler before and after lumbar puncture and CSF withdrawal. Methods An interventional study conducted on 40 patients (31 females and 9 males) fulfilling the modified Dandy criteria for diagnosis of idiopathic intracranial hypertension, MRI brain, and MRV was done to the patients. Lumbar puncture was done for all included patients to measure intracranial pressure and CSF withdrawal. Transcranial Doppler was performed for all included before and after lumbar puncture and CSF withdrawal and the following parameters were measured: peak systolic velocity (PSV), end diastolic velocity (EDV), resistivity index (RI), and pulsatility index (PI). Results Significant relation was found between grades of papilledema and PSV, RI, and PI (p value 0.012, 0.025, 0.016) but no significant relation was found between grades of papilledema and EDV (0.102). Significant changes occurred in parameters of TCD pre- and post-CSF withdrawal including PSV, EDV, and PI (p value 0.001, 0.015, 0.019) denoting a significant change in cerebral hemodynamics after CSF withdrawal which denotes a decrease in intracranial pressure. Conclusion Increased intracranial pressure significantly affects cerebral blood flow. A normalization of transcranial Doppler parameters occurs following lowering of intracranial pressure through lumbar puncture and CSF withdrawal.

scholarly journals Ibuprofen-Induced Aseptic Meningitis in a Male Adolescent with Intracranial Hypertension and Visual Impairment: A Case Report

2021 ◽  
Vol 13 (1) ◽  
pp. 233-238
Author(s):  
Seyed Mohammad Mousavi Mirzaei ◽  
Zahra Ahmadi
Keyword(s):  
Visual Impairment ◽  
Intracranial Hypertension ◽  
Aseptic Meningitis ◽  
Rare Complication ◽  
Clinical Signs ◽  
Male Adolescent ◽  
Drug Induced ◽  
Blurred Vision ◽  
Inflammatory Drugs

Drug-induced aseptic meningitis (DIAM) is a rare complication of certain drugs, most commonly reported with ibuprofen use. The present study reports on a male adolescent with intracranial hypertension and visual impairment accompanied by DIAM. We present a 16-year-old male patient who after ibuprofen consumption displayed headache, fever, photophobia, and blurred vision following heavy exercises. Examination of cerebrospinal fluid showed a mononuclear pleocytosis and an increase in protein concentration. Other examinations had normal results. The development of common clinical signs following ibuprofen use reflected DIAM. The patient’s vision was found to improve with supportive care and stopping of the drug during follow-up. Given the widespread use of nonsteroidal anti-inflammatory drugs and the fact that these drugs are the most common cause of DIAM, the probability of occurrence of this event should be always kept in mind, and screening for autoimmune diseases in these patients is of great importance.

scholarly journals Paraneoplastic polymyositis presenting as a clinically occult breast cancer

2017 ◽  
Vol 99 (2) ◽  
pp. e40-e43 ◽  
Author(s):  
N Merali ◽  
M Yousuff ◽  
V Pronisceva ◽  
A Poddar
Keyword(s):  
Paraneoplastic Syndrome ◽  
Rare Case ◽  
Primary Tumour ◽  
Imaging Studies ◽  
Occult Breast Cancer ◽  
Symptom Stability ◽  
Underlying Malignancy ◽  
Neurological Presentation ◽  
Complete History ◽  
Metaplastic Breast Carcinoma

Paraneoplastic syndrome affects less than 1% of cancer patients. Diagnosis of paraneoplastic syndrome with neurological presentation requires screening for an underlying malignancy, including a complete history, physical examination and imaging studies. Treatment often results in symptom stability, rather than improvement. Paraneoplastic polymyositis can precede or instantaneously occur at diagnosis or treatment of a primary tumour, while neurological symptoms can persist even following cancer treatment. We report a rare case of metaplastic breast carcinoma with an unusual presentation of paraneoplastic polymyositis.

Intracranial hypertension and papilloedema as a complication to low antiretroviral therapy adherence in a man living with chronic HIV

2021 ◽  
Vol 14 (3) ◽  
pp. e237504
Author(s):  
Rosa Maja Møhring Gynthersen ◽  
Helene Mens ◽  
Marianne Wegener ◽  
Neval Ete Wareham
Keyword(s):  
Antiretroviral Therapy ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Ventricular Volume ◽  
Art Adherence ◽  
Hiv Viral Load ◽  
Blurred Vision ◽  
Antiretroviral Therapy Adherence ◽  
Acute Retroviral Syndrome

We describe a 61-year-old man living with HIV on antiretroviral therapy (ART), who presented with headache, dizziness and blurred vision. Latest CD4+ cell count 3 months prior to admission was 570×106 cells/mL and HIV viral load <20 copies/mL. The patient was diagnosed with cerebrospinal fluid (CSF) lymphocytic pleocytosis, raised intracranial pressure and papilloedema. Neuroimaging showed normal ventricular volume and no mass lesions, suggesting (1) neuroinfection (2) idiopathic intracranial hypertension or (3) retroviral rebound syndrome (RRS) as possible causes. Neuroinfection was ruled out and idiopathic intracranial hypertension seemed unlikely. Elevated plasma HIV RNA level was detected consistent with reduced ART adherence prior to admission. RRS is a virological rebound after ART interruption, which can mimic the acute retroviral syndrome of acute primary infection. To the best of our knowledge, we describe the second case of RRS presenting as CSF lymphocytic pleocytosis and elevated intracranial pressure after low ART adherence.

scholarly journals Spinal intraosseous epidural arteriovenous fistula with perimedullary drainage obliterated with Onyx embolization: case report

2015 ◽  
Vol 23 (2) ◽  
pp. 250-253 ◽  
Author(s):  
Chang-Hsien Ou ◽  
Hao-Kuang Wang ◽  
Tzu-Hsien Yang ◽  
Cheng-Loong Liang ◽  
Ho-Fai Wong
Keyword(s):  
Case Report ◽  
Arteriovenous Fistula ◽  
Rare Case ◽  
Direct Evidence ◽  
Embolic Agent ◽  
Imaging Studies ◽  
Disease Evolution ◽  
Compressive Fracture ◽  
Rare Location ◽  
Vein Reflux

The authors report an extremely rare case of spinal intraosseous epidural arteriovenous fistula (AVF) with perimedullary vein reflux causing symptoms of myelopathy. The intraosseous fistula tracts were completely obliterated with Onyx embolic agent, resulting in a total resolution of symptoms. The unique features of this case include the rare location of the fistula in the vertebral body and the association of the fistula with a compressive fracture. Imaging studies confirmed these hemodynamic findings and provided clarity and direct evidence regarding the association of epidural AVF formation with the vertebral compressive fracture. The authors also propose a possible disease evolution based on the previously adduced reflux-impending mechanism.

scholarly journals An Unusual Case of COVID-19 Presenting as Acute Psychosis

2020 ◽  
pp. 089719002097772
Author(s):  
Cameron G. Lanier ◽  
Stacey A. Lewis ◽  
Paras D. Patel ◽  
Ahmed Mohamed Ahmed ◽  
Paul O. Lewis
Keyword(s):  
Antiviral Treatment ◽  
Gastrointestinal Symptoms ◽  
Psychotic Symptoms ◽  
Acute Psychosis ◽  
Shortness Of Breath ◽  
Neurological Manifestations ◽  
Psychiatric Facility ◽  
Disorder Patient ◽  
Artery Disease ◽  
Alcohol Liver Disease

Purpose To report a case of COVID-19 presenting with acute psychosis, without the hallmark respiratory symptoms of fever, cough, and shortness of breath associated with the novel virus. Case Summary A 58 year-old male presented with acute psychosis and no symptoms associated with COVID-19. He denied fever, chills, chest pain, shortness of breath, or gastrointestinal symptoms. The patient had a medical history of coronary artery disease, chronic hepatitis C, polysubstance abuse (including cocaine and alcohol), liver disease, anxiety, and panic disorder. Patient was confused, disruptive, unable to communicate, and admitted to hallucinations. Prior to transfer to a psychiatric facility, the patient developed a cough, triggering COVID-19 testing and a positive result. He was initially treated with hydroxychloroquine before this was discontinued. The patient was treated with haloperidol and lorazepam before returning to baseline. He was discharged home with continued isolation. Conclusion Acute psychosis, with or without other symptoms, appears to be a potential presentation of COVID-19 and should be considered by clinicians as a possible presenting manifestation. Other coronaviruses appear to have also been linked to neurological manifestations, including psychosis. Neurological manifestations of the virus vary widely, but have been reported multiple times. Treatment, as shown in this case report, appears to be supportive and symptom based for the associated psychotic symptoms. Optimal antiviral treatment is still yet to be clearly defined, as research continues on how to best treat the virus itself.

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