scholarly journals A Rare Case of Unilateral Foix-Chavany-Marie Syndrome

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Courtney Raab ◽  
Farrukh Chaudhry, MD
Keyword(s):  
Ischemic Stroke ◽  
Case Report ◽  
Rare Case ◽  
Speech Therapy ◽  
Case Reports ◽  
Intravenous Thrombolysis ◽  
White Matter Lesions ◽  
African American Female ◽  
Presenting Symptoms ◽  
Opercular Syndrome

Background: Bilateral anterior opercular syndrome, or Foix-Chavany-Marie Syndrome (FCMS), is a neurological condition characterized by bilateral anterior opercular lesions. Common presenting symptoms of this rare suprabublar palsy include dysarthria, or slurred speech, as well as paralysis of facial, pharyngeal, lingual, and masticatory voluntary muscles while autonomic function is preserved.1 Most cases of FCMS are bilateral, yet some rare cases have been reported with unilateral opercular lesions with preexisting contralateral white matter lesions.2 In this case report we present a rare case of unilateral FCMS in a patient who had an acute anterior left opercular infarct, as well as a residual right parietal subcortical stroke. Project Methods: The patient we present is a 49 year old African American female with a history of hypertension and previous stroke with residual spastic right hemiplegia who presented to the ED for evaluation of right sided facial droop, right sided weakness, and slurred speech. Patient was evaluated by acute stroke team and was treated with intravenous thrombolysis (Alteplase). On hospital day 2, the patient developed complete disarticulation, unable to produce any speech but able to communicate by appropriate gestures and writing. The patient’s symptoms included anarthria, weakness of bilateral masseters, and lateral/medial pterygoids without dysphagia. Results: The MRI brain showed left insular region/frontal opercular ischemic stroke and a small right parietal subcortical ischemic stroke, likely embolic in nature. Over the hospital stay, the patient’s motor function improved but her anarthria persisted. These radiologic findings along with the symptomology proved consistent with FCMS. She was discharged to home with an NIH stroke scale of 5 and recommended outpatient speech therapy. Conclusion: In this case report, we describe a patient that presents with an extremely rare case of unilateral FCMS, with a preexisting contralateral parietal infarct that could have collectively caused anarthria and masseter weakness.   Works Cited 1. Milanlioglu A, Aydın MN, Gökgül A, Hamamcı M, Erkuzu MA, Tombul T. Ischemic Bilateral Opercular Syndrome. Case Reports in Medicine. 2013;2013:1-3. doi:10.1155/2013/513572. 2. Sa F, Cordeiro IM, Mestre S, Nzwalo H. Unilateral opercular infarction presenting with FoixChavany-Marie syndrome. Case Reports. 2014;2014. doi:10.1136/bcr-2014-206439.

scholarly journals Intravenous Thrombolysis After Reversal of Dabigatran With Idarucizumab in Acute Ischemic Stroke: A Case Report

2021 ◽  
Vol 13 ◽  
Author(s):  
Dan Xie ◽  
Xuefan Wang ◽  
Yao Li ◽  
Ruiling Chen ◽  
Yingying Zhao ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Case Report ◽  
Acute Ischemic Stroke ◽  
Time Window ◽  
Case Reports ◽  
Intravenous Thrombolysis ◽  
Recombinant Tissue Plasminogen Activator ◽  
Limb Weakness ◽  
Left Limb

Background: As there is a growing concern about the cerebral embolism events secondary to non-valvular atrial fibrillation (NVAF), novel oral anticoagulant (NOAC) has been more and more widely used as an anticoagulation treatment for the prevention of stroke. However, in the face of life-threatening bleeding or emergency surgery/treatment, NOAC-related antagonists such as idarucizumab need to be urgently used to reverse the NOAC. Using recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis for acute ischemic stroke requires a time window of 4.5 h. This case reports rt-PA intravenous thrombolysis after reversal of dabigatran anticoagulation with idarucizumab in patients with acute ischemic stroke.Case Presentation: We report the case of 62-year-old Chinese female with NVAF treated with dabigatran 110 mg twice daily, and missed a dose on the eve of the stroke. The patient presented with acute ischemic stroke causing the angle of mouth deviated to right side and left limb weakness in the early morning of the next day. However, the last dosing time of dabigatran was between 24 and 48 h, the patients were given rt-PA intravenous thrombolysis after reversal of dabigatran anticoagulation with idarucizumab, while any potential relative contraindication had been excluded by means of laboratory test and CT scan in the hospitalization services. National Institute of Health stroke scale (NIHSS) score was reduced from 4 to 1, and the patient was discharged after 2 weeks.Conclusion: Our case report adds to the evidence that idarucizumab administration is safe and effective in the setting of patients with atrial fibrillation treated with dabigatran who develop acute ischemic stroke requiring rt-PA intravenous thrombolysis.

scholarly journals Intravenous Thrombolysis after Reversal of Dabigatran with Idarucizumab in Acute Ischemic Stroke: A Case Report

2020 ◽  
Author(s):  
DAN XIE ◽  
Xuefan Wang ◽  
Yao Li ◽  
Ruiling Chen ◽  
Yingying Zhao ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Case Report ◽  
Acute Ischemic Stroke ◽  
Time Window ◽  
Case Reports ◽  
Intravenous Thrombolysis ◽  
Nonvalvular Atrial Fibrillation ◽  
Limb Weakness ◽  
Left Limb

Abstract Background: As there is a growing concern about the cerebral embolism events secondary to non-valvular atrial fibrillation, direct oral anticoagulant (DOAC) has been more and more widely used as an anticoagulation treatment for prevention of stroke. However, in the face of life-threatening bleeding or emergency surgery/treatment, doac-related antagonists such as idarucizumab need to be urgently used to reverse the DOAC. Using rt-PA intravenous thrombolysis for acute ischemic stroke requires a time window of 4.5 hours. This case reports rt-PA intravenous thrombolysis after reversal of dabigatran anticoagulation with idarucizumab in patients with acute ischemic stroke. Case presentation: We report the case of 62-year-old Chinese female with nonvalvular atrial fibrillation treated with dabigatran 110mg twice daily, and missed a dose on the eve of the stroke. The patient presented with acute ischemic stroke causing the angle of mouth deviated to right side and left limb weakness in the early morning of the next day. Due to the last dosing time of dabigatran was between 24-48 hours, the patients were given rt-PA intravenous thrombolysis after reversal of dabigatran anticoagulation with idarucizumab, while all contraindications had been excluded by laboratory test and CT scan. NIHSS score was reduced from 4 to 1, and the patient was discharged after 2 weeks. Conclusion: Our case report adds to the evidence that idarucizumab administration is safe and effective in the setting of patients with atrial fibrillation treated with dabigatran who develop acute ischemic stroke requiring rt-PA intravenous thrombolysis.

An Uncommon Presentation of Polycythemia Vera as Ischemic Stroke—A Rare Case Report

2012 ◽  
Vol 3 (5) ◽  
pp. 455-457
Author(s):  
Dr .KOUSHIK GUDAVALLI ◽  
◽  
Dr .SHILPA CHIKATI ◽  
Dr .MOHAN RAO JAKKAMPUTI ◽  
Dr .KAMAL LOCHAN BEHERA ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Case Report ◽  
Polycythemia Vera ◽  
Rare Case ◽  
Uncommon Presentation ◽  
Rare Case Report

Linezolid Induced Skin Reactions in a Multi Drug Resistant Infective Endocarditis Patient: A Rare Case

2020 ◽  
Vol 15 (3) ◽  
pp. 222-226 ◽  
Author(s):  
Asha K. Rajan ◽  
Ananth Kashyap ◽  
Manik Chhabra ◽  
Muhammed Rashid
Keyword(s):  
Case Report ◽  
Infective Endocarditis ◽  
Rare Case ◽  
Case Reports ◽  
Multidrug Resistant ◽  
The Body ◽  
Prior History ◽  
Skin Reactions ◽  
Rare Case Report ◽  
Multiple Drugs

Rationale: Linezolid (LNZ) induced Cutaneous Adverse Drug Reactions (CADRs) have rare atypical presentation. Till date, there are very few published case reports on LNZ induced CADRs among the multidrug-resistant patients suffering from Infective Endocarditis (MDR IE). Here, we present a rare case report of LNZ induced CARs in a MDR IE patient. Case report: A 24-year-old female patient was admitted to the hospital with chief complaints of fever (101°C) associated with rigors, chills, and shortness of breath (grade IV) for the past 4 days. She was diagnosed with MDR IE, having a prior history of rheumatic heart disease. She was prescribed LNZ 600mg IV BD for MDR IE, against Staphylococcus coagulase-negative. The patient experienced flares of cutaneous reactions with multiple hyper-pigmented maculopapular lesions all over the body after one week of LNZ therapy. Upon causality assessment, she was found to be suffering from LNZ induced CADRs. LNZ dose was tapered gradually and discontinued. The patient was prescribed corticosteroids along with other supportive care. Her reactions completely subsided and infection got controlled following 1 month of therapy. Conclusion: Healthcare professionals should be vigilant for rare CADRs, while monitoring the patients on LNZ therapy especially in MDR patients as they are exposed to multiple drugs. Moreover, strengthened spontaneous reporting is required for better quantification.

scholarly journals Cerebral microbleeds and intravenous thrombolysis: case report

2006 ◽  
Vol 64 (3b) ◽  
pp. 855-857 ◽  
Author(s):  
Adriana Bastos Conforto ◽  
Leandro Tavares Lucato ◽  
Claudia da Costa Leite ◽  
Eli Faria Evaristo ◽  
Fábio Iuji Yamamoto ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Case Report ◽  
Intracranial Hemorrhage ◽  
Intravenous Thrombolysis ◽  
Cerebral Microbleeds

Intravenous thrombolysis is an important procedure that has significant impact on ischemic stroke prognosis. However, intracranial hemorrhage (ICH) is a feared complication of this procedure. It has been suggested that cerebral microbleeds (CMBs) may increase the risk of ICH after thrombolysis. We report on a 69 years-old woman with multiple CMBs submitted to intravenous thrombolysis without complications.

A rare case report of hemochromatosis in an African-American female

2000 ◽  
Vol 95 (9) ◽  
pp. 2580-2580 ◽  
Author(s):  
Hitender Jain ◽  
M.A. Albornoz ◽  
J. Collazo ◽  
J.M. Greenblatt ◽  
J.M. Draganescu ◽  
...  
Keyword(s):  
African American ◽  
Case Report ◽  
Rare Case ◽  
African American Female ◽  
Rare Case Report

A Rare Case of Bilateral Spontaneous Intracerebral Haemorrhage Presenting With Left Hemiplegia: A Case Report

2015 ◽  
Vol 26 (4) ◽  
pp. 109-110
Author(s):  
AK Joy ◽  
Annada Sankar Mohes ◽  
Th Bidyarani ◽  
L Dorendrojit Singh ◽  
Aten Jongky
Keyword(s):  
Case Report ◽  
Basal Ganglia ◽  
Intracerebral Haemorrhage ◽  
Vascular Malformation ◽  
Rare Case ◽  
Case Reports ◽  
Cranial Nerve Involvement ◽  
12Th Cranial Nerve ◽  
Contrast Ct ◽  
Spontaneous Intracerebral Haemorrhage

Abstract Haemorrhage is responsible for around 11% of stroke syndrome. Haemorrhage usually occurs at a single site. However, it can be at multiple sites in some specific conditions i.e. coagulopathy, vascular malformation, malignancy etc. A 56-year-old male with left sided hemiplegia was admitted in the rehabilitation ward of RIMS, Imphal. He was hypertensive and was on irregular medication for that. He was also an alcoholic and chronic smoker for last 20 years. Patient was conscious and clinical examination revealed left 7th and 12th cranial nerve involvement with left hemiplegia. Non-contrast CT scan of brain revealed right thalamus and left basal ganglia haemorrhages. Thorough history and investigations did not reveal any aetiology for bilateral haemorrhage. Patient was treated with conservative management and improvement was noticed in serial follow-ups. There are very few case reports about bilateral spontaneous intracerebral haemorrhage associated with other diseases like migraine, Japanese encephalitis etc. Cause of bilateral haemorrhage in our case is doubtful.

scholarly journals A Patient Presenting with Cardiac Tamponade and the Challenges of Finding Its Cause: A Cardiac Angiosarcoma

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Roshanak Habibi ◽  
Negar Faramarzi ◽  
Alvaro J. Altamirano ◽  
Shahriar Dadkhah
Keyword(s):  
United States ◽  
Case Report ◽  
Pericardial Effusion ◽  
Rare Case ◽  
Case Reports ◽  
The United States ◽  
Disease Entity ◽  
Single Center ◽  
Cardiac Angiosarcoma ◽  
Multimodality Approach

Primary malignancies of the heart are so rare that most of the available data come from case reports or large single-center-based studies, with the overall incidence of 0.02% in the United States. Diagnosis in case of an isolated pericardial effusion as presentation is challenging, and determining that an angiosarcoma is even more challenging. Here, we presented a rare case of pericardial angiosarcoma which presented to us with tamponade. The patient eventually was diagnosed through pericardiectomy. A multimodality approach was attempted to treat the cancer. The clinical details of such a unique disease entity inspired us to present it as a case report.

scholarly journals Case Report: Migrainous Infarct without Aura

2017 ◽  
Vol 9 (3) ◽  
pp. 241-251
Author(s):  
Kamesh Gupta ◽  
Anurag  Rohatgi ◽  
Shivani Handa
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Case Report ◽  
Rare Case ◽  
Case Presentation ◽  
The Past ◽  
Need To Evaluate ◽  
History Of ◽  
Complicated Migraine ◽  
Full Investigation

Background: Stroke in a migraine with aura has been documented in several cases, even deserving the merit of a classification as complicated migraine. Herein, we present a rare case of migrainous infarct without aura. The diagnosis was challenging due to lack of risk factors. The patient was unique in not having any other comorbidities. Case Presentation: The case is of a 21-year-old female presenting with right-sided hemiplegia and facial drooping. She had had an index presentation of throbbing headaches for the past 2 years, typical of a migraine but not preceded by any aura symptoms. However, in the current episode, the pain became excessively severe and accompanied by right-sided hemiplegia and facial drooping. A full investigation workup using MRI revealed evidence of infarct in the left temporoparietal and basal ganglion region. Conclusion: Our case highlights the need to evaluate silent ischemic stroke in case of prolonged headache with a history of migraine as well as the need for precaution to avoid the use of triptans or opioids in such a case. It also highlights the conditions that need to be excluded before labeling it as a migrainous infarct.

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