scholarly journals Acute Percheron Infarction: A Precision Learning

2021 ◽  
Author(s):  
Bei Zhang ◽  
Xiaoxun Wang ◽  
Gang Chen ◽  
Jiping Wang
Keyword(s):  
Clinical Manifestations ◽  
Clinical Feature ◽  
Daily Life Activities ◽  
Thalamic Infarction ◽  
Consciousness Disorder ◽  
Unnecessary Procedures ◽  
Adc Map ◽  
Midbrain Infarction ◽  
Magnetic Resonance Imaging Mri ◽  
Vertical Gaze

Abstract Background: So far, the diagnosis of acute AOP infarction is uncommon. The purpose of our study was to characterize the relationship between the imaging spectrum of acute AOP infarction and its clinical manifestations and prognosis on the basis of 23 cases.Methods: A total of 23 patients with acute AOP infarction in our institution from 2014 to 2019 were reviewed retrospectively. All cases were evaluated with computed tomography (CT), magnetic resonance imaging (MRI), detailed clinical and evaluated prognosis used a modified Rankin scale (mRs), blood studies, electrocardiogram and transthoracic echocardiography. All standard risk factors were recorded in these patients. mRs scores 90 days after discharge. Results: We identified 4 various patterns of acute AOP infarction: (1) bilateral paramedian thalamic infarction (BPTI, 52%), (2) bilateral paramedian thalamic with rostral midbrain infarction (BPTRMI, 30%), (3) bilateral paramedian and anterior thalamic infarction (BPATI, 13%), and (4) bilateral paramedian thalamic with red nuclei infarction (BPTRNI, 4%). These patients had consciousness disorder, memory dysfunctions, vertical gaze paresis, mesencephalothalamic syndrome and so on. The 65% patients with BPTI and BPATI who experienced a good functional recovery and could carry out daily life activities (mRS score ≤ 2). However, patients with BPTRMI who have an unfavorable outcome.Conclusion: Although the clinical feature of patients with AOP infarction is variable, DWI or ADC map can improve the diagnosis of acute AOP infarction patterns. Acute AOP occlusion requires immediate diagnosis and treatment initiation for a more favorable outcome and additional unnecessary procedures.

scholarly journals Fovilles Syndrome a Case to Remember Case Report

2021 ◽  
Vol 2 (10) ◽  
pp. 1015-1017
Author(s):  
Sudikshya Acharya ◽  
Basant Pant ◽  
Avinash Chandra ◽  
Ayush Chandra
Keyword(s):  
Rare Case ◽  
Clinical Manifestations ◽  
Sudden Onset ◽  
The Body ◽  
Clinical Feature ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Acute Headache ◽  
Mr Angiogram

The Foville’s Syndrome is a rare clinical feature of stroke or brain hemorrhage. This is very rare brain stem syndrome and only few cases have been reported worldwide. A case of Foville's syndrome secondary to infarction at the left paramedian pontine region, which was diagnosed and treated at Annapurna Neurological institute and allied Science, Kathmandu, Nepal. A 62 years old gentleman presented with acute headache with sudden onset of vertigo, tinnitus, slurred speech, difficulty while swallowing and numbness and hemiparesis on the right side of the body. The aim of this study was to report a rare case of Foville's syndrome with the infarction at the left paramedian pontine region. The clinical manifestations were well correlated with anatomical involvement. The CT-scan of head, Magnetic Resonance Imaging (MRI), MR-Angiogram (MRA) sequence of cerebral and carotid, etc. helped in the diagnosis of the case along with the other lab investigations.

scholarly journals Identifying a Common Functional Framework for Apathy Large-Scale Brain Network

2021 ◽  
Vol 11 (7) ◽  
pp. 679
Author(s):  
Vincenzo Alfano ◽  
Mariachiara Longarzo ◽  
Giulia Mele ◽  
Marcello Esposito ◽  
Marco Aiello ◽  
...  
Keyword(s):  
Large Scale ◽  
Brain Magnetic Resonance Imaging ◽  
Brain Network ◽  
Neural Pathways ◽  
Resonance Imaging ◽  
Daily Life Activities ◽  
Functional Differences ◽  
Central Gyrus ◽  
Magnetic Resonance Imaging Mri ◽  
Disease Specific

Apathy is a neuropsychiatric condition characterized by reduced motivation, initiative, and interest in daily life activities, and it is commonly reported in several neurodegenerative disorders. The study aims to investigate large-scale brain networks involved in apathy syndrome in patients with frontotemporal dementia (FTD) and Parkinson’s disease (PD) compared to a group of healthy controls (HC). The study sample includes a total of 60 subjects: 20 apathetic FTD and PD patients, 20 non apathetic FTD and PD patients, and 20 HC matched for age. Two disease-specific apathy-evaluation scales were used to measure the presence of apathy in FTD and PD patients; in the same day, a 3T brain magnetic resonance imaging (MRI) with structural and resting-state functional (fMRI) sequences was acquired. Differences in functional connectivity (FC) were assessed between apathetic and non-apathetic patients with and without primary clinical diagnosis revealed, using a whole-brain, seed-to-seed approach. A significant hypoconnectivity between apathetic patients (both FTD and PD) and HC was detected between left planum polare and both right pre- or post-central gyrus. Finally, to investigate whether such neural alterations were due to the underlying neurodegenerative pathology, we replicated the analysis by considering two independent patients’ samples (i.e., non-apathetic PD and FTD). In these groups, functional differences were no longer detected. These alterations may subtend the involvement of neural pathways implicated in a specific reduction of information/elaboration processing and motor outcome in apathetic patients.

scholarly journals Acute Mesenteric Vein Thrombosis in a Pregnant Patient at 10 Weeks Gestation: A Case Report

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1348
Author(s):  
Ying-Ying Chen ◽  
Sheng-Mao Wu ◽  
Russell Oliver Kosik ◽  
Yi-Chien Hsieh ◽  
Tzu-I Wu ◽  
...  
Keyword(s):  
Acute Abdominal Pain ◽  
Clinical Manifestations ◽  
Pregnant Patient ◽  
Resonance Imaging ◽  
Advanced Imaging ◽  
Mesenteric Vein Thrombosis ◽  
Mesenteric Vein ◽  
Vein Thrombosis ◽  
Management Perspective ◽  
Magnetic Resonance Imaging Mri

Acute abdominal pain during pregnancy is challenging, both from a diagnostic and management perspective. A non-localized, persistent pain out of proportion to physical examination is a sign that advanced imaging may be necessary. Mesenteric venous thrombosis in a pregnant patient is extremely rare, but if diagnosis is delayed, can be potentially fatal to both the mother and the fetus. We present here a pregnant patient in the tenth week of gestation with classic clinical manifestations of mesenteric vein thrombosis and the corresponding findings on magnetic resonance imaging (MRI) and computed tomography (CT).

scholarly journals Pulvinar sign in a case of anti-HU paraneoplastic encephalitis

2016 ◽  
Vol 29 (6) ◽  
pp. 436-439 ◽  
Author(s):  
Pierre-Luc Gamache ◽  
Maude-Marie Gagnon ◽  
Martin Savard ◽  
François Émond
Keyword(s):  
Magnetic Resonance Imaging ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Clinical Manifestations ◽  
Resonance Imaging ◽  
Paraneoplastic Encephalitis ◽  
Jakob Disease ◽  
Magnetic Resonance Imaging Mri ◽  
Work Up

This article reports the case of a 68-year-old patient with anti-HU antibodies paraneoplastic encephalitis. The clinical manifestations were atypical and the paraclinical work-up, notably the magnetic resonance imaging (MRI) showing bilateral posterior thalamic hyperintensities (pulvinar sign), misleadingly pointed towards a variant Creutzfeld–Jakob disease. After presenting the case, the differential diagnosis of the pulvinar sign is discussed along with other important diagnostic considerations.

Lateral Medullary Infarction with Contralateral Segmental Dysesthesia and Ipsilateral Headache: A Case Report

2021 ◽  
Vol 17 ◽  
Author(s):  
Renjie Wang ◽  
Yankun Shao ◽  
Lei Xu
Keyword(s):  
Medulla Oblongata ◽  
Clinical Manifestations ◽  
Lateral Medullary Infarction ◽  
Case Presentation ◽  
Specific Sign ◽  
Temperature Sense ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
The Brain ◽  
Medullary Infarction

Introduction: The medulla oblongata is the lowest segment of the brain stem, located adjacent to the spinal cord, with a complex anatomical structure. Thus, a small injury to the medulla oblongata can show complex clinical manifestations. Case Presentation: A patient experienced dysesthesia, which manifested as numbness in her right lower limb and decreased temperature sense, and dizziness 20 days before admission. The numbness worsened 1 week before admission, reaching the right thoracic (T) 12 dermatomes. Her thermoception below the T12 dermatomes decreased, and the degree of dizziness increased, accompanied by nausea and vomiting. Magnetic resonance imaging (MRI) of the neck, chest, and abdomen performed at a local hospital showed no abnormalities. MRI of the brain was performed after admission. One week after admission, she experienced a severe headache in the upper left periorbital area. The numbness extended to T4, and thermoception decreased below T4. Diagnosis: Lateral medullary infarction. Interventions: Anti-platelet aggregation and mitochondrial nutritional therapies were performed along with treatments for improving circulation and establishing collateral circulation. Outcomes: The intensity of limb numbness decreased, and the symptoms of headache and dizziness resolved. Conclusion: Lesions leading to segmental sensory disorders can occur in the medulla oblongata. Ipsilateral headaches with contralateral segmental paresthesia can be a specific sign of lateral medullary infarction.

scholarly journals False diagnosis of and needless therapy for presumed gestational trophoblastic disease in women with an unusual site of residual pregnancy

2018 ◽  
Vol 47 (2) ◽  
pp. 673-681 ◽  
Author(s):  
Tong Gao ◽  
Mingming Sun ◽  
Liangqing Yao ◽  
Wei Jiang
Keyword(s):  
Clinical Manifestations ◽  
Diagnostic Value ◽  
Gestational Trophoblastic Disease ◽  
High Serum ◽  
Resonance Imaging ◽  
Unusual Site ◽  
Pelvic Mri ◽  
Trophoblastic Disease ◽  
False Diagnosis ◽  
Magnetic Resonance Imaging Mri

Objective This study aimed to determine the diagnostic value of magnetic resonance imaging (MRI), hysteroscopy, and laparoscopy to avoid unnecessary treatment when patients present with clinical manifestations that are close to those of gestational trophoblastic neoplasia (GTN). Methods Three patients who were falsely diagnosed with presumed GTN and received needless chemotherapy in our hospital from July 2011 to March 2012 were studied. We also reviewed data of patients with similar clinical features who were diagnosed as having residual pregnancy in recent years. Clinical manifestations were evaluated. Results All three patients had persistently high serum β-human chorionic gonadotrophin levels and a mass with abundant blood supply in the uterus after termination of pregnancy. The patients were diagnosed with GTN and underwent chemotherapy. They responded poorly to chemotherapy and underwent surgery. The pathological diagnosis in all patients was residual pregnancy. In recent years, no patients were misdiagnosed because pelvic MRI, hysteroscopy, or laparoscopy was used when residual pregnancy could not be excluded. Conclusion Gynecologists should diagnose carefully when patients present with clinical manifestations that are close to those of GTN to avoid unnecessary treatment. MRI, hysteroscopy, and laparoscopy could be important examinations for excluding residual pregnancy.

scholarly journals A novel TNNI3 gene mutation (c.235C>T/ p.Arg79Cys) found in a thirty-eight-year-old women with hypertrophic cardiomyopathy

2018 ◽  
Vol 13 (1) ◽  
pp. 374-378 ◽  
Author(s):  
Qin Tao ◽  
Junhua Yang ◽  
Weili Cheng ◽  
Shenghua Yu ◽  
Xu Fang ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Gene Mutation ◽  
Troponin I ◽  
Clinical Manifestations ◽  
Genetic Mutation ◽  
Heterozygous Mutation ◽  
Her Family ◽  
Slow Development ◽  
Magnetic Resonance Imaging Mri ◽  
Dimensional Echocardiography

AbstractWe report the case of a thirty-eight-year-old woman admitted to our hospital due to palpitation and chest distress. ST-T segment change was found in her ECG. She was then diagnosed with hypertrophic cardiomyopathy by two-dimensional echocardiography. Physical examination showed no obvious abnormal signs and all laboratory examinations were within the normal range. Myocardial fibrosis was detected by cardiac magnetic resonance imaging (MRI). A novel heterozygous mutation (c.235C>T/p.Arg79Cys) in TNNI3 for cardiac troponin I was identified in her. Subsequently, her families were investigated. No one died suddenly in her family. Her father, one of her siblings and one of her daughters had the same genetic mutation but with different clinical manifestations while the others were healthy. Her father and brother were also diagnosed with hypertrophic cardiomyopathy with different clinical manifestation. However, the echocardiography of her daughter was absolutely normal. We hypothesized that the Arg79Cys mutation in TNNI3 leads to a slow development of cardiac hypertrophy and the phenotype of this gene mutation is diverse.

scholarly journals Dyke-Davidoff-Masson-Syndrome Manifested by seizures and learning difficulties: A Case Report

2013 ◽  
Vol 5 (2) ◽  
pp. 111-113
Author(s):  
Mohammad Ibrahim Khalil ◽  
Maliha Hakim ◽  
Afzal Momin ◽  
Abu Nayeem ◽  
Md. Mohitul Islam ◽  
...  
Keyword(s):  
Case Report ◽  
Learning Difficulties ◽  
Facial Asymmetry ◽  
Behavioral Changes ◽  
Clinical Feature ◽  
Present Case Report ◽  
Cerebral Hemiatrophy ◽  
Generalized Seizures ◽  
Spastic Hemiplegia ◽  
Magnetic Resonance Imaging Mri

Dyke-Davidoff-Masson Syndrome (DDMS), also known as cerebral hemiatrophy, is a rare clinical condition characterized by seizures, facial asymmetry, contralateral spastic hemiplegia or hemiparesis, with learning difficulties and behavioral changes. It is commonly diagnosed in presence of clinical feature associated radiological findings which include cerebral hemiatrophy with homolateral hypertrophy of the skull and sinuses. In this present case report a 12 year old teenager female patient was diagnosed as DDMS with recurrent generalized seizures, learning difficulties and right sided hemiparesis. Magnetic resonance imaging (MRI) of the brain showed hemiatrophy involving the left cerebral hemisphere and EEG showed generalized epileptiform discharged. An X-ray of the paranasal air sinuses was normal.DOI: http://dx.doi.org/10.3329/jssmc.v5i2.20768J Shaheed Suhrawardy Med Coll 2013;5(2):111-113

scholarly journals Prevalence and characteristics of fever in adult and paediatric patients with coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis of 17515 patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249788
Author(s):  
Md Asiful Islam ◽  
Shoumik Kundu ◽  
Sayeda Sadia Alam ◽  
Tareq Hossan ◽  
Mohammad Amjad Kamal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Clinical Manifestations ◽  
Sensitivity Analyses ◽  
Clinical Feature ◽  
High Grade ◽  
High Grade Fever ◽  
Paediatric Patients ◽  
Pooled Prevalence ◽  
Significant Difference

Background Coronavirus disease 2019 (COVID-19), a pandemic disease caused by the severe acute respiratory syndrome coronavirus 2 started to spread globally since December 2019 from Wuhan, China. Fever has been observed as one of the most common clinical manifestations, although the prevalence and characteristics of fever in adult and paediatric COVID-19 patients is inconclusive. We aimed to conduct a systematic review and meta-analysis to estimate the overall pooled prevalence of fever and chills in addition to fever characteristics (low, medium, and high temperature) in both adult and paediatric COVID-19 patients. Methods The protocol of this systematic review and meta-analysis was registered with PROSPERO (CRD42020176327). PubMed, Scopus, ScienceDirect and Google Scholar databases were searched between 1st December 2019 and 3rd April 2020 without language restrictions. Both adult (≥18 years) and paediatric (<18 years) COVID-19 patients were considered eligible. We used random-effects model for the meta-analysis to obtain the pooled prevalence and risk ratio (RR) with 95% confidence intervals (CIs). Quality assessment of included studies was performed using the Joanna Briggs Institute critical appraisal tools. Heterogeneity was assessed using the I² statistic and Cochran’s Q test. Robustness of the pooled estimates was checked by different subgroups and sensitivity analyses. Results We identified 2055 studies, of which 197 studies (n = 24266) were included in the systematic review and 167 studies with 17142 adults and 373 paediatrics were included in the meta-analysis. Overall, the pooled prevalence of fever in adult and paediatric COVID-19 patients were 79.43% [95% CI: 77.05–81.80, I2 = 95%] and 45.86% [95% CI: 35.24–56.48, I2 = 78%], respectively. Besides, 14.45% [95% CI: 10.59–18.32, I2 = 88%] of the adult COVID-19 patients were accompanied with chills. In adult COVID-19 patients, the prevalence of medium-grade fever (44.33%) was higher compared to low- (38.16%) and high-grade fever (14.71%). In addition, the risk of both low (RR: 2.34, 95% CI: 1.69–3.22, p<0.00001, I2 = 84%) and medium grade fever (RR: 2.79, 95% CI: 2.21–3.51, p<0.00001, I2 = 75%) were significantly higher compared to high-grade fever, however, there was no significant difference between low- and medium-grade fever (RR: 1.17, 95% CI: 0.94–1.44, p = 0.16, I2 = 87%). 88.8% of the included studies were of high-quality. The sensitivity analyses indicated that our findings of fever prevalence for both adult and paediatric patients are reliable and robust. Conclusions The prevalence of fever in adult COVID-19 patients was high, however, 54.14% of paediatric COVID-19 patients did not exhibit fever as an initial clinical feature. Prevalence and risk of low and medium-grade fevers were higher compared to high-grade fever.

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