scholarly journals Non-aneurismatic subarachnoidal hemorrahge of hypertensive etiology: case report

2021 ◽  
Author(s):  
Mayara Menezes Attuy ◽  
Lucas Hideo Yamanaka ◽  
Wylson Azevedo
Keyword(s):  
Case Report ◽  
Arterial Hypertension ◽  
Alcoholic Beverages ◽  
Excessive Alcohol Consumption ◽  
Blood Distribution ◽  
Right Cerebral Hemisphere ◽  
Imaging Results ◽  
The Central Nervous System ◽  
Grade Ii ◽  
The Right

Context: Subarachnoid hemorrhage (SAH) is a neurological emergency defined by the leakage of blood into the spaces that cover the central nervous system. Non-aneurysmatic SAH is defined according to the blood distribution on computed tomography (CT). Perimensencephalic SAH (PM-SAH) has blood distribution in perimesencephalic cisterns in front of the brain stem. Non- perimesencephalic SAH has a more diffuse distribution. Case report: A 54 years old man with systemic arterial hypertension. He reported that he had consumed alcoholic beverages the night before. On the morning of hospitalization he had a headache with loss of sensation on the left side of his body. In the EC, he presented sweating, left parestesia, mild dyslalia and deviation from the right rhyme. A cranial CT scan was performed revealing SAH involving the cisterns and furrows near the right cerebral hemisphere, next to the Sylvian fissure. The clinical and imaging results demonstrated SAH grade II Hunt & Hess and Fischer II, Glasgow 15, without motor loss. Cerebral angiography, the gold standard for the diagnosis and mapping of aneurysms, was performed, with a negative result. On the last day of hospitalization, CT and Doppler indicated resorption of edema and absence of vasospasm, respectively. There was also an adjustment of the hypertensive medications of the patient who did not have sequelae. Conclusion: PMs-SAH have excelente prognosis in short and long term with no risk of future rebleeds. The event occurred after an episode of excessive alcohol consumption in addition to decompensated arterial hypertension.

scholarly journals Clinical-enabled aspects after Neurotoxoplasmosis in a patient with immunosuppression: a case report

2021 ◽  
Author(s):  
Adrielle Galanti ◽  
Verônia Corrêa César Rodrigues ◽  
Daniela Maria Ribeiro Vaz ◽  
Ana Paula Oliveira Borges
Keyword(s):  
Case Report ◽  
Motor Coordination ◽  
Clinical Investigation ◽  
Functional Independence ◽  
Berg Balance Scale ◽  
Fine Motor ◽  
Cross Sectional ◽  
Right Cerebral Hemisphere ◽  
The Right ◽  
Immunodeficiency Syndrome

Background: Neurotoxoplasmosis is an opportunistic infection caused by the protozoan Toxoplasma Gondii, frequent in patients with Acquired Immunodeficiency Syndrome who become immunosuppressed by the presence of the disease. It can be presented by one or more brain abscesses, encephalitis or ventriculitis. Objectives: case report of a volunteer after neurological sequelae of neurotoxoplasmosis in order to highlight the relevant findings for a neurofunctional rehabilitation. Design and setting: This is an observational, cross-sectional case report type study conducted at the Clínica Escola de Fisioterapia of the University of Franca (UNIFRAN), with CEP approval (CAAE 83164918.2.0000.5495). Methods: Female patient, 53 years old. In the physiotherapy sector, neurological evaluation of the components was performed: sensitivity, movement, tone, reflexes, motor coordination, balance and gait. Balance and gait were assessed using the Berg Balance Scale, the Standing and Walking Test and the Dynamic Walking Index. Results: After clinical investigation, neurological toxoplasmosis infection was found in the right cerebral hemisphere. The physiotherapeutic evaluation showed the presence of left hemiparesis, the presence of spastic hypertonia, patellar and achilles hyperreflexia, the absence of fine motor skills and the presence of a reaping gait. The BSE result was 32 points, the TUG was 10.3 seconds and IMD was 20 points. Conclusion: The compromises found have an impact on the functionality of the volunteer. This study emphasizes the valorization of neurofunctional physiotherapeutic semiology for a treatment proposal that promotes greater functional independence.

Superior Hypophyseal Artery Ruptured Aneurysm in a 5-Month-Old Child Presenting as an Acute Subdural Hematoma: A Case Report

2020 ◽  
pp. 1-6
Author(s):  
Piotr Komuński ◽  
Emilia Nowosławska ◽  
Krzysztof Zakrzewski ◽  
Bartosz Polis ◽  
Wojciech Świątnicki
Keyword(s):  
Case Report ◽  
Subdural Hematoma ◽  
Mass Effect ◽  
Ruptured Aneurysm ◽  
Treatment Modalities ◽  
Acute Subdural Hematoma ◽  
Clot Removal ◽  
Right Cerebral Hemisphere ◽  
The Right ◽  
Significant Mass Effect

<b><i>Introduction:</i></b> We present a very rare case of ruptured superior hypophyseal artery (SHA) aneurysm that presented as an acute subdural hematoma (SDH) discussing its initial presentation, diagnosis, and treatment modalities. To our knowledge it is one of very few if any cases of a ruptured aneurysm in infants regarding that specific vascular location. <b><i>Case Report:</i></b> A 5-month-old boy was referred to our department due to acute SDH over the right cerebral hemisphere without significant mass effect nor hydrocephalus. Further evaluation revealed a right internal carotid artery (ICA) aneurysm arising from the SHA segment. Microsurgical clip ligation using a fenestrated, angled clip was performed with simultaneous subdural clot removal and proximal control of the ICA dissected in the neck. Our patient made an excellent recovery without any complicating features. <b><i>Conclusion:</i></b> Surgical management seems to be a better option in this subgroup of patients given the long life expectancy and durability of microsurgical clip ligation. We believe that our brief case report would add some insight into the management of this rare subgroup of patients, leading to better decision-making and outcome.

scholarly journals Facial Palsy, Hypoacusis and Vertigo as Inaugural Symptoms of Neuroborreliosis - Case Report

2021 ◽  
Vol 2 (5) ◽  
pp. 323-327
Author(s):  
JB da Costa
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Facial Palsy ◽  
Cranial Nerves ◽  
Cranial Neuropathy ◽  
Common Causes ◽  
Oral Corticosteroids ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Introduction: Facial Palsy (FP) is the most common acute mononeuropathy and consists of a decrease in facial muscle strength due to facial nerve damage. Peripheral FP (PFP) can result from a wide variety of disorders and aetiologies, with Lyme Disease (LD) being considered one of the most common causes of FP. LD is an infectious disease that affects the central nervous system, causing Neuroborreliosis (NB) in 15% of cases. Cranial neuropathy is the most common form of presentation of NB, as uni or bilateral PFP. We describe a case of PFP with hypoacusis and vertigo as the inaugural presentation of neuroborreliosis. Case Report: We present a case report of a 75-year-old female patient, referred to ENT consultation due to a 3-day course of a grade 4 right PFP, moderate right sensorineural hearing loss and right vestibular hypofunction. The patient underwent cranioencephalic Computed Tomography (CT-CE) which excluded a central event and was treated with 2 cycles of oral corticosteroids, without any clinical improvement. A Magnetic Resonance Imaging (MRI) was performed, which showed an abnormal inflammatory uptake of the right facial nerve. An analytical positivity for Borrelia IgM was found and the diagnosis of polyneuropathic NB with involvement of the VII and VIII right cranial pairs was assumed. The patient completed 28 days of doxycycline, with FP and vertigo improvement and normalization of hearing acuity. Discussion/Conclusion: In the presented case, the absence of the classical migratory erythema or painful meningopolyneuritis didn’t exclude the diagnosis of NB. FP associated to signs of other cranial nerves involvement raised the hypothesis of a systemic polyneuropathic disease, which motivated the etiological investigation carried out.

scholarly journals Intracerebral and Intraventricular Hemorrhage With COVID-19: A Case Report

2021 ◽  
Vol 7 (1) ◽  
pp. 57-60
Author(s):  
Masoomeh Abdi ◽  
◽  
Kioumars Karamizadeh ◽  
Mona Nabovvati ◽  
◽  
...  
Keyword(s):  
Case Report ◽  
Intraventricular Hemorrhage ◽  
The Elderly ◽  
High Resolution Computed Tomography ◽  
Case Presentation ◽  
Level Of Consciousness ◽  
The Central Nervous System ◽  
Polymerase Chain ◽  
The Right ◽  
The Brain

Background and Importance: SARS-CoV-2 virus causes COVID-19. The virus’s primary target is the respiratory system, but it can also affect other systems, such as the cardiovascular and the central nervous system. Case Presentation: In this study, we introduce an 83-year-old man who was referred due to a reduced level of consciousness and hemiparesis in the left part of his body without symptoms such as fever, cough, muscle aches, and fatigue. In High-Resolution Computed Tomography (HRCT) of the lung, the Ground-Glass Opacification/Opacity (GGO) view indicated COVID-19 disease, and in Computerized Tomography (CT) scans of the brain, hemorrhage was evident in the right thalamus, lateral and right ventricle. The Polymerase Chain Reaction (PCR) test performed on the upper part of the nose was also positive. This research is a case report of intracranial and intraventricular hemorrhage in an aged man with asymptomatic COVID-19. Conclusion: Low level of consciousness in the elderly can be a sign of infection with the SARS-CoV-2 virus.

scholarly journals Work ability evaluation in neurosarcoidosis: A case report

2006 ◽  
Vol 134 (5-6) ◽  
pp. 238-240
Author(s):  
Aleksandar Milovanovic ◽  
Jovica Milovanovic ◽  
Nikola Torbica
Keyword(s):  
Case Report ◽  
Unknown Etiology ◽  
Ophthalmological Examination ◽  
Resonance Imaging ◽  
Working Ability ◽  
Bilateral Ptosis ◽  
Focal Lesions ◽  
Initial Manifestation ◽  
The Central Nervous System ◽  
The Right

Sarcoidosis is a multisystemic granulomatous disease of unknown etiology which affects most frequently the hilar lymph nodes and lungs. Symptomatic involvement of the central nervous system may develop in patients diagnosed with sarcoidosis or it may be the initial manifestation of the disease. This is a case report of 48-year old female patient admitted to our clinic for evaluation of working ability. The patient had a total of 24 years of service and occupational exposure and she has been employed as supplies procurement officer. On admission, she complained of the following discomforts: eye-lid pain, intellectual fatigue, psychic uneasiness, forgetfulness, dyspnea and productive cough. Neurological findings indicated the presence of the right eye ophthalmoplegia, psychoorganic syndrome and neurosarcoidosis. Ophthalmological examination evidenced bilateral ptosis and presence of anisocoria. Magnetic resonance imaging revealed discrete focal lesions of the pons (paracentral left) and parietal corona radiata of the left hemisphere. Based on performed examinations and diagnostics procedures, final evaluation of patient?s working ability concluded that the patient was not capable of psychic strains and jobs associated with material accountability.

Cordoid Meningioma A Case Report

2021 ◽  
pp. 1-2
Author(s):  
Romero Cargina ◽  
Keyword(s):  
Case Report ◽  
High Growth ◽  
Brain Parenchyma ◽  
Clinical Aspects ◽  
High Recurrence Rate ◽  
Chordoid Meningioma ◽  
The Central Nervous System ◽  
Grade Ii ◽  
Aggressive Histology ◽  
Aggressive Clinical Course

Introduction: Meningiomas are tumors of the central nervous system derived from the arachnoid layer of cells, represent less than 3% of all primary intracranial tumors in children, are prevalent in adolescents, and are rare in younger ages. Pediatric cases represent approximately 1.5% of all intracranial meningiomas, and very few cases show aggressive histology. The WHO classification meningioma divided into three grades: Grade I benign; II, atypical; and III, anaplastic / malignant. Chordoid meningioma grade II / atypical meningioma is a rare subtype, which represents only 0.5% of all meningiomas, have high growth rates, higher recurrence and greater possibilities to invade the brain parenchyma compared with meningiomas benign. One possible explanation for the high recurrence rate may be related to the quality mucoid stroma, which facilitates extension of tumor and makes it difficult to achieve a complete resection, which leads to subsequent recurrence. Case Report: We report the case of male patient 4 years of age diagnosed with meningioma Grade II, with clinic 2 months of evolution who presented progressive neurological deterioration, tumoral exeresis was performed in 3 opportunities and placement system ventriculo peritoneal in the course of 1 month and radiotherapy. Comments: Accurate diagnosis, therefore, assumes importance because these tumors have an aggressive clinical course and high probability of recurrence so knowing the pathological Clinical Aspects of this rare neoplasm is essential for the Treatment and Comprehensive monitoring.

Cryptococcal infection of the larynx: case report

2013 ◽  
Vol 127 (S2) ◽  
pp. S54-S56 ◽  
Author(s):  
N Mittal ◽  
P Collignon ◽  
T Pham ◽  
M Robbie
Keyword(s):  
Case Report ◽  
Vocal Fold ◽  
Histopathological Examination ◽  
Rare Condition ◽  
Cryptococcus Gattii ◽  
Causative Organism ◽  
Adequate Treatment ◽  
Imaging Results ◽  
The Right ◽  
Laryngeal Involvement

AbstractObjective:Laryngeal cryptococcosis is a rare condition. In this report, we describe the findings for and treatment of a 58-year-old man withCryptococcus gattiiinfection of the right vocal fold.Method:Case report and review of the relevant English language literature.Results:The patient presented with persistent hoarseness of voice. Laryngoscopy demonstrated an irregular, red lesion on the right vocal fold. Histopathological examination identified cryptococcus. The patient was treated with oral fluconazole 400 mg/day for eight weeks.Conclusion:Laryngeal involvement byCryptococcus gattiican result from prolonged inhaled corticosteroid therapy and proximity to eucalyptus trees. The clinical presentation, laryngoscopic findings and imaging results of laryngeal involvement may mimic a neoplasm. Histopathological examination can demonstrate the causative organism. Management consists of advice from an infectious disease specialist together with adequate treatment by antifungal agents.

scholarly journals Neuroparacoccidioidomycosis: Case Report and Literature Review

2018 ◽  
Vol 37 (02) ◽  
pp. 134-139
Author(s):  
Marcus Morais ◽  
Sérgio Georgeto ◽  
Marcelo Haddad ◽  
José Amorim ◽  
Luis Scaliante ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Case Report ◽  
Paracoccidioides Brasiliensis ◽  
Perilesional Edema ◽  
Mri Scans ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Head Computed Tomography

Introduction Paracoccidioidomycosis (PCM) is a systemic mycosis caused by the fungus Paracoccidioides brasiliensis, and it can compromise the central nervous system (CNS) in 10–27% of all cases. Case Report A 31-year-old man presented to the Emergency Department with headache, left-sided weakness, clonus at the ankle and a positive Babinski sign. Head computed tomography (CT) and magnetic resonance imaging (MRI) scans showed a 5.1 × 3.8 cm lobulated lesion with areas of liquefaction in the right centrum semiovale. Discussion Central nervous system PCM can mimic a brain tumor, and most cases are diagnosed by biopsy of the lesion. The treatment includes antibiotics, but some cases require surgery. Conclusion Due to high morbimortality rates, the diagnosis must be considered, and early treatment started in patients who live in rural regions endemic for PCM when a ring-enhancing mass associated with perilesional edema is observed on MRI scans.

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