scholarly journals Secondary parkinsonism and normal pressure hydrocephaly because of cranioencephalic trauma: a case report

2021 ◽  
Author(s):  
Renato Serquiz Elias Pinheiro ◽  
Emanuelly da Costa Nobre Soares ◽  
Maria Eduarda Bezerra Figueiredo ◽  
Stella Mandu Cicco ◽  
Anna Beatriz Graciano Zuza
Keyword(s):  
Case Report ◽  
Cognitive Deficits ◽  
Normal Pressure ◽  
Test Case ◽  
Medical Procedure ◽  
Imaging Studies ◽  
Arachnoid Granulations ◽  
Tap Test ◽  
Significant Clinical Improvement ◽  
Antiparkinsonian Drugs

Context: Normal Pressure Hydrocephalus (NPH) occurs due to the quantitative imbalance of cerebrospinal fluid (CSF), changes in absorption or drainage. It shows idiopathic or secondary etiology. Head trauma (TBI) — which causes brain and/or arachnoid granulations fibrosis and inflammation — impairs CSF reabsorption and induces accumulation in the ventricular system. The diagnosis of sNPH was based on a conjunction of symptoms (e.g.: urinary incontinence, dementia, and gait impairment) and imaging studies. Among the treatments with significant clinical improvement, there are ventriculoperitoneal shunt (VP) and tap test. Case report: FAR, a 74-year old man who was diagnosed with parkinsonian syndrome after 6 months of TBI, showed stiffness, bradykinesia and tremor at rest. In addition, he had CT and Skull MRI. Previous studies suggested PNH. Drug therapy with an optimized dose of Levodopa + Benserazide was established. However, it has shown an unsatisfactory response to antiparkinsonian drugs. Hence, he was submitted to the tap test, obtaining functionality and gait reversion as well as cognitive deficits regression. Those results still remained four weeks after the medical procedure. Conclusions: The work aims to emphasize the importance of a positive tap test response as well as early diagnosis and treatment in the outcome of the morbidity.

scholarly journals Diffuse Glioma manifesting as Normal Pressure Hydrocephalus: A potential pitfall in diagnosis-a case report

2021 ◽  
pp. 100009
Author(s):  
Marianthi Breza ◽  
Vasiliki Kotsali-Peteinelli ◽  
Ioanna Tsantzali ◽  
Antonis Mavromatos ◽  
Eleni Strataki ◽  
...  
Keyword(s):  
Case Report ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Diffuse Glioma ◽  
Potential Pitfall

scholarly journals Leishmania mexicana in a central Texas cat: clinical presentation, molecular identification, sandfly vector collection and novel management

2021 ◽  
Vol 7 (1) ◽  
pp. 205511692199959
Author(s):  
Kaitlin Hopke ◽  
Alyssa Meyers ◽  
Lisa Auckland ◽  
Sarah Hamer ◽  
David Florin ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Success ◽  
Leishmania Species ◽  
Canine Leishmaniosis ◽  
Leishmania Mexicana ◽  
Cutaneous Lesions ◽  
Clinical Appearance ◽  
Significant Clinical Improvement ◽  
Central Texas ◽  
The Right

Case summary This case report documents the clinical appearance, diagnosis and novel treatment of a central Texas cat with cutaneous leishmaniosis. The cat presented with a linear erosion on the right pinnal margin, an ulcerated exophytic nodule on the right hock and a swelling in the right nostril. Cytological and histopathological findings were consistent with leishmaniosis. PCR confirmed the presence of Leishmania mexicana, a species endemic to Texas. An epidemiological investigation was conducted by trapping sandflies from the cat’s environment. Sandflies collected were identified as Lutzomyia species, known vectors of Leishmania species. Given the lack of validated medical therapies for L mexicana in cats, treatments typically prescribed for canine leishmaniosis were administered. Allopurinol achieved clinical success but was discontinued due to suspected drug-related neutropenia. Topical imiquimod also improved lesional skin but was not sustainable due to application difficulty. Oral administration of artemisinin resulted in significant clinical improvement of cutaneous lesions without reported adverse events. Nearly 8 months after the initiation of artemisinin therapy, the cat remained systemically healthy with stable lesions. Relevance and novel information This case report demonstrates endemic feline leishmaniosis in central Texas and provides the clinician with alternative therapeutic options for medical management.

Camptocormia in idiopathic normal pressure hydrocephalus: a case report

2021 ◽  
Author(s):  
Massimiliano Todisco ◽  
Francesca Valentino ◽  
Enrico Alfonsi ◽  
Giuseppe Cosentino
Keyword(s):  
Case Report ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus

scholarly journals An incidental case of biliary fascioliasis with subtle clinical findings: US and MRCP findings

2013 ◽  
Vol 47 (2) ◽  
pp. 125-127
Author(s):  
Hakan Önder ◽  
Faysal Ekici ◽  
Emin Adin ◽  
Suzan Kuday ◽  
Hatice Gümüş ◽  
...  
Keyword(s):  
Case Report ◽  
Bile Duct ◽  
Magnetic Resonance ◽  
Biliary Obstruction ◽  
Fasciola Hepatica ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Clinical Findings ◽  
Imaging Studies ◽  
Laboratory Findings ◽  
Acoustic Shadow

Background. Fascioliasis is a disease caused by the trematode Fasciola hepatica. Cholangitis is a common clinical manifestation. Although fascioliasis may show various radiological and clinical features, cases without biliary dilatation are rare. Case report. We present unique ultrasound (US) and magnetic resonance cholangiopancreatography (MRCP) findings of a biliary fascioliasis case which doesn’t have biliary obstruction or cholestasis. Radiologically, curvilinear parasites compatible with juvenile and mature Fasciola hepatica within the gallbladder and common bile duct were found. The parasites appear as bright echogenic structures with no acoustic shadow on US and hypo-intense curvilinear lesions on T2 weighted MRCP images. Conclusions. Imaging studies may significantly contribute to the diagnosis of patients with subtle clinical and laboratory findings, particularly in endemic regions.

scholarly journals Evaluating the cerebrospinal fluid tap test with the Hellström iNPH scale for patients with idiopathic normal pressure hydrocephalus

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Johanna Rydja ◽  
Andreas Eleftheriou ◽  
Fredrik Lundin
Keyword(s):  
Cerebrospinal Fluid ◽  
Scale Score ◽  
Normal Pressure Hydrocephalus ◽  
Postoperative Outcome ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Urinary Continence ◽  
Predictive Values ◽  
Tap Test ◽  
Total Scale Score

Abstract Background The cerebrospinal fluid tap test (CSF TT) is used for selecting shunt surgery candidates among patients with idiopathic normal pressure hydrocephalus (iNPH). We aimed to evaluate the predictive value of the CSF TT, by using the Hellström iNPH scale for shunted iNPH patients with a standardized method. Methods One hundred and sixteen shunt-operated iNPH patients were retrospectively included in this study. The gait and balance domains in the iNPH scale were used as outcome measures for the CSF TT and the total iNPH scale score as the postoperative outcome. A positive response to CSF TT was defined as a change of ≥ 5 points in the gait domain and ≥ 16 points in the balance domain. Differences between CSF TT responders and non-responders, sensitivity, specificity, positive and negative predictive values, accuracy, and correlations between changes from baseline to post CSF TT and from baseline to the postoperative follow-up, were calculated. Results In the CSF TT there were 63.8% responders in the gait domain and correspondingly 44.3% in the balance domain. CSF TT responders had a significantly better postoperative outcome in the total scale score (gait P ≤ 0.001, balance P ≤ 0.012) and gait CSF TT responders improved more in gait (P ≤ 0.001) and balance CSF TT responders in balance (P ≤ 0.001). No differences between CSF TT gait or balance responders could be found in neuropsychological or urinary continence assessments postoperatively. The sensitivity and specificity of the CSF TT and the outcome of the total iNPH scale score postoperatively were 68.1% and 52.0% for gait and 47.8% and 68.0% for balance, respectively. Conclusions The CSF TT, with the Hellström iNPH scale as the outcome measure, has clear limitations in predicting postoperative results. The gait domain may be used to predict outcomes for gait, but the balance domain is too insensitive.

Driving Performance Deficits Despite Concussion Symptom Resolution: A Case Report

2018 ◽  
Vol 23 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Nicole L. Hoffman ◽  
Hannes Devos ◽  
Julianne D. Schmidt
Keyword(s):  
Case Report ◽  
Cognitive Deficits ◽  
Processing Speed ◽  
Driving Simulator ◽  
Driving Performance ◽  
Performance Study ◽  
Male College Student ◽  
Performance Deficits ◽  
Male College ◽  
Complex Attention

Driving performance prior to concussion is not commonly available to help clinicians identify when deficits return to a preinjury status. This case report examines driving performance prior to and following concussion in a 20-year-old male college student. He initially volunteered as a control for a separate driving performance study. He sustained a concussion 18 months later, and was asked to complete the same driving tasks as previous testing once he was asymptomatic. Poor driving simulator performance and subtle cognitive deficits in complex attention and processing speed were evident despite being symptom-free. Our findings may be useful when considering readiness to drive postconcussion.

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 Blake's Pouch Cyst: A Case Report

2017 ◽  
Vol 06 (02) ◽  
pp. 122-125
Author(s):  
Saurabh Verma ◽  
M. Sridhar ◽  
S. Shashivadhanan ◽  
Manish Garg
Keyword(s):  
Genetic Counseling ◽  
Case Report ◽  
Literature Review ◽  
Posterior Fossa ◽  
Clinical Management ◽  
In Utero ◽  
Prenatal Ultrasound ◽  
Male Child ◽  
Imaging Studies ◽  
Initial Imaging

AbstractIt is a rare and underdiagnosed entity. The adagium “one only sees what one knows” is certainly true in cases of Blake's pouch cyst, as all types of posterior fossa cysts and cyst-like malformations may present nearly identical on initial imaging studies. Only one case of Blake's pouch cyst has been reported from this country, except for a case in utero, in which a diagnosis of Blake's pouch cyst was made on prenatal ultrasound and later confirmed by MRI. In this report we describe a case of Blake's pouch cyst in a 9-month-old male child along with the principles of diagnosis of Blake's pouch cyst, in combination with literature review. Differentiating Blake's pouch cyst from other posterior fossa cysts and cyst-like malformations and recognizing the accompanying hydrocephalus that are essentially noncommunicating have important implications not only on clinical management but also on genetic counseling, which is unnecessary in case of Blake's pouch cyst.

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