Cryptococcal meningitis in a multiple sclerosis patient taking natalizumab.

Importance: Natalizumab was approved in 2004 by the US Food and Drug Administration (US-FDA) for treatment of multiple sclerosis (MS), however it was temporarily withdrawn after its use was associated with progressive multifocal leukoencephalopathy (PML). Other reported adverse events have included melanoma, primary central nervous system (CNS) lymphoma, and gastrointestinal cryptosporidiosis. An MS exacerbation may occur after discontinuation and immune reconstitution inflammatory syndrome (IRIS), particularly in the setting of PML, is also possible.

Treating acute stroke patients with intravenous tPA. The OSF stroke network experience.

Background And Purpose: Since the FDA approved tissue plasminogen activator (tPA) in 1996 for acute ischemic stroke, few data have been obtained during the postmarketing phase, and applicability in rural hospitals does not exist. We attempt to examine the safety and outcome of intravenous tPA for acute ischemic stroke in the OSF Stroke Network.

Methods: Fifty-seven consecutive patients treated with tPA were examined from June 1996 through December 1998.

Demyelinating disease of corpus callosum presenting as glioma on magnetic resonance scan: a case documented with pathological findings.

Magnetic resonance imaging (MRI) has improved the diagnosis of several pathological entities of the brain. MRI especially has been credited with distinguishing demyelinating diseases of the central nervous system from other diseases. The presence of a mass effect in a demyelinating disorder, however, makes difficult the distinction between tumor and a demyelinating disease.

Adrenal defect in adrenomyelodystrophy.

Adrenomyelodystrophy (AMD), a variant of adrenoleukodystrophy, is associated with both neurologic and adrenal dysfunction. Data from an endocrinologic evaluation of a 41-year-old pigmented white man with AMD showed elevation in basal plasma ACTH, 11-deoxycortisol, 17-alpha OH-progesterone and progesterone concentrations, and low normal plasma cortisol levels. Free urinary cortisol and 17-ketosteroid secretion values were within normal limits.