Heroin-induced acute myelopathy with extreme high levels of CSF glial fibrillar acidic protein indicating a toxic effect on astrocytes.

A man aged 33 years with previous heroin substance abuse was found unconscious lying in a bush. The patient had been without heroin for some time but had just started to use intravenous heroin again, 0.5-2 g daily.

Intra-Arterial Mechanical Thrombectomy: An Effective Treatment for Ischemic Stroke Caused by Endocarditis.

Patients with stroke secondary to infectious endocarditis have a high in-hospital morbidity and mortality, with only one-third becoming functionally independent. Infective endocarditis is usually considered a relative contraindication to thrombolytic therapy. We describe 3 consecutive cases of acute middle cerebral artery occlusion due to infective endocarditis, who were all successfully treated with intra-arterial mechanical thrombectomy using the Solitaire device.

Multiple cerebral aneurysms in a patient with cardiac myxoma: what to do?

Cardiac myxomas are a very uncommon cause of cerebral aneurysms. We present a case of a young woman with neurological symptoms attributed to small cortical infarctions and multiple cerebral aneurysms, caused by a cardiac myxoma.

Increased survival using delayed gamma knife radiosurgery for recurrent high-grade glioma: a feasibility study.

Objective: The current study retrospectively assessed delayed gamma knife radiosurgery (GKRS) in the management of high-grade glioma recurrences.

Methods: A total of 55 consecutive patients with high-grade glioma comprising 68 World Health Organization (WHO) III and WHO IV were treated with GKRS for local recurrences between 2001 and 2007. All patients had undergone microsurgery and radiochemotherapy, considered as standard therapy for high-grade glioma.

Progressive multifocal leukoencephalopathy in a patient with Good's syndrome.

Good's syndrome (GS) is an immunodeficiency characterised by thymoma, hypogammaglobulinemia and impaired T-cell function. The clinical symptoms are recurrent or chronic infections from common or opportunistic pathogens and diarrhoea. Encephalitis is rare, mostly associated to cytomegalovirus.

Internal carotid dissection caused by an elongated styloid process (Eagle syndrome).

Eagle syndrome (symptoms associated with an elongated styloid process (SP)) is commonly divided into two presentations. First, the so-called classic Eagle syndrome where patients can present with unilateral sore throat, dysphagia, tinnitus, unilateral facial and neck pain and otalgia. Second, there is the vascular or stylocarotid form of Eagle syndrome in which the elongated SP is in contact with the extracranial internal carotid artery.

Cortical venous thrombosis following exogenous androgen use for bodybuilding.

There are only a few reports of patients developing cerebral venous sinus thrombosis (CVST) after androgen therapy. We present a young man who developed cortical venous thrombosis after using androgens to increase muscle mass. He was hospitalised for parasthesia and dyspraxia in the left hand followed by a generalised tonic-clonic seizure.