West Nile virus encephalomyelitis in an immunocompromised patient.

We report a case of a 50-year-old immunocompromised woman who presented with acute encephalopathy and gait ataxia due to severe West Nile virus encephalomyelitis. The patient remarkably improved following early and sustained aggressive immunomodulation. Diagnosing West Nile neuroinvasive disease could be challenging without biochemical evidence of West Nile virus nucleic acid in the cerebrospinal fluid, a specific but not sensitive test.

Advances in the neuroimaging of motor disorders.

Neuroimaging is a valuable adjunct to the history and examination in the evaluation of motor system disorders. Conventional imaging with computed tomography or magnetic resonance imaging depicts important anatomic information and helps to identify imaging patterns which may support diagnosis of a specific motor disorder. Advanced imaging techniques can provide further detail regarding volume, functional, or metabolic changes occurring in nervous system pathology.

Recurrent tumefactive demyelinating lesions in an elderly woman.

Here we describe a 72-year old Caucasian woman who presented with progressive left hemiparesis and hemisensory deficits due to a pathology-confirmed tumefactive demyelinating lesion in the right frontoparietal region. Symptoms improved with glucocorticoids and plasmapheresis, but five months following initial presentation, the patient developed right visual field deficits and acute encephalopathy. Brain imaging revealed near resolution of the initial lesion with interval development of new multifocal tumefactive demyelinating lesions.

Longitudinal magnetic resonance findings in delayed posthypoxic leukoencephalopathy.

Delayed posthypoxic leukoencephalopathy is a rare condition that can occur following prolonged cerebral hypo-oxygenation and manifests as acute onset of neuropsychiatric symptoms after a period of apparent recovery. We describe a case of a 76-year-old man who presented after an unwitnessed fall of unknown duration with initial recovery followed by progressive neurocognitive decline resulting in dementia, dysphasia, and gait apraxia. Initial brain magnetic resonance imaging was unremarkable but repeated brain imaging revealed progressive leukoencephalopathy, which started as small foci of abnormal diffusion restriction in bilateral frontal lobes and gradually evolved over the next 3 weeks to diffuse signal changes in the white matter.

Obstructive hydrocephalus due to aqueductal stenosis from developmental venous anomaly draining bilateral medial thalami: a case report.

Hydrocephalus is a pathological buildup of cerebrospinal fluid within the ventricles leading to ventricular enlargement out of proportion to sulci and subarachnoid spaces. Developmental venous anomaly is a common benign and usually asymptomatic congenital cerebrovascular malformation. Hydrocephalus caused by aqueductal developmental venous anomaly is extremely rare.

Idiopathic Intracranial Hypertension and Anemia: A Matched Case-Control Study.

Background: An association between idiopathic intracranial hypertension (IIH) and anemia has been speculated from previous case reports and case series. Retrospective studies to date have not used matched case controls to compare standardized complete blood count (CBC) values for the presence of anemia.

Methods: At our tertiary care facility, 50 patients with IIH were matched with 50 case-control patients to compare CBC values from laboratory affiliates with standardized ranges.

Supraorbital Nerve and Cavernous Sinus Invasion with Poorly Differentiated Carcinoma of Unknown Primary.

A 50-year-old man presented with a 4-month history of right-sided trigeminal neuropathy in the V1 and V2 distribution, right sixth nerve palsy and Horner syndrome. Magnetic resonance imaging (MRI) showed enhancement and thickening along the right ophthalmic nerve and supraorbital nerve and fullness at the right cavernous sinus extending to Meckel's cave. Evaluation for a primary tumour was negative.

Mechanical Thrombectomy Outcomes With and Without Intravenous Thrombolysis in Stroke Patients: A Meta-Analysis.

Background And Purpose: Whether prior intravenous thrombolysis provides any additional benefits to the patients undergoing mechanical thrombectomy for large vessel, acute ischemic stroke remains unclear.

Methods: We conducted a meta-analysis of 13 studies obtained through PubMed and EMBASE database searches to determine whether functional outcome (modified Rankin Scale) at 90 days, successful recanalization rate, and symptomatic intracerebral hemorrhage rate differed between patients who underwent mechanical thrombectomy with (MT+IVT) and without (MT-IVT) pre-treatment with intravenous thrombolysis.

Results: MT+IVT patients compared with MT-IVT patients had better functional outcomes (modified Rankin Scale score, 0-2; summary odds ratio [OR], 1.

Systolic Blood Pressure Within 24 Hours After Thrombectomy for Acute Ischemic Stroke Correlates With Outcome.

Background: Current guidelines suggest treating blood pressure above 180/105 mm Hg during the first 24 hours in patients with acute ischemic stroke undergoing any form of recanalization therapy. Currently, no studies exist to guide blood pressure management in patients with stroke treated specifically with mechanical thrombectomy. We aimed to determine the association between blood pressure parameters within the first 24 hours after mechanical thrombectomy and patient outcomes.

Post-stroke dyskinesias.

Strokes, whether ischemic or hemorrhagic, are among the most common causes of secondary movement disorders in elderly patients. Stroke-related (vascular) movement disorders, however, are uncommon complications of this relatively common disease. The spectrum of post-stroke movement disorders is broad and includes both hypo- and hyperkinetic syndromes.

Asthma, chronic obstructive pulmonary disease (COPD), and the overlap syndrome.

Asthma and chronic obstructive pulmonary disease (COPD) are highly prevalent chronic diseases in the general population. Both are characterized by heterogeneous chronic airway inflammation and airway obstruction. In both conditions, chronic inflammation affects the whole respiratory tract, from central to peripheral airways, with different inflammatory cells recruited, different mediators produced, and thus differing responses to therapy.