Internal Carotid Artery Dissection Presenting With Dysgeusia, Horner Syndrome, and Hypesthesia of the Fifth Cranial Nerve: A Case Report.

Background: Carotid artery dissection (CAD) is a significant cause of ischemic stroke. Early recognition and treatment of CAD is important to prevent accompanying cerebral ischemia. This case report presents an atypical clinical presentation of CAD and emphasizes the diagnostic challenge for emergency physicians.

[Back pain and radicular pain after subarachnoid haemorrhages].

Subarachnoid haemorrhages (SAH) are acute life-threatening events that are frequently misdiagnosed. 4% of patients with SAH do not have the typical acute intense headaches, but present with other symptoms. Misdiagnosis leads to treatment delays and, consequently, higher morbidity and mortality.

[Cerebral imaging in a delirious patient].

An 80-year-old woman attended the emergency department with sub-acute confusion and fever. On examination no focal signs were found. Cerebral CT showed an area of hypodensity suspected to be an infarction, but an MRI scan carried out 10 days later showed cerebral abscesses caused by a dental infection that had occurred four weeks previously.

[Acute treatment of hypertension in intracerebral haemorrhage].

Thus far no effective treatment for an intracerebral haemorrhage has been available. A randomized clinical trial recently showed that treatment of hypertension in the acute phase of spontaneous intracerebral haemorrhage with a target systolic blood pressure of 140 mmHg is safe and improves prognosis. The effect of blood pressure reducing therapy was small and not statistically significant for the primary outcome (mortality or severe morbidity).

[Neurological signs in aortic dissection].

A substantial number of patients suffering from aortic dissection will show neurological signs. These can dominate the clinical picture and hinder an accurate diagnosis of this life-threatening disease. We present a case of lower extremity pain and a case of transient global amnesia caused by aortic dissection.

Autosomal dominant restless legs syndrome maps to chromosome 20p13 (RLS-5) in a Dutch kindred.

Six chromosomal loci have been mapped for restless legs syndrome (RLS) through family-based linkage analysis (RLS-1 to RLS-6), but confirmation has met with limited success, and causative mutations have not yet been identified. We ascertained a large multigenerational Dutch family with RLS of early onset (average 18 years-old). The clinical study included a follow-up of 2 years.

[Juxta facet cyst of the lumbar spine: an uncommon cause of lumbar radiculopathy].

Lumbar juxta facet cysts (JFC) are an uncommon cause of radiculopathy. Spontaneous regression of symptomatic JFC has not often been reported. We describe 2 patients, a 59-year-old man and a 55-year-old man, with radiculopathy of the 5th lumbar nerve root due to a JFC at L4-5.

Episodic ataxia associated with EAAT1 mutation C186S affecting glutamate reuptake.

Background: Episodic ataxia (EA) is variably associated with additional neurologic symptoms. At least 4 genes have been implicated. Recently, a mutation in the SLC1A3 gene encoding the glutamate transporter EAAT1 was identified in a patient with severe episodic and progressive ataxia, seizures, alternating hemiplegia, and migraine headache.

Assessment of feasibility of endovascular treatment of ruptured intracranial aneurysms with 16-detector row CT angiography.

Background: It is unclear whether 16-detector row CT angiography (CTA) can replace digital subtraction angiography (DSA) to assess the feasibility of endovascular treatment (EVT) in the acute phase after aneurysmal subarachnoid hemorrhage.

Methods: We studied 80 consecutive patients with aneurysmal subarachnoid hemorrhage, who underwent both CTA and DSA. Two interventional neuroradiologists independently scored CTA and, immediately thereafter, DSA with respect to feasibility of EVT.

Temporary divergence paralysis in viral meningitis.

A 43-year-old woman who reported diplopia and headache was found to have comitant esotropia at distance fixation and normal alignment at reading distance (divergence paralysis). Eye movement, including abduction, was normal as was the rest of the neurologic examination. Brain MRI was normal.

Cerebral hypoperfusion and clinical onset of dementia: the Rotterdam Study.

Cerebral blood flow (CBF) velocity is decreased in patients with Alzheimer's disease. It is being debated whether this reflects diminished demand because of advanced neurodegeneration or that cerebral hypoperfusion contributes to dementia. We examined the relation of CBF velocity as measured with transcranial Doppler with dementia and markers of incipient dementia (ie, cognitive decline and hippocampal and amygdalar atrophy on magnetic resonance imaging) in 1,730 participants of the Rotterdam Study aged 55 years and older.

Cerebral haemodynamics in the elderly: the rotterdam study.

Transcranial Doppler ultrasonography allows the non-invasive assessment of cerebral haemodynamics. Data on the frequency distribution of these parameters in the oldest old are scarce, which makes a distinction between physiological and pathophysiological ageing difficult. We studied the relation between cerebral haemodynamic parameters and age and sex in 1,720 participants of a population-based study by means of transcranial Doppler ultrasonography.