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Ipsilateral Hemiparesis in Lateral Medullary Syndrome: A Case Report on Opalski's Syndrome.
Cureus
December 2024
Neurology, Mahatma Gandhi Medical College and Hospital, Jaipur, Jaipur, IND.
Lateral medullary syndrome (LMS) is a neurological disorder usually presenting as loss of pain and thermal sensation over the ipsilateral face and contralateral half of the body, ipsilateral limb ataxia, Horner's syndrome, dysphagia, nystagmus, hiccups among other symptoms but never with limb weakness. In the present case, the patient presented with ipsilateral hemiparesis, which can be attributed to the extension of the infarct caudally beyond the pyramidal decussation, affecting the corticospinal fibers in the upper cervical cord, a variant of LMS, known as Opalski syndrome (OS).
View Article and Find Full Text PDFDelayed Progression of Ataxia with a Static Cerebellar Lesion- Consider SCA27B.
Cerebellum
January 2025
Department of Neurology, Donders Institute for Brain, Cognition & Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
Repeat expansions in the fibroblast growth factor 14 gene (FGF14), associated with spinocerebellar ataxia type 27B (SCA27B), have emerged as a prevalent cause of previously unexplained late-onset cerebellar ataxia. Here, we present a patient with residual symptom of gait ataxia after complicated meningioma surgery, who presented with progressive symptoms of oculomotor disturbances, speech difficulties, vertigo and worsening of gait imbalance, twelve years post-resection. Neuroimaging revealed a surgical resection cavity in the dorsolateral side of the left cerebellar hemisphere, accompanied by gliosis in left cerebellar hemisphere extending into the vermis, extensive non-specific supratentorial periventricular white matter abnormalities, and mild atrophy of the cerebellar vermis.
View Article and Find Full Text PDFCerebellar Ataxia, Neuropathy, and Vestibular Areflexia as a Presentation of a Novel DNMT1 Mutation.
Cerebellum
January 2025
Department of Neurology, Division of Neuro-Visual & Vestibular Disorders, The Johns Hopkins University School of Medicine, Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD, USA.
A 50-year-old woman with a 20-year history of gait instability presented with new-onset vertigo and oscillopsia. Examination revealed bilateral vestibular loss, cerebellar ataxia, sensory neuropathy, a "yes-yes" head tremor, nystagmus and a family history of a similar syndrome. Genetic testing for cerebellar ataxia with neuropathy and bilateral vestibular areflexia syndrome (RFC1) was negative, but whole exome sequencing identified a novel mutation in the DNA methyltransferase 1 (DNMT1) gene, broadening the differential diagnosis for this phenotype.
View Article and Find Full Text PDFSymptomatic Progression, Recurrence, and Long-Term Follow-Up of Patients With Intracranial Epidermoid Cysts.
Neurosurgery
December 2024
Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
Background And Objectives: Intracranial epidermoid cysts are rare, slow-growing but highly recurrent tumors with incompletely understood symptoms, progression, complications, and outcomes. The aim of the study was to characterize the symptomatology, surgical management, and long-term outcomes of these tumors.
Methods: This single-center retrospective analysis identified patients with pathologically confirmed intracranial epidermoid cysts from 1989 to 2023.
Severe headache as the first presentation of post-COVID-19 brain and spinal cord injury resembling neurosarcoidosis.
Postep Psychiatr Neurol
September 2024
Department of Medical Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Purpose: Sarcoidosis, a multi-organ granulomatous disease, occasionally involves the nervous system, presenting as neurosarcoidosis. The following case demonstrates a potential association between COVID-19 and brain and spinal cord injury mimicking neurosarcoidosis.
Case Description: A 51-year-old woman presented with persistent holocranial headache, nausea, vertigo, and neurological deficits one month after a COVID-19 hospitalization.
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