1/7. Bilateral symmetrical basal ganglia infarction after intravenous use of cocaine and heroin.A case is reported of a young man who developed bilateral symmetrical basal ganglia infarcts after intravenous use of cocaine and heroin. Ischemic infarcts of the brain are a known complication of to cocaine use, alone or in combination with heroin (speed balling). This symmetrical occurrence of infarction, however, is unusual and has not been reported after cocaine use.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/7. A neurocytoma and an associated lenticulostriate artery aneurysm presenting with intraventricular hemorrhage: case report.OBJECTIVE AND IMPORTANCE: Hemorrhage associated with central neurocytoma has been described previously, but never in association with an aneurysm originating from a feeding artery. We present the first reported case of a central neurocytoma in a patient with intraventricular hemorrhage caused by rupture of an aneurysm on a lenticulostriate artery that supplied the tumor. CLINICAL PRESENTATION: A 35-year-old man who presented with an intraventricular hemorrhage underwent magnetic resonance imaging and cerebral angiography that disclosed a right lateral intraventricular mass and a 7-mm fusiform aneurysm from a lateral lenticulostriate branch of the right middle cerebral artery. INTERVENTION: The patient underwent a contralateral transcallosal exploration and resection of the tumor, with excision of the adjacent lenticulostriate artery aneurysm. Pathological review demonstrated that the tumor was a neurocytoma. The aneurysm was discrete from the tumor but occurred on a vessel that supplied the tumor. CONCLUSION: Previous reports have demonstrated that intraventricular neurocytoma may present with tumor hemorrhage. In this case, an aneurysm separate and distinct from the tumor was the bleeding culprit, and the aneurysm was on an artery that fed into the tumor. Any such aneurysm must be identified and treated appropriately for therapy to be complete.- - - - - - - - - - ranking = 31.454155004808keywords = cerebral (Clic here for more details about this article) |
3/7. Anti-beta2-glycoprotein I antibodies and ischemic stroke in a 20-month-old boy.antibodies to beta2-glycoprotein I (anti-beta2GPI) have been associated with recurrent thrombosis and pregnancy morbidity. However, the prevalence of anti-beta2GPI in children suffering from cerebral infarction is unknown. We report on a 20-month-old boy who had an ischemic stroke, secondary to antiphospholipid syndrome with high titers of immunoglobulin g anti-beta2GPI (first titer: 132 U; second titer 6 weeks later: 350 U; normal range: 0-100 U). Anticardiolipin antibodies and lupus anticoagulant tests were negative. All other causes of infarction were excluded. Laboratory studies showed anti-beta2GPI IgG levels of 164 U and 216 U at 6 months and 2 years, respectively, after the onset. The patient received treatment with low-dose aspirin. To our knowledge, this is the first reported case of childhood ischemic stroke with only anti-beta2GPI but no antibodies detectable in standard antiphospholipid assays. This case supports the recommendation of others to search for these antibodies in the presence of strong clinical suspicion of antiphospholipid syndrome, when anticardiolipin antibodies and lupus anticoagulant tests are negative.- - - - - - - - - - ranking = 15.727077502404keywords = cerebral (Clic here for more details about this article) |
4/7. Severe bruxism following basal ganglia infarcts: insights into pathophysiology.bruxism characterized by clenching and grinding of teeth can lead to toothwear, headaches and depression. While bruxism has been associated with a number of neurological diseases, it has not been highlighted following cerebral infarction.An elderly man presented with an acute onset of tooth grinding and jaw clenching associated with dysarthria. His bruxism was worse during the day and resolved during sleep. He had frequent jaw aches, headaches and swallowing difficulty. Examination demonstrated the presence of dysarthria with jaw clenching and tooth grinding, producing persistent high pitch and loud squeaky sounds. A magnetic resonance imaging and angiography examination revealed a recent infarct in the right thalamus. In addition, chronic lacunar infarcts were present in the bilateral caudate nuclei with severe basilar artery stenosis. He was successfully treated with botulinum toxin.We discuss the pathophysiologic mechanisms of bruxism associated with basal ganglia infarcts. Dysfunction of the efferent and/or afferent thalamic or striatopallidal tracts may play a role in bruxism. Early recognition of bruxism following stroke could reduce unnecessary suffering since the condition can be effectively treated.- - - - - - - - - - ranking = 15.727077502404keywords = cerebral (Clic here for more details about this article) |
5/7. Surgical considerations regarding giant dilations of the perivascular spaces.OBJECT: Dilations of brain perivascular spaces (PVSs), also known as Virchow-Robin spaces, are routinely identified on magnetic resonance imaging studies of the brain and recognized as benign normal variants. Giant dilations occur only rarely and can be easily misdiagnosed as central nervous system tumors. The relevant surgical literature was reviewed to help establish indications for surgical intervention in these typically benign lesions. methods: Giant dilations of the PVSs in 12 patients who had undergone surgery for several different indications were identified. Both clinical and radiographic presentations of these patients were reviewed along with the surgical procedures. CONCLUSIONS: Dilations of the PVSs can become giant lesions that may necessitate surgical intervention to relieve mass effect or hydrocephalus. The relationship of these lesions to neurological symptoms such as tremor and seizures remains unclear.- - - - - - - - - - ranking = 2keywords = brain (Clic here for more details about this article) |
6/7. Severe delirium due to basal forebrain vascular lesion and efficacy of donepezil.A severe intractable delirium caused by the basal forebrain vascular lesion and its dramatic recovery after donepezil administration were reported. A 68-year-old man had suffered for a month from delirium of mixed type caused by the right basal forebrain vascular lesion after surgery for craniopharyngioma. magnetic resonance imaging (MRI) showed hemorrhagic infarcts in the head of the right caudate nucleus and the right basal forebrain of the medial septal nucleus, diagonal band of broca and nucleus basalis of Meynert. He had been treated with anti-psychotics, anti-depressants and hypnotics, which resulted in little improvement. Donepezil administration dramatically improved his intractable delirium at the 19th post-donepezil administration day, but this was followed by amnestic symptoms. Clinical correlates of delirium with the basal forebrain lesion and efficacy of donepezil support the hypocholinergic theory of delirium.- - - - - - - - - - ranking = 8keywords = brain (Clic here for more details about this article) |
7/7. Distal lenticulostriate artery aneurysm rupture presenting as intraparenchymal hemorrhage: case report.OBJECTIVE AND IMPORTANCE: Aneurysms involving the distal lenticulostriate artery branches are a rare cause of spontaneous intracerebral hemorrhage. We report a case of ruptured lenticulostriate aneurysm in an otherwise healthy patient and review the literature on this topic.CLINICAL PRESENTATION: Computed tomography showed a right basal ganglia hemorrhage in a 44-year-old Native American woman with acute left hemiparesis. cerebral angiography showed a 2-mm aneurysm in a distal lenticulostriate artery branch. TECHNIQUE: A pterional craniotomy was performed on a delayed basis using computed tomographic angiography and frameless stereotactic guidance. The basal ganglia hematoma was evacuated, and the aneurysm was identified and clipped using microsurgical technique. Because the base of the aneurysm involved a portion of the parent vessel wall, it was wrapped with cotton and reinforced with cyanoacrylate glue. The patient did well after surgery and was discharged to home with outpatient rehabilitation on the third postoperative day. CONCLUSION: Although intraparenchymal hemorrhages are fairly common, the underlying vascular abnormality is rarely identified. Most are related to hypertensive vascular degeneration, rupture of a Charcot-Bouchard aneurysm, or both. When intracerebral hemorrhage occurs in young patients, however, aggressive investigation is warranted to rule out a structural vascular abnormality.- - - - - - - - - - ranking = 165.86994580355keywords = intracerebral, cerebral (Clic here for more details about this article) |