1/2. Trauma-induced extracranial internal carotid artery dissection leading to multiple infarcts in a young girl.Carotid artery dissections (CADs) represent an uncommon clinical condition that should be considered in the differential diagnosis of young individuals presenting with symptoms of stroke. The basic pathological changes in CAD include a disruption in the media or intima of arterial wall, through which the affected vasculature is predisposed to aneurysm or stenosis, and subsequent stroke. Carotid artery dissection may occur spontaneously or result from trauma, an underlying arteriopathic condition, or predisposing risk factors. The heterogeneous clinical presentations of CAD represent significant diagnostic difficulties, which often lead to delays in diagnosis and treatment. Further complicating the clinical picture is the lack of consensus regarding effective treatment modalities. Because of the often-subtle findings present in CAD, the treating physician must have a high index of suspicion to accurately diagnose and manage the condition. We report extracranial internal CAD in a 17-year-old girl leading to multiple infarcts that was successfully managed with initial antiplatelet therapy and subsequent anticoagulation.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/2. clozapine for blepharospasm, obsessive-compulsive symptoms, and psychotic symptoms in a patient of old brain infarction.blepharospasm, psychotic symptoms, and obsessive-compulsive symptoms can result from brain infarction. However, a presentation of these 3 symptoms simultaneously is rare. This report describes a 65-year-old woman who had old brain infarction and presented with these 3 symptoms for 2 years. The patient recovered after receiving a regimen of clozapine 125 mg/d for 3 months. No recurrences of symptoms were noted during a 6-month follow-up. This is the first case report demonstrating that clozapine is effective for a patient with blepharospasm, obsessive-compulsive symptoms, and psychotic symptoms presenting simultaneously. This report also reminds physicians of the possible organic causes of unusual presentations in elderly patients.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |