1/5. Carotid transient ischemic attacks presenting as limb-shaking syndrome: report of two cases.Limb shaking syndrome (LSS) is a rare presentation of transient ischemic attacks (TIAs), usually secondary to a critical carotid stenosis compromising intracranial circulation, first described 40 years ago. Two additional cases are described herein, aiming to add on to previous descriptions, and to warn physicians about this potentially harming and rather uncommon condition.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/5. Cerebral arterial fenestrations associated with intracranial saccular aneurysms.Fenestrations of cerebral arteries other than the anterior communicating artery are rare congenital anomalies, which may be associated with saccular aneurysms. In such cases, the aneurysms may be located at the fenestration itself or may involve other intracranial vessels. This kind of association is not infrequently the cause of angiographic diagnostic problems, as well as surgical difficulties, and consequently needs to be well known to physicians. Four recent cases of rare fenestrations of cerebral arteries associated with intracranial aneurysms are reported in this study and discussed together with a review of the literature.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/5. Transient hemiageusia in cerebrovascular lateral pontine lesions.knowledge of human central taste pathways is largely based on textbook (anatomical dissections) and animal (electrophysiology in vivo) data. It is only recently that further functional insight into human central gustatory pathways has been achieved. magnetic resonance imaging studies, especially selective imaging of vascular, tumoral, or inflammatory lesions in humans has made this possible. However, some questions remain, particularly regarding the exact crossing site of human gustatory afferences. We present a patient with a pontine stroke after a vertebral artery thrombosis. The patient had infarctions in areas supplied by the anterior inferior cerebellar artery and showed vertical diplopia, right sided deafness, right facial palsy, and transient hemiageusia. A review of the sparse literature of central taste disorders and food preference changes after strokes with a focus on hemiageusia cases is provided. This case offers new evidence suggesting that the central gustatory pathway in humans runs ipsilaterally within the pons and crosses at a higher, probably midbrain level. In patients with central lesions, little attention has been given to taste disorders. They may often go unnoticed by the physician and/or the patient. Central lesions involving taste pathways seem to generate perceptions of quantitative taste disorders (hemiageusia or hypogeusia), in contrast to peripheral gustatory lesions that are hardly recognised as quantitative but sometimes as qualitative (dysgeusia) taste disorders by patients.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/5. An unusual cause of transient ischemic attacks: case report.A 42-year-old black man, a physician, presented with a three week history of intermittent right arm and leg numbness and weakness, lasting about five minutes. This was not associated with headache, visual changes, seizures, aphasia or loss of consciousness. There was no history of head trauma, migraines, or previous attacks. Positive findings on physical examination were confined to a blood pressure of 182/80; evidence of hypertensive retinopathy; normal carotid pulses without bruits; and a Grade II/VI systolic ejection murmur with normal sinus rhythm. Initial hematocrit was 25.7%; white blood cell count 14,000 cu/mm with a normal differential; platelet count 532,000 cu/mm. An electrocardiogram showed left ventricular hypertrophy. Duplex scan demonstrated normal carotid bifurcations bilaterally, and arteriogram revealed no carotid or intracranial pathology. Hemoglobin electrophoresis revealed sickle cell disease of the SS type. He was treated with transfusion therapy and has remained asymptomatic at 40 months. Approximately 20% of children with the SS type sickle cell disease will have cerebrovascular symptoms caused by small intracranial artery occlusion due to sludging of the abnormal hemoglobin. This unusual cause of transient ischemic attacks can occur in older patients of African-American ancestry and must be recognized to enable early and effective therapy with exchange transfusion.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/5. Electronic stethoscope for detection of cerebral aneurysm, vasospasm and arterial disease.A specially designed acoustic stethoscope electronic-computer-analysis system has repeatedly detected and identified angiographically demonstrated anteriorly located intracranial aneurysms by their characteristic signals. The system has detected and measured clinically significant disease in the carotid siphon and bifurcation, even in cases with normal angiograms, and has recorded the onset and disappearance of cerebral vasospasm. Our data suggests that an aneurysm may act as a flexible Helmholtz resonator, possibly being driven by vortex shed or turbulence. Our goal is the development of a safe, non-invasive method by which the physician could investigate warning symptoms of aneurysms, cerebral vasospasm, and arterial disease in order to recommend preventive surgery or medical treatment early before the patient's condition might deteriorate. Individual cases, falsely positive and negative results are discussed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |