1/16. cerebral infarction in a 24-year-old pilot.Ischemic stroke is a rare event in young adults. We report on a 24-yr-old pilot with cerebral infarction of undetermined etiology, temporally associated with chain smoking. The patient exhibited dysphasia, stupor (confused consciousness), and right facial-nerve palsy. Computed-tomography revealed a low-density area in the left insular cortex. Cerebroangiography showed severe stenosis in a branch of the left middle cerebral artery. After admission, the patient made a rapid and uneventful recovery within 72 h. MRI showed an area of hyperintensity on T2-weighted images 2 mo after the attack. Based on the hyperintense area on FLAIR (fluid attenuated inversion recovery sequence) images obtained in MRI performed 10 mo after the attack, we diagnosed a cerebral infarction. In the japan air Self-Defense Force, cerebral infarction is an aeromedically disqualifying condition. However, in the evaluation 2 mo after the attack, differentiation from reversible ischemic neurological deficit was difficult. We discuss the criteria used for diagnosis and the risk factors for cerebral infarction in young adults, as well as the aeromedical disposition of young pilots.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/16. Cerebral blepharoptosis: two new cases, literature review and proposal for diagnostic criteria.Cerebral ptosis (CP) consists of acute and bilateral drooping eyelids due to a right or left middle cerebral artery territory stroke, without involvement of brain stem, third cranial nerve or oculosympathetic fibres. The pathogenesis of CP is still unknown, but most authors have hypothesised that eyelid control is hemispherically lateralised. Two new cases of CP and a complete literature review are reported in this paper. Because no unanimous criteria for CP diagnosis are currently available, a proposal for new criteria is also included.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
3/16. Bilateral oculomotor nerve palsies due to posterior cerebral arterial compression relieved by microvascular decompression--case report.A 59-year-old male developed peripheral oculomotor nerve paresis due to compression by the left posterior cerebral artery (PCA), which was successfully treated by microvascular decompression. Two months later, a similar oculomotor nerve paralysis due to the same mechanism occurred contralaterally and was also treated by microvascular decompression. The previous condition was probably caused by arteriosclerotic changes in the PCA, and the following condition by postsurgical adhesion of the arachnoid membrane. The possibility of vascular compression should be considered when oculomotor nerve palsy rapidly develops, although not proven by angiography.- - - - - - - - - - ranking = 7keywords = nerve (Clic here for more details about this article) |
4/16. Recurrent cranial nerve palsies, midbrain infarction and hydrocephalus due to megadolichobasilar artery.A 67-year-old man presented four recurrent, alternating facial palsies, two right abducens palsies and eventually a right extrinsic third nerve palsy due to brain-stem infarction in a 37-year time-span. Neuroradiological examinations showed hydrocephalus and an elongated, tortuous, ectasic basilar artery. This patient presented in his lifetime the whole clinical spectrum of the dolichoectasic basilar artery complications.- - - - - - - - - - ranking = 5keywords = nerve (Clic here for more details about this article) |
5/16. Multiple neurological lesions due to vertebrobasilar dolichoectasia.Four cases which presented with multiple neurological signs caused by vertebrobasilar dolichoectasia are reported. The pathology was revealed by CT, MRI and angiograms. In one case, hemifacial spasm and other neurological deficits were cured by microvascular facial nerve decompression. The literature on the subject is reviewed.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
6/16. Dolichoectasia and cranial nerve palsies. A case report.An elderly man with glaucoma and acute onset of left-sided cranial nerve III, V, and VII palsies was found to have associated marked intracranial artery dolichoectasia. Dolichoectasia (arterial elongation and distension) affects the intracranial arteries, producing various neurological and ophthalmological findings. The patients are usually men who are more than 40 years old and have a history of hypertension. Diagnosis is made by characteristic radiologic findings. In patients with neurologic symptoms and signs suggesting a space-occupying mass, intracranial dolichoectasia should be considered.- - - - - - - - - - ranking = 5keywords = nerve (Clic here for more details about this article) |
7/16. Unusual manifestations of basilar artery ectasia.Three patients with unusual presentations of basilar artery ectasia are described: subarachnoid hemorrhage was manifest in one and autonomic dysfunction developed in the other two. Aneurysmal rupture was the cause in the first patient, while compression of the brainstem and/or of the baroreceptor afferences of the IXth and Xth cranial nerves is postulated to be responsible for the symptoms found in the other two. basilar artery aneurysms should be considered in cases with subarachnoid hemorrhage or autonomic dysfunction, particularly when diagnostic procedures fail to disclose other possible etiologies.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
8/16. Unusual vascular events in the territory of the posterior cerebral artery.There is an unusual type of vascular episode in the territory of the posterior cerebral artery which remains relatively unknown. Ten cases are presented in which a posterior cerebral artery deficit developed suddenly in dramatic fashion with headache, visual symptoms, sensory and motor deficits and signs of third nerve involvement. Nine of the patients were female and one was male. Seven were under the age of 33. In all instances there was a permanent neurologic sequela, usually a hemianopia. A similar case was described in 1901. The nature of the underlying process remains obscure, but the evidence favors accompanied migraine in which a particularly severe attack results in permanent damage. The term "catastrophic migraine" is suggested.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
9/16. chickenpox with delayed contralateral hemiparesis caused by cerebral angiitis.chickenpox and herpes zoster ophthalmicus are caused by the same virus. herpes zoster ophthalmicus can be followed by contralateral hemiparesis, which is thought to be caused by spread of varicella-zoster virus to blood vessels contiguous to the trigeminal nerve and its branches. We report what we believe to be the first case of a patient with chickenpox followed by hemiparesis in whom there was angiographic evidence of an associated vasculitis similar to that found with herpes zoster ophthalmicus.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
10/16. Large suprasellar aneurysms imitating pituitary tumour.Two patients had large (20--30 mm) suprasellar aneurysms with clinical findings resembling an expanding pituitary tumour. One aneurysm was giant (30 mm). Its delayed diagnosis for six years led to severe chiasmal compression. The other aneurysm was compressing the optic nerve. Visual improvement resulted after surgery.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
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