1/21. Scleroderma cerebritis, an unusual manifestation of progressive systemic sclerosis.A 42-year-old female with scleroderma experienced two exacerbations in which behavioral changes were the main clinical features. On both occasions she presented with paranoid delusions, perceptual aberrations, and disorientation. After treatment with corticosteroids, the patient's mental status returned to normal, and her electroencephalogram showed an increase in alpha wave frequency, which is consistent with a resolving delirium. Unlike systemic lupus erythematosus, scleroderma rarely involves the central nervous system. This case illustrates an unusual manifestation of progressive systemic sclerosis, primary cerebral involvement which presented as an acute organic brain syndrome. connective tissue diseases, notably systemic lupus erythematosus, often present neuropsychiatric symptoms. Despite the fact that there appears to be a clinical and pathological continuum among the connective tissue diseases, an organic psychosis rarely occurs in progressive systemic sclerosis (scleroderma. Described here is a patient with scleroderma in whom behavioral abnormalities were the main features of two exacerbations of the disease.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system, brain (Clic here for more details about this article) |
2/21. central nervous system involvement following type I aviator's bends complicated by complacency.A false sense of security surrounds the possibility of post-flight complications resulting from "aviator's bends." The accepted clinical clue that a patient is at risk for serious complications is the presence of some form of dysbarism at altitude. This principle has been inappropriately extended to imply that serious post-flight complications of the evolved gas syndrome only follow serious in-flight symptoms. This paper, in addition to reporting the occurrence of post-flight neurologic signs in a patient after Type I pain-only bends during an altitude chamber flight, also identifies a broader subtle complacency in the professional community that routinely deals with hypobarics.- - - - - - - - - - ranking = 1.3845623551979keywords = nervous system (Clic here for more details about this article) |
3/21. neurologic manifestations of intravascular coagulation in patients with cancer. A clinicopathologic analysis of 12 cases.Among 1,459 autopsied patients with cancer, 12 had multifocal infarcts of the brain that appeared to be caused by intravascular coagulation. Most of these patients were women with leukemia or lymphoma, and all had a clinical course in which neurologic signs and symptoms were prominent. All had evidence of generalized brain disease (delirium and stupor or coma), and several also had focal brain disease (focal seizures, hemiparesis). All patients had laboratory evidence of coagulation abnormalities, although these were often not severe when neurologic symptoms began. Pathologically, there were multifocal hemorrhagic or ischemic infarcts in the distribution of several cerebral vessels, without a systemic source for cerebral emboli. fibrin thrombi were identified in cerebral vessels and in vessels of several other organs. The clinical findings fit the pathologic picture, and in most instances the correct diagnosis might have been made earlier had it been considered.- - - - - - - - - - ranking = 0.31387027812701keywords = brain (Clic here for more details about this article) |
4/21. Cytoplasmic tubular arrays in cells of American Burkitt's type lymphoma.Aggregates of tubular arrays associated with cysternae of endoplasmic reticulum were observed in untreated primary American form Burkitt's lymphoma. The tumor occurred in a white female child who died with severe central nervous system (CNS) involvement. Although the significance of the tubular structures and the mechanism by which they are formed remains unknown, the predilection of these structures for lymphoid and reticuloendothelial cells and their frequent association with either viral or suspected viral conditions cannot be overlooked. However, it is possible that the tubular structures may reflect an increased production of antibody protein in response to a viral antigen.- - - - - - - - - - ranking = 0.89537657395766keywords = central nervous system, nervous system (Clic here for more details about this article) |
5/21. Metastatic cystosarcoma phyllodes. A report of 2 cases presenting with neurological symptoms.Two cases of cystosarcoma phyllodes of the breast are presented with central nervous system (CNS) metastases appearing several years after mastectomy for the primary lesion. Unusual features in these cases include the widespread metastases themselves, neurologic symptomatology and CNS involvement, metastases into a uterine leiomyoma and into an area of hepatic adenomatous hyperplasia, and glomus-like structures in one of the primaries with similar structures resembling glomus cells in metastases. The distant metastases were of stromal cells only and frequently surrounded epithelial cells to isolate the indigenous glandular structures. The concept that cytosarcoma is a peculiar stromal neoplasm rather than a tumor of dual neoplastic origin is discussed.- - - - - - - - - - ranking = 0.89537657395766keywords = central nervous system, nervous system (Clic here for more details about this article) |
6/21. Neurologic disturbances in Paget disease of bone: response to calcitonin.The neurologic manifestations of Paget disease and the therapeutic effect of calcitonin were studied in 49 patients. Twenty-four patients (49%) had neurologic disorders involving cranial nerves other than the auditory system, brainstem, spinal cord, or spinal roots and nerves. Eighteen of the 24 patients (75%) showed significant subjective or objective improvement after calcitonin treatment. The effect of calcitonin treatment on spinal cord compression was dramatic in three of six patients. The observations made of these patients support previous data suggesting that the neurologic signs and symptoms of Paget disease have their pathogenesis in both mechanical impingement and vascular distortion. The importance of early detection of neurologic signs and symptoms is emphasized, since prompt treatment with calcitonin may prevent severe complications.- - - - - - - - - - ranking = 0.10462342604234keywords = brain (Clic here for more details about this article) |
7/21. neurologic manifestations of cogan syndrome.cogan syndrome is a multisystem inflammatory vascular disease, characterized by nonsyphilitic interstitial keratitis and vestibuloauditory symptoms. Recent reports have directed attention to involvement of other organ systems. Respiratory, cardiovascular, gastrointestinal, and musculoskeletal problems are common, as are laboratory abnormalities and general symptoms such as fever, chills, and weight loss. Prominent neurologic problems in two patients prompted a review of 79 cases of cogan syndrome. More than half had nervous system involvement, including electroencephalographic or spinal fluid abnormality, headache, psychosis, coma, convulsion, neuropathy, and stroke. cogan syndrome should be considered when neurologic deficits are accompanied by eye, ear, and systemic symptoms.- - - - - - - - - - ranking = 0.34614058879948keywords = nervous system (Clic here for more details about this article) |
8/21. Facial myokymia--a false localizing sign in obstructive communicating hydrocephalus. A case report.Facial myokymia was evident in a 57-year-old man exhibiting both clinical and radiological signs of obstructive communicating hydrocephalus. Insertion of a ventriculoatrial shunt resulted in resolution of clinical symptomatology including the facial myokymia. Since there was no evidence of a structural brain stem pathology, it is believed that in this case, facial myokymia represented a false localizing sign secondary to obstructive communication hydrocephalus.- - - - - - - - - - ranking = 0.10462342604234keywords = brain (Clic here for more details about this article) |
9/21. neurologic manifestations of legionnaires' disease.The neurologic manifestations of legionnaires' disease were reviewed in this paper. Nine (42.9%) of 21 patients seen at this institution had neurologic abnormalities during acute infection, comparable to 52% of patients found in the literature. Abnormal mentation was most common, occurring in all our patients and in 29.6% of patients in the literature. Encephalopathy disproportionate to metabolic disturbances varied from mild confusion to coma, was not associated with increased mortality, and tended to resolve with acute illness although some patients reported persistent memory defects. Rarely did these changes in mentation precede the development of pulmonary infiltrates. headache occurred in two (22.2%) of our patients and in 28.7% of those in the literature. headache, noted in many febrile illnesses, is common but nonspecific in legionnaires' disease. Other neurologic abnormalities including cerebellar dysfunction and focal deficits were relatively infrequent and tended to persist beyond resolution of clinical infection. In some cases these neurologic derangements may have occurred coincidentally with legionnaires' disease. Diagnostic evaluations and autopsies were frequently normal, nonspecific, or revealing of pathology unrelated to infection. Only two patients had evidence of direct invasion of the central nervous system by legionella, and the cause of encephalopathy and neurologic abnormalities in most cases remains unclear. patients with neurologic abnormalities and legionnaires' disease deserve full evaluation to exclude other entities. Only encephalopathy appears to be a characteristic manifestation of legionnaires' disease.- - - - - - - - - - ranking = 0.89537657395766keywords = central nervous system, nervous system (Clic here for more details about this article) |
10/21. Whipple's disease of the central nervous system.Whipple's disease presenting as a neurological disease without gastrointestinal symptoms is an unusual occurrence. A 40 year old man suffered hypersomnia, memory loss and progressive ophthalmoplegia for 6 months prior to death. The nature of this disease was not established during life. Extensive granulomatous inflammation affecting the hypothalamus, hippocampus and periaqueductal gray matter of the brain was found to represent Whipple's disease by electron microscopy. Characteristic lesions were also present in spleen, mesenteric lymph nodes, small intestine and myocardium. Bacillary bodies and membranous inclusions similar to those seen in visceral lesions of Whipple's disease were present in macrophages. The findings supported the theory of direct involvement of the central nervous system by bacilli rather than a metabolic origin for the lesions.- - - - - - - - - - ranking = 4.5815062958307keywords = central nervous system, nervous system, brain (Clic here for more details about this article) |
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