Cases reported "Recurrence"

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1/5. Aggravation of poststroke sensory symptoms after a second stroke on the opposite side.

    The role of the ipsilateral hemisphere in sensory functions remains unknown. The author describes 5 patients who presented with hemisensory symptoms due to unilateral strokes occurring in the left putamen, left thalamus, right putamen, right lateral medulla and left thalamic-internal capsular area, respectively. Sensory symptoms had gradually improved or remained stable after the initial events. However, when another stroke occurred on the contralateral thalamic-occipital, frontoparietal, lateral medulla, temporoparietal and pontine areas, respectively, previous sensory symptoms significantly worsened and became painful. These observations suggest that ipsilateral sensory pathways play a role in the modulation of sensory functions.
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keywords = putamen
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2/5. Progressive MRI abnormalities in late recurrence of Sydenham's chorea.

    We report four cases of adult recurrence of Sydenham's chorea (SC). The first episodes all followed childhood tonsillopharyngitis. Many years later, subsequent episodes appeared after the triggering circumstances: throat or cutaneous infection, pregnancy, childbirth, contraceptive treatment or stress. Other inflammatory diseases were ruled out and streptococcal serology was weakly positive. magnetic resonance imaging (MRI) revealed focal areas of T2 hypersignal in the caudate nucleus, the pallidum, the putamen and the white matter. One year later, repeat MRI variously gave evidence of the persistence, disappearance or even new appearance of abnormalities. Specific features of SC recurrence in the adult may include: a personal history of chorea after a throat infection during childhood; a second episode of isolated chorea with or without slight neuropsychological disorders; streptococcal serology weakly positive; focal hypersignals involving the basal ganglia; the triggering circumstances. Since SC is considered to be an autoimmune disease, the progressive MRI abnormalities suggest that certain circumstances may trigger the reactivation of persistent immune disorders.
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ranking = 0.5
keywords = putamen
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3/5. Bilateral intracerebral haemorrhage presenting with supranuclear ophthalmoplegia, bradykinesia and rigidity.

    A 70 year old man recovered from a left putamenal haemorrhage in 1984 with a residual mild right hemiparesis. In 1985 he presented following the sudden onset of inability to stand. The clinical findings of supranuclear ophthalmoplegia, bradykinesia and rigidity resembled those of progressive supranuclear palsy. CT scan revealed a recent haemorrhage deep in the right hemisphere white matter in addition to a low density change in the left basal ganglia reflecting the site of previous haemorrhage. The patient's course was uncomplicated and the ophthalmoplegia resolved. Bradykinesia and rigidity persist. This case illustrates an unusual clinical presentation of bilateral intracerebral haemorrhage with supranuclear ophthalmoplegia, bradykinesia and rigidity.
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ranking = 0.5
keywords = putamen
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4/5. Acute fatal deterioration in putaminal hemorrhage.

    BACKGROUND: Clinical deterioration in patients with spontaneous intracerebral hemorrhage has rarely been studied. It has been previously thought that intracranial hematomas bleed in a monophasic fashion. Recent studies have demonstrated continuous active bleeding within hours after the event, resulting in enlargement of the hematoma. However, acute sudden and fatal deterioration suggesting a rebleed is rarely reported. SUMMARY OF REPORTS: An 84-year-old man was admitted with a moderate-size hemorrhage in the putamen and was treated for hypertension during the first day of admission. He acutely demonstrated extensor posturing and light-fixed pupils. Repeat CT scan showed massive enlargement of the intracranial hematoma and extension into the ventricles causing acute hydrocephalus. A 72-year-old man was admitted with a mid-size hemorrhage in the putamen. Acute deterioration with loss of all brain stem reflexes except for cornea reflexes was associated with a large increase in volume of the hematoma, 7 hours after the initial hemorrhage. An 85-year-old woman was admitted with a small hemorrhage in the putamen and recovered to be able to walk unassisted. She suddenly died from a recurrent massive putaminal hemorrhage 2 weeks after the ictus. CONCLUSIONS: patients with spontaneous intracerebral hemorrhage in the putamen may die acutely from fatal catastrophic enlargement of the initial hematoma hours to days after the ictus. In some patients with spontaneous intracerebral hemorrhage and clinical deterioration, rebleeding may be a possible mechanism.
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keywords = putamen
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5/5. Unusual case of hypertonic hemorrhage.

    Hemorrhage arose simultaneously in the leftside putamen and the brain stem region in a 45-year-old hypertonic woman. The cause of death, which occurred on the seventh day after the incident, was the recurrence of hemorrhage into the brain stem, which was disclosed at autopsy. Possible causes of recurrent brain stem hemorrhage are discussed.
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ranking = 0.5
keywords = putamen
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