No abstract available.
Dysarthria ; Skull ; Skull Base ; Tongue

BACKGROUND: Neuron-specific enolase (NSE) is a useful indicator of neuronal injury in acute cerebral infarction. We investigated the changes in serial serum NSE levels in patients with acute cerebral infarction. METHODS: We measured serial serum NSE levels at 24, 48, 72, and 96 hours, and 2 weeks after the onset of cerebral infarction in 30 patients (15 territorial and 15 lacunar infarctions). We also measured the NSE levels in age-matched controls (n=15) who had no evidence of acute stroke or other neurological disorders. The NSE level was measured using a radioimmunoassay. RESULTS: The initial serum NSE level was significantly higher in the cerebral infarction group than in the control group (6.6+/-2 vs 4.7+/-1.6 ng/mL [mean+/-SD], p=0.006). This difference was also observed between the territorial and lacunar infarction groups until 72 hours after the cerebral infarction. The serum NSE level peaked at 72 hours after the infarction in both lacunar and territorial infarction groups. The correlation between the NSE level and the score on the NIH Stroke Scale was strongest at 48 hours after the cerebral infarction (r=0.469). CONCLUSIONS: Serum NSE level can be a good indicator for distinguishing lacunar from territorial infarction during the acute stage of cerebral infarction.
Cerebral Infarction ; Humans ; Infarction ; Nervous System Diseases ; Neurons ; Phosphopyruvate Hydratase ; Stroke ; Stroke, Lacunar

Relapse of herpes simplex virus (HSV) encephalitis rarely occurs after acyclovir treatment. We experienced a case of relapsing HSV encephalitis in the contralateral temporal lobe, resulting in Kluver-Bucy syndrome, after a full dose acyclovir treatment. Sudden behavioral and emotional changes after HSV encephalitis treatment suggest relapsing HSV encephalitis as well as temporal lobe epilepsy.
Acyclovir ; Encephalitis ; Encephalitis, Herpes Simplex ; Herpes Simplex ; Kluver-Bucy Syndrome ; Methylmethacrylates ; Polystyrenes ; Recurrence ; Simplexvirus ; Temporal Lobe

Thrombotic thrombocytopenic purpura(TTP) is an uncommon fatal disorder of young adults characterized by thrombocytopenia, microangiopathic hemolytic anemia, fluctuating neurologic dysfunction, fever, and renal dysfunction. The fluctuating neurologic dysfunction, which is mainly due to small arteriolar or capillary ischemic vasculopathy, suggests impending stroke. We report a 72-year-old woman who has had recurrent and progressive transient ischemic attacks and confusion after a large amount of bloodletting. She recovered completely after intensive plasmapheresis and immunosuppressant treatment. This case illustrates that aggressive treatment, even in old age, may prevent permanent neurologic deficits when stroke is impending and complicated by TTP.
Aged ; Anemia, Hemolytic ; Bloodletting ; Capillaries ; Female ; Fever ; Humans ; Ischemic Attack, Transient ; Neurologic Manifestations ; Plasmapheresis ; Purpura, Thrombotic Thrombocytopenic ; Stroke ; Thrombocytopenia ; Young Adult

Dementia with Lewy bodies (DLB) usually presents with progressive cognitive decline and parkinsonism. We report a 68-year-old man who showed parkinsonism including resting tremor and mild cognitive decline. After anticholinergic medication, he showed recurrent visual hallucination. Neuropsychological tests revealed frontal and memory impairments. PET showed hypometabolism in the primary visual and visual association cortices. It is necessary to consider the possibility of DLB as well as anticholinergic side effect when visual hallucination occurs during the treatment of parkinsonism.
Aged ; Cholinergic Antagonists ; Dementia ; Hallucinations ; Humans ; Lewy Bodies ; Memory ; Neuropsychological Tests ; Parkinsonian Disorders ; Tremor

Foot drop usually results from lesions affecting the peripheral neural pathway related to dorsiflexor muscles, especially the peroneal nerve. Although a central nervous system lesion is suspected when there is a lack of clinical evidence for a lower motor neuron lesion, such cases are extremely rare. We describe a patient with sudden isolated foot drop caused by a small acute cortical infarction in the high convexity of the precentral gyrus. This report indicates that a cortical infarction may have to be considered as a potential cause of foot drop.
Central Nervous System ; Cerebral Infarction* ; Foot* ; Humans ; Infarction ; Motor Neurons ; Muscles ; Neural Pathways ; Peroneal Nerve

No abstract available.
Brain Abscess* ; Brain* ; Magnetic Resonance Spectroscopy ; Protons*

No abstract available.
Adult ; Brain Ischemia/diagnosis/*etiology ; Cerebral Angiography ; Fatal Outcome ; Female ; Humans ; Hyperventilation/complications ; Moyamoya Disease/*complications/diagnosis/therapy ; Risk Factors ; Stroke/diagnosis/*etiology ; Thyroid Crisis/*complications/diagnosis/therapy

BACKGROUND: The verbal fluency test consists of two separate tests of semantic fluency and phonemic fluency. The performance patterns of these tests differ with the type of dementia. We studied the patterns of verbal fluency between Alzheimer's disease (AD) and subcortical vascular dementia (SVaD), and assessed the clinical utility of these tests. METHODS: The 1,475 selected participants comprised 73 normal control subjects, 673 patients with amnestic mild cognitive impairment (aMCI), 535 AD patients, 42 patients with subcortical vascular mild cognitive impairment (svMCI), and 152 SVaD patients. We analyzed the z-score for the total number of animal items as a semantic fluency index and the z-score of the phonemic total score as a phonemic fluency index. RESULTS: The performance of semantic fluency was lower than that of phonemic fluency in all groups. The SVaD group showed the worst scores and abnormal performances on both tests, while the AD group presented abnormal performance only for semantic fluency. Dividing the patients with dementia according to severity revealed a different pattern between AD and SVaD for the clinical dementia rating (CDR) stage of 0.5. The performance of the AD group declined gradually with CDR. However, the SVaD group performed very poorly in both tests even for very mild dementia (CDR stage of 0.5). The aMCI and svMCI groups exhibited similar performance patterns. CONCLUSIONS: The pattern of semantic and phonemic fluency was not clinically useful at the MCI stage, but it could be helpful in differentiating AD and SVaD in the early stage of dementia.
Alzheimer Disease* ; Animals ; Dementia* ; Dementia, Vascular* ; Humans ; Mild Cognitive Impairment ; Semantics ; Task Performance and Analysis*

It is controversial whether isolated lesions of mammillothalamic tract (MTT) produce significant amnesia. Since the MTT is small and adjacent to several important structures for memory, amnesia associated with isolated MTT infarction has been rarely reported. We report a patient who developed amnesia following an infarction of the left MTT that spared adjacent memory-related structures including the anterior thalamic nucleus. The patient s memory deficit was characterized by a severe anterograde encoding deficit and retrograde amnesia with a temporal gradient. In contrast, he did not show either frontal executive dysfunction or personality change that is frequently recognized in the anterior or medial thalamic lesion. We postulate that an amnesic syndrome can develop following discrete lesions of the MTT.
Aged ; Amnesia/*etiology ; Cerebral Infarction/*complications ; Humans ; Male ; Mamillary Bodies/*physiopathology ; Neuropsychological Tests ; Thalamus/*physiopathology