No abstract available.
Arnold-Chiari Malformation*

Brain metastasis can form large cystic lesions, and its differentiation on the basis of imaging findings alone is difficult. A 36-year-old woman with headache visited emergency room. Two years ago, she was diagnosed as neurocysticercosis and had taken anti-parasite medications. However, in the current visit, the sizes of intracranial cystic lesions increased. Brain biopsy reported metastatic neuroendocrine tumor, and chest CT showed the primary site of the tumor. Cystic brain metastasis should be considered in cases with cystic brain lesions.
Adult ; Biopsy ; Brain ; Emergency Service, Hospital ; Female ; Headache ; Humans ; Neoplasm Metastasis* ; Neurocysticercosis* ; Neuroendocrine Tumors ; Pregnant Women* ; Tomography, X-Ray Computed

A 43-year-old man presented with progressive ataxic gait of 5 months duration. His gait speed was almost normal, and he did not exhibit shuffling, freezing, or festination. A formal neuropsychological evaluation revealed a deficit in visuospatial function and memory with mild frontal dysfunctions. Brain MRI revealed communicating hydrocephalus with an Evans' ratio of 0.32. After CSF removal by lumbar puncture the patient showed a marked improvement in gait as well as frontal lobe functions, and was finally diagnosed as having idiopathic normal-pressure hydrocephalus.
Adult ; Brain ; Cerebrospinal Fluid ; Freezing ; Frontal Lobe ; Gait* ; Humans ; Hydrocephalus* ; Magnetic Resonance Imaging ; Memory ; Spinal Puncture

Takotsubo cardiomyopathy is a reversible cardiac syndrome that occurs subsequently to other medical illnesses such as cerebral hemorrhage, shock, or seizure disorders that are presumed to disturb autonomic regulation. This syndrome is characterized by chest pain, dyspnea, and electrocardiographic changes mimicking an acute coronary syndrome. Mild elevation of cardiac enzymes and transient wall-motion abnormalities of apical akinesia can appear. However, takotsubo cardiomyopathy following epilepsy is not well recognized. We report two cases of takotsubo-cardiomyopathy-related idiopathic status epilepticus presenting with cardiogenic shock.
Acute Coronary Syndrome ; Cerebral Hemorrhage ; Chest Pain ; Dyspnea ; Electrocardiography ; Epilepsy ; Shock ; Shock, Cardiogenic ; Status Epilepticus* ; Takotsubo Cardiomyopathy*

Myasthenia gravis (MG) and inflammatory myopathy are both rare autoimmune disorders that present with signs of muscle weakness and can sometimes be accompanied by other connective-tissue diseases such as Sjogren's syndrome. However, the simultaneous occurrence of MG and inflammatory myopathy is very rare. We describe the case of a 68-year-old woman with MG occurring simultaneously with inflammatory myopathy in Sjogren's syndrome.
Aged ; Female ; Humans ; Muscle Weakness ; Myasthenia Gravis* ; Myositis* ; Sjogren's Syndrome*

HMG-CoA reductase inhibitor is widely used for the treatment of dyslipidemia, and for the prevention of stroke and cardiovascular disease. However, it is necessary to consider the adverse effects associated with this drug. Myopathy is a well-known side effect of statin therapy, but myotonic potentials in cases with statin myopathy have thus far been reported only rarely. We report four cases of myopathy with myotonic potentials on electromyography after multidrug administration. All of the patients recovered shortly after statin withdrawal.
Cardiovascular Diseases ; Dyslipidemias ; Electromyography ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Muscular Diseases* ; Oxidoreductases* ; Stroke

Autoimmune hemolytic anemia (AIHA) can be considered in the differential diagnosis of hemolytic anemia with a concomitant cerebral infarction. We report a 79-year-old woman who was stuporous at presentation, and ultimately diagnosed with AIHA and cerebral infarction. Microembolic signals (MES) were detected by transcranial Doppler monitoring on the first hospitalization day. MES disappeared on the sixth hospitalization day following treatment with steroid and anticoagulation. This case represents a rare arterial ischemic complication of AIHA possibly associated with a hypercoagulable state.
Aged ; Anemia, Hemolytic ; Anemia, Hemolytic, Autoimmune* ; Cerebral Infarction ; Diagnosis, Differential ; Female ; Hospitalization ; Humans ; Stroke* ; Stupor ; Thrombophilia

It is believed that migrainous aura is correlated with cortical spreading depression and spreading benign oligemia. A 54-year-old female with migraine with aura presented with left hemianopia preceding pulsating headache. Perfusion-weighted images revealed delayed contrast arrival to the right occipital lobe and nearly normal relative cerebral blood volume images, indicating benign oligemia. Follow-up perfusion-weighted images revealed resolution of the perfusion abnormalities. We report herein a case of migraine with aura presenting with reversible delayed perfusion in the right occipital lobe on perfusion-weighted images.
Blood Volume ; Cortical Spreading Depression ; Epilepsy ; Female ; Follow-Up Studies ; Headache ; Hemianopsia ; Humans ; Middle Aged ; Migraine Disorders ; Migraine with Aura* ; Occipital Lobe ; Perfusion*

A 50-year-old woman who had chronic headache was admitted to the hospital. Stent-assisted coil embolization of the aneurysm in the right vertebral artery was performed. After the procedure, the patient experienced a transient memory impairment. A microembolic lesion in the right medial temporal lobe and cerebral hemisphere was observed on diffusion-weighted imaging. We report a case of transient global amnesia caused by microembolus in the medial temporal lobe after embolization of an aneurysm.
Amnesia, Transient Global* ; Aneurysm ; Cerebrum ; Embolization, Therapeutic* ; Female ; Headache Disorders ; Humans ; Intracranial Aneurysm* ; Memory ; Middle Aged ; Temporal Lobe ; Vertebral Artery

Pregnancy related stroke is rare and poorly understood. A 28-year-old pregnant woman at 20 weeks of gestation presented with sudden headache and left homonymous hemianopsia. MRI revealed acute right posterior cerebral artery territory infarction. Laboratory data revealed combined protein C and S deficiencies. Coagulation profiles returned to normal 6 months after the delivery. Although stroke can occur either with protein C or S deficiency, acute cerebral infarction associated with combined protein C and S deficiencies during gestation is very rare.
Adult ; Cerebral Infarction ; Female ; Headache ; Hemianopsia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Posterior Cerebral Artery ; Pregnancy* ; Pregnant Women ; Protein C* ; Protein S ; Stroke*