Global aphasia without other focal neurologic lateralizing signs (GWLS) is an uncommon stroke syndrome. The pathogenesis of GWLS has been thought as the result of multiple cardioembolism. However, a few cases of GWLS with a single lesion have been reported. We report an unusual case of GWLS with a single left superior temporal infarction. A 73-year-old right handed man was admitted with receptive and expressive language impairment without other focal neurologic lateralizing signs. The patient's global aphasia symptom has being 4 weeks after symptom onset. Brain CT showed only one lesion of left superior temporal lobe. Our case notes that the multiple lesions of the speech area are not only necessary to produce GWLS, and it is not necessarily imply a double lesion or an embolic causes.
Aged ; Aphasia* ; Brain ; Hand ; Humans ; Infarction ; Stroke ; Temporal Lobe

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Humans ; Statistics as Topic*

No abstract available.
Incontinentia Pigmenti*

No abstract available.
Incontinentia Pigmenti*

Acute mountain sickness is an illness caused by climbing to a high altitude without prior acclimatization. Neurological consequences, like parkinsonism following acute mountain sickness without lesion of brain MRI have been reported rarely. A healthy 56-year-old man presented with dysarthria and gait disturbance. Neurological examination revealed tremor of hands, limb rigidity, and bradykinesia. The symptoms developed approximately 30 days following a 3,500 m climb of the Annapurna in the Himalayas. Brain MRI did not reveal any abnormalities including globus pallidus. The parkinsonism symptoms persisted for about 3 months before a complete recovered was made. We suggest that parkinsonism can develop after climbing to a high altitude but that the symptoms can be transient if a brain MRI detects no abnormalities.

Even a single brain infarct can cause dementia when it occurs in functionally critical areas of the brain. A 71- year-old female developed sudden cognitive impairment without any other focal neurologic deficits. A brain MRI revealed a bilateral anterior fornix infarction. Neuropsychological evaluation revealed verbal and visual memory deficits, visuospatial dysfunction, and frontal executive dysfunction. The cognitive impairment did not improve for 3 months and the patient showed impairments in daily activities. We report a patient who demonstrated strategic infarct dementia after a bilateral anterior fornix infarction.
Brain ; Dementia* ; Dementia, Vascular ; Female ; Fornix, Brain ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Memory Disorders ; Neurologic Manifestations

PURPOSE: The liver hanging maneuver (LHM) is a useful technique enabling a safe anterior approach, which is one of the most important innovations in the field of major hepatic resections. This study was conducted to review tumors' profiles after applying this procedure and to evaluate the usefulness of LHM and Glissonean pedicle transaction method (GPTM). METHODS: Medical records of 64 patients who underwent hepatic resection using LHM and GPTM at the Asan Medical Center were reviewed. The classic LHM was conducted according to the Belghiti method. RESULTS: Among 64 patients, 46 patients had hepatocellular carcinoma; 7, intrahpatic cholangiocarcinoma; 4, hilar cholangiocarcinoma; 4, metastatic liver cancer; 3, benign liver tumor. Mean tumor size was 10.6 cm (3~22). Mean liver parenchymal transection time was 20 min (15~30). Right side hepatectomy was performed in 44 patients; left side hepatectomy with or without caudate lobe was performed in 19 patients. Twenty patients (31.3%) required blood transfusion during surgery. There was no in-hospital mortality or major complications. Minor complications developed in 6 patients (9.37%). CONCLUSION: GPTM and LHM are a safe and useful surgical application of various anatomical resections for huge liver tumor and an effective procedure during left hepatectomy with or without caudate lobe.
Blood Transfusion ; Hepatectomy ; Hospital Mortality ; Humans ; Liver ; Medical Records

The generally accepted taste pathway in an animal projects ipsilaterally from the solitary nucleus. However, the path-way of gustatory fibers in the human brainstem has not been sufficiently clarified. A 57-year-old hypertensive man was admitted with sudden dizziness and hemiageusia. A neurological examination revealed also a diminution of taste on the left half of his tongue. A MRI showed a high signal intensity in the right lower pontine area. This case suggests that the unilateral lesion of the pons may lead to contralateral taste disturbances.
Ageusia ; Animals ; Brain Stem ; Cerebral Infarction ; Dizziness ; Facial Nerve ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Examination ; Pons ; Solitary Nucleus ; Tongue

Retroperitoneal fibrosis, although benign, has a malignant course due to an encasement and obstruction of the retroperitoneal structures, particularly the urinary system. The most common treatment is often a surgical exploration followed by urologic intervention. However, steroid or azathioprine therapy has been advocated, with varying results and major side-effects. Recently, the successful medical therapy in patients with an early stage and low malignant potential has been reported. Here we report a male patient who underwent successful treatment of an idiopathic retroperitoneal fibrosis with tamoxifen and prednisolone.
Azathioprine ; Humans ; Male ; Prednisolone ; Retroperitoneal Fibrosis* ; Tamoxifen ; Ureter

Giant cell arteritis (GCA) is an autoimmune vasculitic disorder of unknown origin. Systemic GCA causing cerebral infarction due to intracranial arteritis is rare. Early diagnosis and anti-inflammatory treatment of the GCA are necessary to prevent systemic involvement. A 66-year-old woman presented with dysarthria and left hemiparesis. A brain MRI showed ischemic lesions in the right temporoparietal area. We report a pathological case of GCA with clinical and neuroradiological evidence of cerebral infarction.
Aged ; Arteritis ; Brain ; Cerebral Infarction* ; Dysarthria ; Early Diagnosis ; Female ; Giant Cell Arteritis* ; Giant Cells* ; Humans ; Magnetic Resonance Imaging ; Paresis ; Pathology