Cerebral venous sinus thrombosis (CVST) may be complicated with various intracranial hemorrhage such as petechial hemorrhage, hemorrhagic infarction, parenchymal hemorrhage, subarachnoid hemorrhage (SAH), and subdural hematoma (SDH). However, combination of these types of intracranial hemorrhages supervening on CVST is seldom reported. A 55-year-old female with rectal cancer presented with severe headache, nausea, vomiting and diplopia. She was diagnosed as having CVST in the superior sagittal sinus with left frontal parenchymal hemorrhage and was treated with anticoagulants. The CVST were extended to inferior sagittal and straight sinuses. Moreover, SDH along the left cerebral convexity and SAH in the left sylvian fissure were simultaneously observed. Our present case shows that combination of various types of hemorrhages is rare but may occur in advanced CVST.
Anticoagulants ; Diplopia ; Female ; Headache ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Infarction ; Intracranial Hemorrhages ; Nausea ; Rectal Neoplasms ; Sinus Thrombosis, Intracranial ; Subarachnoid Hemorrhage ; Superior Sagittal Sinus ; Vomiting

Sturge-Weber syndrome (SWS) is a rare sporadic neurocutaneous syndrome, characterized by port-wine nevus of face, ocular vascular abnormalities and leptomeningeal angioma. A 63-year-old man developed sudden onset of right hemiparesis and global aphasia. He had a past history of epilepsy. Physical examination showed no skin lesions. Brain CT demonstrated gyriform calcification in the left frontal area. Brain MRI revealed cortical atrophy in the left hemisphere with no diffusion restrictions. Fourteen hours later, he was completely recovered from aphasia and motor weakness. We report a case of atypical SWS with episode of acute hemiparesis which highlight the difficulty in distinguishing seizure from ischemic symptoms.
Aphasia ; Atrophy ; Brain ; Diffusion ; Epilepsy ; Hemangioma ; Neurocutaneous Syndromes ; Nevus ; Paresis ; Physical Examination ; Seizures ; Skin ; Stroke ; Sturge-Weber Syndrome

Cough-induced syncope is belongs to the heterogeneous group of situational syncope. It is characterized by the loss of consciousness occurring after excessive coughing. A 63-year-old man complained of cough syncope for 15 days. During vigorous coughing, he lost consciousness for a few seconds. He had past medical history of bronchial asthma and diabetes mellitus. Various tests for syncope including electroencephalogram, electrocardiogram, 24-hours Holter monitoring, echocardiogram, carotid sinus massage, tilt table test, carotid duplex, and brain MRI were normal. He was treated successfully with anti-tussives and bronchodilators. We report a case of cough-induced syncope in a patient with bronchial asthma.
Asthma ; Brain ; Bronchodilator Agents ; Carotid Sinus ; Consciousness ; Cough ; Diabetes Mellitus ; Electrocardiography ; Electrocardiography, Ambulatory ; Electroencephalography ; Humans ; Massage ; Syncope ; Tilt-Table Test ; Unconsciousness

No abstract available.
Brain Stem ; Hemorrhage

Vertical gaze palsy is usually associated with lesions of the rostral midbrain and thalamo-mesencephalic junction. The rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF), the interstitial nucleus of Cajal, and the posterior commissure located in the midbrain are the critical area in supranuclear control of vertical eye movements. We describe a case of vertical one-and-a-half syndrome accompanying contralateral abduction and incomplete depression palsy due to thalamo-mesencephalic infarction. These vertical eye movement abnormalities are presumed to be caused by damage to the ipsilateral riMLF, interstitial nucleus of Cajal, and oculomotor fascicles.
Cerebral Infarction ; Depression ; Eye Movements ; Infarction ; Mesencephalon ; Paralysis ; Tegmentum Mesencephali

Epileptic seizures have been shown to cause increased signal intensities on diffusion-weighted images (DWI). Extensive hemispheric involvement on MRI after status epilepticus was very rare. A 56-year-old man transferred to our hospital due to status epileticus. The status epilepticus lasted nearly 7 hours. Neurological examination showed confusional consciousness, left hemiplegia and hemineglect of left side. Brain DWI demonstrated extensive high signal intensities in the right posterior frontal, parietal, temporal and occipital lobes resembling acute cerebral infarction. EEG revealed periodic lateralized epileptiform discharges over the right hemisphere. Follow-up DWI showed more decreased signal intensity in right hemispheric lesions. This case demonstrates the importance of recognizing the characteristics that help differentiate status epilepticus from other disorders.
Brain ; Cerebral Infarction ; Consciousness ; Diffusion Magnetic Resonance Imaging ; Electroencephalography ; Epilepsy ; Follow-Up Studies ; Hemiplegia ; Humans ; Middle Aged ; Neurologic Examination ; Occipital Lobe ; Status Epilepticus

Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are recognized complications of hypona-tremia and its overly rapid correction. A 42-year-old woman with uterine cervical cancer had a subacute onset of choreoathetosis on the thirteenth day after a rapid correction of severe hyponatermia. A follow-up brain magnetic reso-nance image (MRI) showed abnormal signal intensity changes in the central pons, putamen, and caudate nucleus. We report an unusual case of central pontine and extrapontine myelinolysis, that presented with choreoathetosis. (J Korean Neurol Assoc 19(4):393~395, 2001)
Adult ; Brain ; Caudate Nucleus ; Female ; Follow-Up Studies ; Humans ; Myelinolysis, Central Pontine* ; Pons ; Putamen ; Uterine Cervical Neoplasms

Parvovirus B19 (PVB19) infection is a rare cause of meningoencephalitis. A 53-year-old previously healthy woman presented with fever, headache, and multiple erythema on the both legs. Cerebrospinal fluid study revealed pleocytosis and elevated opening pressure and protein level. Brain MRI showed multiple, asymmetric, hyperintensity in the brain stem, basal ganglia, white matter, and gray matter. Anti-B19 IgM antibody and PCR for PVB19 were positive in serum. Clinician should consider PVB19 infection in any case of acute febrile illness with erythema and meningoencephalitis.
Basal Ganglia ; Brain ; Brain Stem ; Cerebrospinal Fluid ; Erythema ; Female ; Fever ; Headache ; Humans ; Immunoglobulin M ; Leg ; Leukocytosis ; Magnetic Resonance Imaging ; Meningoencephalitis* ; Middle Aged ; Parvovirus* ; Polymerase Chain Reaction

Ehlers-Danlos syndrome (EDS) is an inherited connective tissue disorder characterized by fragility of the skin, hyperelasticity of the skin, hyperextensible joints, vascular lesions, easy bruising, and excessive scarring after injuries. Some patients with EDS have neurological symptoms and signs, such as muscular hypotonia, muscular atrophy, spin-ocerebellar tract degeneration, cerebral atrophy, mental retardation, and epilepsy. We report a 16-year-old man who showed mental retardation, hyperelasticity of the skin, joint hypermobility, and muscular atrophy on the bilateral hand muscles. A skin biopsy revealed dermal thickening, a decrease in the density and number of collagen fibrils, distur-bances of the wickerwork pattern, and a disproportional increase in the number of elastic fibers.
Adolescent ; Atrophy ; Biopsy ; Cicatrix ; Collagen ; Connective Tissue ; Ehlers-Danlos Syndrome* ; Elastic Tissue ; Epilepsy ; Hand ; Humans ; Intellectual Disability ; Joint Instability ; Joints ; Muscle Hypotonia ; Muscles ; Muscular Atrophy ; Skin