Posterior reversible encephalopathy syndrome (PRES) is a disorder of reversible vasogenic edema which mainly involves the parieto-occipital lobes in various clinical settings. Isolated involvement of the brainstem, basal ganglia, and cerebellum is rare. An 81-year-old female was admitted because of a decreased level of consciousness, and she had a head trauma history a day before. Brain magnetic resonance imaging (MRI) showed extensive confluent T2 hyperintensity with swelling involving the bilateral thalami, brainstem, and cerebellar peduncle without cortical lesions. We reports a case of central-variant PRES after traumatic brain injury.

Posterior reversible encephalopathy syndrome (PRES) is a disorder of reversible vasogenic edema which mainly involves the parieto-occipital lobes in various clinical settings. Isolated involvement of the brainstem, basal ganglia, and cerebellum is rare. An 81-year-old female was admitted because of a decreased level of consciousness, and she had a head trauma history a day before. Brain magnetic resonance imaging (MRI) showed extensive confluent T2 hyperintensity with swelling involving the bilateral thalami, brainstem, and cerebellar peduncle without cortical lesions. We reports a case of central-variant PRES after traumatic brain injury.

Posterior reversible encephalopathy syndrome (PRES) is a disorder of reversible vasogenic edema which mainly involves the parieto-occipital lobes in various clinical settings. Isolated involvement of the brainstem, basal ganglia, and cerebellum is rare. An 81-year-old female was admitted because of a decreased level of consciousness, and she had a head trauma history a day before. Brain magnetic resonance imaging (MRI) showed extensive confluent T2 hyperintensity with swelling involving the bilateral thalami, brainstem, and cerebellar peduncle without cortical lesions. We reports a case of central-variant PRES after traumatic brain injury.

Intravascular large B-cell lymphoma (IVLBCL) is a rare form of non-Hodgkin’s lymphoma that selectively involves the lumina of vessels, and may present as ischemic stroke. A 62-year-old man presented with progressive aphasia, dementia, seizure and stroke-like symptom. Brain magnetic resonance imaging revealed dynamic progressive fluid attenuated inversion recovery lesions and multiple punctate microbleeds in the bilateral subcortical region. A kidney biopsy revealed IVLBCL. We report a patient with IVLBCL presenting as rapidly progressive encephalopathy.

No abstract available.
Humans ; Myasthenia Gravis ; Myositis ; Thymus Neoplasms

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

BACKGROUND: The objective of the study was to evaluate the predictive value of plasma D-dimer at admission after acute ischemic stroke, and to assess its effect on short-term functional outcome. METHODS: Fasting plasma D-dimer was measured in 290 consecutive patients (61.7% men, mean age 67.0±12.3 years) within 3 days after the onset of acute ischemic stroke. The outcomes were measured at 3-months after stroke onset, by the modified Rankin Scale (mRS). RESULTS: Atrial fibrillation, hypertension, diabetes and involvement of the insular cortex, the levels of serum high sensitive C-reactive protein and D-dimer, as well as incidence of women and age, were all significantly higher in the poor outcome group (P<0.05). After the adjustment of National Institutes of Health Stroke Scale (NIHSS) scores on admission, the plasma D-dimer levels positively correlated with mRS (Spearman partial rho=0.247, P<0.001). The cut-off value of D-dimer level for prediction of poor outcomes was 0.35 mg/L (sensitivity 0.70, specificity 0.63, area under the curve 0.71). Furthermore, two multivariated logistic regression analysis models were performed. One model excluded the NIHSS score as an independent variable, and demonstrated that D-dimer (odds ratio, 1.24 for every 1.0 mg/L, P<0.05) was independently associated with poor functional outcome. Conversely, the other model which included the NIHSS score, did not show any such association. CONCLUSIONS: Plasma D-dimer level is a useful marker for short-term outcomes in acute ischemic stroke, and may have a role in risk stratification for predicting a poor outcome.
Atrial Fibrillation ; C-Reactive Protein ; Cerebral Cortex ; Cerebral Infarction ; Fasting ; Female ; Humans ; Hypertension ; Incidence ; Logistic Models ; Male ; National Institutes of Health (U.S.) ; Plasma ; Prognosis ; Sensitivity and Specificity ; Stroke

No abstract available.
Cellulitis ; Humans ; Lymphedema

We describe two patients with acute myeloradiculitis associated with herpes simplex virus type 2 (HSV-2). They were previously healthy and immunocompetent and had no history of herpes infection or rash. Myeloradiculitis manifested as an acute flaccid paralysis that primarily involved the conus medullaris and cauda equina. laccid paralysis can be caused by HSV-2 myeloradiculitis, and so early antiviral treatment should be considered.
Cauda Equina ; Exanthema ; Herpes Simplex* ; Herpesvirus 2, Human* ; Humans ; Myelitis ; Paralysis* ; Radiculopathy ; Simplexvirus* ; Spinal Cord