The author reports a patient with anterior cerebral artery (ACA) territory infarction presenting with myelopathy-like symptoms. The patient developed leg weakness and sensory loss below T4 level on the right side. Magnetic resonance imaging revealed no abnormalities in the spinal cord, but acute infarction in the left medial frontal lobe and stenosis of the left ACA. This case presents unusual clinical manifestation of ACA infarction mimicking myelopathy.

The author reports a patient with anterior cerebral artery (ACA) territory infarction presenting with myelopathy-like symptoms. The patient developed leg weakness and sensory loss below T4 level on the right side. Magnetic resonance imaging revealed no abnormalities in the spinal cord, but acute infarction in the left medial frontal lobe and stenosis of the left ACA. This case presents unusual clinical manifestation of ACA infarction mimicking myelopathy.

The author reports a patient with anterior cerebral artery (ACA) territory infarction presenting with myelopathy-like symptoms. The patient developed leg weakness and sensory loss below T4 level on the right side. Magnetic resonance imaging revealed no abnormalities in the spinal cord, but acute infarction in the left medial frontal lobe and stenosis of the left ACA. This case presents unusual clinical manifestation of ACA infarction mimicking myelopathy.

Dry ice is a solid form of carbon dioxide and is commonly used in everyday life to keep food or medicine cold. In South Korea, there have been rare cases of carbon dioxide asphyxiation and poisoning from dry ice, though there have been no reports of its use in suicide. In the first case, a man was found lying down dead and left a large amount of dry ice in his room. In the second case, a man died by tying a belt around his neck after placing a plastic bag filled with dry ice over his head. The third death was by placing a large amount of dry ice in a large rubber basin in his room and filling it with water. Dry ice itself is mostly harmless, but if it is not handled carefully in a confined space, it can cause accidents due to accidental oxygen deprivation. Its easy availability in everyday life also means it is likely to be misused for suicidal purposes. Investigators should consider the potential for asphyxiation or poisoning incidents if they discover dry ice or its packaging at the forensic scene.

Syringobulbia is a rare neurological disorder characterized by a fluid-filled cavity in the brainstem. In this study, clinical signs, features on magnetic resonance imaging (MRI), and the diseases present concurrently with syringobulbia were investigated in 33 small breed dogs. Most dogs (97%) had concurrent syringomyelia, and some dogs (24%) presented with vestibular or cranial nerve symptoms associated with the medulla oblongata. MRIs revealed slit-like, bulbous, and vertical linear shapes of the cavities on T2-weighted hyperintense and T1-weighted hypointense signals similar to the cerebrospinal fluid. Chiari-like malformations were identified in all dogs. This study highlights the association of syringobulbia with syringomyelia and Chiari-like malformations in small breed dogs with or without brainstem-associated clinical signs.

Heat stroke is a condition of severe heat injury characterized by hyperthermia, multiorgan failure and central nervous system dysfunction. A 79-year-old woman was brought to our hospital in a semicomatose state. She was found lying unconscious on her house yard at a hot summer day. Her body temperature was 40.3°C. Laboratory findings were consistent with multiorgan failure and rhabdomyolysis. Brain magnetic resonance imaging showed multifocal infarctions in the bilateral basal ganglia, cerebellum, and occipital lobe. Despite cooling therapy and supportive treatment, her mentality was not recovered. This case suggests that multiple cerebral infarction may occur as a complication of heat stroke and prompt treatment is crucial.

Purpose: To derive the optimized intraocular lens (IOL) constants from automated and manifest refraction after cataract surgery in Korean patients, and to evaluate whether there is a difference in optimized IOL constants according to the refraction method. Methods: This retrospective multicenter cohort study enrolled 4,103 eyes of 4,103 patients who underwent phacoemulsification and in-the-bag IOL implantation at 18 institutes. Optimized IOL constants for the SRK/T, Holladay, Hoffer Q, and Haigis formulas were calculated via autorefraction or manifest refraction of samples using the same biometry and IOL. The IOL constants derived from autorefraction and manifest refraction were compared. Results: Of the 4,103 eyes, the majority (62.9%) were measured with an IOLMaster 500 followed by an IOLMaster 700 (15.2%). A total of 33 types of IOLs were used, and the Tecnis ZCB00 was the most frequently used (53.0%). There was no statistically significant difference in IOL constants derived from autorefraction and manifest refraction when IOL constants were optimized with a large number of study subjects. On the other hand, optimized IOL constants derived from autorefraction were significantly smaller than those from manifest refraction when the number of subjects was small. Conclusions It became possible to use the IOL constants optimized from Koreans to calculate the IOL power. However, if the IOL constant is optimized using autorefraction in a small sample group, the IOL constant tends to be small, which may lead to refractive error after surgery.

A 26-year old woman developed left homonymous superior quadrantanopia followed by severe pulsating headache with vomiting. Thereafter, she experienced recurrent left hemiparesis and paresthesia with or without headache. Brain magnetic resonance imaging showed diffusion restriction in the territory of the right posterior cerebral artery and contrast enhancement in the right lingual gyrus adjacent to the diffusion-restricted region. This case suggests an occurrence of cerebral infarction and blood-brain barrier disruption associated with migraine with aura.