- CIDP, myasthenia gravis, and membranous glomerulonephritis - three autoimmune disorders in one patient: a case report. [Journal Article]
- BNBMC Neurol 2018 Aug 14; 18(1):113
- CONCLUSIONS: All three diseases are of autoimmune origin with distinctive immunopathogenetic mechanisms. The present case of CIDP, MG, and MGN occurring in one patient indicates a common underlying immune mechanism in these distinct conditions, including the involvement of autoantibodies and T cells.
- Dural arteriovenous fistulas at the petrous apex. [Journal Article]
- WNWorld Neurosurg 2018 Aug 10
- CONCLUSIONS: Petrous apex DAVF carried a high risk of embolization-related complications. Based on the vascular architecture, this classification may reflect their clinical features and provide some advices on the treatment of DVAFs at the petrous apex.
- Magnetic resonance imaging of developmental facial paresis: a spectrum of complex anomalies. [Journal Article]
- NNeuroradiology 2018 Aug 03
- CONCLUSIONS: To our knowledge, this is the largest series of patients with DFP that represents a continuum of isolated and combined malformations. Understanding of embryological basis can give insights into the anomalous development of the facial nerve.
- Orbital tumors: report of 70 surgically treated cases. [Journal Article]
- WNWorld Neurosurg 2018 Jul 30
- CONCLUSIONS: We recommend, i) the endoscopic endonasal approach for primary orbital tumors located in the medial or inferior orbital walls without extra-orbital extension; ii) the trans-eyelid approach for tumors of the upper and upper-lateral quadrants extraconally located, and iii) the fronto-orbital approach for intraconally located tumors involving more than one quadrant.
- Carotid artery stenting versus endarterectomy for the treatment of both symptomatic and asymptomatic patients with carotid artery stenosis: 2 years' experience in a high-volume center. [Journal Article]
- ACAdv Clin Exp Med 2018 Jul 31
- CONCLUSIONS: Carotid endarterectomy is equally effective as CAS in stroke prevention, but is associated with a higher incidence of cranial nerve palsy, access site hematoma and other non-stroke complications. Symptomatic patients had a higher incidence of stroke, regardless of the treatment method.
- Transitioning from a gold weight to an "enhanced" palpebral spring in the management of paralytic lagophthalmos secondary to facial nerve palsy. [Journal Article]
- OOrbit 2018 Jul 26; :1-5
- CONCLUSIONS: Patients with lagophthalmos due to cranial nerve seven palsy who have undergone gold weight placement but continue to exhibit objective and subjective corneal symptoms may have symptomatic improvement with the transition to a palpebral spring.
- Characteristics, outcome and treatments with cranial pachymeningitis: A multicenter French retrospective study of 60 patients. [Multicenter Study]
- MMedicine (Baltimore) 2018; 97(30):e11413
- The aim of this study was to determine the characteristics, treatment, and outcome according to each etiology of pachymeningitis.We conducted a retrospective multicenter French nationwide study betwe...
The aim of this study was to determine the characteristics, treatment, and outcome according to each etiology of pachymeningitis.We conducted a retrospective multicenter French nationwide study between 2000 and 2016 to describe the characteristics, outcome, and treatment of pachymeningitis.We included 60 patients (median age 55.5 years; interquartile range [IQR] 30-80, female/male ratio 0.43). Neurologic signs were present in 59 patients (98%) and consisted of headache in 43 (72%), cranial nerve palsy in 33 (55%), confusion in 10 (17%), seizures in 7 (12%), and focal neurologic signs in 9 (15%). Fever and weight loss were present in 8 (13%) and 13 cases (22%), respectively. Cerebral venous thrombosis was present in 8 cases (13%). Analysis of cerebrospinal fluid showed moderate hyperproteinorachia (median 0.68 g/L; IQR 0.46-3.2) with or without pleiocytosis. Diagnosis included idiopathic pachymeningitis (n = 18; 30%); granulomatosis with polyangiitis (n = 13; 17%); Erdheim-Chester disease (n = 10; 17%); IgG4-related disease and tuberculosis (n = 3; 5% each); Rosai-Dofman disease, microscopic polyangiitis, and sarcoidosis (n = 2, 3% each); cryptococcal meningitis, Lyme disease, ear-nose-throat infection, postlumbar puncture, low spinal-fluid pressure syndrome, and lymphoma (n = 1 each). We found no difference in demographics and neurologic presentation among idiopathic pachymeningitis, Erdheim-Chester disease, and granulomatosis with polyangiitis. In contrast, frequencies were lower with idiopathic pachymeningitis than Erdheim-Chester disease for general signs (6% and 40%, respectively, P = .041) and complete neurologic response (0% vs 39%, P = .045).The detection of extraneurologic signs and routine screening are needed to classify the pachymeningitis origin. Prospective studies are warranted to determine the best treatment in each case.
- Unruptured aneurysm producing thunderclap headache treated with endovascular coil embolization. [Journal Article]
- AGRIAgri 2018; 30(3):146-149
- The abrupt onset of acute, high-intensity headache, unlike any experienced before, can be an urgent medical condition, which requires attention. A 32-year-old female patient developed thunderclap hea...
The abrupt onset of acute, high-intensity headache, unlike any experienced before, can be an urgent medical condition, which requires attention. A 32-year-old female patient developed thunderclap headache attacks had applied with increasing intensity and frequency since 1 week. She had visited the emergency department several times, and cranial computed tomography findings were normal. On the last presentation, neurological examination showed complete oculomotor nerve palsy on the left. Brain magnetic resonance imaging together with intracranial brain angiography revealed left posterior communicating aneurysm compressing the ipsilateral oculomotor nerve, with no evidence of subarachnoid hemorrhage. The patient was treated with endovascular balloon-assisted coil embolization of the aneurysm under digital subtraction angiography. As a result, the headache resolved soon after the intervention. Furthermore, complete ptosis recovered by the third month. Although thunderclap headache has rarely been attributed to an enlarging unruptured cerebral aneurysm, early recognition and treatment are rather important as it may indicate a high risk of rupture.
- Chronic Myelogenous Leukemia Presenting with Facial Nerve Palsy in an Infant. [Journal Article]
- IJIran J Child Neurol 2018; 12(3):122-125
- When a child presents with cranial nerve palsy and a bulging fontanel, a pediatric neurologist is often consulted to determine the cause of increased intracranial pressure. This report describes an i...
When a child presents with cranial nerve palsy and a bulging fontanel, a pediatric neurologist is often consulted to determine the cause of increased intracranial pressure. This report describes an infant with chronic myelogenous leukemia (CML) referred to Ali-bin-Abitaleb Hospital, Zahedan, eastern Iran in 2013 who presented with seventh cranial nerve palsy and bulging fontanel. Chromosomal analysis and peripheral blood smear confirmed the diagnosis of CML.
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- Flow Alteration Therapy for Ruptured Vertebral Artery Dissecting Aneurysms Involving the Posterior Inferior Cerebellar Artery. [Journal Article]
- NMNeurol Med Chir (Tokyo) 2018 Aug 15; 58(8):341-349
- Surgery for- and endovascular treatment of vertebral artery (VA) dissecting aneurysms involving the origin of the posterior inferior cerebellar artery (PICA) remain challenging. Their ideal treatment...
Surgery for- and endovascular treatment of vertebral artery (VA) dissecting aneurysms involving the origin of the posterior inferior cerebellar artery (PICA) remain challenging. Their ideal treatment is complete isolation of the aneurysm by surgical or endovascular trapping plus PICA reconstruction. However, postoperative lower cranial nerve palsy and medullary infarction are potential complications. We report four patients with VA dissecting aneurysms involving the PICA origin who were treated by occipital artery (OA)-PICA bypass followed by proximal occlusion of the VA and clip ligation of the PICA origin instead of trapping. There were no procedural or ischemic complications. In all patients, angiography performed 2-3 weeks later showed good patency of the bypass graft and complete obliteration of the aneurysm. During the follow-up period ranging from 1 to 14 years, none experienced bleeding. Although retrograde blood flow to the dissecting aneurysm persisted in the absence of trapping, iatrogenic lower cranial nerve injury could be avoided. The decrease in aneurysmal flow might elicit spontaneous thrombosis and prevent aneurysmal rerupture. Our technique might be less invasive than aneurysmal trapping and help to prevent rebleeding.