Thalamomesencephalic Stroke in a Patient with HIV[Version 3; Peer
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Cerebellar Ataxia
CEREBELLAR ATAXIA Dr. Waqar Saeed Ziauddin Medical University, Karachi, Pakistan What is Ataxia? ■ Derived from a Greek word, ‘A’ : not, ‘Taxis’ : orderly Ataxia is defined as an inability to maintain normal posture and smoothness of movement. Types of Ataxia ■ Cerebellar Ataxia ■ Sensory Ataxia ■ Vestibular Ataxia Cerebellar Ataxia Cerebrocerebellum Spinocerebellum Vestibulocerebellum Vermis Planning and Equilibrium balance Posture, limb and initiating and posture eye movements movements Limb position, touch and pressure sensation Limb ataxia, Eye movement dysdiadochokinesia, disorders, Truncal and gait Dysmetria dysarthria nystagmus, VOR, ataxia hypotonia postural and gait. Gait ataxia Types of Cerebellar Ataxia • Vascular Acute Ataxia • Medications and toxins • Infectious etiologies • Atypical Infectious agents • Autoimmune disorders • Primary or metastatic tumors Subacute Ataxia • Paraneoplastic cerebellar degeneration • Alcohol abuse and Vitamin deficiencies • Systemic disorders • Autosomal Dominant Chronic • Autosomal recessive Progressive • X linked ataxias • Mitochondrial • Sporadic neurodegenerative diseases Vascular Ataxia ▪ Benedikt Syndrome It is a rare form of posterior circulation stroke of the brain. A lesion within the tegmentum of the midbrain can produce Benedikt Syndrome. Disease is characterized by ipsilateral third nerve palsy with contralateral hemitremor. Superior cerebellar peduncle and/or red nucleus damage in Benedikt Syndrome can further lead in to contralateral cerebellar hemiataxia. ▪ Wallenberg Syndrome In -
Topical Diagnosis in Neurology
V Preface In 2005 we publishedacomplete revision of Duus’ Although the book will be useful to advanced textbook of topical diagnosis in neurology,the first students, also physicians or neurobiologists inter- newedition since the death of its original author, estedinenriching their knowledge of neu- Professor PeterDuus, in 1994.Feedbackfromread- roanatomywith basic information in neurology,oR ers wasextremelypositive and the book wastrans- for revision of the basics of neuroanatomywill lated intonumerous languages, proving that the benefit even morefromit. conceptofthis book wasasuccessful one: combin- This book does notpretend to be atextbook of ing an integrated presentation of basic neu- clinical neurology.That would go beyond the scope roanatomywith the subject of neurological syn- of the book and also contradict the basic concept dromes, including modern imaging techniques. In described above.Firstand foremostwewant to de- this regard we thank our neuroradiology col- monstratehow,onthe basis of theoretical ana- leagues, and especiallyDr. Kueker,for providing us tomical knowledge and agood neurological exami- with images of very high quality. nation, it is possible to localize alesion in the In this fifthedition of “Duus,” we have preserved nervous system and come to adecision on further the remarkablyeffective didactic conceptofthe diagnostic steps. The cause of alesion is initially book,whichparticularly meets the needs of medi- irrelevant for the primarytopical diagnosis, and cal students. Modern medical curricula requirein- elucidation of the etiology takes place in asecond tegrative knowledge,and medical studentsshould stage. Our book contains acursoryoverviewofthe be taught howtoapplytheoretical knowledge in a major neurologicaldisorders, and it is notintended clinical settingand, on the other hand, to recognize to replace the systematic and comprehensive clinical symptoms by delving intotheir basic coverage offeredbystandardneurological text- knowledge of neuroanatomyand neurophysiology. -
THE SYNDROMES of the ARTERIES of the BRAIN and SPINAL CORD Part 1 by LESLIE G
65 Postgrad Med J: first published as 10.1136/pgmj.29.328.65 on 1 February 1953. Downloaded from THE SYNDROMES OF THE ARTERIES OF THE BRAIN AND SPINAL CORD Part 1 By LESLIE G. KILOH, M.D., M.R.C.P., D.P.M. First Assistant in the Joint Department of Psychological Medicine, Royal Victoria Infirmary and University of Durham Introduction general circulatory efficiency at the time of the Little interest is shown at present in the syn- catastrophe is of the greatest importance. An dromes of the arteries of the brain and spinal cord, occlusion, producing little effect in the presence of and this perhaps is related to the tendency to a normal blood pressure, may cause widespread minimize the importance of cerebral localization. pathological changes if hypotension co-exists. Yet these syndromes are far from being fully A marked discrepancy has been noted between elucidated and understood. It must be admitted the effects of ligation and of spontaneous throm- that in many cases precise localization is often of bosis of an artery. The former seldom produces little more than academic interest and ill effects whilst the latter frequently determines provides Protected by copyright. nothing but a measure of personal satisfaction to infarction. This is probably due to the tendency the physician. But it is worth recalling that the of a spontaneous thrombus to extend along the detailed study of the distribution of the bronchi affected vessel, sealing its branches and blocking and of the pathological anatomy of congenital its collateral circulation, and to the fact that the abnormalities of the heart, was similarly neglected arterial disease is so often generalized. -
Crossed Brainstem Syndrome Revealing
Beucler et al. BMC Neurology (2021) 21:204 https://doi.org/10.1186/s12883-021-02223-7 CASE REPORT Open Access Crossed brainstem syndrome revealing bleeding brainstem cavernous malformation: an illustrative case Nathan Beucler1,2* , Sébastien Boissonneau1,3, Aurélia Ruf4, Stéphane Fuentes1, Romain Carron3,5 and Henry Dufour1,6 Abstract Background: Since the nineteenth century, a great variety of crossed brainstem syndromes (CBS) have been described in the medical literature. A CBS typically combines ipsilateral cranial nerves deficits to contralateral long tracts involvement such as hemiparesis or hemianesthesia. Classical CBS seem in fact not to be so clear-cut entities with up to 20% of patients showing different or unnamed combinations of crossed symptoms. In terms of etiologies, acute brainstem infarction predominates but CBS secondary to hemorrhage, neoplasm, abscess, and demyelination have been described. The aim of this study was to assess the proportion of CBS caused by a bleeding episode arising from a brainstem cavernous malformation (BCM) reported in the literature. Case presentation: We present the case of a typical Foville syndrome in a 65-year-old man that was caused by a pontine BCM with extralesional bleeding. Following the first bleeding episode, a conservative management was decided but the patient had eventually to be operated on soon after the second bleeding event. Discussion: A literature review was conducted focusing on the five most common CBS (Benedikt, Weber, Foville, Millard-Gubler, Wallenberg) on Medline database from inception to 2020. According to the literature, hemorrhagic BCM account for approximately 7 % of CBS. Microsurgical excision may be indicated after the second bleeding episode but needs to be carefully weighted up against the risks of the surgical procedure and openly discussed with the patient. -
High-Yield Neuroanatomy
LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page i Aptara Inc. High-Yield TM Neuroanatomy FOURTH EDITION LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page ii Aptara Inc. LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page iii Aptara Inc. High-Yield TM Neuroanatomy FOURTH EDITION James D. Fix, PhD Professor Emeritus of Anatomy Marshall University School of Medicine Huntington, West Virginia With Contributions by Jennifer K. Brueckner, PhD Associate Professor Assistant Dean for Student Affairs Department of Anatomy and Neurobiology University of Kentucky College of Medicine Lexington, Kentucky LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page iv Aptara Inc. Acquisitions Editor: Crystal Taylor Managing Editor: Kelley Squazzo Marketing Manager: Emilie Moyer Designer: Terry Mallon Compositor: Aptara Fourth Edition Copyright © 2009, 2005, 2000, 1995 Lippincott Williams & Wilkins, a Wolters Kluwer business. 351 West Camden Street 530 Walnut Street Baltimore, MD 21201 Philadelphia, PA 19106 Printed in the United States of America. All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at 530 Walnut Street, Philadelphia, PA 19106, via email at [email protected], or via website at http://www.lww.com (products and services). -
True and False Localization in Neuro- Ophthalmology—A Report of Two Cases
Case Report Neuro-ophthalmology True and False Localization in Neuro- ophthalmology—a Report of Two Cases Jared Raabe,1 Lance J Lyons,2 Bayan Al Othman,3 Andrew G Lee3,4,5,6 1. University of Texas Medical Branch, School of Medicine, Galveston, TX, USA; 2. Department of Ophthalmology & Visual Sciences, University of Texas Medical Branch, Galveston, TX, USA; 3. Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA; 4. Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, USA; 5. Section of Ophthalmology, University of Texas MD Anderson Cancer Center, Houston, TX, USA; 6. Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA his report of two cases describes two patients who each had ocular motor cranial neuropathies in addition to a second neurologic finding that usually, in combination, hold localizing value. One of these cases localized as anticipated, and the other case demonstrated Ta false localizing sign. We detail these two cases and review the localizing value of various combinations of neurologic signs. Keywords The Parkinson sign is classically described as a sixth nerve palsy and an ipsilateral Horner syndrome Oculomotor palsy, Horner syndrome, ocular motor that localizes to the cavernous sinus. 1,2 The localizing value of any afferent and efferent (e.g., Horner cranial nerve, Parkinson sign, cavernous sinus, syndrome) pupillary finding with an ipsilateral ocular motor cranial neuropathy merits revisiting the anisocoria, relative afferent pupillary defect Parkinson sign.3,4 For example, a unilateral pupil-sparing cranial nerve III palsy with an ipsilateral Disclosure: Jared Raabe, Lance Lyons, smaller pupil (rather than a larger pupil), a normal pupillary light reaction, an anisocoria worse in the Bayan Al Othman, and Andrew Lee have no dark (ocular sympathetic pupil dilation problem), and absence of aberrant regeneration suggests a relevant conflicts of interest to declare. -
High-Yield Neuroanatomy, FOURTH EDITION
LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page i Aptara Inc. High-Yield TM Neuroanatomy FOURTH EDITION LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page ii Aptara Inc. LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page iii Aptara Inc. High-Yield TM Neuroanatomy FOURTH EDITION James D. Fix, PhD Professor Emeritus of Anatomy Marshall University School of Medicine Huntington, West Virginia With Contributions by Jennifer K. Brueckner, PhD Associate Professor Assistant Dean for Student Affairs Department of Anatomy and Neurobiology University of Kentucky College of Medicine Lexington, Kentucky LWBK110-3895G-FM[i-xviii].qxd 8/14/08 5:57 AM Page iv Aptara Inc. Acquisitions Editor: Crystal Taylor Managing Editor: Kelley Squazzo Marketing Manager: Emilie Moyer Designer: Terry Mallon Compositor: Aptara Fourth Edition Copyright © 2009, 2005, 2000, 1995 Lippincott Williams & Wilkins, a Wolters Kluwer business. 351 West Camden Street 530 Walnut Street Baltimore, MD 21201 Philadelphia, PA 19106 Printed in the United States of America. All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at 530 Walnut Street, Philadelphia, PA 19106, via email at [email protected], or via website at http://www.lww.com (products and services). -
Eponym Study.Pdf
Clinical Neurology and Neurosurgery 200 (2021) 106367 Contents lists available at ScienceDirect Clinical Neurology and Neurosurgery journal homepage: www.elsevier.com/locate/clineuro Declining use of neurological eponyms in cases where a non-eponymous alternative exists Christopher J. Becker *, Mollie McDermott , Zachary N. London Department of Neurology, University of Michigan, Ann Arbor, MI, United States ARTICLE INFO ABSTRACT Keywords: Eponyms are common in neurology, but their use is controversial. Recent studies have demonstrated increasing Eponym eponym use over time in the scientific literature, but it is unclear whether this is a result of authors choosing to History of neurology use eponyms more frequently, or is merely a product of increasing rates of scientificpublication. Our goal was to Twentieth century explore trends in decision-making pertaining to eponym usage. We identified cases where an eponym and a Evidence-based medicine corresponding non-eponymous term existed, and assessed temporal trends in the relative usage of these terms using Google’s n-gram viewer for each decade from 1900 2019. Relative to corresponding non-eponymous terms, the use of eponyms increased across the 20th century, peaking in the decade from 1980 to 1989, before sharply declining after the turn of the 21st century. This indicates that when faced with a choice between using an eponym and non-eponymous term, contemporary authors increasingly chose the non-eponymous term. This recent trend may reflectincreased awareness of the limitations of eponyms, greater attention to the personal and political lives of namesakes, and a cultural shift toward viewing scientificadvances as the result of collective and collaborative efforts rather than the solitary achievements of eminent individuals. -
Posterior Circulation Stroke
Posterior Circulation Stroke Sheryl Martin-Schild, MD, PhD, FANA, FAHA Stroke Medical Director for Louisiana Emergency Response Network (LERN) Medical Director of Neurology & Stroke – New Orleans East Hospital and Touro Infirmary President & CEO - Dr. Brain, Inc. Webinar #15 Posterior circulation stroke • Review anatomy – pipes, plumbing, & parenchyma • Common stroke syndromes • NIHSS exam - limitations • The 5 D’s – working through ddx • Supplemental examination • Evaluating the acutely vertiginous patient • Evaluating the patient with perceived minor stroke • Advanced imaging - pitfalls • Standard-of-care treatment options Posterior circulation stroke - Pipes Posterior circulation stroke Plumbing variation • Normal Circle of Willis • <50% population Posterior circulation stroke Plumbing variation Fetal PCA • fPCA (9.5%) is continuation of Pcomm • No communication with basilar • Partial fPCA (15%) has atretic communication with basilar artery • lack of or smaller thalamoperforators in the absence of a P1 or atretic P1 Posterior circulation stroke Plumbing variation • Dominant VA 2/3 • Persistent trigeminal artery • PCA = midbrain, thalamus, medial surface of occipital lobe, inferior and medial surfaces of temporal lobe • SCA = superior cerebellum & rostral laterodorsal pons • AICA = lateral caudal pons & part of cerebellum • PICA = lateral medulla & inferior cerebellum Common stroke syndromes associated with vessel occlusions • Posterior cerebral artery • Basilar artery • Superior cerebellar artery • Anterior inferior cerebellar artery -
Handbook on Clinical Neurology and Neurosurgery
Alekseenko YU.V. HANDBOOK ON CLINICAL NEUROLOGY AND NEUROSURGERY FOR STUDENTS OF MEDICAL FACULTY Vitebsk - 2005 УДК 616.8+616.8-089(042.3/;4) ~ А 47 Алексеенко Ю.В. А47 Пособие по неврологии и нейрохирургии для студентов факуль тета подготовки иностранных граждан: пособие / составитель Ю.В. Алексеенко. - Витебск: ВГМ У, 2005,- 495 с. ISBN 985-466-119-9 Учебное пособие по неврологии и нейрохирургии подготовлено в соответствии с типовой учебной программой по неврологии и нейрохирургии для студентов лечебного факультетов медицинских университетов, утвержденной Министерством здравоохра нения Республики Беларусь в 1998 году В учебном пособии представлены ключевые разделы общей и частной клиниче ской неврологии, а также нейрохирургии, которые имеют большое значение в работе врачей общей медицинской практики и системе неотложной медицинской помощи: за болевания периферической нервной системы, нарушения мозгового кровообращения, инфекционно-воспалительные поражения нервной системы, эпилепсия и судорожные синдромы, демиелинизирующие и дегенеративные поражения нервной системы, опу холи головного мозга и черепно-мозговые повреждения. Учебное пособие предназначено для студентов медицинского университета и врачей-стажеров, проходящих подготовку по неврологии и нейрохирургии. if' \ * /’ L ^ ' i L " / УДК 616.8+616.8-089(042.3/.4) ББК 56.1я7 б.:: удгритний I ISBN 985-466-119-9 2 CONTENTS Abbreviations 4 Motor System and Movement Disorders 5 Motor Deficit 12 Movement (Extrapyramidal) Disorders 25 Ataxia 36 Sensory System and Disorders of Sensation -
Neurological Syndromes
Neurological Syndromes J. Gordon Millichap Neurological Syndromes A Clinical Guide to Symptoms and Diagnosis J. Gordon Millichap, MD., FRCP Professor Emeritus of Pediatrics and Neurology Northwestern University Feinberg School of Medicine Chicago, IL, USA Pediatric Neurologist Ann & Robert H. Lurie Children’s Hospital of Chicago Chicago , IL , USA ISBN 978-1-4614-7785-3 ISBN 978-1-4614-7786-0 (eBook) DOI 10.1007/978-1-4614-7786-0 Springer New York Heidelberg Dordrecht London Library of Congress Control Number: 2013943276 © Springer Science+Business Media New York 2013 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifi cally for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. -
Localization Neurology Cortical Signs and Brain Stem
LOCALIZATION NEUROLOGY EPISODE I CORTICAL SIGNS AND BRAIN STEM 1 Motor pathway Upper motor (Corticospinal tract) neuron Lower motor neuron UPPER MOTOR NEURON LESION CORTICOSPINAL TRACT CORTEX X INT. CAPSULE X BRAIN STEM X MOTOR DECUSSATION SPINAL CORD X SPINOTHALAMIC TRACT UPPER MOTOR CORTICOSPINAL TRACT NEURON LESION CORTEX X INT. CAPSULE X BRAIN STEM X MOTOR DECUSSATION SPINAL CORD X SPINOTHALAMIC TRACT FACIAL PALSY UPPER MOTOR NEURON : contralateral facial palsy below upper eyelid LOWER MOTOR NEURON ipsi lateral facial palsy HEMISPHERIC LESION CORTICAL and SUBCORTICAL MOTOR : contralateral hemiparesis UMN type FACE : contralateral UMN type facial palsy SENSORY : contralateral hemianesthesia EPISODE I CORTICAL SIGNS CORTICAL SIGNS AND BRAIN STEM 8 CORTICAL vs SUBCORTICAL CORTICAL SIGNS PATTERN of WEAKNESS CONSCIOUSNESS EYE DEVIATION CORTICAL LESION: DOMINANT DOMINANT HEMISPHERE Right handed: Left (95%)>>>Right Left handed: Left (60%), Right (40%) Language: aphasia Learn motor skills: apraxia CORTICAL LESION: NON DOMINANT NON DOMINANT HEMISPHERE Rhythm and music Amusia, loss of prosody, monotonal voice Visuospatial analysis Dressing and Constructional apraxia Attention deficit Neglect CORTICAL LESION: NON DOMINANT DRESSING APRAXIA Not true apraxia (bad term) Disorder of visuo-spatial perception that difficulty dressing Lesion at right parietal lobe CONSTRUCTIONAL APRAXIA Disorder of visuospatial perception Inability to copy or construct complex figure Test by ask patient to copy a complex figure Lesion at right parietal