1/17. Acute onset of blindness during labor: report of a case of transient cortical blindness in association with hellp syndrome.The coincidence of hellp syndrome and cortical blindness is an uncommon but very dramatic event, for the patient as well as the obstetrician. This report describes the first case of HELLP-syndrome-associated cortical blindness occuring suddenly in the third stage of labour. There were only modest correlates of cortical blindness in cerebral CT, MRI and angiography findings, but no signs of a posterior leucoencephalopathy syndrome. Mother and baby were discharged from hospital to outpatient care in good health on the 12th day.- - - - - - - - - - ranking = 1keywords = encephalopathy (Clic here for more details about this article) |
2/17. Can diffusion weighted magnetic resonance imaging help differentiate stroke from stroke-like events in MELAS?The precise mechanism of neurological symptoms in patients with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) is still controversial. The diffusion weighted MR findings at the acute phase of a neurological event in MELAS are described and the pathophysiology of stroke-like lesion in the light of diffusion changes is discussed.brain MRI was performed 2 days after the sudden onset of cortical blindness in a 25 year old patient with MELAS. Fluid attenuated inversion recovery (FLAIR) images showed multifocal cortical and subcortical hyperintensities located bilaterally in the frontobasal and the temporo-occipital lobes. diffusion weighted images showed normal to increased apparent diffusion coefficient values in the acute left temporooccipital lesion and increased values in the older stroke-like lesions.These diffusion weighted findings support the metabolic rather than the ischaemic pathophysiological hypothesis for stroke-like episodes occurring in MELAS. Normal or increased apparent diffusion coefficient values within 48 hours of a neurological deficit of abrupt onset should raise the possibility of MELAS, especially if conventional MR images show infarct-like lesions.- - - - - - - - - - ranking = 1keywords = encephalopathy (Clic here for more details about this article) |
3/17. Late onset cyclosporine-induced cerebral blindness with abnormal SPECT imagings in a patient undergoing unrelated bone marrow transplantation.A 23-year-old woman underwent HLA-matched unrelated BMT for CML. She developed cerebral blindness on day 81. brain magnetic resonance imaging revealed hyperintensity on a T2-weighted image in the white and gray matter of the right frontal and both occipital lobes. Single-photon emission computed tomography (SPECT) was consistent with a decrease in radionuclide uptake in these areas, suggesting a vasoconstrictive mechanism. A diagnosis of CsA-induced encephalopathy was made and CsA was discontinued. Her vision recovered completely after 24 h and abnormal imaging resolved within 2 weeks. This case demonstrates late onset CsA-induced cerebral blindness with the previously unreported abnormalities on SPECT.- - - - - - - - - - ranking = 1keywords = encephalopathy (Clic here for more details about this article) |
4/17. Creutzfeldt-Jakob disease : report of 10 cases from North india.Creutzfeldt-Jakob disease (CJD) is increasingly being reported over the last three decades as a result of heightened awareness of the disease. Various studies have reported annual incidence of 0.5-1.5 cases of CJD per million of general population. In india, the disease is still under reported. Over the period spanning from 1968-1997, National Institute of mental health and neurosciences (NIMHANS), Bangalore recorded 69 cases of CJD from different parts of india in the CJD registry. This paper describes the clinical experience with cases of CJD managed at the Department of neurology, G.B. Pant Hospital, New Delhi from 1990-1998. In this series, the mean age of the patients was 53.80 ( /- 7.32) years and there were 5 females and 5 males. myoclonus was present in all the cases and abnormal behaviour with or without other features was the presenting complaint in 7 of the 10 patients, while one patient of CJD had cerebellar ataxia as the presenting feature. One patient with occipital variant of CJD presented with acute onset cortical blindness and myoclonic jerks. One of the patients had acute psychosis precipitated by emotional stress at the onset. Extrapyramidal features were noted in 7 of the 10 patients before death. The mean duration of symptoms from the onset of disease to death was 6.6 ( /- 6.11) months. Classical EEG changes were observed in all the patients, except in one possible case of occipital variant of CJD, where we did not have access to EEG record. brain biopsy could be undertaken in 3 patients, and in 2 patients the features of subacute spongiform encephalopathy (SSE) were noted.- - - - - - - - - - ranking = 1keywords = encephalopathy (Clic here for more details about this article) |
5/17. MRI findings in a case of transient cortical blindness after cardiac catheterization.The magnetic resonance imaging findings in a case of transient cortical blindness (TCB) after cardiac catheterization are described for the first time. In addition, a literature review of TCB, comparison with reversible posterior leukoencephalopathy, and a hypothesis regarding the pathophysiology of TCB are presented.- - - - - - - - - - ranking = 1keywords = encephalopathy (Clic here for more details about this article) |
6/17. Posterior reversible encephalopathy syndrome due to severe hypercalcemia.Posterior reversible encephalopathy syndrome (PRES) is a leukoencephalopathy clinically characterized by headache, altered mental status, visual loss and seizures. neuroimaging demonstrates symmetrical posterior cortical and subcortical lesions. The exact pathophysiology is unknown but there is a strong association with immunosuppressants and hypertension. We report two cases of PRES in normotensive patients with severe hypercalcemia as the only identifiable cause. Possible pathophysiological mechanisms are discussed.- - - - - - - - - - ranking = 6keywords = encephalopathy (Clic here for more details about this article) |
7/17. Cortical blindness in a boy with acute glomerulonephritis.Post-infectious acute glomerulonephritis with hypertensive encephalopathy is characterized by episodic hypertension with headache, vomiting, and hematuria. The association between hypertensive encephalopathy and cortical blindness in children with acute glomerulonephritis is extremely rare. We report the case of a 10-year-old boy with acute glomerulonephritis who presented with gross hematuria, headache, vomiting, and oliguria, and developed transient cortical blindness as a complication of hypertensive encephalopathy. No occurrence of seizure was observed during the clinical course. T2-weighted cranial magnetic resonance imaging showed a high-intensity signal over cortical and subcortical areas of bilateral occipital regions. His vision recovered fully, 2 days after receiving antihypertensive therapy. The patient was well without complaint at 1-year follow-up. This case highlights the possibility that cortical blindness may develop as a complication of acute glomerulonephritis in children. Prevention of the occurrence of neurological deficits in children with acute glomerulonephritis and hypertensive encephalopathy requires careful evaluation and appropriate management of hypertension.- - - - - - - - - - ranking = 4keywords = encephalopathy (Clic here for more details about this article) |
8/17. Cortical blindness and hepatic encephalopathy.PURPOSE: To present a case of permanent cortical blindness (CB) following hepatic encephalopathy. methods: Systematic clinical examination and further investigations to elicit the diagnosis. CONCLUSION: Complete CB is an uncommon neurological disorder and is rarely persistent. In rare cases of hepatic encephalopathy, the visual cortex may be affected and CB may occur, which resolves following treatment of the hepatic encephalopathy. We report a previously unreported complication involving permanent CB following hepatic encephalopathy in a young man.- - - - - - - - - - ranking = 15.079555562208keywords = encephalopathy, hepatic encephalopathy, hepatic (Clic here for more details about this article) |
9/17. Postpartum blindness: two cases.We present 2 cases, one eclamptic patient and one noneclamptic patient, of headache, cortical blindness, and seizures. Both patients demonstrated findings consistent with posterior leukoencephalopathy syndrome. posterior leukoencephalopathy syndrome is a rapidly evolving neurologic condition that is characterized by headache, nausea and vomiting, seizures, visual disturbances, altered sensorium, and occasionally focal neurologic deficits. posterior leukoencephalopathy syndrome can be triggered by numerous conditions, including preeclampsia-eclampsia, and can be seen in the postpartum period. It is characterized predominately by white matter vasogenic edema of the occipital and posterior parietal lobes. This condition can be difficult to differentiate clinically from cerebral ischemia, and magnetic resonance imaging with diffusion-weighted imaging and apparent diffusion coefficient are needed to do so. In most cases of posterior leukoencephalopathy syndrome, the prognosis is excellent, with full resolution of symptoms.- - - - - - - - - - ranking = 4keywords = encephalopathy (Clic here for more details about this article) |
10/17. MR findings of cortical blindness following cerebral angiography: is this entity related to posterior reversible leukoencephalopathy?We describe MR findings in three patients who experienced transient cortical blindness following cerebral angiograms. All angiograms were performed by using the same nonionic contrast medium. On the basis of similar clinical and radiologic findings, we believe that this entity is closely related to and probably has the same pathophysiology as posterior reversible leukoencephalopathy.- - - - - - - - - - ranking = 5keywords = encephalopathy (Clic here for more details about this article) |
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