1/12. Contralateral cortical diaschisis in a patient with cerebellar astrocytoma after radiation therapy.Contralateral cerebellar diaschisis, hypometabolism in the cerebellum contralateral to a cortical lesion, is a well described phenomenon in patients with stroke and brain tumor. However, few reports exist of patients with cerebellar lesions with the finding of contralateral cortical hypometabolism. The authors present a case of a patient with a right cerebellar astrocytoma after surgical resection and radiation therapy in which fluorine-18 fluorodeoxyglucose positron emission tomographic imaging, performed to rule out recurrent tumor, revealed global hypometabolism in the left cerebral cortex. The concept of contralateral cortical diaschisis and possible mechanisms and clinical implications are reviewed.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/12. Presigmoid transpetrosal approach for the treatment of a large trochlear nerve schwannoma--case report.A 61-year-old man presented with a rare, large trochlear nerve schwannoma manifesting as left-sided weakness and hypesthesia, bilateral bulbar pareses, and trochlear nerve paresis persisting for 3 months. T1-weighted magnetic resonance imaging with gadolinium revealed an intensely enhanced, well-circumscribed lesion with multicystic formation occupying the prepontine and interpeduncular cisterns and compressing the pons and midbrain with greater extension to the right. The mass was completely removed through the presigmoid transpetrosal approach with preservation of the posterior cerebral, superior cerebellar, and basilar arteries and their branches. Neuroradiological examination after 3 years demonstrated no recurrence. Enlargement of a tumor in the cisternal portion is inclined to involve and/or encase the adjacent major arteries and their branches. The presigmoid transpetrosal approach is one of the best surgical routes to remove a large trochlear nerve schwannoma safely and completely.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
3/12. Galloping ophthalmoplegia and numb chin in burkitt lymphoma.A 57-year-old man developed complete bilateral ophthalmoplegia over a period of 10 days, together with bilateral facial pain and numbness of the chin. He had no other clinical manifestations. Findings on brain magnetic resonance imaging and spinal fluid formula from the first lumbar puncture were normal, but cerebrospinal fluid flow cytometry disclosed a kappa restriction monoclonal B-cell population, indicating malignant lymphoma. Computed tomography of the chest, abdomen, and pelvis then revealed multiple enlarged lymph nodes. biopsy of an inguinal node showed findings consistent with burkitt lymphoma. Within six weeks, intravenous and intrathecal chemotherapy resolved all neurologic findings except a partial right-side sixth nerve palsy and mild chin numbness. Eighteen months after disease onset, the patient remained in remission. Meningeal spread of burkitt lymphoma is not commonly a presenting feature in immunocompetent adults. chin numbness, a characteristic feature caused by infiltration of the mental nerve, should facilitate earlier recognition, which may be life saving.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
4/12. The numb chin syndrome as an early manifestation of giant-cell (temporal) arteritis: a case report.We describe a 70-year-old woman with a 2-month history of a numb chin and gradually increasing bilateral headache and malaise. Neurological examination disclosed chin hypoesthesia while investigations showed a normocytic anemia, ESR of 100, and CRP of 72. A CT brain scan, chest X-ray, and bone scan showed no evidence of malignancy. Temporal arteritis was suspected and prednisolone started with prompt resolution of the headache, chin hypoesthesia, ESR, and CRP. This case illustrates an unusual etiology of the numb chin syndrome, which in most occasions is associated with malignancy. Temporal arteritis should be borne in mind as a possible explanation for this as it is a treatable condition with potentially serious, life-threatening complications.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
5/12. Double dissociation between representational personal and extrapersonal neglect.BACKGROUND: Although perceptual and representational neglect are frequently associated, the demonstration of a double dissociation between both neglect forms suggests that both rely on different central mechanisms. In addition, perceptual neglect can be selectively observed within personal space or extrapersonal space. However, it is not known whether the latter dissociation also exists in representational neglect. methods: The authors investigated this question in two brain-damaged patients with anatomically different lesions sites, using neuropsychological tests specifically designed to assess perceptual and representational neglect in both personal and extrapersonal space. RESULTS: patients presented a double dissociation with respect to personal and extrapersonal space in representational neglect. CONCLUSIONS: These data suggest that the cerebral networks that process mental space representation use similar principles of space compartmentalization as those used by cerebral networks processing perceived space.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
6/12. Non-visualization of the internal carotid artery with a normal ipsilateral common carotid artery Doppler waveform: a finding suggesting congenital absence of the ICA on colour Doppler ultrasound.We report a case of congenital absence of the left internal carotid artery (ICA) that presented with left-sided facial numbness. On MRI of the brain, occlusion of the left cavernous ICA was suggested. On colour Doppler ultrasound (CDS), the left ICA was not visualized and the ipsilateral common carotid artery (CCA) showed normal flow in systole and diastole. Combined with the correct identification of the left external carotid artery (ECA), these findings were suggestive of congenital absence of the ICA rather than occlusion. The final diagnosis of congenital absence of the ICA was confirmed with CT of the skull base.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
7/12. Cheiro-oral syndrome with bilateral oral involvement: a study of pontine lesions by high-resolution magnetic resonance imaging.Two cases of unusual cheiro-oral syndrome due to small pontine haemorrhage are described, in which both sides of the mouth were involved in the initial stage. High resolution magnetic resonance imaging revealed a small lesion at the paramedian pontine tegmentum in both cases and suggested involvement of the medial portion of the medial lemniscus.- - - - - - - - - - ranking = 8518.7808357954keywords = pontine haemorrhage, haemorrhage (Clic here for more details about this article) |
8/12. Unilateral thermal anaesthesia.A patient is described who had a deep parieto-temporal haemorrhage. Following resolution, the patient exhibited contralateral hemi-anaesthesia limited to the temperature sense. The possible mechanisms are discussed.- - - - - - - - - - ranking = 16.310299020536keywords = haemorrhage (Clic here for more details about this article) |
9/12. The human thalamocortical sensory path in the internal capsule: evidence from a small capsular hemorrhage causing a pure sensory stroke.A patient is presented who suffered a strokelike event during life that resulted in a hemisensory dificit for some modalities. On pathological examination of the brain, the lesion responsible for the deficit was found to be a small slit hemorrhage located in the posterior limb of the internal capsule adjacent to and minimally involving the thalamus. Clinicopathological correlation suggests that the sensory thalamocortical radiations must lie farther posterior in the posterior limb of the internal capsule than the corticospinal motor fibers, and that they probably lie adjacent to the thalamus. The case emphasizes that small slit hemorrhages deep in the brain, although rare, must be considered in the differential diagnosis of sudden hemisensory deficits.- - - - - - - - - - ranking = 2keywords = brain (Clic here for more details about this article) |
10/12. Cheiro-oral-pedal syndrome in the lesion of thalamocortical projections.Unilateral sensory disturbance in the hand and mouth (cheiro-oral syndrome) is well known, but one in the hand, mouth and foot region (cheiro-oral-pedal syndrome) has been reported only in 2 patients with brainstem lesion and in 2 patients with thalamic infarction. We report the first case of cheiro-oral-pedal syndrome due to involvement of thalamocortical projections, which favors somatotopy in thalamocortical projections.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
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