1/124. Anterior lumbosacral radiculopathy after intrathecal methotrexate treatment.Intrathecal chemotherapy with methotrexate or cytosine arabinoside is the standard approach to prophylaxis and treatment of central nervous system leukemia in children. Progressive paraplegia, one of the devastating neurologic complications related to this mode of treatment, has been attributed to spinal cord toxicity. Reported are three children who developed progressive paraparesis after intrathecal methotrexate administration followed by complete or partial recovery. gadolinium enhancement of anterior lumbosacral spinal nerve roots was demonstrated in all three patients, and an elevation of cerebrospinal fluid immunoglobulin g synthesis was evident in two patients with more severe symptoms. The clinical data suggest that anterior lumbosacral radiculopathy is also a type of neurologic complication associated with intrathecal methotrexate treatment.- - - - - - - - - - ranking = 1keywords = stem (Clic here for more details about this article) |
2/124. Pure motor monoparesis of a lower limb due to a small infarction in the contralateral motor cortex.Pure motor monoparesis (PMM) is a rare condition characterized by weakness limited to one limb without sensory disturbance. We report a 42-year-old woman with PMM of the right lower limb caused by a small infarction in the contralateral motor cortex that could be detected by the magnetic resonance imaging of the brain. This case suggests that small lesions, missed by carelessly performed scans, could be a potential cause of PMM. This is especially true in the case of lower limb PMM, because the lesion may be located in the top of the frontal lobe cortex, an area that can be easily missed by routine scans. Therefore, we should pay careful attention to the opposite side of the motor cortex in examining neuroimages of PMM cases.- - - - - - - - - - ranking = 118.67685404411keywords = brain (Clic here for more details about this article) |
3/124. Sequestrum-like appearance of a multiple sclerosis brain lesion on serial magnetic resonance images.Using serial magnetic resonance imaging, we monitored an unique lesion of the brain in a 15-year-old girl with clinically definite and laboratory-supported remitting-relapsing multiple sclerosis. During initial phases of the disease course, cystic necrosis around the plaque was observed. Later, remyelination of the central core of the lesion was speculated, as similarities in signal intensity between the core and the normal appearing white matter were partially recovered both on the T1- and the T2-weighted images.- - - - - - - - - - ranking = 593.38427022053keywords = brain (Clic here for more details about this article) |
4/124. Parietal and cingulate processes in central pain. A combined positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) study of an unusual case.Parietal, insular and anterior cingulate cortices are involved in the processing of noxious inputs and genesis of pain sensation. Parietal lesions may generate central pain by mechanisms generally assumed to involve the 'medial' pain system (i.e. medial thalamic nuclei and anterior cingulate cortex (ACC)). We report here PET and fMRI data in a patient who developed central pain and allodynia in her left side after a bifocal infarct involving both the right parietal cortex (SI and SII) and the right ACC (Brodmann areas 24 and 32), thus questioning the schematic representation of cortical pain processing. No rCBF increase was found in any part of the residual cingulate cortices, neither in the basal state (which included spontaneous pain and extended hypoperfusion around the infarct), nor during left allodynic pain. Thus, as previously observed in patients with lateral medullary infarct, neither spontaneous pain nor allodynia reproduce the cingulate activation observed after noxious pain in normal subjects. Conversely, both PET and fMRI data argue in favour of plastic changes in the 'lateral discriminative' pain system. Particularly, allodynia was associated with increased activity anteriorly to the infarct in the right insula/SII cortex. This response is likely to be responsible for the strange and very unpleasant allodynic sensation elicited on the left side by a non-noxious stimulation.- - - - - - - - - - ranking = 2keywords = stem (Clic here for more details about this article) |
5/124. sagittal sinus thrombosis associated with transient free protein s deficiency after L-asparaginase treatment: case report and review of the literature.Cerebral sinus thrombosis associated with acquired free protein s deficiency is very rare. We report the case of an adult patient with acute lymphoblastic leukemia who presented with repeated transient ischemic attacks followed by a seizure during consolidation treatment with L-asparaginase. Magnetic resonance of the brain showed a small cortical hemorrhagic infarct. Superior sagittal sinus thrombosis was demonstrated by cerebral angiogram. A marked decrease of the free form of protein S was documented. One month later, when the patient was free of symptoms, the follow-up free protein S antigen level was restored to the normal range. We suggest that the sagittal sinus thrombosis in this patient was caused by acquired, transient free protein s deficiency. This case also extends the clinical spectrum of cerebral sinus thrombosis to include recurrent transient ischemic attacks alternating with seizures.- - - - - - - - - - ranking = 118.67685404411keywords = brain (Clic here for more details about this article) |
6/124. Primary CNS lymphoma associated with streptococcal abscess: an autopsy case.This report describes a case of streptococcal abscess in the nodules of a primary central nervous system (CNS) lymphoma. magnetic resonance imaging (MRI) of the brain revealed multiple lesions with ringlike enhancement over the bilateral frontal, right temporal, and left parietal lobes. On admission, acute brain edema occurred following angiography, which resulted in respiratory arrest. autopsy findings showed that the ringlike enhanced lesions on MRI were streptococcal abscesses localized in the lymphoma nodules. The lymphoma was classified as non-Hodgkin, diffuse large cells of B-cell lineage. No other lymphoma mass was found extracranially. An immunohistochemical study showed that the lymphoma cells were positive for leukocyte common antigen, Epstein-Barr virus, bax. and bcl-XL, and negative for L-26 and bcl-2. This case demonstrated that an opportunistic streptococcal abscess developed in primary CNS lymphoma in a patient without acquired immunodeficiency syndrome (AIDS), though a few similar cases have been reported in patients with AIDS.- - - - - - - - - - ranking = 238.35370808821keywords = brain, stem (Clic here for more details about this article) |
7/124. Toxoplasmic encephalitis in patients with acquired immunodeficiency syndrome--four case reports.Four patients, all males aged 40-64 years, presented with toxoplasmic encephalitis associated with human immunodeficiency virus (hiv) infection manifesting as nonspecific neurological deficits such as epilepsy or hemiparesis. magnetic resonance imaging showed single or multiple lesions with ring enhancement, mimicking metastatic brain tumor or brain abscess. Marked eosinophilia was noted in three patients. Two patients who received anti-toxoplasma chemotherapy in the early stage had a good outcome. However, the other two patients suffered rapid neurological deterioration and needed decompressive surgery, resulting in a poor outcome. toxoplasma diffusely infects the whole central nervous system from the early stage. The outcome for patients who needed emergency surgery was poor. Therefore, this rare but increasingly common infectious disease must be considered in the differential diagnosis of a patient with neuroimaging findings similar to those of metastatic tumor or brain abscess. Appropriate chemotherapy should be started immediately after hiv-positive reaction is identified in patients with single or multiple mass lesions with ring enhancement.- - - - - - - - - - ranking = 357.03056213232keywords = brain, stem (Clic here for more details about this article) |
8/124. Familial occurrence of cerebral arteriovenous malformation in sisters: case report and review of the literature.Cerebral arteriovenous malformations (AVMs) are considered to be congenital disorders. However, their familial occurrence has so far been described in only 19 families in the literature. The authors report on two cases in one family and review the literature. A 45-year-old female subject with sudden onset of headache and vomiting due to a subarachnoid haemorrhage from a small AVM in the posterior part of the corpus callosum near the midline on the left side was studied. Irradiation of the AVM using Leksell's gamma knife led to its complete obliteration. Her older sister presented with temporal seizures at the age of 49 and later also with left hemiparesis, left hemihypaesthesia and dizziness - caused by a large AVM in the right temporal lobe. This AVM was treated by a combination of embolization and irradiation by the Leksell's gamma knife.- - - - - - - - - - ranking = 1768.1619375317keywords = haemorrhage (Clic here for more details about this article) |
9/124. Blue rubber bleb nevus syndrome with central nervous system involvement.An 11-month-old female patient presented with focal seizures. She was born at term with multiple scattered tiny protuberances and dark purple soft compressible nevi over her entire body. She had clumsiness and decreased muscle power in her left extremities. magnetic resonance imaging and magnetic resonance angiography revealed cerebral atrophy of the right central area around the anomalous venous sinus and multiple small enhancing lesions throughout the brain with gadolinium-diethylenetriamine pentaacetic acid enhancement. Despite right partial neonatal seizures, she had no further seizures for 3 years while receiving carbamazepine, and no change was observed in the number and size of the nevi. At last evaluation, language and psychomotor development were normal for her age.- - - - - - - - - - ranking = 122.67685404411keywords = brain, stem (Clic here for more details about this article) |
10/124. Hypoperfusion of right hemisphere on brain SPECT in a patient with exanthem subitum and left hemiparesis.Left hemiparesis exhibited during the post-eruptive stage of exanthem subitum (ES) in an 11-month-old girl. Tc-99m HMPAO brain SPECT showed diffuse hypoperfusion in right hemisphere. Hemiparesis has occasionally been reported as central nervous system (CNS) complications of ES, and Tc-99m HMPAO brain SPECT was useful for evaluating of CNS involvement.- - - - - - - - - - ranking = 713.06112426464keywords = brain, stem (Clic here for more details about this article) |
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