1/7. dialysis disequilibrium: another reversible posterior leukoencephalopathy syndrome?dialysis disequilibrium syndrome is a disorder of the central nervous system in patients on dialysis. The underlying etiology is thought to be primarily due to cerebral edema; however, neuroradiologic findings have not been described previously. We describe a patient who presented with new onset headaches and status epilepticus after beginning hemodialysis. Her neuroimaging studies revealed white matter changes in the posterior parietal and occipital lobes similar to those seen in patients with reversible posterior leukoencephalopathy syndrome (RPLS). This case suggests that dialysis disequilibrium syndrome and RPLS may represent a spectrum of disorders in which the underlying mechanism is vasogenic edema.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
2/7. poisoning due to white seed variety of abrus precatorius.We report an unusual case of poisoning involving the white seed variety of abrus precatorius that caused serious manifestations in a middle-aged male who had consumed the seeds on the advice of a folk medicine practitioner. He recovered after a prolonged duration of hospital treatment without any subsequent complications or sequelae. The case is being reported on account of its rarity.- - - - - - - - - - ranking = 5keywords = white (Clic here for more details about this article) |
3/7. Positional nystagmus of central origin.Audiometric, electrophysiologic, and radiographic findings for a 68-year-old male with an "imbalance" concern are presented. This paper has a two-fold purpose: (1) to present an unusual electronystagmography case study and (2) to highlight the importance of test conditions in lesion localization. The specific disease pathophysiology remains obscure. Repeated hearing tests documented a known hearing impairment with worsening word-recognition ability of the right ear. An initial electronystagmographic exam was normal except for a mild ageotropic direction-changing positional nystagmus with eyes open and fixed. No repeatable click-evoked auditory brainstem response waveforms could be collected. A magnetic resonance imaging of the brain documents diffuse ischemic white matter disease. A repeated vestibular examination some months later supports the initial findings. The case illustrates the importance of following diagnostic protocol, of repeated measures, and of using both a visual fixation and a nonfixation condition for select electronystagmographic subtests.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
4/7. White matter lesions and disequilibrium in older people. II. Clinicopathologic correlation.OBJECTIVE: To identify the cause of subcortical white matter lesions seen on magnetic resonance imaging in older patients with progressive deterioration of gait and balance. DESIGN: Postmortem examination of three patients with objective impairment of gait and balance thought to be due to subcortical white matter lesions identified on magnetic resonance imaging. Brain sections were stained with routine methods and for glial fibrillary acid protein using an immunoperoxidase technique. patients: Part of a prospective study of gait and balance problems in older people. None had a history of hypertension or discrete strokelike episodes. RESULTS: Other than a few small infarcts in the basal ganglia and internal capsule in the patient with the mildest gait disorder, there were no gross or microscopic features on routine examination post mortem to explain the white matter hyperintensities on magnetic resonance imaging or the progressive gait deterioration. By contrast, immunohistochemical staining with anti-glial fibrillary acid protein showed prominent astrocytosis T2-weighted high-intensity signal areas on magnetic resonance imaging. CONCLUSIONS: The astrocytes presumably swell as they take up extravasated protein at the site of a breakdown in the blood-brain barrier, and the increased water content per unit volume increases the magnetic resonance imaging proton signal. We hypothesized that the astrocytes may have been initially activated by small infarcts or subclinical ischemia, but the process then became self-perpetuating, ultimately involving most of the white matter and producing the severe gait disorder.- - - - - - - - - - ranking = 4keywords = white (Clic here for more details about this article) |
5/7. Thoracic myelopathy due to compression by the epidural tophus: a case report.A 60-year-old man with a 5-year history of gout underwent laminectomy for thoracic myelopathy. At operation, white chalky material in the epidural space was found to compress the spinal cord. Laboratory and histologic studies suggested that his myelopathy was caused by a gouty tophus.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
6/7. Distinctive serial magnetic resonance changes in a young woman with rapidly evolved neurocysticercosis, with positron emission tomography results.A woman aged 21 years noticed numbness of the left hand, dysarthria, and right hemiparesis. magnetic resonance imaging (MRI) showed homogeneously enhanced lesions in the bilateral cerebral white matter; these enlarged within 2 weeks, showing ring-like enhancement, and then spontaneously decreased in size and enhancement. neurocysticercosis was confirmed by repeated, significantly positive serology results and the dramatic response to praziquantel. Subsequently, positron emission tomography (PET) revealed persisting regions of possibly decreased cerebral uptake of [18F]2-fluoro-2-deoxyglucose. This is the first documentation of such distinctive serial MRI changes and the results of PET in neurocysticercosis.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
7/7. Effect of shoe color on shoe temperature and potential solar injury to the insensate foot.The authors compared shoes of different colors in terms of the amount by which their temperature increased when subjected to radiant heat. Three trials of temperature measurements were performed for white and black leather walking shoes. A balloon filled with water was placed in the shoe and the surface temperature of the balloon was measured at baseline and after the shoe had been exposed to an infrared heat lamp for 15- and 30-minute periods. The results were significant: The mean increase in temperature after 15 minutes of exposure was between 4.0 degrees F and 8.8 degrees F greater in the black shoe than in the white shoe. After 30 minutes of exposure, the mean increase in temperature was between 7.8 degrees F and 13.6 degrees F greater in the black shoe than in the white shoe. This information can help prevent thermal injury to the insensate foot when shoes are worn in the sun for a prolonged period. Brief case reports of three patients who experienced such thermal injury are presented.- - - - - - - - - - ranking = 3keywords = white (Clic here for more details about this article) |