1/48. Treatment of a vancomycin-resistant enterococcus faecium ventricular drain infection with quinupristin/dalfopristin and review of the literature.central nervous system infections involving vancomycin-resistant enterococcus faecium (VREF) are infrequently described and pose significant therapeutic difficulties, because these organisms are intrinsically resistant to many antibiotics. We describe the use of intrathecal quinupristin/dalfopristin to treat a VREF-associated infection in a neuro--surgical patient.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
2/48. Central nervous system superficial siderosis, headache, and epilepsy.Almost 95 cases of superficial siderosis of the central nervous system have been reported in the literature. These patients showed a clinical syndrome characterized by ataxia, deafness, pyramidal system involvement, and mental deterioration with xanthochromic cerebrospinal fluid and neuroradiological findings of hemosiderin deposits. About 30% of the patients had headache as an accompanying symptom. In the present case report, we describe a 33-year-old man with the typical clinical features of superficial siderosis, who complained, since aged 8, of a severe recurrent frontal headache often associated with loss of consciousness occurring after at least 2 hours of pain. The MRI and CSF findings were consistent with subarachnoid bleeding. In our patient, headache due to meningeal irritation by subarachnoid blood induced seizures as a probable reflex of extreme pain. carbamazepine and nimodipine prophylaxis dramatically reduced the frequency of headaches and seizures.- - - - - - - - - - ranking = 8.2986944590574keywords = central nervous system, nervous system (Clic here for more details about this article) |
3/48. Observations on the electrocardiographic changes associated with subarachnoid hemorrhage with special reference to their genesis.A 36 year old man presented with bizarre behavior and had abnormal electrocardiograms on two occasions. Because of ST-T wave changes, he was treated both times for a possible subendocardial infarction. A more complete evaluation during the second admission revealed a basilar artery aneurysm with subarachnoid hemorrhage as the cause of the central nervous system symptoms. While the aneurysm was successfully clipped, the patient's electrocardiogram was recorded. Several electrocardiographic changes characteristic of intracranial disease were observed during the procedure. These changes developed with distortion of the circle of willis and reverted when such distortion stopped. We review the spectrum of the electrocardiographic changes associated with intracranial disease. This list of abnormalities was compiled from observations obtained by the impatient tracings of persons with various central nervous system pathology. The mechanisms used to explain the changes are based solely on work performed on laboratory animals. The results of our findings in our patient link electrocardiographic abnormalities directly with a central nervous system lesion.- - - - - - - - - - ranking = 12.896083377172keywords = central nervous system, nervous system (Clic here for more details about this article) |
4/48. churg-strauss syndrome presenting as spontaneous subarachnoid haemorrhage.churg-strauss syndrome (CSS) is a systemic small-vessel vasculitis characterised by the presence of asthma and eosinophilia. Central nervous system involvement (cerebral infarctions or intracerebral haemorrhage) is rare in CSS. Spontaneous subarachnoid hemorrhage (SAH) has been described in other systemic vasculitides. SAH is exceptional in CSS. We present a 47-year-old woman with CSS presenting as a spontaneous SAH with cerebral angiography findings consistent with vasculitis of the basilar artery and without aneurysms or arteriovenous malformations. She received treatment with prednisone and cyclophosphamide, and 2 months later the basilar artery was normal on magnetic resonance angiography.- - - - - - - - - - ranking = 1keywords = nervous system (Clic here for more details about this article) |
5/48. Superficial siderosis of the central nervous system: pathogenetic heterogeneity and therapeutic approaches.OBJECTIVE: Superficial siderosis of the central nervous system (CNS) is a rare chronic progressive disorder caused by chronic subarachnoid hemorrhage. We present four patients with superficial siderosis of the CNS to describe the characteristic symptoms, and to discuss the pathogenetic heterogeneity and possible new therapeutic approaches. RESULTS: The causes of chronic subarachnoid bleeding in superficial siderosis were different. In two patients surgical treatment of ependymoma or cerebral cavernomas were the underlying diseases. No cause was detected in one patient. For the first time, we present one patient with vasculitis of the central nervous system associated with systemic hemochromatosis in superficial siderosis. Therapeutic approaches included exstirpation of cavernomas as the source of chronic bleeding in one patient, immunosuppressive therapy and venupunctures in the patient with vasculitis and hemochromatosis, and symptomatic treatment with chelating agents and antioxidants. The patients remained clinically stable for the follow-up period of up to 2 years. CONCLUSIONS: Our cases underline the pathogenetic heterogeneity of superficial siderosis and favor the early diagnosis for prompt initiation of therapy. Besides treatment of the underlying condition, antioxidants and radical scavengers may be effective in halting the progression of the disease.- - - - - - - - - - ranking = 25.792166754345keywords = central nervous system, nervous system (Clic here for more details about this article) |
6/48. Superficial siderosis of the meninges and its otolaryngologic connection: a series of five patients.OBJECTIVE: To study the otolaryngologic disorders in patients with superficial siderosis of the meninges. BACKGROUND: Superficial siderosis of the central nervous system is a rare disorder characterized by progressive bilateral hearing loss and ataxia caused by recurrent bleeding into the subarachnoid space. The cerebellum, eighth cranial nerve, and olfactory nerve are particularly susceptible to the deposition of hemosiderin, which is responsible for the symptoms. The diagnosis is confirmed by magnetic resonance imaging. methods: The clinical notes of five patients with superficial siderosis of the meninges were reviewed with the intent of reporting the otolaryngologic symptoms and signs, the clinical investigations, and treatments. RESULTS: Four of the five patients had sensorineural deafness, two had smell disturbances, and three had gait abnormalities. magnetic resonance imaging was the most important investigation used to identify the condition. CONCLUSIONS: Superficial siderosis of the meninges is an important differential diagnosis in patients with progressive sensorineural deafness.- - - - - - - - - - ranking = 4.2986944590574keywords = central nervous system, nervous system (Clic here for more details about this article) |
7/48. Superficial siderosis of the central nervous system many years after neurosurgical procedures.Recurrent haemorrhage into the subarachnoid space causes superficial siderosis, which clinically manifests as cerebellar ataxia, sensorineural hearing loss, and myelopathy. Two patients developed clinical, radiological, and biochemical evidence of superficial siderosis many years after surgery. One had two posterior fossa operations, a left temporal craniectomy, and radiotherapy for a presumed brain tumour before developing clinical evidence of superficial sidersosis 37 years later. The other had small bilateral subdural collections from recurrent shunt revisions following posterior fossa surgery for a Chiari malformation, and then developed deafness and ataxia. The first patient currently has the longest recorded delay between presumed subarachnoid bleeding and clinical manifestations of superficial siderosis. Both patients provide further evidence that superficial siderosis of the central nervous system, a progressive neurodegenerative vascular condition, may be a delayed complication of neurosurgical procedures.- - - - - - - - - - ranking = 21.493472295287keywords = central nervous system, nervous system (Clic here for more details about this article) |
8/48. Longitudinal analysis of hearing loss in a case of hemosiderosis of the central nervous system.OBJECTIVE: To describe cochleovestibular aspects of superficial hemosiderosis of the central nervous system. BACKGROUND: Superficial hemosiderosis of the central nervous system is a rare disease in which cochleovestibular impairment, cerebellar ataxia, and myelopathy are the most frequent signs. Chronic recurrent subarachnoidal hemorrhage with bleeding into the cerebrospinal fluid is the cause of deposition of hemosiderin in leptomeningeal and subpial tissue, cranial nerves, and spinal cord. Removing the cause of bleeding can prevent irreversible damage to these structures. Because this is the only effective treatment, an early diagnosis is crucial. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENT: A 72-year-old woman with superficial hemosiderosis of the central nervous system that developed when she was age 39. methods: Neurologic and imaging diagnostic examinations and longitudinal evaluation of cochleovestibular features were performed. neurosurgery was not performed. RESULTS: Progressive bilateral sensorineural hearing loss and severe vestibular hyporeflexia developed within 15 years, which can be attributed to lesions in the cochleovestibular system. Additional pathology of the central nervous system developed later. CONCLUSION: The patient demonstrated cochlear and vestibular findings that are typical of this pathologic condition. It is the first documented case with extensive serial audiometry used to precisely outline the degree of hearing deterioration during the course of the disease.- - - - - - - - - - ranking = 31.090861213402keywords = central nervous system, nervous system (Clic here for more details about this article) |
9/48. Delayed central nervous system superficial siderosis following brachial plexus avulsion injury. Report of three cases.Chronic subarachnoid hemorrhage may cause deposition of hemosiderin on the leptomeninges and subpial layers of the neuraxis, leading to superficial siderosis (SS). The symptoms and signs of SS are progressive and fatal. Exploration of potential sites responsible for intrathecal bleeding and subsequent hemosiderin deposition may prevent disease progression. A source of hemorrhage including dural pathological entities, tumors, and vascular lesions has been previously identified in as many as 50% of patients with SS. In this report, the authors present three patients in whom central nervous system SS developed decades after brachial plexus avulsion injury. They believe that the traumatic dural diverticula in these cases may be a potential source of bleeding. A better understanding of the pathophysiology of SS is important to develop more suitable therapies.- - - - - - - - - - ranking = 21.493472295287keywords = central nervous system, nervous system (Clic here for more details about this article) |
10/48. Angiodysgenetic necrotising encephalopathy: presentation as an intrauterine death.The various morphological manifestations of intracranial vascular anomalies include the rare diffuse meningo-cerebral angiomatosis, sometimes termed "angiodysgenetic necrotising encephalopathy" on account of the severe associated hypoxic damage to the cerebral cortex and white matter. It may occur in any age group and displays both sporadic and familial forms. A further case is reported which is apparently unique in presenting as an intrauterine death with extensive subarachnoid haemorrhage. Associated pathological abnormalities of the adrenal glands indicate that cerebral damage may have commenced from as early as the 20th week of pregnancy. Possible relationships of this entity to other central nervous system vascular malformations are discussed.- - - - - - - - - - ranking = 4.2986944590574keywords = central nervous system, nervous system (Clic here for more details about this article) |
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