Cases reported "Cerebral Hemorrhage"

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1/169. Intracerebral hemorrhage caused by cerebral amyloid angiopathy: a case report.

    cerebral amyloid angiopathy (CAA) accounts for approximately 10% of spontaneous intracerebral hemorrhages (ICH), and typically occurs in the cortex and subcortical white matter. It is characterized by the deposition of amyloid fibrils in the leptomeningeal, cortical and subcortical arteries. Pathologically, amyloid is stained pink with congo red and shows yellow-green birefringence when viewed under polarized light. Although there have been many reports of CAA in the literature, it has rarely been described in taiwan. This is the report of a case of a 75-year-old man with ICH caused by CAA. The postoperative course was uneventful. The incidence of this disease increases with age. The authors, therefore, suggest conducting a brain biopsy and special stain for CAA in each operative case of spontaneous ICH, especially in the elderly.
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2/169. cleidocranial dysplasia with neonatal death due to central nervous system injury in utero: case report and literature review.

    cleidocranial dysplasia (CCD), an uncommon disorder involving membranous bones, is rarely lethal in early life. The calvaria is defective and wormian bones are present. Abnormalities of the clavicles vary in severity from a minor unilateral defect to bilateral absence. This report concerns pre- and postmortem anatomical and radiological findings in a 15-day-old female neonate with CCD. Her postnatal course was characterized by seizures and recognition of hydrocephalus during the first day of life. The calvaria was hypoplastic with numerous wormian bones. A pseudofracture of the right clavicle was present. hydrocephalus was present in the brachycephalic brain which had a severely thinned cerebral cortex. hemosiderin in the ventricular lining and marked subependymal gliosis were interpreted as evidence of old intraventricular hemorrhage that had occurred in utero. A CCD-related condition, Yunis-Varon syndrome (YVS), is noted for early lethality and for developmental and secondary abnormalities of the central nervous system. The present case only partially matches the phenotype of YVS and might represent a part of a spectrum of phenotypic variants ranging from viable CCD to lethal YVS.
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3/169. Transcortical sensory aphasia due to a left frontal subcortical haemorrhage.

    A case of transcortical sensory aphasia caused by a cerebral haemorrhage in the left frontal lobe is presented. A 72-year-old right-handed woman was admitted to the hospital, with a history of acute onset of speech disturbance and headache. On initial assessment, her spontaneous speech was fluent. She had no difficulty initiating speech, articulated normally, and did not exhibit logorrhea. Her ability to repeat phonemes and short sentences (5-6 words) was fully preserved, however she had severe difficulty with visual recognition of words, and with aural comprehension at the word level, although she was able to read words aloud. Computed tomography and magnetic resonance imaging showed cerebral haemorrhage in the left frontal lobe, involving the superior and middle frontal gyrus. Single photon emission CT revealed a wider area of low perfusion over the entire left frontal lobe, including the superior, middle and inferior frontal gyrus. The aphasia symptoms, mainly poor comprehension, disappeared quickly several weeks after the event. This may have been due to a reduction in the size of the haematoma and a resolution of the oedema around the haematoma. Clinically, the transcortical sensory aphasia in this case was indistinguishable from that caused by damage to the posterior language areas. Further case reports of transcortical sensory aphasia associated with frontal lobe lesions would help to confirm whether a relatively rapid recovery is characteristic in cases such as this.
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ranking = 0.19015813358284
keywords = visual
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4/169. brain imaging in a patient with hemimicropsia.

    Hemimicropsia is an isolated misperception of the size of objects in one hemifield (objects appear smaller) which is, as a phenomenon of central origin, very infrequently reported in literature. We present a case of hemimicropsia as a selective deficit of size and distance perception in the left hemifield without hemianopsia caused by a cavernous angioma with hemorrhage in the right occipitotemporal area. The symptom occurred only intermittently and was considered the consequence of a local irritation by the hemorrhage. Imaging data including a volume-rendering MR data set of the patient's brain were transformed to the 3-D stereotactic grid system by Talairach and warped to a novel digital 3-D brain atlas. Imaging analysis included functional MRI (fMRI) to analyse the patient's visual cortex areas (mainly V5) in relation to the localization of the hemangioma to establish physiological landmarks with respect to visual stimulation. The lesion was localized in the peripheral visual association cortex, Brodmann area (BA) 19, adjacent to BA 37, both of which are part of the occipitotemporal visual pathway. Additional psychophysical measurements revealed an elevated threshold for perceiving coherent motion, which we relate to a partial loss of function in V5, a region adjacent to the cavernoma. In our study, we localized for the first time a cerebral lesion causing micropsia by digital mapping in Talairach space using a 3-D brain atlas and topologically related it to fMRI data for visual motion. The localization of the brain lesion affecting BA 19 and the occipitotemporal visual pathway is discussed with respect to experimental and case report findings about the neural basis of object size perception.
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ranking = 3.1409488014971
keywords = cortex, visual
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5/169. Chiasmal apoplexy due to hemorrhage from a pituitary adenoma into the optic chiasm: case report.

    OBJECTIVE AND IMPORTANCE: Chiasmal apoplexy, defined as hemorrhage into the optic chiasm, generally is caused by an intrachiasmal vascular malformation. We report the first case of chiasmal apoplexy due to hemorrhage from a pituitary macroadenoma into the optic chiasm. CLINICAL PRESENTATION: A 52-year-old man presented with headache, sudden and severe deterioration of visual acuity in the left eye, and a bitemporal visual field deficit. magnetic resonance imaging revealed a large intra- and suprasellar homogeneously enhancing mass, which elevated a markedly thickened optic chiasm. After emergent transsphenoidal resection of the pituitary adenoma, vision did not improve. INTERVENTION: A pterional craniotomy was subsequently performed, during which a hematoma was found and evacuated from within the substance of the left optic nerve and chiasm. The hematoma cavity was found to communicate with the sella through a defect in the diaphragm. Vision improved dramatically after the operation. CONCLUSION: Chiasmal apoplexy resulting from pituitary adenoma should be distinguished from pituitary apoplexy, particularly because it requires a different surgical treatment. Clinical and radiographic features that may help distinguish the two are discussed.
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ranking = 0.38031626716569
keywords = visual
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6/169. Interhemispheric transfer of visual motion information after a posterior callosal lesion: a neuropsychological and fMRI study.

    Interhemispheric transfer of visual information was investigated behaviourally and with functional magnetic resonance imaging (fMRI) 6 months after a lesion of the posterior two-thirds of the corpus callosum. On tachistoscopical left hemifield presentation, the patient was severely impaired in reading letters, words and geographical names and moderately impaired in naming pictures and colours. In contrast, interhemispheric transfer of visual motion information, tested by verbal report of the direction of short sequences of coherent dot motion presented within the left hemifield, was preserved. The pattern of cerebral activation elicited by apparent motion stimuli was studied with fMRI and compared to that of normal subjects. In normal subjects, apparent motion stimuli, as compared to darkness, activated strongly striate and extrastriate cortex. When presented to one hemifield only, the contralateral calcarine region was activated while regions on the occipital convexity, including putative area V5, were activated bilaterally. A similar activation pattern was found in the patient with a posterior callosal lesion; unilateral left or right hemifield stimulation was accompanied by activation in the contralateral and ipsilateral occipital convexity. Ipsilateral hemifield representation in the extrastriate visual cortex is believed to depend on callosal input. Our observation suggests that this is not the case for visual motion representation and that other, probably parallel, pathways may mediate visual motion transfer after posterior callosotomy.
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ranking = 3.7114232022456
keywords = cortex, visual
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7/169. A transparent sheath for endoscopic surgery and its application in surgical evacuation of spontaneous intracerebral hematomas. Technical note.

    The authors advocate the use of a transparent sheath for guiding an endoscope, a simple and unique tool for endoscopic surgery, and describe preliminary results of its application in the evacuation of hypertensive intracerebral hematomas. This sheath is a 10-cm-long tube made of clear acrylic plastic, which greatly improves visualization of the surgical field through a 2.7-mm nonangled endoscope inserted within. Between April 1997 and December 1998, the authors performed endoscopic evacuation of intracerebral hematomas by using this sheath inserted into the patients' heads through a burr hole. In nine consecutive cases in which the hematoma was larger than 40 ml in volume, nearly complete evacuation (86-100%) of the lesion was achieved without complication. Excellent visualization of the border between the brain parenchyma and the hematoma facilitated accurate intraoperative orientation, and also allowed easy identification of the bleeding point. Thus, this combination of sheath and endoscope achieves both minimal invasiveness and the maximum extent of hematoma removal with secure hemostasis. This tool will reduce the inherent disadvantage of endoscopic procedures and may expand their application in other areas of neurosurgical management.
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ranking = 0.38031626716569
keywords = visual
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8/169. facial pain as a presenting feature of intracerebral haemorrhage.

    A literature review from 1966 using medline with keywords 'cerebral haemorrhage' and 'facial pain' failed to reveal any cases in which facial pain was the initial feature of intracranial haemorrhage. The following case describes ipsilateral facial pain which is previously undescribed as a presentation of intracranial bleeding. A 53 year old female who was previously well, with no significant history of headache, developed right facial pain from the orbit to the maxilla. Ten to 15 min later she developed nausea and vomiting with unsteadiness and confusion. She had difficulty with left-hand fine finger movements, with normal sensation and reflexes but an extensor plantar response on the left. facial pain persisted for 3 days. Initial imaging revealed a 4 x 3 cm right temporal lobe haemorrhage with mass effect and oedema extending into the subarachnoid space. Angiogram revealed a right temporal lobe arteriovenous malformation. The basis of the pain remains speculative but includes sensation from the torn vessel wall being referred to the face and subarachnoid blood irritation of the meninges in the middle cranial fossa. Another possibility is irritation of somatosensory cortex II, but why this should result in only ipsilateral pain is unclear. facial pain should be an alerting symptom to the neurologist when it appears with no apparent cause.
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9/169. Terson syndrome caused by ventricular hemorrhage associated with moyamoya disease--case report.

    A 24-year-old female presented with Terson syndrome secondary to bilateral ventricular hemorrhage as a complication of moyamoya disease. ophthalmoscopy and magnetic resonance imaging clearly demonstrated vitreous hemorrhage in the left eye globe. Various visual symptoms are associated with moyamoya disease, almost all of which result from ischemic lesions in the visual cortex and optic pathways. In this case, the visual disturbance was caused by Terson syndrome secondary to ventricular hemorrhage. Close ophthalmological and radiological evaluation is mandatory even in patients with moyamoya disease and hemorrhagic manifestation located in the intracerebral, subarachnoid, or intraventricular space.
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ranking = 1.5704744007485
keywords = cortex, visual
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10/169. Unusual CT and MRI appearance of carbon monoxide poisoning.

    Unilateral low attenuation areas within the right putamen, globus pallidus and thalamus were observed on CT in a patient after exposure to carbon monoxide. A transient bilateral appearance was found on subsequent CT examinations. Hemorrhagic infarction of the right putamen, and ischemic lesions in both thalami were visualized on MRI 2 weeks later.
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ranking = 0.19015813358284
keywords = visual
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