Blackmeredith7049
A 57-year-old man presented with palpitations and dizziness for one day. He reported a history of similar short-lasting, self-limiting episodes in the past. Evaluation showed a hemodynamically stable, ongoing monomorphic ventricular tachycardia (VT) with positive concordance in the precordial leads and inferior axis. A structurally normal heart was seen on echocardiography. The VT was cardioverted to normal sinus rhythm with a biphasic 100-J direct-conversion shock under mild sedation, only to spontaneously start over again. In view of the patient's structurally normal heart, a previous history of similar complaints in the past, and no obvious trigger including ischemia for VT, he subsequently underwent an electrophysiology study (EPS).
Hirayama's disease (HD) is characterized by an insidious onset asymmetric weakness and atrophy of the forearm and hand. Taking as a premise, the etiopathogenesis of the disease is attributed to forward displacement of posterior wall of lower cervical dural canal in neck flexion causing marked compression and flattening of lower spinal cord. This may result in compression of the posterior column of the spinal cord and seems likely to result in somatosensory evoked potentials (SSEPs) abnormalities. In the present study, we studied the possible involvement of the lemniscal dorsal pathway in patients with HD.
SSEPs in upper and lower extremities were prospectively performed in eight patients with HD. All the patients were recruited from the outpatient clinic of a neuromuscular disorder center from South Brazil. SSEPs were obtained by transcutaneous electrical stimulation of the median and posterior tibial nerves, on both sides. We collected the amplitude and the latency of the different components obtained in each channel. The interpretation was based on Brazilian study standards.
We evaluated seven men and one woman (mean age 27). The data obtained were compared to a control group consisting of eight patients with spondylotic cervical myelopathy, 6 men and 2 women with mean age of 59 years. The measurements of obtained by the SSEP were also compared between the groups and no significant difference was found for any of them.
SSEP did not turn out to be an electrophysiological marker in our HD patients.
SSEP did not turn out to be an electrophysiological marker in our HD patients.
Sarcoidosis is an idiopathic, granulomatous, and multi-system inflammatory disorder that can also involve the central nervous system in the form of meningeal, parenchymal, or cranial nerve involvement. Imaging findings can be non-specific and may overlap with other inflammatory, infectious and neoplastic processes, and posing diagnostic challenges. Parenchymal involvement in neurosarcoidosis (NS) predominantly manifests as either non-enhancing white matter lesions or as enhancing parenchymal granulomas. Granulomas usually manifest as multiple solid lesions with nodular enhancement.
A 72-year-old man presented with right-eye visual field changes with the non-contrast head computed tomography showing a large cystic lesion in the left frontoparietal lobe. Subsequent contrast-enhanced magnetic resonance imaging study revealed a large cystic mass with irregular rim enhancement and mural nodule concerning for glial neoplasm. Cyst decompression with biopsy and histopathological analysis revealed gliosis and prominent perivascular granulomatous inflammation with mixed picture of CD4 and CD8-positive cells suggestive of sarcoidosis. Further subsequent work-up showed mediastinal and cervical lymphadenopathy which on biopsy showed non-necrotizing granulomatous inflammation, consistent with sarcoidosis.
Herein, we report unique imaging findings of a NS case manifesting as a solitary cystic intraparenchymal lesion with an enhancing nodular component, mimicking primary intra-cranial tumor. This appearance is highly atypical and rarely been reported earlier.
Herein, we report unique imaging findings of a NS case manifesting as a solitary cystic intraparenchymal lesion with an enhancing nodular component, mimicking primary intra-cranial tumor. This appearance is highly atypical and rarely been reported earlier.
Metastatic epidural spinal cord compression (MESCC) is a debilitating sequela of cancer. Here, we evaluated various subtypes of posterior-only minimally invasive spinal (MIS) procedures utilized to address different cancers.
Within this retrospective review, we analyzed the treatment of thoracolumbar MESCC treated with three MIS techniques decompression and fusion (Subgroup A), partial corpectomy (Subgroup B), and full corpectomy (Subgroup C).
There were 51 patients included in the study; they averaged 58.7 years of age, and 51% were females. Most tumors were in the thoracic spine (51%). The average preoperative Frankel grade was D (62.7%); 69% (35) improved postoperatively. The patients were divided as follows subgroup A (15 patients = 29.4%), B (19 patients = 37.3%), and C (17 patients = 33.3%). The length of hospitalization was similar (~5.4 days) for all groups. The overall complication rate was 31%, while blood loss was lower in Subgroups A and B versus C.
Different MIS surgical techniques were utilized in patients with thoracic and/or lumbar MESCC. Interestingly, clinical outcomes were similar between MIS subgroups, in this study, with a trend toward higher complications and greater blood loss associated with those undergoing more aggressive MIS procedures (e.g., full corpectomy and fusion).
Different MIS surgical techniques were utilized in patients with thoracic and/or lumbar MESCC. Interestingly, clinical outcomes were similar between MIS subgroups, in this study, with a trend toward higher complications and greater blood loss associated with those undergoing more aggressive MIS procedures (e.g., full corpectomy and fusion).
Intracranial convexity lesions are poorly defined by recognizable anatomical landmarks. Tofacitinib in vivo Even in expert hands, exact localization of small subcortical lesion and its projection to the skull is sometimes unreliable and can cause potential surgical complications. In this report, a simple and handy technique for localizing superficial intracranial lesions on the scalp under computed tomography (CT)-scan guidance is described.
This technique, HeaDax, is based on using extracranial landmarks. We constructed an isosceles square triangle with three pieces of copper electrical wire and placed it on the skin scalp. Then, we took a CT-scan but without the need of the classic head reference planes (e.g., orbitomeatal or along the orbital roof).
For the measurements, we need to have the intracranial lesion located on the CT slice with respect to the two landmarks which are the height and hypotenuse of the triangle. The promising preliminary results of HeaDax applied to a phantom skull model encourage us to use it successfully for our first patient presenting a right subcortial supramarginal retrorolandic cavernoma.