Venous infarction of brainstem and cerebellum

Brainstem Venous Infarction from Thrombosis on the Jugular Bulb as a Serious Complication of Blunt Head Trauma Injury: A Case Report

The incidence of dural venous sinus thrombosis (DVST) and the cerebral venous infarct have not exactly known, but DVST is closely related to the skull fracture around the venous sinus. A 56-year-old man experienced massive watery discharge after hitting on his face by a falling machine. He was alert and no cerebrospinal fluid discharge on admission. Air-density was shown on the jugular fossa in the brain computed tomography. On the 3th day of trauma, he suddenly had dyspnea and loss of consciousness and became comatose. Acute edema on medulla, pons and right cerebellar hemisphere and focal infarct on right medulla were visualized on the brain magnetic resonance imaging. And the sigmoid sinus and the jugular vein were occluded and venous circulation on the right posterior fossa was diminished on the cerebral angiography. Air-density on the sinus may be an indicator into developing venous thrombosis and brainstem venous infarct could be followed by the DVST round the jugular bulb.

Isolated numbness of the tip of the tongue in hemispheric stroke

Although the somatosensory afferent of the tip of the tongue runs proximal and parallel along the spinothalamocortical and trigeminothalamocortical pathway up to the sensory cortex, central involvement has been rarely described in cases of nongustatory sensory disturbance at the tip of the tongue. In a hypertensive woman who experienced an acute onset of an isolated numbness at the tip of her tongue, recent small infarctions were found at the postcentral gyrus of the right parietal lobe. Thus, central involvement should not be neglected in the case of sensory disturbance at the tip of tongue.