1
|
de Medeiros Rimkus C, Fragoso DC, Apóstolos Pereira SL, da Costa Leite C. Atypical Demyelinating Disorders: MR Imaging Features, Atypical Triggers, and Etiopathogenesis. Neuroimaging Clin N Am 2024; 34:421-438. [PMID: 38942525 DOI: 10.1016/j.nic.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
Atypical demyelinating lesions (ADLs) can be idiopathic, occurring as isolated and self-limited events, or can appear in different stages of relapsing demyelinating diseases. Not infrequently, ADLs occur in inflammatory syndromes associated with exogenous or endogenous toxic factors, metabolic imbalance, or infectious agents. It is important to recognize imaging patterns that indicate an inflammatory/demyelinating substrate in central nervous system lesions and to investigate potential triggers or complicating factors that might be associated. The prognostic and treatment strategies of ADLs are influenced by the underlying etiopathogenesis.
Collapse
Affiliation(s)
- Carolina de Medeiros Rimkus
- Department of Radiology and Oncology, Faculdade de Medicina da Universidade de São Paulo, R. Dr. Ovídio Pires de Campos, 75, Cerqueira Cesar, São Paulo-SP, 05403-010, Brazil; Instituto D'Or de Ensino e Pesquisa (IDOR), Av. Brigadeiro Luís Antônio, 5001 - Jardim Paulista, São Paulo - SP - CEP 01401-002; MS Center, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, De Boelelaan, 1117, 1081 HV, Amsterdam, The Netherlands.
| | - Diego Cardoso Fragoso
- Department of Radiology and Oncology, Faculdade de Medicina da Universidade de São Paulo, R. Dr. Ovídio Pires de Campos, 75, Cerqueira Cesar, São Paulo-SP, 05403-010, Brazil; Fleury Group, Av. Morumbi, 8860 - Jardim das Acacias, São Paulo - SP, 04580-060, Brazil
| | - Samira Luisa Apóstolos Pereira
- Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255 - Sala 5083, 5° andar - Cerqueira César, São Paulo-SP, 05402-000, Brazil
| | - Claudia da Costa Leite
- Department of Radiology and Oncology, Faculdade de Medicina da Universidade de São Paulo, R. Dr. Ovídio Pires de Campos, 75, Cerqueira Cesar, São Paulo-SP, 05403-010, Brazil; Fleury Group, Av. Morumbi, 8860 - Jardim das Acacias, São Paulo - SP, 04580-060, Brazil
| |
Collapse
|
2
|
Jiang Y, Chen S, Wu D, He W, Ma X, Zhang L, Zhang Q. Case report: Symmetrical and increased lateral sway-based walking training for patients with corpus callosum infarction: a case series. Front Neurol 2024; 15:1330975. [PMID: 38978808 PMCID: PMC11228249 DOI: 10.3389/fneur.2024.1330975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/31/2024] [Indexed: 07/10/2024] Open
Abstract
Introduction Corpus callosum injury is a rare type of injury that occurs after a stroke and can cause lower limb dysfunction and a decrease in activities of daily living ability. Furthermore, there are no studies that focus on the progress in rehabilitation of the lower limb dysfunction caused by infarction in the corpus callosum and the effective treatment plans for this condition. We aimed to present a report of two patients with lower limb dysfunction caused by corpus callosum infarction after a stroke and a walking training method. Methods We implemented a walking training method that prioritizes bilateral symmetry and increases lateral swaying before the patients established sitting/standing balance. The plan is a rapid and effective method for improving walking dysfunction caused by corpus callosum infarction. Case characteristics Following sudden corpus callosum infarction, both patients experienced a significant reduction in lower limb motor function scores and exhibited evident gait disorders. Scale evaluations confirmed that walking training based on symmetrical and increased lateral sway for patients with lower limb motor dysfunction after corpus callosum infarction led to significant symptom improvement. Conclusion We report two cases of sudden motor dysfunction in patients with corpus callosum infarction. Symmetrical and increased lateral sway-based walking training resulted in substantial symptom improvement, as confirmed by scale assessments.
Collapse
Affiliation(s)
- Ying Jiang
- Department of Rehabilitation, Jiangsu Zhongshan Geriatric Rehabilitation Hospital, Nanjing, Jiangsu, China
| | - Sijing Chen
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Dan Wu
- Department of Rehabilitation, The Second People's Hospital of Lishui, Lishui, Zhejiang, China
| | - Wei He
- Department of Rehabilitation, Rehabilitation Hospital Affiliated to Nanjing Institute of Physical Education, Wuxi, Jiangsu, China
| | - Xiaoqing Ma
- Department of Rehabilitation, Rehabilitation Hospital Affiliated to Nanjing Institute of Physical Education, Wuxi, Jiangsu, China
| | - Lixia Zhang
- Department of Rehabilitation, The Geriatric Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qian Zhang
- Department of Rehabilitation, The Geriatric Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China
| |
Collapse
|
3
|
Tang QY, Zhong YL, Wang XM, Huang BL, Qin WG, Huang X. Machine Learning Analysis Classifies Patients with Primary Angle-Closure Glaucoma Using Abnormal Brain White Matter Function. Clin Ophthalmol 2024; 18:659-670. [PMID: 38468914 PMCID: PMC10926922 DOI: 10.2147/opth.s451872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 02/05/2024] [Indexed: 03/13/2024] Open
Abstract
Objective Primary angle-closure glaucoma (PACG) is a globally prevalent, irreversible eye disease leading to blindness. Previous neuroimaging studies demonstrated that PACG patients were associated with gray matter function changes. However, whether the white matter(WM) function changes in PACG patients remains unknown. The purpose of the study is to investigate WM function changes in the PACG patients. Methods In total, 40 PACG patients and 40 well-matched HCs participated in our study and underwent resting-state functional magnetic resonance imaging (rs-fMRI) scans. We compared between-group differences between PACG patients and HC in the WM function using amplitude of low-frequency fluctuations (ALFF). In addition, the SVM method was applied to the construction of the PACG classification model. Results Compared with the HC group, ALFF was attenuated in right posterior thalamic radiation (include optic radiation), splenium of corpus callosum, and left tapetum in the PACG group, the results are statistically significant (GRF correction, voxel-level P < 0.001, cluster-level P < 0.05). Furthermore, the SVM classification had an accuracy of 80.0% and an area under the curve (AUC) of 0.86 for distinguishing patients with PACG from HC. Conclusion The findings of our study uncover abnormal WM functional alterations in PACG patients and mainly involves vision-related regions. These findings provide new insights into widespread brain damage in PACG from an alternative WM functional perspective.
Collapse
Affiliation(s)
- Qiu-Yu Tang
- College of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang City, Jiangxi, 330004, People’s Republic of China
| | - Yu-Lin Zhong
- Department of Ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, 330006, People’s Republic of China
| | - Xin-Miao Wang
- School of Ophthalmology and Optometry, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, 330000, People’s Republic of China
| | - Bing-Lin Huang
- College of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang City, Jiangxi, 330004, People’s Republic of China
| | - Wei-Guo Qin
- Department of Cardiothoracic Surgery, The 908th Hospital of Chinese People’s Liberation Army Joint Logistic Support Force’, Nanchang, People’s Republic of China
| | - Xin Huang
- Department of Ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, 330006, People’s Republic of China
| |
Collapse
|
4
|
Abbuehl LS, Lippert J, Hakim A. Split-brain syndrome after subarachnoid haemorrhage. BMJ Case Rep 2024; 17:e258538. [PMID: 38272506 PMCID: PMC10826499 DOI: 10.1136/bcr-2023-258538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
We present the case of a patient with extensive ischaemia of the corpus callosum (CC) including all its anatomical subdivisions, caused by a ruptured aneurysm of the anterior cerebral artery (ACA). This resulted in subarachnoid haemorrhage (SAH) and subsequently in cerebral vasospasm. The aneurysm was coiled, the vasospasm treated with repetitive intra-arterial spasmolysis and the patient then received intensive neurorehabilitative care. The case is an example of ischaemic infarction, which happens rarely in the CC after SAH, and even more rarely affects the CC along its entire length. The case is further remarkable for the resulting nearly complete and isolated split-brain syndrome: CC disconnection syndromes are only exceptionally seen after vascular callosal damage because they are most often overshadowed by symptoms resulting from coaffected adjacent brain areas.
Collapse
Affiliation(s)
- Lena Simone Abbuehl
- Department of Neurology, University Hospital of Bern, Spital Netz Bern AG, Bern, Bern, Switzerland
| | - Julian Lippert
- Department of Neurology, University Hospital of Bern, Spital Netz Bern AG, Bern, Bern, Switzerland
| | - Arsany Hakim
- Institute of Diagnostic and Interventional Neuroradiology, University Hospital of Bern, Spital Netz Bern AG, Bern, Bern, Switzerland
| |
Collapse
|
5
|
Sato H, Lepić M, Suzuki K, Tabata S, Tamada K, Kume H, Shiwaku H, Ooigawa H, Kurita H. Reversible splenial lesion after surgery for distant arteriovenous malformation: a case report. Acta Neurochir (Wien) 2023; 165:1603-1607. [PMID: 37055680 PMCID: PMC10101539 DOI: 10.1007/s00701-023-05573-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/29/2023] [Indexed: 04/15/2023]
Abstract
Isolated lesions of the corpus callosum are rare and may represent permanent but also transient responses to various pathology termed "reversible splenial lesion syndrome" (RESLES) when in light of relevant clinical presentation. We present the first case of the RESLES after elective surgery for distant arteriovenous malformation (AVM), followed by a slight speech disturbance and MRI verified small, oval, well-circumscribed area of apparent cytotoxic edema in the center of the corpus callosum splenium, which completely resolved within 15 days. Surgery for AVM is followed by the complex adaptation to a new vascular pattern, RESLES might develop, and should be suspected.
Collapse
Affiliation(s)
- Hiroki Sato
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan.
| | - Milan Lepić
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan
| | - Kaima Suzuki
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan
| | - Shinya Tabata
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan
| | - Keita Tamada
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan
| | - Haruka Kume
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan
| | - Hiroya Shiwaku
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan
| | - Hidetoshi Ooigawa
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan
| | - Hiroki Kurita
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan
| |
Collapse
|
6
|
Kızılgöz V, Kantarci M, Kahraman Ş. Imaging findings of two patients with isolated infarction of the splenium during COVID-19. SAGE Open Med Case Rep 2022; 10:2050313X221135232. [PMID: 36337160 PMCID: PMC9629540 DOI: 10.1177/2050313x221135232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/04/2022] [Indexed: 11/12/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is caused by the virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the literature, this virus has been associated with coagulation dysfunction and arterial thromboembolism. In clinical practice, corpus callosum infarcts are very rare, and the incidence of isolated splenium infarct is very low. Here, two cases of isolated splenium infarct after COVID-19 are reported with clinical and imaging findings. These findings are thought to be useful in daily practice for our colleagues. In addition, differential diagnoses of this entity will also be discussed in this case report.
Collapse
Affiliation(s)
- Volkan Kızılgöz
- Department of Radiology, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan, Turkey,Volkan Kızılgöz, Department of Radiology, Faculty of Medicine, Erzincan Binali Yıldırım University, 24100 Erzincan, Turkey.
| | - Mecit Kantarci
- Department of Radiology, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan, Turkey,Department of Radiology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Şevket Kahraman
- Department of Radiology, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan, Turkey
| |
Collapse
|
7
|
Muacevic A, Adler JR. Corpus Callosum Infarct in the Background of Varicella-Zoster Infection: A Report of a Rare Case. Cureus 2022; 14:e29943. [PMID: 36348837 PMCID: PMC9635220 DOI: 10.7759/cureus.29943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2022] [Indexed: 11/22/2022] Open
Abstract
Infarctions of the corpus callosum are rare due to a rich blood supply. Corpus callosum derives its blood supply from four vessels from the anterior and posterior circulation and for this reason, they have a rare, atypical presentation. There is scarce literature regarding this pathology. Corpus callosum infarcts usually present with non-specific signs and symptoms. Here, we describe a case of corpus callosum infarction in a 5-year-old boy who was a known case of acute lymphoblastic leukaemia. He presented with disseminated varicella infection and developed tonic-clonic seizures. MRI brain was performed and a diagnosis of corpus callosum infarct was made. The patient was treated conservatively.
Collapse
|
8
|
Abdulghani M, Das S, Manfredonia F. Lesson of the month: Cytotoxic lesions of the corpus callosum (CLOCCs) in status epilepticus. Clin Med (Lond) 2022; 22:493-495. [PMID: 38589075 PMCID: PMC9595017 DOI: 10.7861/clinmed.2022-0298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A 26-year-old man was diagnosed with epilepsy a few months previously and admitted with status epilepticus. Computed tomography (CT) of the brain and CT venography were unremarkable. Magnetic resonance imaging (MRI) of the brain showed evidence of possible acute focal infarction in the splenium of the corpus callosum that showed a true restricted diffusion. The patient had no vascular risk factors and no focal neurological deficit on examination to explain the occurrence of an acute infarction. MRI of the brain was repeated 1 month later to assess for progression of that lesion and showed resolution of it. This case highlights the association of cytotoxic lesions of the corpus callosum that show true restricted diffusion with status epilepticus. It also emphasises the importance of medical reasoning and not being solely dependent on diagnostic investigations without reasonably linking them to the history and examination.
Collapse
|
9
|
Cai Y, Ren L, Liu X, Li C, Gang X, Wang G. Thyroid storm complicated by corpus callosum infarction in a young patient: A case report and literature review. Medicine (Baltimore) 2022; 101:e30318. [PMID: 36042649 PMCID: PMC9410692 DOI: 10.1097/md.0000000000030318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
RATIONALE Thyroid storm (TS) is a rare life-threatening hypermetabolic thyrotoxicosis with an incidence of 0.57-0.76/100,000. The coexistence of TS and acute cerebral infarction is rare. Previous studies have shown that hyperthyroidism complicated by cerebral infarction mainly occurs in the intracranial basal ganglia; however, there are no reports of corpus callosum infarction. We report a case of TS complicated by cerebral infarction of the corpus callosum at our hospital. PATIENT CONCERNS A 31-year-old male patient with a history of hyperthyroidism was admitted to the hospital because of fatigue, palpitations, fever, and profuse sweating accompanied by a mild decrease in the muscle strength of the left limb. Diagnosis of a TS was confirmed by the laboratory test results. The patient's clinical symptoms gradually improved after treatment. However, his left limb muscle strength progressively decreased, and the bilateral pathological signs were positive at the same time. Magnetic resonance imaging (MRI) of the head revealed acute cerebral infarction of the corpus callosum and pons. DIAGNOSIS The diagnosis was thyroid strom with acute cerebral infarction of the corpus callosum and pons and severe stenosis or occlusion of the basilar artery. INTERVENTIONS The patient was given 300 mg hydrocortisone intravenously per day, propylthiouracil tablets of 200 mg 3 times a day by nasal feeding, and 20 mg propranolol three times a day by nasal feeding. Aspirin and clopidogrel were administered to prevent platelet aggregation, and atorvastatin calcium was administered to lower lipid levels to stabilize plaques. OUTCOMES The patient's left limb muscle strength recovered to grade 4+, and he could walk beside the bed with support. Simultaneously, thyroid function was better than before. LESSONS Careful physical examination should be performed in patients with thyroid storm, and head imaging examination should be improved for the early detection of cerebral infarction.
Collapse
Affiliation(s)
- Yunjia Cai
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China
| | - Linan Ren
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China
| | - Xinming Liu
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China
| | - Chen Li
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China
| | - Xiaokun Gang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China
| | - Guixia Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China
| |
Collapse
|
10
|
Abstract
BACKGROUND Metronidazole has been used to treat a broad range of infections over the decades, and its safety profile has been presumably well studied. However, neurological severe adverse events after prescription and nonprescription use of metronidazole is well recognized but underdiagnosed. CASE PRESENTATION We report the case of a 48-year-old Indian man who presented with unremitting symptoms of peripheral neuropathy along with a silent callosal lesion in the splenium ("boomerang" sign). Because he had visited 3 neurologists previously, there were many targeted and nontargeted investigations, which failed to reach an etiological diagnosis and hence to provide relief. The patient was questioned about a potential neurotoxin exposure, and at this point, he said that he was taking metronidazole for a long time, without any supervision, as an over-the-counter remedy for self-diagnosed "chronic amebiasis." On stopping metronidazole, he recovered gradually. In the sixth month of follow-up, brain magnetic resonance imaging showed disappearance of the callosal lesion and significant improvement in the nerve conduction studies. CONCLUSIONS Clinicians should keep metronidazole toxicity in mind while dealing with a case of cytotoxic lesion of the corpus callosum with splenium involvement and peripheral neuropathy.
Collapse
|
11
|
Chiou-Tan F, Ughwanogho U, Taber K. Special anatomy series: Updates in structural, functional, and clinical relevance of the corpus callosum: What new imaging techniques have revealed. THE JOURNAL OF THE INTERNATIONAL SOCIETY OF PHYSICAL AND REHABILITATION MEDICINE 2022. [DOI: 10.4103/jisprm.jisprm-000159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
12
|
Katsuki M, Kato H, Niizuma H, Nakagawa Y, Tsunoda M. Homonymous Hemianopsia Due to the Infarction in the Splenium of the Corpus Callosum. Cureus 2021; 13:e19574. [PMID: 34926046 PMCID: PMC8671077 DOI: 10.7759/cureus.19574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2021] [Indexed: 11/05/2022] Open
Abstract
The precise functions of the splenium of the corpus callosum (CC) remain unclear, and infarction of this location manifests varied clinical symptoms. We describe a rare case of right homonymous hemianopsia resulting from pure infarction in the right-side splenium of the CC. An 85-year-old man presented with right homonymous hemianopsia lasting for a week. Diffusion-weighted imaging showed a high-intensity area in the right-side splenium of the CC and did not show any other lesions in other portions of the visual pathways. Magnetic resonance angiography demonstrated anterior and posterior cerebral arteries, indicating that no large vessel occlusion existed. The visual field examination revealed right homonymous hemianopsia. The diagnosis was atherothrombotic infarction in the splenium of the CC, which resulted in right homonymous hemianopsia. Two months later, T2-weighted imaging showed a high-intensity lesion localizing the right-side splenium with shrinkage of the lesion compared to that on the acute phase, and his visual field was slightly improved. There are few reports on the splenial infarction of the CC, and this is the first case manifesting as homonymous hemianopsia, to our knowledge. Our case might help to understand complicated visual information processing involving the splenium of the CC.
Collapse
Affiliation(s)
- Masahito Katsuki
- Neurosurgery, Senseki Hospital, Higashi-Matsushima, JPN.,Neurosurgery, Itoigawa General Hospital, Itoigawa, JPN
| | - Hideaki Kato
- Neurosurgery, Senseki Hospital, Higashi-Matsushima, JPN
| | | | | | | |
Collapse
|
13
|
Chakraborty AP, Dubey S, Sarkar P, Das S, Ray BK, Pandit A. A Case of Moyamoya Syndrome with Isolated Protein S Deficiency Unmasked by Pregnancy. Ann Indian Acad Neurol 2021; 24:628-630. [PMID: 34728978 PMCID: PMC8513990 DOI: 10.4103/aian.aian_833_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 09/30/2020] [Accepted: 11/18/2020] [Indexed: 12/02/2022] Open
Affiliation(s)
- Arka P Chakraborty
- Department of Neurology, Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| | - Souvik Dubey
- Department of Neurology, Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| | - Peyalee Sarkar
- Department of Neurology, Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| | - Shambaditya Das
- Department of Neurology, Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| | - Biman K Ray
- Department of Neurology, Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| | - Alak Pandit
- Department of Neurology, Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| |
Collapse
|
14
|
Affiliation(s)
- Pankaj Jalan
- Department of Neurology, Norvic International Hospital, Thapathali, Kathmandu, Nepal
| | - Gentle S Shrestha
- Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| |
Collapse
|
15
|
Corpus callosum infarction in uncontrolled diabetes mellitus. Acta Neurol Belg 2021; 121:1335-1337. [PMID: 34184193 DOI: 10.1007/s13760-021-01729-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/17/2021] [Indexed: 10/21/2022]
|
16
|
Zhao Q, Sun L, Hu B, Lin W. Nonconvulsive status epilepticus manifesting as rapidly progressive dementia and infarction in the splenium of the corpus callosum: A case report. Medicine (Baltimore) 2021; 100:e25263. [PMID: 33847624 PMCID: PMC8051981 DOI: 10.1097/md.0000000000025263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/04/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Nonconvulsive status epilepticus (NCSE) is a heterogeneous disease with multiple subtypes. NCSE poses great diagnostic and therapeutic challenges due to the lack of typical symptoms. Here, we report a case of NCSE manifesting as rapidly progressive dementia (RPD) and infarction in the splenium of the corpus callosum. Additionally, the relevant literature was reviewed. PATIENT CONCERNS A 63-year-old man presented with RPD. Electroencephalogram (EEG) revealed NCSE, and brain magnetic resonance imaging (MRI) showed an isolated infarction in the splenium of the corpus callosum. Mini-mental state examination showed moderate cognitive impairment (14/30 points). DIAGNOSIS A diagnosis of NCSE with RPD and infarction in the splenium of the corpus callosum was made. INTERVENTIONS The patient was treated with intravenous diazepam (10 mg), oral levetiracetam (1.0g twice daily), oral sodium valproate (0.2g twice daily), and intramuscular phenobarbital sodium (0.2g once daily). OUTCOMES After the treatment, the symptoms were improved. The patient could answer questions. Repeated EEG showed that the background a rhythm was slightly overdeveloped, and no clinical or electrical seizures were observed. After discharge, the patient was treated with oral levetiracetam (1.0g twice daily) and oral sodium valproate (0.2g twice daily) for 6 months. At the last follow-up, the patient had clear consciousness, sensitive response, and fluent answering ability. Repeated mini-mental state examination showed that his cognitive function was significantly improved (28/30 points); nevertheless, the lesion in the splenium of corpus callosum remained unchanged on MRI. LESSONS NCSE manifesting as RPD and infarction in the splenium of the corpus callosum is extremely rare. Epileptic events and focal infarction are usually overlooked in patients with dementia, and the diagnostic value of MRI and EEG should be highlighted.
Collapse
Affiliation(s)
- Qian Zhao
- Department of Neurology, Neuroscience Center
| | - Lichao Sun
- Department of Emergency, The First Hospital of Jilin University
| | - Boqi Hu
- Department of Radiology, China-Japan Friendship Hospital of Jilin University, Changchun, Jilin, China
| | - Weihong Lin
- Department of Neurology, Neuroscience Center
| |
Collapse
|
17
|
Alshoabi SA, Alareqi AA, Omer AM, Suliman AG, Daqqaq TS. Diffuse astrocytoma and the diagnostic dilemma of an unusual phenotype: A case report. Radiol Case Rep 2020; 16:319-326. [PMID: 33304444 PMCID: PMC7718471 DOI: 10.1016/j.radcr.2020.11.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 11/30/2022] Open
Abstract
Diffuse astrocytoma is an infiltrating type of glioma (World Health Organization grade II), which even with histopathology, is difficult to diagnose. Magnetic resonance imaging (MRI) is the cornerstone for diagnoses and follow-up of brain gliomas. This report describes a case of diffuse astrocytoma in a 48-year-old man who presented with sudden right-sided weakness and repeated convulsive attacks. On brain computed tomography, the case was diagnosed and treated as an acute infarction. Ten days later, the patient returned with a total loss of consciousness. Brain MRI images revealed an irregularly outlined lesion involving the splenium of the corpus callosum that extended into the left periventricular parietal lobe of the brain with cystic foci in the septum pellucidum. Contrast-enhanced and new sequences of MRI was helpful in approach to diagnosis because of its superior tissue characterization. The histopathology results ultimately confirmed the diagnosis of diffuse astrocytoma. The patient died postoperatively.
Collapse
Affiliation(s)
- Sultan A. Alshoabi
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah, 42312, Kingdom of Saudi Arabia
- Corresponding author.
| | - Amal A. Alareqi
- Department of Radiology, University of Science and Technology Hospital (USTH), Sana'a, Republic of Yemen
- Radiology department, 21 September university of medical and applied sciences, Sana'a, Republic of Yemen
| | - Awatef M. Omer
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah, 42312, Kingdom of Saudi Arabia
| | - Awadia G. Suliman
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah, 42312, Kingdom of Saudi Arabia
| | - Tareef S. Daqqaq
- Department of Radiology, Faculty of Medicine, Taibah University, Almadinah Almunawwarah, Kingdom of Saudi Arabia
| |
Collapse
|
18
|
Bouvy C, Ackermans N, Maldonado Slootjes S, Rutgers MP, Gille M. Reversible cerebral vasoconstriction syndrome revealed by fronto-callosal infarctions. Acta Neurol Belg 2020; 120:1467-1469. [PMID: 32157672 DOI: 10.1007/s13760-020-01319-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 02/27/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Céline Bouvy
- Department of Neurology, Europe Hospitals, 206 Avenue de Fré, 1180, Brussels, Belgium
| | - Nathalie Ackermans
- Department of Neurology, Europe Hospitals, 206 Avenue de Fré, 1180, Brussels, Belgium
| | | | | | - Michel Gille
- Department of Neurology, Europe Hospitals, 206 Avenue de Fré, 1180, Brussels, Belgium.
| |
Collapse
|
19
|
Abstract
Background and Purpose: Ischemic infarction of the corpus callosum is rare and infarction isolated to the corpus callosum alone rarer still, accounting for much <1% of ischemic stroke in most stroke registries. About half of callosal infarctions affect the splenium. Methods: During a 2-week period, at the height of the coronavirus disease 2019 (COVID-19) pandemic in New York City, 4 patients at Montefiore Medical Center in the Bronx were found to have ischemic lesions of the splenium of the corpus callosum, 2 with infarction isolated to the corpus callosum. Results: All patients tested positive for COVID-19 and 3 had prolonged periods of intubation. All had cardiovascular risk factors. Clinically, all presented with encephalopathy and had evidence of coagulopathy and raised inflammatory markers. Conclusions: Infarction of the splenium of the corpus callosum is exceedingly rare and a cluster of such cases suggests COVID-19 as an inciting agent, with the mechanisms to be elucidated.
Collapse
Affiliation(s)
- Steven A Sparr
- Saul R. Korey Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine
| | - Phyllis L Bieri
- Saul R. Korey Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine
| |
Collapse
|
20
|
Mechanisms for Recurrent Strokes in the Territory of an Internal Carotid Artery Occlusion. Can J Neurol Sci 2020; 47:560-562. [PMID: 32122434 DOI: 10.1017/cjn.2020.42] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
21
|
Blaauw J, Meiners LC. The splenium of the corpus callosum: embryology, anatomy, function and imaging with pathophysiological hypothesis. Neuroradiology 2020; 62:563-585. [PMID: 32062761 PMCID: PMC7186255 DOI: 10.1007/s00234-019-02357-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 12/27/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND PURPOSE The splenium of the corpus callosum is the most posterior part of the corpus callosum. Its embryological development, anatomy, vascularization, function, imaging of pathology, possible pathophysiological mechanisms by which pathology may develop and the clinical consequences are discussed. METHODS A literature-based description is provided on development, anatomy and function. MR and CT images are used to demonstrate pathology. The majority of pathology, known to affect the splenium, and the clinical effects are described in three subsections: (A) limited to the splenium, with elaboration on pathophysiology of reversible splenial lesions, (B) pathology in the cerebral white matter extending into or deriving from the splenium, with special emphasis on tumors, and (C) splenial involvement in generalized conditions affecting the entire brain, with a hypothesis for pathophysiological mechanisms for the different diseases. RESULTS The development of the splenium is preceded by the formation of the hippocampal commissure. It is bordered by the falx and the tentorium and is perfused by the anterior and posterior circulation. It contains different caliber axonal fibers and the most compact area of callosal glial cells. These findings may explain the affinity of specific forms of pathology for this region. The fibers interconnect the temporal and occipital regions of both hemispheres reciprocally and are important in language, visuospatial information transfer and behavior. Acquired pathology may lead to changes in consciousness. CONCLUSION The development, location, fiber composition and vascularization of the splenium make it vulnerable to specific pathological processes. It appears to play an important role in consciousness.
Collapse
Affiliation(s)
- J Blaauw
- Department of Radiology, University Medical Center Groningen, University of Groningen, 9700 RB, Groningen, The Netherlands.,Faculty of Medical Sciences/Department of Neurology, University Medical Center Groningen, University of Groningen, 9700 RB, Groningen, The Netherlands
| | - L C Meiners
- Department of Radiology, University Medical Center Groningen, University of Groningen, 9700 RB, Groningen, The Netherlands.
| |
Collapse
|
22
|
Tetsuka S. Reversible lesion in the splenium of the corpus callosum. Brain Behav 2019; 9:e01440. [PMID: 31588684 PMCID: PMC6851813 DOI: 10.1002/brb3.1440] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/15/2019] [Accepted: 09/18/2019] [Indexed: 12/17/2022] Open
Abstract
AIM OF REVIEW The presence of isolated, reversible lesions in the splenium of the corpus callosum (SCC) is essential to confirm the diagnosis of mild encephalitis/encephalopathy. The lesions usually heal within a month after the onset of neurological symptoms. Magnetic resonance imaging (MRI) has increasingly been used as a diagnostic tool, which has led to the publication of an increasing number of case reports. These have highlighted some inconsistencies about encephalitis/encephalopathy. First, the condition is not always mild and may be severe. Second, reversible lesions in the SCC have been identified in various diseases and conditions other than viral encephalitis/encephalopathy. Third, lesions in SCC are not always completely reversible. On this note, this review describes the specific clinical and radiological features of encephalitis/encephalopathy. FINDINGS The reversible lesion in SCC is an MRI finding observable in a wide variety of diseases and conditions. Thus, it should be considered as a secondary change rather than a peculiar feature associated with mild encephalitis/encephalopathy. If reversible lesions are present in the SCC, the symptoms and prognosis are not necessarily favorable, with manifestations of encephalitis/encephalopathy varying from absent to severe. Neuroradiological features that appear as isolated high-intensity signals on diffusion-weighted images and a decreased apparent diffusion coefficient of the lesion might indicate a diagnosis of cytotoxic edema. Findings of previous studies suggest that cytokine-mediated cytotoxic edema of the SCC may be an important pathophysiological manifestation of this condition. CONCLUSION The reversible lesions in the SCC found on MRI are not exclusive to encephalitis/encephalopathy but may be secondary to other disorders.
Collapse
Affiliation(s)
- Syuichi Tetsuka
- Department of Neurology, International University of Health and Welfare Hospital, Nasushiobara, Japan
| |
Collapse
|
23
|
Clinical Features, Etiology, and 6-Month Prognosis of Isolated Corpus Callosum Infarction. BIOMED RESEARCH INTERNATIONAL 2019; 2019:9458039. [PMID: 31218228 PMCID: PMC6537009 DOI: 10.1155/2019/9458039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 04/30/2019] [Indexed: 12/18/2022]
Abstract
As the largest subcortical commissural fiber, the corpus callosum plays an important role in cerebral functions and has abundant blood supply from bilateral circulation. Isolated corpus callosum infarction (ICCI) may have specific characteristics. The aim of the study is to evaluate the clinical features, etiology, and 6-month prognosis of ICCI. Consecutive patients with acute ICCI treated at the China-Japan Friendship Hospital between June 2012 and June 2016 were retrospectively assessed for clinical and imaging findings. These cases were compared with patients suffering from other isolated supratentorial subcortical infarctions, matched for age, sex, and infarction size (n=60; control group). ICCI etiology and 6-month prognosis were further analyzed. ICCI cases accounted for 2.9% (33/1125) of all acute ischemic strokes and 30 patients were included. Most patients (n=28, 93.3%) presented nonspecific clinical symptoms, and only two (6.7%) with diffuse infarction developed callosal disconnection syndrome (CDS). The splenium was the most frequent site (37.5%). Large artery atherosclerosis (LAA) (n=16, 53.3%) was the most common etiology. Only four (13.3%) patients developed transient ischemic attacks (n=1, 3.3%) or cerebral infarction (n=3, 10%) during the 6-month follow-up. The frequency of good prognosis (modified Rankin score of 1-2 and without cardiovascular events) was higher in patients with ICCI compared with controls (P=0.024). Poor prognosis was associated with multiple cerebrovascular stenosis, diffuse/large infarction, and diabetes (all P<0.05). ICCI is a rare stroke type, frequently involving the splenium; its common etiology is likely LAA. Most patients show nonspecific symptoms, with only a few developing CDS. ICCI generally shows favorable short-term outcome.
Collapse
|
24
|
Sun X, Li J, Fan C, Zhang H, Si Y, Fang X, Guo Y, Zhang JH, Wu T, Ding S, Bi X. Clinical, neuroimaging and prognostic study of 127 cases with infarction of the corpus callosum. Eur J Neurol 2019; 26:1075-1081. [PMID: 30793437 PMCID: PMC6767551 DOI: 10.1111/ene.13942] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 02/19/2019] [Indexed: 11/26/2022]
Abstract
Background and purpose The aim of this study was to retrospectively investigate clinical and neuroimaging characteristics in the largest sample size of patients with corpus callosum infarction to date and then to follow up these patients for 1 year to clarify the prognosis of this rare stroke entity. Methods A total of 127 patients with acute callosal infarction out of 5584 acute ischaemic stroke patients were included in this study. The recruited patients were divided into a pure callosal infarction group and a complex callosal infarction group (coupled with other infarct locations simultaneously), and clinical and neuroimaging features were analyzed. Some of the patients were followed up for 1 year to evaluate recurrence rate and mortality. Results The incidence of acute callosal infarction was 2.3%. Most patients presented with advanced neurological dysfunction with or without mild to moderate motor or sensory disorders on admission. The negative rate of computed tomography scan was still 76.4% even at >24 h after onset. Large‐artery atherosclerosis was the most common etiological type. Compared with complex callosal infarction, the pure callosal infarction group had more mental disorders (P = 0.030). Compared with common basal ganglia infarction, the pure callosal infarction group had better short‐term recovery (P = 0.016) but higher 1‐year mortality (P = 0.037). Age and mental disorders were independent risk factors for death in callosal infarction. Conclusions Callosal infarction is a white matter stroke that occurs with low incidence. Elderly patients with vascular risk factors showed sudden mental or cognitive disorders and callosal infarction could not be excluded. More attention should be paid to the early diagnosis and secondary prevention of callosal infarction because of its poor long‐term outcome.
Collapse
Affiliation(s)
- X Sun
- Department of Neurology, Changhai Hospital, Shanghai
| | - J Li
- Department of Neurology, Changhai Hospital, Shanghai
| | - C Fan
- Department of Neurology, Changhai Hospital, Shanghai
| | - H Zhang
- Department of Neurology, Changhai Hospital, Shanghai
| | - Y Si
- Department of Transfusion Medicine, Xinhua Hospital Affiliated to Shanghai JiaoTong University, Shanghai
| | - X Fang
- Department of Radiology, Changhai Hospital, Shanghai
| | - Y Guo
- Department of Health Statistics, Second Military Medical University, Shanghai, China
| | - J H Zhang
- Department of Neurosurgery, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - T Wu
- Department of Neurology, Changhai Hospital, Shanghai
| | - S Ding
- Department of Neurology, Changhai Hospital, Shanghai
| | - X Bi
- Department of Neurology, Changhai Hospital, Shanghai
| |
Collapse
|
25
|
Hirono S, Kawauchi D, Kobayashi M, Orimoto R, Ikegami S, Horiguchi K, Iwadate Y. Mechanism of Corpus Callosum Infarction Associated with Acute Hydrocephalus: Clinical, Surgical, and Radiological Evaluations for Pathophysiology. World Neurosurg 2019; 127:e873-e880. [PMID: 30954745 DOI: 10.1016/j.wneu.2019.03.288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/27/2019] [Accepted: 03/28/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Corpus callosum (CC) infarction has been reported to be rare because of the rich blood supply in the CC. The pathophysiology of CC infarction associated with acute hydrocephalus is unknown. The aim of the present study was to clarify the characteristics and mechanism of CC infarction associated with acute noncommunicating hydrocephalus (ANCH). METHODS We reviewed clinical the data from all patients who had undergone surgical intervention for ANCH at Chiba University Hospital from January 2008 to March 2018. Patients with vascular lesions, a history of hydrocephalus, and lacking magnetic resonance imaging studies were excluded. The clinical, surgical, and radiological parameters were obtained retrospectively for pathophysiological analysis. RESULTS A total of 23 patients with ANCH who had undergone surgical intervention and had met the inclusion criteria were included in the present study. Of the 23 patients, 6 (23%) had developed CC infarction. All CC infarctions were located in the splenium. Although no clinical or surgical features were associated with splenial infarction, the radiological parameters of lateral ventricle enlargement and a narrower callosal angle at the posterior commissure and the foramen of Monro were significantly associated with splenial infarction. CONCLUSION The present study has presented evidence that increased intraventricular pressure by ANCH applied transversely in the splenium will directly induce compression of the superior branch of the posterior callosal artery and pericallosal pial plexus, resulting in splenium-specific infarction in patients with ANCH.
Collapse
Affiliation(s)
- Seiichiro Hirono
- Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba-City, Japan.
| | - Daisuke Kawauchi
- Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba-City, Japan
| | - Masayoshi Kobayashi
- Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba-City, Japan
| | - Ryosuke Orimoto
- Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba-City, Japan
| | - Shiro Ikegami
- Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba-City, Japan
| | - Kentaro Horiguchi
- Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba-City, Japan
| | - Yasuo Iwadate
- Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba-City, Japan
| |
Collapse
|
26
|
Yoo HS, Kim HS. Crossed Aphasia after Right Corpus Callosum Infarction: a Case Report. BRAIN & NEUROREHABILITATION 2019. [DOI: 10.12786/bn.2019.12.e6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Ho Sang Yoo
- Department of Rehabilitation Medicine and Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hyoung Seop Kim
- Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| |
Collapse
|
27
|
Kusnanto K, Prajayanti ED, Harmayetty H. Jigsaw Puzzle Improve Fine Motor Abilities of Upper Extremities in Post-Stroke Ischemic Clients. JURNAL NERS 2017. [DOI: 10.20473/jn.v12i1.2790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: Ischemic stroke is a disease caused by focal cerebral ischemia, where is a decline in blood flow that needed for neuronal metabolism, leading to neurologic deficit include motor deficit such as fine motor skills impairment. Therapy of fine motor skills disorders is to improve motor function, prevent contractures and complications. These study aimed to identify the effect of playing Jigsaw Puzzle on muscle strength, extensive motion, and upper extremity fine motor skills in patients with ischemic stroke at Dr. Moewardi Hospital, Surakarta.Methods: Experimental Quasi pre-posttest one group control. The number of samples were 34 respondents selected using purposive sampling technique. The samples were divided into intervention and control groups. The intervention group was 17 respondents who were given standard treatment hospital and played Jigsaw Puzzle 2 times a day for six days. Control group is one respondent given by hospital standard therapy without given additional Jigsaw Puzzle game. Evaluation of these research is done on the first and seventh day for those groups.Results: The results showed that muscle strength, the range of joint motion and fine motor skills of upper extremities increased (p = 0.001) significantly after being given the Jigsaw Puzzle games. These means playing Jigsaw Puzzle increase muscle strength, the range of joint motion and upper extremity fine motor skill of ischemic stroke patients.Conclusion: Jigsaw puzzle game administration as additional rehabilitation therapy in upper extremity fine motor to minimize the occurrence of contractures and motor disorders in patients with ischemic stroke. Jigsaw puzzle game therapy capable of creating repetitive motion as a key of neurological rehabilitation in Ischemic Stroke. This study recommends using jigsaw puzzle game as one of intervention in the nursing care of Ischemic Stroke patients.
Collapse
|
28
|
Park SE, Choi DS, Shin HS, Baek HJ, Choi HC, Kim JE, Choi HY, Park MJ. Splenial Lesions of the Corpus Callosum: Disease Spectrum and MRI Findings. Korean J Radiol 2017; 18:710-721. [PMID: 28670166 PMCID: PMC5447647 DOI: 10.3348/kjr.2017.18.4.710] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 12/18/2016] [Indexed: 11/17/2022] Open
Abstract
The corpus callosum (CC) is the largest white matter structure in the brain, consisting of more than 200–250 million axons that provide a large connection mainly between homologous cerebral cortical areas in mirror image sites. The posterior end of the CC is the thickest part, which is called the splenium. Various diseases including congenital to acquired lesions including congenital anomalies, traumatic lesions, ischemic diseases, tumors, metabolic, toxic, degenerative, and demyelinating diseases, can involve the splenium of the CC and their clinical symptoms and signs are also variable. Therefore, knowledge of the disease entities and the imaging findings of lesions involving the splenium is valuable in clinical practice. MR imaging is useful for the detection and differential diagnosis of splenial lesions of the CC. In this study, we classify the disease entities and describe imaging findings of lesions involving the splenium of the CC based on our experiences and a review of the literature.
Collapse
Affiliation(s)
- Sung Eun Park
- Department of Radiology, Gyeongsang National University School of Medicine, Jinju 52727, Korea
| | - Dae Seob Choi
- Department of Radiology, Gyeongsang National University School of Medicine, Jinju 52727, Korea.,Gyeongsang Institute of Health Science, Gyeongsang National University School of Medicine, Jinju 52727, Korea
| | - Hwa Seon Shin
- Department of Radiology, Gyeongsang National University School of Medicine, Jinju 52727, Korea
| | - Hye Jin Baek
- Department of Radiology, Gyeongsang National University School of Medicine, Jinju 52727, Korea
| | - Ho Cheol Choi
- Department of Radiology, Gyeongsang National University School of Medicine, Jinju 52727, Korea
| | - Ji Eun Kim
- Department of Radiology, Gyeongsang National University School of Medicine, Jinju 52727, Korea
| | - Hye Young Choi
- Department of Radiology, Gyeongsang National University School of Medicine, Jinju 52727, Korea
| | - Mi Jung Park
- Department of Radiology, Gyeongsang National University School of Medicine, Jinju 52727, Korea
| |
Collapse
|
29
|
Gomes D, Fonseca M, Garrotes M, Lima MR, Mendonça M, Pereira M, Lourenço M, Oliveira E, Lavrador JP. Corpus Callosum and Neglect Syndrome: Clinical Findings After Meningioma Removal and Anatomical Review. J Neurosci Rural Pract 2017; 8:101-106. [PMID: 28149091 PMCID: PMC5225689 DOI: 10.4103/0976-3147.193549] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Two types of neglect are described: hemispatial and motivational neglect syndromes. Neglect syndrome is a neurophysiologic condition characterized by a malfunction in one hemisphere of the brain, resulting in contralateral hemispatial neglect in the absence of sensory loss and the right parietal lobe lesion being the most common anatomical site leading to it. In motivational neglect, the less emotional input is considered from the neglected side where anterior cingulate cortex harbors the most frequent lesions. Nevertheless, there are reports of injuries in the corpus callosum (CC) causing hemispatial neglect syndrome, particularly located in the splenium. It is essential for a neurosurgeon to recognize this clinical syndrome as it can be either a primary manifestation of neurosurgical pathology (tumor, vascular lesion) or as a postoperative iatrogenic clinical finding. The authors report a postoperative hemispatial neglect syndrome after a falcotentorial meningioma removal that recovered 10 months after surgery and performs a clinical, anatomical, and histological review centered in CC as key agent in neglect syndrome.
Collapse
Affiliation(s)
- David Gomes
- Department of Anatomy, Lisbon Medical School, Lisboa, Portugal
| | | | - Maria Garrotes
- Department of Anatomy, Lisbon Medical School, Lisboa, Portugal
| | - Maria Rita Lima
- Department of Anatomy, Lisbon Medical School, Lisboa, Portugal
| | - Marta Mendonça
- Department of Anatomy, Lisbon Medical School, Lisboa, Portugal
| | - Mariana Pereira
- Department of Anatomy, Lisbon Medical School, Lisboa, Portugal
| | - Miguel Lourenço
- Department of Anatomy, Lisbon Medical School, Lisboa, Portugal
| | - Edson Oliveira
- Department of Anatomy, Lisbon Medical School, Lisboa, Portugal; Department of Neurosurgical, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - José Pedro Lavrador
- Department of Anatomy, Lisbon Medical School, Lisboa, Portugal; Department of Neurosurgical, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal; Department of Paediatric and Adult Neurosurgery, King's College Hospital NHS Foundation Trust, Denmark Hill, London
| |
Collapse
|
30
|
Clinical value of detection on serum monocyte chemotactant protein-1 and vascular endothelial cadherin levels in patients with acute cerebral infarction. JOURNAL OF ACUTE DISEASE 2016. [DOI: 10.1016/j.joad.2016.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
31
|
|
32
|
Serum miR-126 and miR-146a levels in patients with acute cerebral infarction and their relationship with severity of the disease. JOURNAL OF ACUTE DISEASE 2016. [DOI: 10.1016/j.joad.2016.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
33
|
Li C, Wu X, Qi H, Cheng Y, Zhang B, Zhou H, Lv X, Liu K, Zhang HL. Reversible splenial lesion syndrome associated with lobar pneumonia: Case report and review of literature. Medicine (Baltimore) 2016; 95:e4798. [PMID: 27684805 PMCID: PMC5265898 DOI: 10.1097/md.0000000000004798] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Reversible splenial lesion syndrome (RESLES) is a rare clinico-radiological disorder with unclear pathophysiology. Clinically, RESLES is defined as reversible isolated splenial lesions in the corpus callosum, which can be readily identified by magnetic resonance imaging (MRI) and usually resolve completely over a period of time. RESLES could be typically triggered by infection, antiepileptic drugs (AEDs), poisoning, etc. More factors are increasingly recognized. METHODS AND RESULTS We reported herein an 18-year-old female patient with lobar pneumonia who developed mental abnormalities during hospitalization. An isolated splenial lesion in the corpus callosum was found by head MRI and the lesion disappeared 15 days later. Based on her clinical manifestations and radiological findings, she was diagnosed with lobar pneumonia associated RESLES. We further summarize the up-to-date knowledge about the etiology, possible pathogenesis, clinical manifestations, radiological features, treatment, and prognosis of RESLES. CONCLUSION This report contributes to the clinical understanding of RESLES which may present with mental abnormalities after infection. The characteristic imaging of reversible isolated splenial lesions in the corpus callosum was confirmed in this report. The clinical manifestations and lesions on MRI could disappear naturally after 1 month without special treatment.
Collapse
Affiliation(s)
- Chunrong Li
- Neuroscience Center, Department of Neurology
| | - Xiujuan Wu
- Neuroscience Center, Department of Neurology
| | - Hehe Qi
- Neuroscience Center, Department of Neurology
| | | | - Bing Zhang
- Neuroscience Center, Department of Neurology
| | - Hongwei Zhou
- Department of Radiology, the First Hospital of Jilin University, Jilin University, Changchun, China
| | - Xiaohong Lv
- Neuroscience Center, Department of Neurology
| | - Kangding Liu
- Neuroscience Center, Department of Neurology
- Correspondence: Kangding Liu, Hong-Liang Zhang, Neuroscience Center, Department of Neurology, the First Hospital of Jilin University, Xinmin Street 71#, 130021 Changchun, China (e-mail: , )
| | - Hong-Liang Zhang
- Neuroscience Center, Department of Neurology
- Correspondence: Kangding Liu, Hong-Liang Zhang, Neuroscience Center, Department of Neurology, the First Hospital of Jilin University, Xinmin Street 71#, 130021 Changchun, China (e-mail: , )
| |
Collapse
|
34
|
Correlation between the condition of patients with acute cerebral infarction and serum β2-microglobulin levels. JOURNAL OF ACUTE DISEASE 2016. [DOI: 10.1016/j.joad.2016.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
35
|
Mahawish K. Corpus callosum infarction presenting with anarchic hand syndrome. BMJ Case Rep 2016; 2016:bcr-2016-216071. [PMID: 27307432 DOI: 10.1136/bcr-2016-216071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Karim Mahawish
- Department of Older Persons Rehabilitation Services, Rotorua Hospital, Rotorua, New Zealand
| |
Collapse
|
36
|
Mahale R, Mehta A, Buddaraju K, John AA, Javali M, Srinivasa R. Diffuse corpus callosum infarction - Rare vascular entity with differing etiology. J Neurol Sci 2016; 360:45-8. [PMID: 26723971 DOI: 10.1016/j.jns.2015.11.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 11/21/2015] [Accepted: 11/23/2015] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Infarctions of the corpus callosum are rare vascular events. It is relatively immune to vascular insult because of its rich vascular supply from anterior and posterior circulations of brain. OBJECTIVE Report of 3 patients with largely diffuse acute corpus callosum infarction. METHODS 3 patients with largely diffuse acute corpus callosum infarction were studied and each of these 3 patients had 3 different aetiologies. RESULTS The 3 different aetiologies of largely diffuse acute corpus callosum infarction were cardioembolism, tuberculous arteritis and takayasu arteritis. CONCLUSION Diffuse corpus callosum infarcts are rare events. This case series narrates the three different aetiologies of diffuse acute corpus callosum infarction which is a rare vascular event.
Collapse
Affiliation(s)
- Rohan Mahale
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bangalore 560054, Karnataka, India.
| | - Anish Mehta
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bangalore 560054, Karnataka, India
| | - Kiran Buddaraju
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bangalore 560054, Karnataka, India
| | - Aju Abraham John
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bangalore 560054, Karnataka, India
| | - Mahendra Javali
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bangalore 560054, Karnataka, India
| | - Rangasetty Srinivasa
- Department of Neurology, MS Ramaiah Medical College & Hospital, Bangalore 560054, Karnataka, India
| |
Collapse
|