Adams–Oliver syndrome in a newborn infant Zakanj, Zora; Bedek, Darko; Kotrulja, Lena ...
International journal of dermatology,
February 2016, Letnik:
55, Številka:
2
Journal Article
A case is reported of a 72-year-old woman who presented with severe vertigo, vomit, and mild neck and occipital pain. She had a medical history of hypertension, angina pectoris, cholelithiasis, ...gastric ulcer, pyelonephritis and periodical mild dizziness. Neuroimaging revealed right vertebral artery occlusion, right cerebellar stroke and basilar impression. The therapeutic approach chosen in our patient was conservative, with non-steroid anti-inflammatory drugs and neck collar. Although our patient's prior risk factors for stroke supported a diagnosis of vertebrobasilar stroke, it is possible that the vertebral artery occlusion was the result of changes in the atlantoaxial anatomy and that cerebellar infarction was secondary to craniocervical anomaly. Although the presence of vertebral artery occlusion, cerebellar stroke and basilar impression in our patient may have been coincidental, we suggest that patients with basilar impression and craniocervical anomalies in general may be at an increased risk of vertebrobasilar vascular disease and vertebrobasilar stroke.
Creutzfeldt-Jakob disease is the most common form of human prion diseases. A 57-year-old woman was transferred to our Department from a local hospital, where she had been treated for two weeks due to ...consciousness disorders and convulsive epileptic attacks that progressed to refractory status epilepticus. Electroencephalography showed diffuse spike-wave complex discharges and development of nonconvulsive status epilepticus. The causes of metabolic encephalopathy and paraneoplastic syndrome were ruled out. A combination of clinical features and findings of diagnostic procedures including electroencephalography, biomarkers in the cerebrospinal fluid and magnetic resonance imaging suggested with great probability that the patient was affected with sporadic Creutzfeldt-Jakob disease.
We have recently reported that transcranial sonography (TCS) is a method competitive to magnetic resonance neuroimaging (MRI) in the evaluation of pineal gland lesions. The aim of the present is ...study was to assess the usefulness of TCS in a larger patient sample during a two-year follow up. Twenty patients with incidental pineal gland cyst (PGC) detected by MRI scan of the brain and 40 healthy controls without any previous documented data on a disease related to pineal gland were evaluated by TCS and compared with MRI scans. There were no statistically significant differences in PGC size measured by TCS by two observers (p = 0.475), PGC size measured by TCS and MRI (first observer, p = 0.453; and second observer, p = 0.425), size of the pineal gland measured by TCS and MRI in control group (first observer, p = 0.497; and second observer, p = 0.370), and pineal gland size measured by TCS by two observers in control group (p = 0.473). Study results suggested TCS to be a suitable method in the evaluation of pineal gland lesions. Although its resolution cannot match the MRI resolution, its repeatability and accuracy might add to its practical value. We suggest that the repeat MRI scan of such lesions might be replaced by clinical and TCS follow up.
Adams-Oliver syndrome in a newborn infant Zakanj, Zora; Bedek, Darko; Kotrulja, Lena ...
International Journal of Dermatology,
02/2016, Letnik:
55, Številka:
2
Report
Prikazuje se slučaj sedamdesetdvogodišnje bolesnice primljene na bolničko liječenje zbog jake vrtoglavice, povraćanja te blage zatiljne i boli u području vrata. Anamnestički se doznaje kako boluje od ...arterijske hipertenzije, pektoralne angine, žučnih kamenaca, želučanog ulkusa, pijelonefritisa te kako je do tada povremeno imala blaže vrtoglavice. Neuroradiološkom i ultrazvučnom obradom utvrđena je okluzija desne vertebralne arterije, ishemijski moždani udar u području desne hemisfere malog mozga i bazilarna impresija. Bolesnica je liječena konzervativno. Premda je bolesnica imala prethodno utvrđene rizične čimbenike za ishemijski moždani udar, moguće je kako je okluzija vertebralne arterije nastala uslijed poremećaja atlanto-aksijalne anatomije te kako je moždani udar u području malog mozga nastao kao rezultat priležeće kranio-cervikalne anomalije. Premda je povezanost okluzije vertebralne arterije, moždanog udara u malom mozgu i bazilarne impresije moguće slučajna, bolesnici s bazilarnom impresijom i anomalijama kranio-cervikalnog prijelaza možda imaju povećani rizik za nastanak okluzivnih promjena krvnih žila vertebro-bazilarnog sliva te posljedičnog ishemijskog moždanog udara u tom opskrbnom području.