This case highlights the diagnostic pitfalls that may

ari

This case highlights the diagnostic pitfalls that may

arise when relying on only one modality for assessing intracranial vasculature and the importance of clarifying the diagnosis of basilar thrombosis or fenestration. “
“Rheumatoid arthritis (RA) is a chronic inflammatory multisystem disease with articular and extra-articular manifestations. BGB324 Intracranial manifestations of RA are rare. Purpose of this article is to report on a rarely described leptomeningeal involvement in RA, and on its neuroimaging features, including diffusion-weighted imaging (DWI). The authors describe the case of a 74-year-old woman with a 5-year history of RA presenting with progressive left-side weakness and hypoesthesia. The patient underwent laboratory investigation and brain contrast-enhanced MRI, also with DWI, before undergoing brain biopsy. Neuroimaging revealed abnormal high T2-signal in right frontal and parietal lobes, restricted diffusion in the subarachnoid space, and diffuse thick linear leptomeningeal contrast-enhancement. These findings Selleck BVD-523 were interpreted as rheumatoid leptomeningitis, and brain biopsy confirmed this diagnosis. In summary, rheumatoid meningitis is a rare neurological complication of RA, but it should be considered in the proper clinical setting when patient presentation and laboratory results

fail to support the other differential diagnostic possibilities proposed by the MR imaging findings. “
“Wernicke encephalopathy (WE) is a serious neurological disorder caused by thiamine (vitamin B1) deficiency. We report a case of atypical and extensive location of abnormal selleck products signal lesions on magnetic resonance imaging (MRI) in a man with alcohol abuse with WE. MRI performed on the first hospital day showed signal intensity alterations extending in the whole brain stem and diencephalon; the mismatch between diffusion-weighted images and apparent

diffusion coefficient map was highly suggestive of vasogenic edema. This report further supports the view that WE may represent a spectrum of radiological entities and can have a wide spectrum of manifestations on MRI; thus, clinical features are essential to diagnose it. “
“Recombinant tissue plasminogen activator (rtPA)-associated hyperperfusion syndrome in brainstem after acute stroke has not yet been reported. The current report demonstrates that rtPA-associated hyperperfusion syndrome can be a cause of clinical deterioration following improvement (DFI) after rtPA in acute stroke. We observed a transient DFI in a 59-year-old man with acute ischemic stroke who received rtPA. The phenomenon was assessed by magnetic resonance imaging (MRI) with diffusion-weighted image (DWI) and a series of transcranial Doppler scan evaluating changes in the basilar arterial flow.

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