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Personal testimonies
Published in Jack Ryalls, Nick Miller, Foreign Accent Syndromes, 2014
With the first occurrence I was hospitalized within 48 hours to investigate the possibility of a Transient Ischemic Attack, also known as a Mini Stroke; TIA; or Little Stroke. A TIA was eliminated. This initiated the long search for an answer. After a numerous tests, scans and consultations with specialist neurologists over three months, a further possible explanation of “Sagittal Sinus Thrombosis,” which had appeared on an MRI scan with a dye contrast, was also ruled out. At this time speech was intact with no sign of an accent.
Management and outcomes of pediatric septic thrombophlebitis: a case series
Published in Pediatric Hematology and Oncology, 2020
Jenny Koo, Alice Pong, Christopher Dory, Lauge Farnaes, Courtney D. Thornburg
Twenty-five of 28 (89%) patients received anticoagulation therapy concomitantly with antimicrobials. For all patients who received anticoagulation, the median duration was 92 days (range 41 to 268 days). Of the 25 patients who were treated with anticoagulation, most patients received ∼12 weeks of anticoagulation therapy, with six (24%) patients receiving <12 weeks and 19 (76%) patients receiving >12 weeks. It was noted that the duration of anticoagulation therapy decreased over time. Most notably, patients who received six months or more of anticoagulation therapy were treated prior to the year 2012. Subsequent to 2012 only two patients received anticoagulation therapy for longer than six months; one for persistent vessel occlusion (cerebral venous sinus thrombosis with internal carotid artery narrowing) and one due to delay in hematology follow-up. Three of 28 (11%) patients did not receive anticoagulation therapy. Two of the patients had superior sagittal sinus thrombosis that resolved with intravenous (IV) antibiotic therapy alone. One patient had right axillary and cephalic vein thrombus with adjacent osteonecrosis, septic arthritis and MSSA bacteremia that also resolved without anticoagulation therapy. Table 2 shows a summary of the anticoagulation management and outcomes.
Neuroimaging findings in patients with idiopathic intracranial hypertension and cerebral venous thrombosis, and their association with clinical features
Published in Neurological Research, 2020
In the CVT group, three of the patients were diagnosed with superior sagittal sinus thrombosis, three were diagnosed with right transverse sinus thrombosis and sigmoid sinus thrombosis, and one was diagnosed with left transverse sinus thrombosis. In two of the patients with sagittal sinus thrombosis (case 6 and case 7) and frontal parenchymal lesions, poststroke seizures and encephalopathy had developed. However, anticoagulant and antiepileptic drug therapies fully improved the symptoms, and the patients were discharged without sequelae. Abducens paralysis was involved in the clinical manifestations of two of the patients (Table 4). Remarkably, four of the MRI criteria werepositive in one of the patients (*), whereas three of the MRI findings were positive in the other (**), suggesting increased intracranial tension by radiological evidence in a strong manner (Figure 2).
The Significance and Reliability of Imaging Findings in Pseudotumor Cerebri
Published in Neuro-Ophthalmology, 2019
Firuze Delen, Elif Peker, Mehmet Onay, Çetin Murat Altay, Oya Tekeli, Canan Togay Işıkay
There have been several reports of transverse sinus stenosis due to elevated CSF, as documented by MRV. However, some authors suggest that intracranial hypertension conversely may arise from hypoplastic or narrowed transverse sinuses, which represent anatomic variations. Such patients may also benefit from stenting.32–34 The cause-and-effect relationship has not been clearly understood. Transverse sinus hypoplasia is a rather common finding in the general population, with some studies reporting unilateral transverse sinus flow impairment in up to 30% of individuals in the general population. However, bilateral transvers sinus stenosis is not common and should be considered as an underlying factor of PTC, and patients with this finding should be evaluated as possible candidates for this syndrome. In our study, patients and controls did not differ significantly with regard to the frequency of transverse sinus hypoplasia or stenosis. In patients with transverse sinus stenosis, no control MRV was performed after the treatment. Therefore, it was not possible to determine whether stenosis was an etiological factor or the result of the condition. Three patients had thrombosis in the transverse sinuses. One of these secondary PTC patients had a history of hormone treatment for pregnancy. Another patient had a past history of orbital myositis. During the follow-up, she had positive laboratory results for lupus anticoagulant and control MRI showed dural contrast enhancement. No underlying infection could be detected; thus a diagnosis of autoimmune pachymeningitis was made. In the third case with superior sagittal sinus thrombosis, no etiological factors could be identified.