OpenMed/multicare-articles huggingface dataset:
Case Report: resolution of refractory seizures after neurosurgical intervention in newborns with cerebral extra-axial hemorrhages
Authors: C Rohaert, J K H Spoor, M Dremmen, A M van Hengel-Jacobs, L S Smit, R Knol
Journal: Front Pediatr (2024)
Keywords: case report, extra-axial hemorrhage, intracranial hemorrhage, needle aspiration, neonate, neurosurgical decompression, refractory seizures
MeSH terms: Case Reports

Introduction:
Intracranial hemorrhage is a significant cause of neurological damage in newborns. Extra-axial hemorrhages with intraparenchymal extension can precipitate acute clinical deterioration. Seizures are one of the presenting symptoms, which can be refractory to treatment. These hemorrhages can result in considerable long-term morbidity and mortality.
Aim:
The objective of this report was to present three cases of extra-axial hemorrhages in neonates, all exhibiting refractory seizures that resolved after neurosurgical intervention. In addition, a review of literature is provided.
Methods:
Data collected included clinical history, laboratory findings, neuroimaging studies, type of neurosurgical intervention, and patient outcome. All infants presented with extra-axial hemorrhages along with clinical and radiological signs of increased intracranial pressure within the first 6 days of life. These manifestations included a decreased level of consciousness, hypertension, bradycardia, and cerebral midline shift on imaging. Refractory seizures were present in all cases. Urgent magnetic resonance imaging was performed followed by neurosurgical intervention (two needle aspirations, one cranial trepanation), leading to amelioration of clinical symptoms and complete resolution of seizures. Follow-up outcomes included normal psychomotor development in one infant, mild cerebral paresis in another, and delayed motor development in the third. None of the infants developed epilepsy.
Conclusion:
This study underscores the critical importance of monitoring seizure activity, conducting urgent and appropriate imaging, and implementing targeted neurosurgical intervention, preferably through minimally invasive methods such as percutaneous needle aspiration. Clinicians should be aware of this clinical picture and respond promptly to mitigate neurological damage.
Successful medical management of a pituitary macroadenoma with features of resistant acromegaly and hyperprolactinemia using pasireotide
Authors: Khaled Ahmed Baagar, Amna Sadiq, Adeel Ahmad Khan, Zeinab Dabbous, Zaina Rohani
Journal: Qatar Med J (2024)
Keywords: acromegaly, case report, hyperprolactinemia, pasireotide, pituitary macroadenoma

Background:
The somatostatin analog, pasireotide, is used for the treatment of acromegaly after the failure of surgery and/or first-line medical treatment.
Case presentation:
A 48-year-old male reported that during a workup for obesity in his home country, hyperprolactinemia was diagnosed and a 3.5 × 3.5 cm pituitary macroadenoma was identified on pituitary MRI. He received cabergoline for 6 months; then he was lost to follow-up. He presented at our Endocrine clinic 2 years later for treatment of obesity (BMI 49.5 kg/m2). Biochemical workup revealed that in addition to hyperprolactinemia (7,237 [normal: 85-323 mIU/L), he had acromegaly, evident by elevated insulin-like growth factor 1 (IGF-1) level (450 [normal: 88-210 µg/L]), and a positive growth hormone suppression test, secondary hypothyroidism, and secondary hypogonadism. Pituitary MRI showed that the adenoma encased parts of the left and right internal carotid arteries and encroached on the optic chiasm. Surgical excision was therefore not feasible. He was treated with cabergoline and later, long-acting release (LAR) octreotide. Prolactin levels were reduced with cabergoline, but IGF-1 levels did not respond to octreotide, and it was discontinued. The patient abandoned radiotherapy after two sessions. He was started on LAR pasireotide 40 mg every 4 weeks and continued on cabergoline 0.5 mg per week. His biochemical response was dramatic, with a near normalization of IGF-1 levels in 3 months. After 6 months from starting pasireotide, we increased cabergoline dose from 0.5 mg/week to 3 mg/week. Three months later, IGF-1 level was normalized. The patient developed type 2 diabetes as a side effect of pasireotide; however, this was well-controlled with medications.
Conclusions:
The case suggests that pasireotide can provide marked biochemical improvement in acromegaly after the failure of both cabergoline monotherapy and cabergoline plus octreotide. This further confirms a potentially efficacious treatment regimen in treatment-resistant acromegaly with hyperprolactinemia.
Posterior reversible encephalopathy syndrome associated with use of anlotinib to treat squamous cell carcinoma of the cervix: case report and literature review
Authors: Jietao Lin, Wenmin Chen, Sha Zhong, Kai Qian, Hanrui Chen, Lizhu Lin
Journal: Front Pharmacol (2023)
Keywords: anlotinib, case report, cervical carcinoma, posterior reversible encephalopathy syndrome, targeted therapy
MeSH terms: Case Reports

Background: Posterior reversible encephalopathy syndrome (PRES), a neurological disorder with an unknown aetiology, is characterised by visual impairment, headache, vomiting, seizures, and transient alterations in consciousness. Case report: We present the case of a 49-year-old woman with advanced cervical carcinoma who received second-line therapy with oral anlotinib (12 mg, days 1-14, every 21 days) and injectable tislelizumab (200 mg, day 1, every 21 days). After 7 days of anlotinib administration, she began experiencing symptoms suggestive of PRES and was diagnosed on day 11. Interruption of anlotinib and supportive treatment led to recovery of her binocular vision. The Naranjo score (+5) graded the causality of this reaction as probable, suggesting the possibility that the event may have been an adverse reaction to anlotinib. Ethics: This case report was approved by the Ethics Committee of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine (Reference no. K-2023-068, 2023/06/09). Informed consent was obtained from the patient and her family.
Vision Threatening Raised Intracranial Pressure Associated with Recreational Nitrous Oxide Use
Authors: Aimee Goel, Pavan S Khatkar, Jenny L Hepschke, Athanasios Zisakis, Susan P Mollan
Journal: Neuroophthalmology (2024)
Keywords: chronic abuse, illicit drug, laughing gas, nitrous oxide, papilloedema, raised intracranial pressure, recreational use
MeSH terms: Case Reports

Nitrous oxide is used as an anaesthetic and analgesic agent in the medical setting and is known to cause raised intracranial pressure. The use of nitrous oxide recreationally for the drug's euphoric and relaxant properties has been linked to multiple neurological and psychiatric sequelae including neuropathy, myelopathy, and psychosis. We describe a case of a young person who declared heavy nitrous oxide use resulting in vision-threatening papilloedema secondary to raised intracranial pressure. He underwent emergency lumbar drainage alongside high-dose acetazolamide and parenteral vitamin B12 injections. To our knowledge, there have yet to be other reports of cases where heavy nitrous oxide use has caused secondary pseudotumor cerebri syndrome.
Comprehensive Rehabilitation of a Patient With Foot Drop Secondary to Lumbar Canal Stenosis: A Case Report
Authors: Mahek R Mohani, Neha Arya, Grisha Ratnani, Pallavi Harjpal, Pratik Phansopkar
Journal: Cureus (2024)
Keywords: case report, foot drop, lumbar canal stenosis, lumbar decompression, physiotherapy, physiotherapy rehabilitation, spinal fusion
MeSH terms: Case Reports

One of the most prevalent degenerative musculoskeletal conditions is lumbar spinal canal stenosis (LSS), which is characterized by narrowing of the lumbar spinal canal that pressures the nerve roots and cauda equine. LSS, when treated surgically, usually presents with foot drop as its major complication. Foot drop is a common presentation of several clinical diseases, traditionally characterized as severe weakening of ankle and toe dorsiflexion. Foot drop has a great impact on patients' lives, lowering their quality of life and affecting their activities of daily living. Ankle dorsiflexion weakness leads to foot drop and a high-stepping gait, which can cause multiple falls and accidents. This case study aimed to assess the efficacy of a customized physiotherapy program in a 50-year-old woman with paraparesis along with left foot drop and post-surgery complications following lumbar decompression and spinal fusion at L3-S1 (lumbar-sacral) level after a jerk experienced by her while working out in the gym. The objective was to determine the impact of individualized exercises on the patient's strength, gait, balance, and pelvic floor function over a 12-week rehabilitation period. The interventions included lower limb exercises (stretching exercises, strengthening exercises, and weight-bearing exercises), pelvic floor exercises, and core stability training. The findings demonstrated significant improvements in the patient's functional outcomes, as evidenced by enhanced scores in the Berg Balance Scale, Manual Muscle Testing, Dynamic Gait Index, Barthel Index, and Stanmore Assessment Questionnaire. Notable progress was observed in the strength, balance, gait, and pelvic floor function, highlighting the positive influence of targeted physiotherapeutic interventions. This case underscores the importance of tailored exercise plans in addressing the complexities of post-surgery challenges, emphasizing the potential for comprehensive recovery and improved overall quality of life through personalized physiotherapy.
A great simulator in clinical practice: mononeuritis multiplex in HIV infection
Authors: José Pedro Soares Baima, Beatriz Carneiro Gondim Silva, Vanessa Lopes Vieira, Luiz Pedro Meireles, Milton Hideaki Arai, Angelina Maria Martins Lino
Journal: Autops Case Rep (2024)
Keywords: biopsy, hiv, mononeuropathies, vasculitis
MeSH terms: Case Reports

HIV infection is a chameleon, mimicking several diseases. Herein, we report a previously healthy 39-year-old woman who, over 2 months, developed arthritis, weight loss, and confluent multiple mononeuropathy. Extensive laboratory investigation showed positive serology for HIV, with a CD4 count of 100 cells, and necrotizing vasculitis on a nerve biopsy not associated with CMV co-infection, allowing the diagnosis of polyarteritis nodosa-like vasculitis in an HIV-infected patient. Apart from the infection, HIV-related autoimmunity can affect any organ and contribute to the complexity of the clinical presentation of HIV infection.
Primary lipoblastic nerve sheath tumor in an inguinal lymph node mimicking metastatic tumor: a case report and literature review
Authors: Chengxin Chen, Jiachen Cao, Lingxie Song, Wenjie Wang, Dandan Guo, Qi Shi, Ying Zhang, Yunzhao Chen, Chunxia Liu, Feng Li
Journal: Front Oncol (2023)
Keywords: case report, lipoblast-like cells, lipoblastic nerve sheath tumor, lymph node, nuclear atypia
MeSH terms: Case Reports

Lipoblastic nerve sheath tumors of soft tissue are characterized as schwannoma tumors that exhibit adipose tissue and lipoblast-like cells with signet-ring morphology. They have been documented to arise in various anatomic locations, including the thigh, groin, shoulder, and retroperitoneum. However, to our knowledge, this tumor has not been previously reported as a lymph node primary. We present herein the first case of a benign primary lipoblastic nerve sheath tumor arising in an inguinal lymph node in a 69-year-old man. Microscopic examination revealed a multinodular tumor comprising fascicles of spindle cells, as well as adipocytic and lipoblast-like signet-ring cell component in the context of schwannoma. Despite the presence of some bizarre cells with nuclear atypia, no obvious mitotic activity or necrosis was observed. Immunohistochemical analysis showed strong and diffuse expression of S-100, SOX10, CD56, and NSE in the spindle cells as well as in the signet-ring lipoblast-like cells and the mature adipocytes. Sequencing analysis of the neoplasm identified six non-synonymous single nucleotide variant genes, specifically NF1, BRAF, ECE1, AMPD3, CRYAB, and NPHS1, as well as four nonsense mutation genes including MRE11A, CEP290, OTOA, and ALOXE3. The patient remained alive and well with no evidence of recurrence over a period of ten-year follow-up.
Rhino-orbital-cerebral mucormycosis caused by Rhizopus arrhizus diagnosis via metagenomics next-generation sequencing: a case report
Authors: Jianhong Li, Yuwen Ge, Chengqi Xin, Li Jiang
Journal: Front Cell Infect Microbiol (2024)
Keywords: rhizopus arrhizus, diagnosis, fungal infection, metagenomics next-generation sequencing, rhino-orbital-cerebral mucormycosis
MeSH terms: High-Throughput Nucleotide Sequencing, Metagenomics / methods, Mucormycosis / diagnosis, Mucormycosis / microbiology, Rhizopus / genetics, Rhizopus / isolation & purification, Case Reports, Antifungal Agents / therapeutic use, Fatal Outcome, Humans, Male, Middle Aged, Orbital Diseases / diagnosis, Orbital Diseases / microbiology, Antifungal Agents

Rhino-orbital-cerebral mucormycosis (ROCM) is a rare, invasive, and fatal fungal disease that is often easily misdiagnosed in the early stages due to the lack of specific clinical manifestations and adequate auxiliary examinations. Early diagnosis and timely therapy are essential for successful treatment. In this report, we presented a 46-year-old man with diabetes who experienced gradual vision loss, right ptosis, swelling, and headaches that progressively worsened to death within 4 days after admission. It was finally confirmed as a fungal Rhizopus arrhizus infection by metagenomics next-generation sequencing (mNGS). Our report has proved that mNGS testing should be strongly recommended in highly suspected patients.
Peripheral neurotoxicity induced by albumin-bound paclitaxel: a case report
Authors: Xiaojing Li, Liuting Wu, Dunyao Bai, Juan Li
Journal: Front Oncol (2024)
Keywords: albumin-bound paclitaxel, case report, liposomal paclitaxel, non-small cell lung cancer, peripheral neurotoxicity
MeSH terms: Case Reports

Background:
Despite its excellent therapeutic efficacy, albumin-bound paclitaxel often leads to peripheral neurotoxicity, significantly affecting patients' quality of life. This study reported a case of non-small cell lung cancer (NSCLC) with peripheral neurotoxicity induced by albumin-bound paclitaxel.
Case presentation:
A 70-year-old male was admitted to the Hubei Cancer Hospital complaining of left-side limb weakness and numbness for one month following the first cycle of albumin paclitaxel plus cisplatin plus tislelizumab regimen for the right-side NSCLC in December 2021. Chest CT displayed a soft tissue density mass in the apical segment of the right upper lung lobe (5.5×4.9 cm2). Immunohistochemistry results and CT-guided percutaneous lung biopsy confirmed NSCLC stage cT3NXMX. The pain and numbness in both feet were alleviated after the first cycle of this regimen of liposomal paclitaxel 240 mg plus cisplatin 90 mg plus tislelizumab 200 mg. After four treatment cycles, the tumor treatment was evaluated as partial response (PR), and the tumor lesion became 2.9×2.7 cm2.
Conclusion:
The regimen containing liposomal paclitaxel, cisplatin, and tislelizumab alleviated the symptoms of peripheral neurotoxicity induced by albumin-bound paclitaxel in an NSCLC case, which may be a potential therapeutic option.
Thrombotic microangiopathy in patients with sickle cell disease
Authors: Gabriella Biasi Carrasco, Patricia Belintani Blum, Josefina Aparecida Pellegrini Braga
Journal: Rev Paul Pediatr (2024)
MeSH terms: Anemia, Sickle Cell / complications, Anemia, Sickle Cell / therapy, Thrombotic Microangiopathies / diagnosis, Thrombotic Microangiopathies / etiology, Thrombotic Microangiopathies / therapy, Case Reports, Adolescent, Child, Female, Humans, Male

Objective:
To describe two cases of patients who had thrombotic microangiopathy (TMA) associated with sickle cell disease (SCD).
Case description:
Both patients started with a painful crisis and had acute chest syndrome during hospitalization. They showed significant worsening of hemolytic anemia, with very high levels of lactate dehydrogenase, thrombocytopenia, lowered level of consciousness, organ damage and the presence of schistocytes in peripheral blood. Due to the possibility of TMA, despite the very rare association with SCD, they were treated with fresh frozen plasma replacement and plasmapheresis, with good response.
Comments:
TMA is a serious, life-threatening disease, characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ damage. The association of SCD and TMA is difficult to diagnose, since they can share a similar clinical presentation. Recognizing this association and promptly instituting treatment may impact the survival of these patients.
Multiple ocular manifestations in a patient diagnosed with herpes zoster ophthalmicus: case report
Authors: David-Ionuț Beuran, Mioara-Laura Macovei, Ioana Ruxandra Boca
Journal: Rom J Ophthalmol (2024)
Keywords: antivirals, episcleritis, herpes zoster ophthalmicus, uveitis
MeSH terms: Conjunctivitis, Herpes Zoster Ophthalmicus / complications, Herpes Zoster Ophthalmicus / diagnosis, Herpes Zoster Ophthalmicus / drug therapy, Herpes Zoster Vaccine, Scleritis, Uveitis, Anterior / diagnosis, Uveitis, Anterior / drug therapy, Uveitis, Anterior / etiology, Case Reports, Aged, Humans, Male, Herpes Zoster Vaccine

Objective: Our purpose was to present a case of a patient diagnosed with herpes zoster ophthalmicus with multiple ocular manifestations. Case presentation: A 70-year-old Caucasian male presented to the hospital for headache and skin hyperesthesia on the scalp and forehead on the left side. The diagnoses of herpes zoster ophthalmicus and acute conjunctivitis were made for the left eye. The patient was followed up for 6 months and during that period the following diagnoses were made for the same eye: peripheral sterile corneal infiltrates, episcleritis, and hypertensive anterior uveitis. Discussions: Herpes zoster ophthalmicus occurs when the reactivation of the dormant virus involves the ophthalmic division of the trigeminal nerve. The most frequent ocular presentations are conjunctivitis, keratitis, uveitis, episcleritis, and scleritis. The standard therapy consists of antivirals, such as acyclovir, valacyclovir, and famciclovir to limit the replication of the virus. The patient's risk factors, the course of treatment, and the severity of the disease, all affect the prognosis, which is highly variable. Prevention of the disease consists of vaccination with one of the following two vaccines, Zostavax and Shingrix. Conclusions: Final visual acuity for the left eye remained 1 despite numerous manifestations of the disease. Abbreviations: VZV = Varicella-zoster virus, BCVA = best-corrected visual acuity, OU = both eyes, OD = right eye, OS = left eye, IOP = intraocular pressure, NCT = non-contact tonometer, ZVX = Zostavax vaccine.
Management of Acute Lymphoblastic Leukemia During Pregnancy: A Case Report and Review of the Literature
Authors: Saleha Nadeem, Ehsan Elahi, Imran Iftikhar, Sobia Umar, Bushra Ahsan, Usman Ahmad, Syed W Bokhari
Journal: Cureus (2024)
Keywords: acute lymphoblastic leukemia, intrathecal cytarabine, intrathecal methotrexate, pegasperginase, pregnancy
MeSH terms: Case Reports

Acute lymphoblastic leukemia (ALL) during pregnancy necessitates treatment with high-dose chemotherapy, which can threaten the lives of both the mother and fetus. The aim of the treatment not only focuses on selecting and administering optimal chemotherapy with appropriate doses to the mother but also reflects the crucial understanding of the fetal gestational age at the time of administration of chemotherapy to minimize fetal exposure. We describe the case of a 19-year-old patient diagnosed with ALL at 29 weeks gestation. She received treatment in the third trimester with the Berlin-Frankfurt-Munster (BFM) 2000 induction chemotherapy protocol consisting of a combination of daunorubicin, vincristine, pegaspargase, prednisolone, and intrathecal (IT) methotrexate and gave birth to a healthy baby girl via vaginal delivery four weeks after initiating the induction of chemotherapy.
Case Report: Could topical epidermal growth factor be considered a new therapy for skin injuries in premature infants?
Authors: F Cossovel, F Marrazzo, S Nider, A Traunero, G Dussi, L Travan, M Cirino, D Zanon
Journal: Front Pediatr (2024)
Keywords: decubit lesion, epithelial growth factor, newborn, preterm, skin injuries
MeSH terms: Case Reports

In this case report, we present the experience of a premature neonate born at 28 weeks of gestation who, following prolonged respiratory support, developed a pressure injury on the columella despite the implementation of all appropriate preventive techniques. This injury did not improve with standard therapies; therefore, it was necessary to apply a topical galenic therapy containing epidermal growth factor, resulting in complete healing of the lesion.
Pulpotomy for the Management of Irreversible Pulpitis in Mature Teeth
Authors: Utkarsh Umre, Shweta Sedani, Aditya Patel, Akansha Bansod, Simran Kriplani
Journal: Cureus (2024)
Keywords: apical periodontitis, calcium hydroxide, irreversible pulpitis, mineral trioxide aggregate (mta), pulpotomy
MeSH terms: Case Reports

Strict protocols for evaluating the pulp's preoperative state should be developed, along with a new classification scheme for the different pulp states, as case selection plays a major role in the effectiveness of adult pulpotomy. In this case report, a male patient, age 15, who had a carious lower left first molar underwent pulpotomy. The pulp's initial state was ascertained by pulse oximetry, electric pulp testing (EPT), and cold testing. The final diagnosis was symptomatic irreversible pulpitis. A 12-month follow-up period following the placement of mineral trioxide aggregate (MTA) (MTA Angelus Angelus, Londrina, Brazil; Clinician's Choice, New Milford, CT) and tooth-colored composite restoration revealed no visible anomalies in the postoperative radiographs, and the tooth remained functional and free of symptoms.
Utility of MR lymphangiography in chylous ascites: A report of two cases
Authors: Pratibha Bhatia, Poonam Sherwani, Intezar Ahmed, Udit Chauhan, Sudhir Saxena
Journal: SA J Radiol (2023)
Keywords: mr lymphangiography, central conducting lymphatics, chylous ascites, cisterna chyli, nodal lymphangiography
MeSH terms: Case Reports

Dynamic contrast-enhanced (DCE) lymphangiography is a novel imaging technique with a potential role in suspected cases of lymphatic leaks. A 15-year-old male with a post operative chylous leak and an 8-year-old male who developed chylous ascites secondary to disseminated tuberculosis are presented. Both children underwent MR lymphangiography.
Contribution:
The role of DCE-MR lymphangiography in cases of chylous ascites to help guide appropriate management.