Successful Intra-arterial Thrombolysis in a Patient with an Intracranial Meningioma

Alteplase (recombinant tissue plasminogen activator [rt-PA]) label approval by the Food and Drug Administration remarks the contraindication of its use with known intracranial neoplasm because of potential bleeding complications. Despite this concern, the real risk of intracerebral bleeding in patients with intracranial neoplasms treated with rt-PA is unknown, and there are few reports of thrombolysis in patients with brain tumors. We report a case of a 78-year-old man who was seen in our emergency department within 2 hours from sudden onset of aphasia, right-sided hemiplegia, hypoesthesia, and homonymous hemianopsia. the National Institutes of Health Stroke Scale (NIHSS) score at admission was 20. Intra-arterial thrombolysis was performed with administration of .3 mg/kg of alteplase combined with mechanical thrombectomy. At discharge, his NIHSS score was 1, and after 90 days, his modified Rankin score was 1. To our knowledge, this is the first report of intra-arterial thrombolysis in a patient with acute ischemic stroke with an intracranial tumor.Hosp Coracao, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Neurol & Neurocirurgia, BR-04039000 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Neurol & Neurocirurgia, BR-04039000 São Paulo, BrazilWeb of Scienc

Ondine's curse after brainstem infarction

This report describes a rare case of acquired Ondine′s curse. The patient developed central sleep apnea syndrome named Ondine′s curse after a brainstem infarction. Lesions involving the descending medullocervical pathways that subserve automatic breathing can result in this syndrome

Teaching NeuroImages: Brucellosis mimicking demyelinating disease

Univ Fed Sao Paulo, Dept Neurol & Neurocirurgia, BR-04039000 Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Med, BR-04039000 Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Neurol & Neurocirurgia, BR-04039000 Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Med, BR-04039000 Sao Paulo, BrazilWeb of Scienc

Ginkgo biloba and Cerebral Bleeding A Case Report and Critical Review

Ginkgo biloba is a herbal medication that is often used worldwide. Although side effects are uncommon, G. biloba has been associated with serious bleeding complications, especially intracranial hemorrhage. We report the case of a young woman who made chronic use of G. biloba and suffered from cerebral bleeding without any structural abnormalities. Several studies have pointed to the association between G. biloba and intracranial hemorrhage.Universidade Federal de São Paulo, Dept Neurol & Neurosurg, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Neurol & Neurosurg, São Paulo, BrazilWeb of Scienc

Hepatitis C virus: A rare manifestation - Remitting relapsing central and peripheral demyelination

The most frequent neurologic manifestations of hepatitis C virus infection include peripheral neuropathy axonal type and central nervous system (CNS) vasculitis. Affected patients usually have cryoglobulinemia and other signs of vasculitis. Demyelinating lesions, both central and peripheral are rarely described. We present a case of simultaneous peripheral nervous system and CNS demyelination that comes in relapsing episodes, with negative cryoglobulins.Universidade Federal de São Paulo, Dept Neurol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Neuromuscular Dis, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Neurol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Neuromuscular Dis, São Paulo, BrazilWeb of Scienc

Teaching NeuroImages: A prematurely aging patient presenting with severe leukoaraiosis and stroke

Universidade Federal de São Paulo, Dept Neurol & Neurosurg, São Paulo, BrazilHosp Sick Children, Toronto, ON M5G 1X8, CanadaUniversidade Federal de São Paulo, Dept Neurol & Neurosurg, São Paulo, BrazilWeb of Scienc