Neurological and neuropsychological complications in the course of chronic Whipple's disease : case report

Introduction. Whipple’s disease (WD) is a chronic, multisystemic infectious disease caused by Gram-positive bacillus Tropheryma whipplei (T.w.). Its common symptoms arise in the digestive system, however, during the infection the CNS (Central Nervous System) may also be affected. Aim. The aim of this work is to present a case report of a patient diagnosed with Whipple’s disease with dominant neuropsychological and behavioural complications in the late phase. Conclusions. Whipple’s disease is a rare disease with possible neurological and neuropsychiatric complications. Neurological disorders (eye movement disorders, myoclonus, oculoskeletal miorhythmia, progressive dementia) may develop in spite of correct pharmacological treatment. Apart from its classical symptoms, unspecified cognitive function disorders and autonomic nervous system disorders may develop. Providing right antibiotic treatment may not always lead to complete remission or prevent neuropsychiatric complications. However, early diagnosis and clinical alertness allow to administer right treatment and improve further prognosis

The use of mechanical thrombectomy in the treatment of basilar artery occlusion – case report

Occlusion of the basilar artery (BAO) is a rare cause of stroke, making up approximately 1% of all cases. Ischemic stroke within the basilar artery is associated with serious complications and high mortality (75–91%). BAO may occur initially in the form of mild prodromal symptoms with neurological disorders, the consequences of which can lead to death. For these reasons, BAO requires rapid diagnosis and treatment. We report the case of a 26-year-old man who suffered basilar artery occlusion and was treated with endovascular therapy. The patient was disqualified from intra-venous thrombolysis and endovascular treatment due to exceeding the therapeutic time window. Despite this, due to the location of ischemia and age of the patient, it was decided to proceed with a mechanical thrombectomy (TM). Vessel patency was restored using the Solitaire FR stent. Treatment continued with antiplatelet therapy. Despite a significant overshoot of the time window the procedure was successful and complete recanalization was achieved. During hospitalization, significant neurological symptom reductions were observed. There is no accurate data on which method of treatment of ischemic stroke is best for BAO. Expectations about the effectiveness of endovascular techniques are high

Endovascular treatment of acute ischemic stroke – Own experience

Objective Presentation of the own experience in the treatment of ischemic stroke using endovascular methods of simultaneous evaluation of their effectiveness and safety. Materials and methods The retrospective study involved a group of 18 patients hospitalized in 2005–2012 who were treated with intraarterial thrombolysis and mechanical thrombectomy. Overall there were 24 procedures performed. The investigated group consisted of seven (38.89%) women and 11 (61.11%) men. The average age of the patients was 60 years (SD±17, median – 60 years). Results In 62.50% of cases (n=15) the effect of revascularization has been achieved and another 12.50% of cases (n=3) recanalization was achieved only partially. Only in 25% of procedures (n=6) failed to achieve recanalization of the artery (TICI≤1). The highest percentage of recanalized arteries were obtained by following the procedure of thrombolysis targeted – 69.24% (TICI≥2b). In the case of mechanical thrombectomy total patency (TICI≥2b) was 54.55%. The average duration of treatment (operation) is 157min. After 30 days successful result of the neurological status was achieved in 57.14% of patients (n=8). Full return to independent functioning as defined within 3 months after the surgery (mRS≤2) reached 57.14% of patients (n=8). Conclusion Studies suggest that endovascular techniques are effective and safe in the treatment of ischemic stroke. Greater efficiency is characterized by intraarterial thrombolysis. Patients who were treated endovascular improved significantly