Cerebral Malaria: Case Report

Cerebral malaria is a rare complication caused by Plasmodium infection. Capillary blockage caused by infected erythrocytes, microglia activation and apoptosis of astrocytes as a result of cytokine leakage to the parenchyma are cited in the pathogenesis. Recently, a concept has evolved that metabolic changes in the brain in malaria infection may also be responsible for the epilepsy and encephalopathy pathogenesis. A 25-year-old male was admitted to our clinic for seizures and encephalopathy. The patient, diagnosed with cerebral malaria, recovered with antiedema, antiepileptic and antimalarial therapy. The pathophysiology and clinical and laboratory findings are discussed in light of the literature

Prognostic factors in Guillain-Barre syndrome

Objective: Guillain–Barre syndrome (GBS) is an immune-mediated disorder of peripheral nerves resulting as acute inflammatory demyelinating polyradiculoneuropathy. GBS has a heterogeneous clinical course and laboratory findings. Acute onset and progressive course, and is usually associated with a good prognosis but some forms have a poor prognosis. Factors that can affect the prognosis of GBS have been investigated in several studies. Assessment of poor prognostic factors of GBS plays a vital role in the management and monitorization of patients. Methods: In this retrospective study of patients admitted to the acute phase of GBS removing clinical and laboratory profiles and was planned to investigate the prognostic factors. Results: Totally 23 patients (Female/male: 16/7) were recruited. Mean age was 47 (range: 17-70) years. Statistically significant poor prognostic factors were advanced age (p=0.042), erythrocyte sedimentation rate (p=0.027) and serum albumin level (p=0.007). Conclusion: Advanced age, increased ESR and decreased albumin levels were found as poor prognostic factors in GBS

Anesthesia in multiple sclerosis and obstructive sleep apnea: case report and literature review

While patients with obstructive sleep apnea (OSA) or multiple sclerosis (MS) are at high risk of developing postoperative complications, both of them have special anesthetic considerations in intraoperative and postoperative periods. A careful preoperative evaluation, use of the optimal anesthetic regimen and close postoperative care is essential for these patients. Rarity of coexistence of both obstructive sleep apnea and multiple sclerosis in a surgical patient necessitates careful anesthetic management. We here report anesthetic management of a female patient with OSA and MS who underwent anesthesia three times for surgery and review the literature

Multiple Cranial Nerve Palsy Due to Cerebral Venous Thrombosis

Cerebral venous thrombosis (CVT) is a rare clinical condition between cerebrovasculer diases. The most common findings are headache, seizure and focal neurological deficit. Multiple cranial nerve palsy due to CVT is rarely seen and it is not clear pathology. A pathology that could explain the lack of cranial nerve imaging is carrying suspected diagnosis but the disease is known to provide early diagnosis and treatment. We want to emphasize with this case multipl cranial nerve palsy due to CVT is seen rarely and good response to treatment

Guillian-Barre sendromu ilişkili hiponatremi

Amaç: Guillian-Barre sendromu GBS ve hiponatremi ilişkisi bilinen bir antitedir. Bu fenomenin altta yatan etyolojik nedeninin uygunsuz antidiüretik hormon sekresyonu olduğu düşünülse de intravenöz immunoglobulin tedavisi ile ilişkili yalancı hiponatremi de sebep olarak düşünülmektedir. Çalışmamızda, merkezimizde GBS tanısı ile takip edilmiş olan hastalarda hiponatremi olup olmadığını ve hiponatremi varlığı durumunda, tedavi ve hastalığın şiddeti ile sodyum değerlerinin ilişkisini araştırmayı amaçladık. Gereç ve Yöntem: Çalışmaya, merkezimiz nöroloji kliniğinde, GBS tanısı ile yatırılarak takip ve tedavi edilmiş olan 29 hasta retrospektif olarak dahil edildi. Tüm hastaların hastaneye kabul edildikleri sıradaki ya da tedavi başlanmadan hemen öncesindeki serum sodyum değerleri, kliniğe kabul edildikleri ve taburcu edildikleri sıradaki muayene bulguları, elektrofizyolojik inceleme sonuçları değerlendirildi. Bulgular: Hastaların 14 ü erkek 15 i kadındı. Yaş ortalaması 51,9 yıldı. 29 olgunun 9 %31 unda tedavi öncesinde hiponatremi tespit edildi. Hiponatremik olan grupta serum sodyum değeri 130-135 mEq/L olan 6 %66,6 olgu, serum sodyum değeri 120-130mEq/L olan 2 %22,2 olgu ve 120 mEq/L nin altında olan 1 %11,1 olgu bulunmaktaydı. Olgulardan biri takibi sırasında ex olurken 28 hasta taburcu edildi. Sonuç: Çalışmamızın sonuçlarına göre hiponatremi, Guillian-Barre sendromuna eşlik edebilen bir elektrolit bozukluğudur. Hiponatremi ile IVIG tedavisi arasında bir ilişki varlığı düşünülmemişti

Cerebral Venous Thrombosis Presenting with Subracnoid Hemorrhage

Subarachnoid hemorrhage (SAH) associated with cerebral venous thrombosis (CVT) is rarely reported. In our case, the initial CT shows with suspected lesions that SAH. After the initial diagnosis of SVT with history and neurological examination findings MRV taken and consistend with thrombus signal change. Dural sinus thrombosis with secondary venous hypertension may lead to SAH into the subarachnoid space due to the rupture of fragile, thin-walled cortical veins. Patients with non-traumatic, non-aneurysmal and non-perimesencephalic subaracnoid hemorrhage tend to have clots circumscribed along the cortical convexity, a condition referred as acute cortical SAH. CVT is a potential cause of cortical SAH. This case; SAH may be the first sign of SVT and especially SVT must do in etiologic research without the involvement of the basal sisterna in cases of SAH

A Rare Pontine Neuro-ophthalmic Syndrome: Eight-and-a-Half Syndrome

One-and-a half syndrome is seen in paramedian pontine lesions, and may also co-exist with cranial nerve paralysis. This clinical situation is called eight-and-a-half syndrome when facial nerve paralysis also accompanies this manifestation. A man aged 38 years was admitted with symptoms of sudden-onset binocular diplopia and dizziness. The patient had no known co-morbidities. Cranial magnetic resonance imaging showed a small-sized infarct in the left paramedian pontine tegmentum posterior area. In his neuro-ophthalmologic examination, total paresis of left eye horizontal movements, mild lateral deviation, and monocular nystagmus during abduction of the right eye were observed. The patient also had peripheral facial paralysis on the left side; therefore, no signs of motor deficit of his extremities were examined. Eight-and-a-half syndrome is a rare disorder that is seen in localized-small pons lesions, mostly accompanied by infarcts. This clinical manifestation is called eight-and-a-half syndrome and arises within lesions in both the parapontine reticular formation and the medial longitudinal fasciculus in the inferior pons tegmentum where horizontal eye movements are controlled, and facial axons adjacent to the nucleus of the sixth nerve. We wanted to present this case to emphasize this rare situatio