Juvenile Bow Hunter’s Stroke without Hemodynamic Changes

Bow hunter’s stroke (BHS) is a cerebrovascular disease caused by occlusion of the vertebral artery (VA) on head rotation. BHS is generally associated with hemodynamic changes, often leading to vertebrobasilar insufficiency symptoms, such as vertigo and faintness. Although artery-to-artery embolism has also been proposed as an underlying mechanism, it remains controversial. This report documents a case of BHS without hemodynamic changes. We describe a 26-year-old male patient who had VA occlusion on head rotation and repetitive infarction of thalami. He had an anomalous bypass of the VA and therefore no symptomatic hemodynamic changes. Thus, non-hemodynamic BHS should be considered in juvenile patients with vertebrobasilar stroke

Asymmetrical Weakness Associated with Central Nervous System Involvement in a Patient with Guillain-Barrè Syndrome

Guillain-Barrè syndrome (GBS) is usually associated with symmetrical weakness, and therefore asymmetrical weakness may confuse diagnosis. We report on a patient with GBS subsequent to Campylobacter jejuni enteritis who had asymmetrical weakness with CNS involvement. The patient tested positive for anti-ganglioside antibodies, including anti-GM1 IgM, anti-GD1b IgG, and anti-GT1a IgG. Patients with GBS can manifest asymmetrical signs and symptoms attributable to CNS involvement. Prompt, accurate diagnosis and treatment of post- C. jejuni GBS is especially important because its prognosis is relatively poor

RENOVASCULAR HYPERTENSION AND ERECTILE DYSFUNCTION SECONDARY TO POLYARTERITIS NODOSA : A CASE REPORT

We describe a patient with secondary hypertension and erectile dysfunction due to polyarteritis nodosa. A 30-year-old man was admitted because of hypertension and impotence. Blood pressure was 156/94 mm Hg, and was similar in both arms. Superficial sensation was diminished in the soles of the feet. Plasma renin activity was elevated. Intra-arterial digital subtraction angiography (DSA) of the renal arteries showed bilateral multiple microaneurysms in peripheral arterial branches between the interlobular and arcuate arteries of both kidneys. DSA of the internal iliac artery, the internal pudendal artery, and the hepatic artery also showed multiple microaneurysms, as well as focal stenoses. A diagnosis of organic (vascular) erectile dysfunction was made based on findings by the Rigi-scan (Dacomed Inc.). The patient, then, had polyarteritis nodosa presenting hypertension and erectile dysfunction

A CASE OF MALIGNANT RENAL NEOPLASM WITH RHABDOID FEATURES IN AN ADULT

We report a case of malignant neoplasm with rhabdoid features of the kidney in a 68 year old man. To our knowledge malignant rhabdoid tumor of the kidney (MRTK) has been limited to the pediatric age group. Malignant renal neoplasm similar to MRTK occurring in adults is very rare. However, there has been a recent review in which the authors found 23/480 cases of renal cell carcinoma (RCC) (4.7%) exhibiting rhabdoid features, all in adults. In the present case, examination of many sections of tumor-affected tissue revealed no sign of any other malignant tumor included RCC, so-called pure adult malignant rhabdoid tumor in the kidney. MRTK does not respond well to aggressive chemotherapy regimens and survival tends to be short. This patient remains alive with no metastasis and local recurrence more than 45 months from the operation without adjuvant therapy