The Experts below are selected from a list of 93 Experts worldwide ranked by ideXlab platform

Gary L. Bernardini - One of the best experts on this subject based on the ideXlab platform.

  • Diagnosis and management of brain abscess and subdural empyema
    Current Neurology and Neuroscience Reports, 2004
    Co-Authors: Gary L. Bernardini
    Abstract:

    Advances in the diagnosis and treatment of brain abscess and subdural empyema with neuroimaging techniques such as computerized tomography, magnetic resonance imaging, magnetic resonance spectroscopy, the availability of new antimicrobials, and the development of novel surgical techniques have significantly contributed to the decreased morbidity and mortality associated these infections. Determination of point of entry and source of infection is paramount to adequate treatment. A high index of suspicion along with typical clinical presentation of headache, seizures, or Focal Neurologic Signs can lead to early diagnosis so that effective therapy can be instituted as soon as possible. This review discusses etiology and pathology of brain abscess and subdural empyema, neuroimaging techniques useful in the diagnosis, and optimal treatment, including use of antimicrobials and surgical procedures.

Keehyun Chang - One of the best experts on this subject based on the ideXlab platform.

  • scrub typhus encephalomyelitis with prominent Focal Neurologic Signs
    JAMA Neurology, 2000
    Co-Authors: Kyungil Park, Keehyun Chang
    Abstract:

    Background Encephalomyelitis with prominent Focal Neurologic Signs and associated neuroradiologic abnormalities has not been previously described in scrub typhus. Case Description A 22-year-old woman was admitted because of fever and an altered mental state. Neurologic examination revealed bilateral sixth and seventh nerve palsies, bilateral gaze evoked nystagmus, anarthria, dysphagia, quadriparesis, and sensory level at T1. Serum and cerebrospinal fluid samples were positive for tsutsugamushi antibody. The patient's magnetic resonance images demonstrated the lesions responsible for the Neurologic dysfunctions: in the lower brainstem, cerebellar peduncles, and spinal cord. It was interesting that the gray matter of the spinal cord was predominantly involved. Conclusions The recognition of unusual manifestations and the clinical suspicion of this treatment-responsive disease may be important, particularly in the face of increasing international and intranational travel.

Kyungil Park - One of the best experts on this subject based on the ideXlab platform.

  • scrub typhus encephalomyelitis with prominent Focal Neurologic Signs
    JAMA Neurology, 2000
    Co-Authors: Kyungil Park, Keehyun Chang
    Abstract:

    Background Encephalomyelitis with prominent Focal Neurologic Signs and associated neuroradiologic abnormalities has not been previously described in scrub typhus. Case Description A 22-year-old woman was admitted because of fever and an altered mental state. Neurologic examination revealed bilateral sixth and seventh nerve palsies, bilateral gaze evoked nystagmus, anarthria, dysphagia, quadriparesis, and sensory level at T1. Serum and cerebrospinal fluid samples were positive for tsutsugamushi antibody. The patient's magnetic resonance images demonstrated the lesions responsible for the Neurologic dysfunctions: in the lower brainstem, cerebellar peduncles, and spinal cord. It was interesting that the gray matter of the spinal cord was predominantly involved. Conclusions The recognition of unusual manifestations and the clinical suspicion of this treatment-responsive disease may be important, particularly in the face of increasing international and intranational travel.

Ralph F. Frankowski - One of the best experts on this subject based on the ideXlab platform.

  • Brain tumor masquerading as stroke
    Journal of Neuro-Oncology, 1999
    Co-Authors: Lewis B Morgenstern, Ralph F. Frankowski
    Abstract:

    Discriminating brain tumor from stroke in patients presenting with acute Focal Neurologic Signs and symptoms is crucial to avoid improper treatment, or delay correct treatment of the brain tumor patient. Data from the era before computed tomography (CT) suggests that 3% of patients with brain tumors are initially thought to have had a stroke. Our goal was to see if this has improved in the CT era. We reviewed hospital charts of all patients admitted to the Johns Hopkins Hospital with a brain tumor during a one year period. Eleven (4.9%) of the 224 patients discharged with a diagnosis of brain tumor were initially thought to have had a stroke. Seven had primary brain tumors and 4 had metastatic tumors. Patients who were originally misdiagnosed were significantly older (p = 0.01) and more likely to have a Glioblastoma Multiforme (p = 0.04) than those correctly diagnosed. Eighty-two percent of those misdiagnosed had no prior history of cancer compared to 59% of patients correctly diagnosed. Distinguishing the acute presentation of brain tumor and stroke remains an important diagnostic consideration. Physicians should recognize that while CT is frequently employed for acute Neurologic deficits to exclude intracranial hemorrhage, CT may not be sufficient to exclude brain tumor. A prospective study is needed to confirm these findings.

Laurence Teisseyre - One of the best experts on this subject based on the ideXlab platform.

  • headache with Focal Neurologic Signs in children at the emergency department
    The Journal of Pediatrics, 2014
    Co-Authors: Davide Massano, Sebastien Julliand, Lakshmi Kanagarajah, Maxime Gautier, Audrey Vizeneux, Monique Elmaleh, M Alison, Emilie Lejay, Silvia Romanello, Laurence Teisseyre
    Abstract:

    Objective To identify predictors of secondary headache in children consulting at the pediatric emergency department (ED) for headache with a Focal Neurologic deficit. Study design In this prospective cohort study, we enrolled children aged 6-18 years presenting to the ED of a tertiary care hospital with moderate to severe headache and Focal Neurologic deficit. Enrollment took place between March 2009 and February 2012. Children with a history of trauma, fever, or neurosurgical intervention were excluded from the study. The final diagnosis was made after 1 year of follow-up. Our primary aim was to identify any differences in the frequency of clinical Signs between children with a final diagnosis of primary headache and those with a final diagnosis of secondary headache. Results Of the 101 patients included in the study, 66% received a final diagnosis of primary headache (94% migraine with aura), and 34% received a final diagnosis of secondary headache (76.5% Focal epilepsy). On multivariate analysis, children with bilateral localization of pain had a higher likelihood (aOR, 8.6; 95% CI, 3.2-23.2; P Conclusion Among children presenting to the ED with Focal Neurologic deficits, a bilateral headache location was associated with higher odds of having a secondary cause of headache. Additional longitudinal studies are needed to investigate whether our data can aid management in the ED setting.