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Transient splenial lesion of the corpus callosum can be observed in various diseases such as cancer, drug use, metabolic disorders, and cerebrovascular disorders, as well as in patients with infectious diseases. During the coronavirus disease 2019 (COVID-19) pandemic, there were increasing reports of these lesions being detected on brain imaging tests performed in patients with neurological symptoms. On brain magnetic resonance imaging, findings suggestive of cytotoxic edema are observed in the splenium; these are known to disappear with improvement of clinical symptoms. Cytokinopathy caused by infection increases the permeability of the blood-brain barrier and activates the glial cells of the brain to induce cytotoxic edema. Most patients have a good prognosis. The causes, mechanism, diagnosis, treatment and prognosis of transient splenial lesions of the corpus callosum will be summarized in this review. [ABSTRACT FROM AUTHOR]

Background & Objective: EGB 761 is a standardized natural extract used to treat impaired cerebral perfusion and nutrition (cerebrovascular insufficiency) in Korea. Although several animal studies have been conducted, few studies have investigated the clinical effects of EGB 761 in acute stroke. This study assessed the clinical benefit of intravenous EGB 761 in patients with acute ischemic stroke. Methods: This retrospective study examined a prospectively collected stroke database. We evaluated 232 patients with acute ischemic stroke within 48 hours of symptom onset. All patients were treated with antiplatelet or anticoagulation agents. We compared baseline characteristics between the EGB 761-treated and non-treated groups. The functional outcome measure was the modified Rankin Scale (mRS) score 90 days after stroke onset. Results: Of the 232 patients, 170 received EGB 761 during the first 3 days after arrival in the emergency department. We found no significant differences in baseline characteristics between the groups, with the exception of atrial fibrillation (p=0.032). After adjusting for baseline factors, intravenous administration of EGB 761 was associated with an improved 90-day functional outcome (mRS 2) compared with the control group (odds ratio, 2.56; p<0.05). Conclusions: Our results showed a clinical benefit of intravenous EGB 761 in patients with acute ischemic stroke. [ABSTRACT FROM AUTHOR]

Spontaneous cervical epidural hematoma (SCEH) is a rare condition that causes paraparesis or quadriparesis. As spontaneous resolution is seldom expected, it usually requires surgical treatment for relieve symptoms. Even if spontaneous resolution occurs, relief from symptoms usually requires several hours to days. In contrast, hemiparesis is the most common symptom of a transient ischemic attack (TIA), and usually resolves over minutes to hours. We report here two patients with SCEH who presented with hemiparesis with severe neck pain. Both patients were taking antiplatelet drugs. Their neurological symptoms recovered spontaneously over a very short time. They were initially misdiagnosed as TIA. These cases show that patients with transient hemiparesis may have SCEH if there is severe neck pain and no cranial nerve involvement. [ABSTRACT FROM AUTHOR]

Bilateral Moyamoya disease manifesting as ischemic stroke in a patient with Williams syndrome has not been previously reported. Williams syndrome is a genetic disorder characterized by infantile hypercalcemia, elfin facial features, an outgoing personality, and cardiovascular abnormalities. It has been found to be related to elastin gene defect. Cerebrovascular abnormalities with associated strokes in Williams syndrome have been described only recently and rarely. Moyamoya disease is a cerebrovascular disorder characterized by progressive occlusion of the supraclinoid internal carotid artery. The pathogenesis of Moyamoya disease is unclear. Only a single report of Moyamoya disease associated with Williams syndrome manifesting as an intracerebral hemorrhage has been published. We report the first case of bilateral Moyamoya disease manifesting as ischemic stroke in a patient with Williams syndrome. We propose that inherited moyamoya disease is also related to elastin gene defect. [ABSTRACT FROM AUTHOR]

Bilateral Moyamoya disease manifesting as ischemic stroke in a patient with Williams syndrome has not been previously reported. Williams syndrome is a genetic disorder characterized by infantile hypercalcemia, elfin facial features, an outgoing personality, and cardiovascular abnormalities. It has been found to be related to elastin gene defect. Cerebrovascular abnormalities with associated strokes in Williams syndrome have been described only recently and rarely. Moyamoya disease is a cerebrovascular disorder characterized by progressive occlusion of the supraclinoid internal carotid artery. The pathogenesis of Moyamoya disease is unclear. Only a single report of Moyamoya disease associated with Williams syndrome manifesting as an intracerebral hemorrhage has been published. We report the first case of bilateral Moyamoya disease manifesting as ischemic stroke in a patient with Williams syndrome. We propose that inherited moyamoya disease is also related to elastin gene defect. [ABSTRACT FROM AUTHOR]

Moyamoya disease (MMD) is a progressive cerebrovascular disorder caused by narrowing of the arteries located at the base of the brain in the basal ganglia. Dystonia is a relatively rare symptom of MMD, and little is known about the treatment of this symptom in MMD patients. We report a case of dystonia in an MMD patient that was alleviated after valproate treatment. A 57-year-old female patient with MMD presented with new-onset dystonia of the left upper extremity and left hemifacial spasm. Although she already suffered from mild cognitive dysfunction, there was no exacerbation when dystonia presented. She was treated with valproate 300 mg b.i.d, and the symptoms were alleviated. We discuss the efficacy of valproate in terms of anatomy and neurotransmitters. In addition, the patient's symptoms are similar to those associated with LGI-1 encephalitis but are distinguished by the progression of the disease. [ABSTRACT FROM AUTHOR]

Moyamoya disease (MMD) is a progressive cerebrovascular disorder caused by narrowing of the arteries located at the base of the brain in the basal ganglia. Dystonia is a relatively rare symptom of MMD, and little is known about the treatment of this symptom in MMD patients. We report a case of dystonia in an MMD patient that was alleviated after valproate treatment. A 57-year-old female patient with MMD presented with new-onset dystonia of the left upper extremity and left hemifacial spasm. Although she already suffered from mild cognitive dysfunction, there was no exacerbation when dystonia presented. She was treated with valproate 300 mg b.i.d, and the symptoms were alleviated. We discuss the efficacy of valproate in terms of anatomy and neurotransmitters. In addition, the patient’s symptoms are similar to those associated with LGI-1 encephalitis but are distinguished by the progression of the disease. [ABSTRACT FROM AUTHOR]

Ankle brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) are widely used noninvasive modalities to evaluate atherosclerosis. Recently, evidence has increased supporting the use of ABI and baPWV as markers of cerebrovascular disease. This study sought to examine the relationship between ABI and baPWV with ischemic stroke. This study also aimed to determine which pathogenic mechanism, large artery disease (LAD) or small vessel disease (SVD), is related to ABI or baPWV. Retrospectively, 121 patients with ischemic stroke and 38 subjects with no obvious ischemic stroke history were recruited. First, ABI and baPWV were compared between the groups. Then, within the stroke group, the relevance of ABI and baPWV with regard to SVD and LAD, which were classified by brain magnetic resonance image (MRI) and magnetic resonance angiography (MRA) or computed tomography angiography (CTA) findings, was assessed. The baPWV was higher in the stroke group than non-stroke group (1,944.18±416.6 cm/s vs. 1,749.76±669.6 cm/s, P<0.01). Regarding LAD, we found that mean ABI value was lower in the group with extracranial large artery stenosis (P<0.01), and there was an inverse linear correlation between ABI and the grade of extracranial large artery stenosis (P<0.01). For SVD, there was a significant correlation between SVD and baPWV (2,057.6±456.57 cm/s in the SVD (+) group vs. 1,491±271.62 cm/s in the SVD (-) group; P<0.01). However, the grade of abnormalities detected in SVD did not correlate linearly with baPWV. These findings show that baPWVis a reliable surrogate marker of ischemic stroke. Furthermore, baPWVand ABI can be used to indicate the presence of small vessel disease and large arterial disease, respectively. [ABSTRACT FROM AUTHOR]

Background: Behcet's disease is a heterogeneous, multisystem, inflammatory disorder of unknown etiology. The classic triad of oral and genital ulcerations in conjunction with uveitis was originally described by the Turkish dermatologist Hulusi Behcet in 1937, but associated symptoms of the cardiovascular, central nervous, pulmonary, and gastrointestinal systems were later identified. In fact, Behcet's disease with neurological involvement (neuro-Behcet's disease) is not uncommon. Patients with neuro-Behcet's disease typically exhibit a diverse array of symptoms, most commonly in the brainstem and diencephalic regions. Herein, we report an unusual case of neuro-Behcet's disease in a patient who presented with a solitary cerebellar hemorrhage.Case Presentation: A 39-year-old Asian woman was admitted to our hospital with complaints of a sudden speech difficulty that had manifested the same morning, and dizziness and mild vomiting experienced over the previous 3 days. Magnetic resonance images revealed target-like hemorrhagic lesions in the right hemisphere of the cerebellum. Risk factors that may result in cerebellar hemorrhage, such as high blood pressure or bleeding diathesis, were ruled out, and subsequent brain angiograms were normal.Conclusions: These findings suggest that the patient's cerebellar hemorrhage could have been due to intracranial vasculitis in a rare, if not unique, complication of neuro-Behcet's disease. [ABSTRACT FROM AUTHOR]

Vogt-Koyanagi-Harada (VKH) disease is a systemic disease consisting of bilateral granulomatous panuveitis combined with cutaneous and neurologic manifestations. However, there have been few reports of brain magnetic resonance imaging (MRI) in VKH disease. A 54-year-old Korean woman presented with severe periorbital pain, blurred vision and meningismus. Ophthalmologic examination disclosed bilateral optic disc edema with peripapillary nerve fiber hemorrhages. Lumbar puncture revealed monocytic pleocytosis. After a diagnosis of VKH disease was made, the patient was treated with high-dose corticosteroid. Brain MRI showed diffusely thickened posterior ocular walls with retinal detachment and perineural infiltrative changes along the optic nerves and adjacent pachymeningeal enhancement of the anterior temporal lobes bilaterally. We report a case of VKH disease with panuveitis and meningeal involvement of the anterior temporal lobe detected by brain MRI. [ABSTRACT FROM AUTHOR]