Mixed Aphasia Caused by Bilateral Cerebellar Infarcts: a Case Report.

Although neuroanatomical and physiological understanding of the cerebellum has evolved over recent decades and continues to develop, there is much that remains to be expounded upon, especially with regard to nonmotor roles. Neurocognitive and language processing is one area where involvement of the cerebellum is no longer in question, but the extent and mechanism of this relationship have yet to be defined. For example, which of the cerebellar hemispheres is involved continues to be debated. We present a case wherein a thrombus in the basilar artery led to bihemispheric cerebellar strokes with profound mixed effects on the patient's language and cognition. To the authors' knowledge, this is the first reported case of bilateral cerebellar strokes resulting in a mixed aphasia reported in scientific literature. This demonstrates the importance of continued research into a model for cerebellar function and the clinical impact of lesions to various cerebellar regions.

Post-traumatic Secondary Complications Resembling Stroke Symptoms Following Axillofemoral Bypass Surgery: A Case Report.

Peripheral artery disease exerts a substantial toll on public health in the United States, straining healthcare resources. In challenging cases, the axillofemoral bypass graft had emerged as a cornerstone in managing this condition. Unforeseen events, such as trauma, can lead to a presentation mimicking stroke and thus exacerbating the complexity of the diagnostic process. Herein, we present the case of a 64-year-old male with complex peripheral artery disease who developed a pseudoaneurysm mimicking stroke symptoms following a traumatic incident post axillofemoral bypass graft surgery. This case underscores the critical importance of employing diverse diagnostic modalities to navigate the complex differential diagnosis of stroke-like symptoms in patients post-surgery.

Staged Arterial and Venous Embolizations in Treatment of Type IV Intraosseous Dural Arteriovenous Fistula.

OBJECTIVE: This is a case report of an adult male with complex type IV intraosseous DAVF causing severe venous hypertension and bony destruction, presenting with severe hemotympanum, and a novel way of staged arterial and venous embolizations to treat the emergent symptoms. METHODS: First and second stages were direct selective arterial embolizations using Onyx liquid agent. Goal was to reduce flow into the fistula by embolizing the feeder branch and distal penetration of the nidus with Onyx. The third stage was performed through the venous route: the transverse sinus and the sigmoid sinus were embolized using Penumbra Ruby coils and Onyx, two microcatheters were used and two large coils were placed simultaneously to form a stable coil mass, and the entire sinus was embolized using Coils and Onyx. RESULTS: Patient's venous hypertension and degree of hydrocephalus had significantly decreased after the procedure. He was able to return to work, but was instructed to avoid heavy lifting and placing anything in and around his right ear. CONCLUSIONS: Multiple step arterial and venous embolization procedures were successful in decreasing the frequency of hemotympanum, degree of hydrocephalus, and improving quality of life of this patient.

Carotid body tumor as a reversible cause of syncope.

The causes of syncope are diverse and extensive; carotid body tumors are an extremely rare cause of syncope. These rare neoplasms represent less than 0.5% of all head and neck tumors. The authors present a case of a woman with syncope who was found to have a right-sided carotid body tumor. After surgical resection was performed, she did not have any additional syncopal or near-syncopal events. The authors provide a review of the literature on the natural history, presentation, and preferred management of carotid body tumors. With modern diagnostic tools and treatment options, most patients with this diagnosis can expect to recover fully.

Moyamoya disease: case report and literature review.

Moyamoya disease is a chronic, progressive occlusion of the circle of Willis arteries that leads to the development of characteristic collateral vessels seen on imaging, particularly cerebral angiography. The disease may develop in children and adults, but the clinical features differ. Moyamoya disease occurs predominantly in Japanese individuals but has been found in all races with varying age distributions and clinical manifestations. As a result, moyamoya disease has been underrecognized as a cause of ischemic and hemorrhagic strokes in Western countries. At this time, there is no known cure, and existing treatment options are controversial. The authors describe the case of a 44-year-old African American woman with a history of hypertension, cervical cancer, breast cancer, and stroke who was diagnosed as having moyamoya disease. A review of the literature for the various facets of this condition is also provided.