Background: Creutzfeldt-Jakob disease (CJD) is a rare prion disease characterized by rapidly progressive dementia. Case Report: A 76-year-old woman exhibited pronounced signs and symptoms of dressing apraxia for about seven weeks before the disease progressed and probable CJD was diagnosed supported by imaging and CSF findings. Discussion: Dressing apraxia as the initial manifestation of CJD has been sparsely reported. This remarkably focal syndrome should be considered with view on movement and neuropsychological disorders in early CJD.
Apraxias/physiopathology , Creutzfeldt-Jakob Syndrome/physiopathology , Aged , Brain/diagnostic imaging , Creutzfeldt-Jakob Syndrome/diagnosis , Diffusion Magnetic Resonance Imaging , Female , Humans , Magnetic Resonance Imaging
BACKGROUND: Cerebral air embolism (CAE) is a critical clinical condition necessitating rapid diagnosis and therapeutic measures. METHODS: The authors describe two patients with lethal CAE. RESULTS: An 81-year-old man rapidly developed coma with tetraplegia. CT-scan revealed prominent CAE whereby the entry of the air was via a port catheter for parenteral nutrition. A 45-year-old man with severe alcohol-toxic multiple organ damage needed endoscopic retrograde cholangio-pancreatography (ERCP) and a second esophagogastroscopy. After an epileptic seizure, the CT-scan of the brain showed small amounts of cerebral air in the posterior right hemisphere and in the sagittal superior sinus. Despite critical care the patient died. CONCLUSION: CAE is a neurocritical emergency case. Early CT-scan of the brain can detect air, guide further therapy, and contribute to the assessment of the prognosis.
