The risk factors affecting the persistence of corpus callosum splenium lesions.

BACKGROUND: The most compact portion of the corpus callosum (CC) is the corpus splenium (CS). PURPOSE: To evaluate the connection between clinical and demographic features to determine whether neuroimaging findings will be permanent or temporary in CS patients. MATERIAL AND METHODS: We enrolled 93 patients (age range = 18-86 years) with CS lesions. Demographic and clinical information were recorded. We examined the lesions depending on the location. Group 1 (n = 20) had lesions limited to the CS (egg-shaped or round); group 2 (n = 15) had "boomerang sign" lesions; and group 3 (n = 58) had splenium involvement in conditions affecting the whole brain (Boomerang sign+ plus). RESULTS: Group 1 had a lower mean age, shorter disease duration, and fewer persistent lesions than others (P < 0.01, P < 0.001, and P < 0.001, respectively). The mean disease onset age (in years) in group 1 was higher than that of the other groups (P < 0.045). Group 2 had lower potassium (K) (P < 0.003) and red cell distribution width levels (P < 0.029) than the other groups. Age <41.5 years (P < 0.001), age at illness initiation <48.5 years (P < 0.002), disease duration <5.5 months (P < 0.001), and eosinophil level <0.29 uL (P 0.014) all point to temporary lesions. CONCLUSION: Cases with limited CS lesions have younger onset ages, lower disease onset ages, and shorter disease durations. Age, age of disease onset, disease duration, and eosinophil level are risk variables that affect whether CS lesions are permanent or temporary.

Moyamoya Syndrome Secondary to Coinfection of Meningovascular Neurosyphilis and Acquired Immunodeficiency Syndrome.

Moyamoya angiopathy is a rare cerebrovascular condition characterized by insufficient cerebral blood flow resulting from arterial vessel narrowing or occlusion, potentially leading to cerebral ischemia due to inadequate oxygen and nutrient supply to the brain tissue. The development of collateral vessels in stenotic regions, inherently fragile and prone to rupture, may further precipitate intracerebral hemorrhage. Alongside focal neurological symptoms, the common clinical presentations of Moyamoya angiopathy encompass headaches, dizziness, cognitive impairments, seizures, and involuntary movements. When associated with an underlying systemic illness, including Down Syndrome, cranial radiation, neurofibromatosis type 1, or meningitis, the condition is termed Moyamoya syndrome; whereas when idiopathic and a genetic mutation are identified, it is referred to as Moyamoya disease. In this report, we present a case of the rare Moyamoya syndrome, which was attributed to syphilis and HIV infection and was identified during an investigation into the etiology of ischemic stroke in a young patient.

Reversible Severe Parkinsonism Caused by Extra-Pontine Myelinolysis in a patient with Primary Adrenal Failure.

PURPOSE: Extrapontine myelinolysis (EPM) is a highly uncommon, life-threatening disease, particularly in individuals who initially appear with severe clinical symptoms. Here, we describe a case of EPM caused by the rapid correction of hyponatremia that had severe clinical signs at first but parkinsonism symptoms were fully improved after treatment. CASE REPORT: A 46-year-old female patient was admitted to the hospital due to impaired consciousness. Her medical history reveals that she has PAI, or primary adrenal insufficiency. Initial laboratory measurements showed that the serum's sodium (Na) concentration was 104 mEq/L, chloride (Cl) content was 70 mmol/L, potassium (K) content was 4.95 mEq/L, glucose was 42 mg/dL, hydrogen potential (Ph) was 7.12, and bicarbonate (HCO3) concentration was 10 mmol/l. The adrenocorticotropic hormone (ACTH) level was 21 mg/ml, while the cortisol level was 1.2ug/dl. Her mental state was unclear, she had sluggish hypophonic speech, generalized akinesia/rigidity in both upper and lower extremities, trouble swallowing solid and liquid meals, and sialorrhea were all discovered after the Na level was corrected. Hyperintense lesions were visible in the bilateral putamen and caudate nuclei of the Magnetic Resonance Imaging (MRI) T2 and flair-weighted scans, which indicate EPM. EPM was treated with corticosteroids and dopamine agonists, and she was eventually released after complete recovery. CONCLUSION: Even if there are severe clinical symptoms at first, prompt diagnosis and treatment, such as dopaminergic, corticosteroid, and palliative therapy, can save a patient's life.