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May 28, 2019; 92 (22) Resident & Fellow Section

Resident & Fellow Rounds

View ORCID ProfileJohn J. Millichap, Roy E. Strowd
First published May 27, 2019, DOI: https://doi.org/10.1212/WNL.0000000000007590
John J. Millichap
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Roy E. Strowd III
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Resident & Fellow Rounds
John J. Millichap, Roy E. Strowd
Neurology May 2019, 92 (22) 1065-1067; DOI: 10.1212/WNL.0000000000007590

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A summary of recently published articles in the Neurology® Resident & Fellow Section

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#NeurologyRF

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May 7, 2019 issue

This issue contains a Journal Club article of a case–control study of association between aspirin dose and subarachnoid hemorrhage from saccular aneurysms. One Teaching NeuroImages case describes a patient with pterygoid myositis mimicking giant cell arteritis and the second shows the zigzag edging sign of adult-onset neuronal intranuclear inclusion disease. The Teaching Video NeuroImages case discusses opsoclonus in anti-DPPX encephalitis.

Journal Club: Association between aspirin dose and subarachnoid hemorrhage from saccular aneurysms: A case-control study

We suggest that the element of time is critical to study design when evaluating risk and the true effect of antiplatelet therapies would best be evaluated prospectively or in a randomized study.

Page 920

Teaching NeuroImages: Pterygoid myositis mimicking giant cell arteritis

This article describes a patient with pterygoid myositis mimicking giant cell arteritis. This report would expand the view for differential diagnosis of giant cell arteritis.

Page e2297

Teaching NeuroImages: The zigzag edging sign of adult-onset neuronal intranuclear inclusion disease

We describe a typical case of adult-onset neuronal intranuclear inclusion disease. To describe the radiologic feature vividly, we named it zigzag edging sign.

Page e2295

Teaching Video NeuroImages: Opsoclonus in anti-DPPX encephalitis

Anti-DPPX encephalitis is a relatively new autoimmune encephalitis that may have significant neuro-ophthalmic manifestations. Opsoclonus has not been described in this condition.

Page e2298

May 14, 2019 issue

This issue starts with a Clinical Reasoning article on refractory status epilepticus in a primigravida. The issue also features 2 Teaching NeuroImages articles showing a child with macrocephaly and psychomotor development delay and the second a fuzzy determination of stroke onset. A Teaching Video NeuroImage describes a case of hourglass-like fascicular constriction in Parsonage-Turner syndrome.

Clinical Reasoning: Refractory status epilepticus in a primigravida

This report details the presentation, clinical reasoning, and management of a young pregnant woman with mitochondrial disease who presented with first seizure of life and developed refractory status epilepticus.

Page 968

Teaching NeuroImages: A child with macrocephaly and psychomotor development delay

This report highlights clinical and radiologic features of megalencephalic leukoencephalopathy with subcortical cysts, which is of interest because it is a rare type of leukodystrophy.

Page e2397

Teaching NeuroImages: A fuzzy determination of stroke onset

The case highlights a patient who presented with an acute occlusion of the right internal carotid artery, manifesting with profound hemineglect, of an unclear duration. He may have been considered a candidate for endovascular thrombectomy on the basis of his neuroimaging.

Page e2395

Teaching Video NeuroImages: Hourglass-like fascicular constriction in Parsonage-Turner syndrome

A 43-year-old woman presented with intense pain in the left upper arm, a plegic flexor pollicis longus, and flexor digitorum profundus of the 2nd digit without sensory symptoms occurring 8 days after a hysterectomy.

Page e2399

May 21, 2019 issue

The Pearls & Oy-sters article in this issue describes May-Thurner syndrome as a cause of embolic stroke of undetermined source. A Global & Community health piece shares information on the Gorgas Diploma Course in Clinical Tropical Medicine. The 2 Teaching NeuroImages featured this month describe advanced imaging of neurosarcoidosis and medically intractable epilepsy and ictal asystole treated with cardiac pacing.

Pearls & Oy-sters: May-Thurner syndrome as a cause of embolic stroke of undetermined source in a young patient

We provide an example of how in patients with embolic strokes with undetermined source, an extended workup leads to a change in management, with a better outcome.

Page e2507

Global & Community Health: The Gorgas experience

In this article, I describe my experience attending the Gorgas Diploma Course in Clinical Tropical Medicine, taught over 9 weeks in Peru. The Gorgas course is one of the best internationally recognized courses for obtaining the Diploma in Tropical Medicine & Hygiene, which is an excellent stepping stone for those interested in Global Health Neurology.

Page 1019

Teaching NeuroImages: Advanced imaging of neurosarcoidosis with 68Ga-DOTATATE PET/CT

This image underlines the diagnostic but also the therapeutic possibilities of somatostatin-receptor targeted radioligands in patients with neurosarcoidosis.

Page e2512

Teaching NeuroImages: Medically intractable epilepsy and ictal asystole treated with cardiac pacing

A 43-year-old man with bihemispheric periventricular nodular heterotopia had medically intractable multifocal epilepsy and seizure-related falls.

May 28, 2019 issue

This issue begins with a Clinical Reasoning case describing a 55-year-old obese woman with headache and rhinorrhea. The Mystery Case illustrates a rare and therefore commonly missed etiology for ischemic stroke in young adults. A Teaching NeuroImages case describes aspergillosis-induced vasculitis presenting as ischemic stroke in an immunocompetent patient. The Teaching Video NeuroImages article shows a case of Foix-Chavany-Marie syndrome.

Clinical Reasoning: A 55-year-old obese woman with headache and rhinorrhea

A 55-year-old obese woman with a history of migraine and tension-type headaches presented with headache for 5 days with acute worsening for 1 day.

Page e2614

Mystery Case: Missed diagnosis of hereditary hemorrhagic telangiectasia presenting with recurrent ischemia

A 35-year-old patient presented with hemianopia, decreased consciousness, and bilateral cortical foci of restricted diffusion. Hereditary hemorrhagic telangiectasia is an easily underdiagnosed cause of ischemic stroke in young adults. Delayed diagnosis results in recurrent but preventable peripheral and neurologic ischemic events.

Page 1068

Teaching NeuroImages: Aspergillosis-induced vasculitis presenting as ischemic stroke in an immunocompetent patient

We report the case of a 56-year-old immunocompetent man who experienced right-sided hemiplegia 2 months after surgery for pansinusitis (during which culture grew Aspergillus fumigatus). MRI revealed a recent infarction of the left lentiform and caudate nucleus with left internal carotid and middle cerebral arteries stenosis caused by a perivascular infiltrative mass.

Page e2618

Teaching Video NeuroImages: Foix-Chavany-Marie syndrome

We include one figure showing MRI and 18Fluorodeoxyglucose-PET findings, accompanied by a patient video demonstrating characteristic dissociation between voluntary and automatic bulbar expression.

Page e2620

Footnotes

  • Editor’s Blog: NPub.org/rfblog

  • Neurology Podcast: NPub.org/rf

  • Clinical Reasoning Book Free Download: NPub.org/crb

  • Global and Community Health Subsection: NPub.org/gch

  • Resident & Fellow e-Pearls: NPub.org/epearls

  • © 2019 American Academy of Neurology

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Related Articles

  • Journal Club: Association between aspirin dose and subarachnoid hemorrhage from saccular aneurysmsA case-control study
  • Teaching NeuroImages: Pterygoid myositis mimicking giant cell arteritis
  • Teaching NeuroImages: The zigzag edging sign of adult-onset neuronal intranuclear inclusion disease
  • Teaching Video NeuroImages: Opsoclonus in anti-DPPX encephalitis
  • Clinical Reasoning: Refractory status epilepticus in a primigravida
  • Teaching NeuroImages: A child with macrocephaly and psychomotor development delay
  • Teaching NeuroImages: A fuzzy determination of stroke onset
  • Teaching Video NeuroImages: Hourglass-like fascicular constriction in Parsonage-Turner syndrome
  • Pearls & Oy-sters: May-Thurner syndrome as a cause of embolic stroke of undetermined source in a young patient
  • Global & Community Health: The Gorgas experience
  • Teaching NeuroImages: Advanced imaging of neurosarcoidosis with 68Ga-DOTATATE PET/CT
  • Clinical Reasoning: A 55-year-old obese woman with headache and rhinorrhea
  • Mystery Case: Missed diagnosis of hereditary hemorrhagic telangiectasia presenting with recurrent ischemia
  • Teaching NeuroImages: Aspergillosis-induced vasculitis presenting as ischemic stroke in an immunocompetent patient
  • Teaching Video NeuroImages: Foix-Chavany-Marie syndrome

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