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Tuberculous radiculomyelitis (TBRM) is a complication of tuberculous meningitis (TBM), which has been reported rarely in the modern medical literature. We describe a case of TBRM, which developed during the treatment of TBM. A 28-year-old man suddenly developed lower back pain, flaccid paraparesis, urinary incontinence, while the TBM was improving with the treatment at 9th day after admission. Spinal MRI revealed leptomeningeal enhancement along with thoracolumbar spinal canal, thickening of nerve roots, spinal meninges and intramedullary high signal lesion in T2 level
Background : Predictors of recurrence after ischemic stroke are well known, but factors influencing on severity of recurrent stroke are not well known. The determinants of recurrent stroke severity will be of increasing importance because the frequency of ischemic stroke survivors increases in our population. Methods : Our, subjects included recurrent stroke patients who were admitted to the Chonnam Stroke Center between January 1997 and April 2001. Patients who had intracranial hemorrhage, vertebrobasilar insufficiency or transient ischemic attack were excluded. The severity of recurrent stroke was measured on admission by National Institutes of Health Stroke Scale(NIHSS) score and Modified-Barthel Index(MBI) score. We analyzed association of severity of recurrent stroke with confounders such as the way of secondary prevention, lesion laterality, type of ischemic stroke, risk factors of ischemic stroke by multiple linear regression. Results : Subjects were 63 patients(43 men and 20 women, aged 61.8¡¾11.5). The significant predictors of severity were medication of antiplatelet agent or anticoagulant(p〈0.01) and lesion laterality of recurrent stroke(p〈0.01). The severity of recurrent stroke was milder in patients who sustained medication(N=42) than who quitted medication(N=21). The severity of patients who had ipsilateral lesion(N=32) was milder than with had contralateral lesion N=31). Conclusions : The most significant independent predictor of the severity of recurrent stroke was whether medication was sustained or not. There fore, secondary prevention is extremely important for long term functional outcome of stroke victims. Korean Journal of Stroke 2002;4(1): 30~35
Backgroud: To investigate the clinical significance of flow diversion (FD) of the anterior cerebral artery (ACA) or posterior cerebral artery (PCA), a transcranial doppler (TCD) was used in patients with middle cerebral artery (MCA) occlusive disorders. Methods: This is a retrospective study of 51 patients from 1999 to 2001. FD was determined using TCD. Leptomeningeal collateral channels (LMCs) were identified by conventional angiography. The author analyzed the sensitivity, specificity, positive and negative predictability of FD of ACA or PCA to predict the LMCs, and also evaluated the relationship between FD and leptomeningeal collateral circulation. Results: LMC was noted in 41% of patients with M1 (MCA) occlusive disorders. It showed a tendency of increasing prevalence with an increasing degree of M1 MCA stenosis (rho=0.605, p<0.001). FD was noted in 47% of patients with MCA occlusive diseases. It also had a tendency of high prevalence with an increasing degree of M1 MCA stenosis (rho=0.382, p=0.006). To predict the presence of LMCs, FD of ACA or PCA had a sensitivity of 81%, specificity of 76%, positive predictive value of 71% and negative predictive value of 85%. FD of ACA or PCA had a good correlation with LMCs in patients with MCA occlusive disorders (rho=0.568, p<0.001). Conclusions: These results suggest that FD had good sensitivity and specificity to predict the LMCs, and demonstrated that FD was a reliable source of evidence of LMCs in patients with M1 MCA occlusive disorders. Patients with M1 MCA stenosis had heterogeneous hemodynamics in the development of collateral circulation.
Acute sensory neuropathy (ASN) is rare and is characterized by acute onset of sensory ataxia, loss of deep tendon reflexes and impaired vibratory and joint position sensations. Similar to Guillain-Barre syndrome (GBS) with prominent sensory ataxia, a few cases of ASN associated with antiganglioside antibodies have been reported. This suggests that a common autoimmue mechanism operates in some cases of ASN and of GBS with sensory ataxia. We report a patient with ASN associated with anti-GD1b IgG antibody.