Background: Glufosinate ammonium (Basta®) was developed in Japan in 1994 and was introduced to Korea as a non-selective herbicide. Recently, there is increasing concern about the glufosinate ammonium (GLA) intoxication. Case Report: We report a bilateral basal ganglia lesion that developed after Basta® ingestion. Hippocampal cytotoxic edema is usually encountered after GLA intoxication because profound hypotension or prolonged generalized tonic clonic seizures are usually accompanied. However, profound hypotensive episode or elevated creatine kinase was not observed during the hospital admission. After conservative ventilator support and antibiotic care for aspiration pneumonia, the patient was discharged to a chronic care facility. Conclusion: Bilateral striatal lesion except hippocampal involvement is one of the features of GLA intoxication. Toxic properties for GLA and other additives in Basta® should be thoroughly investigated.
Background: Polycythemia vera (PV) is a myeloproliferative stem cell disorder which increases the risk of ischemic stroke. We evaluated an ischemic stroke patient with PV using serial perfusion computed tomography (PCT). Case Report: A 48-year-old female presented with intermittent right upper extremity weakness for 2 months and speech disturbance for 1 month. Precontrast brain CT did not reveal any ischemic areas but mean transit time (MTT) map of PCT showed decreased perfusion in left temporo-occipital areas. MR angiography was normal. Ischemic lesions on diffusion-weighted MRI were mismatched compared to MTT map of PCT. After treatment with aspirin and serial phlebotomy, her aphasia was partially improved. After treatment with alkylating agent, hypoperfusion areas on PCT were more decreased than before. Conclusion: Improvement of brain perfusion may be delayed without normalization of hematologic abnormality in an ischemic stroke patient with PV. PCT is a useful method for assessing ischemic stroke in PV.
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