Introduction: Hypercoagulable state may be an important first presentation in malignancies especially pancreatic cancer. The trousseau syndrome is caused by venous thrombosis, non-bacterial thrombotic endocarditis and arterial thrombosis. We describe a patient who had the cerebral infarction as the initial manifestation of pancreatic cancer and we discuss that full work up for every patient with atypical stroke should be done. Case Presentation: We report a 67-year-old man who developed multiple cerebral infarctions as the initial manifestation of pancreatic cancer. Cancer antigen 19-9 (CA 19-9) was 52,065 U/mL (Normal value: 0 -33 U/mL), computerized tomography (CT) scan of the abdomen showed multiple hypodensities in both lobes of the liver and Heterogeneous hypodensity was seen in the pancreas that was highly suggestive of pancreas adenocarcinoma and was confirmed with the biopsy. Conclusions: In the case of multiple brain infarctions in both anterior and posterior circulation, without evidence of common cause, trousseau syndrome and hypercoagulability state should be considered.
Introduction:Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) can involve multiple systems and cause stroke-like episodes and status epilepticus.Case Presentation:A 48-year-old female with history of early fatigability, migraine-type headaches, and bilateral sensory-neural hearing loss presented 3 episodes of serial seizures. On admission she was affected by Wernicke aphasia and, then, right hemiparesis. Investigations showed elevated arterial lactate and ragged red fibers on muscle biopsy.Conclusion:Though more commonly diagnosed during childhood, some cases of adult-onset MELAS syndrome are reported. This syndrome should be considered in patients with stroke-like events in adults without cerebrovascular risk factors and difficult-to-treat seizures.
Recombinant tissue plasminogen activator (rTPA) is one of the main portions of acute ischemic stroke management, but unfortunately has some complications. Myocardial infarction (MI) is a hazardous complication of administration of intravenous rTPA that has been reported recently. A 78-year-old lady was admitted for elective coronary artery bypass graft surgery. On the second day of admission, she developed acute left hemiparesis and intravenous rTPA was administered within 120 minutes. Three hours later, she has had chest pain. Rescue percutaneous coronary intervention was performed on right coronary artery due to diagnosis of inferior MI, and the symptoms were resolved.
Background and Aims: Alzheimer's disease (AD) is the main cause of dementia and over the 55 million people live with dementia worldwide. We aimed to establish the first database called the Iranian Alzheimer's Disease Registry to create a powerful source for future research in the country. In this report, the design and early results of the Iranian Alzheimer's Disease Registry will be described.
Methods:We performed this multicenter investigation and patients' data including age, sex, educational level, disease status, Mini-Mental State Examination (MMSE), and Geriatric Depression Scale (GDS) from 2018 to 2021 were collected, registered, and analyzed by GraphPad Prism software.
Introduction: An impaired sense of smell has a remarkable impact on the quality of life. It is seen in a variety of neurodegenerative diseases such as Parkinson disease. In this study, we assessed the olfactory function in patients with Multiple Sclerosis (MS) by Sniff Magnitude Test (SMT). Methods: A cross-sectional study was conducted on 48 patients with MS. A questionnaire, including demographic and clinical variables, was completed for each patient. The SMT was used for the evaluation of olfactory function. Results: Olfactory dysfunction was found in 14.6% of patients (8.3% hyposmia and 6.3% anosmia). Older age, longer disease duration, higher hospital admission rate, lower mini-mental status examination score, and secondary progressive course of MS were significantly related to olfactory dysfunction. Conclusion: Secondary progressive MS and markers of advanced disease toward neurodegenerative phase (including older age, longer disease duration, and lower cognitive function) can be associated with olfactory dysfunction in MS patients.
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