Table Of ContentMore Case Studies in Stroke
Common and UncommonPresentations
More Case Studies in Stroke
Common and Uncommon Presentations
Edited by
Michael G. Hennerici
ProfessorofNeurology,
ChairmanattheDepartmentofNeurology,
UniversitätsMedizinMannheim,
UniversityofHeidelberg,Mannheim,Germany
Rolf Kern
ProfessorofNeurologyattheDepartmentofNeurology,
UniversitätsMedizinMannheim,
UniversityofHeidelberg,Mannheim,Germany
Louis R. Caplan
ProfessorofNeurology,SeniorNeurologist,
BethIsraelDeaconessMedicalCenter,
HarvardMedicalSchool,Boston,MA,USA
Kristina Szabo
ProfessorofNeurologyattheDepartmentofNeurology,
UniversitätsMedizinMannheim,
UniversityofHeidelberg,Mannheim,Germany
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LibraryofCongressCataloguinginPublicationdata
Morecasestudiesinstroke:commonanduncommonpresentations/[editedby]MichaelG.Hennerici,
RolfKern,LouisR.Caplan,KristinaSzabo.
p. cm.
Precededby:Casestudiesinstroke/editedbyMichaelG.Hennerici,etal.2007.
Includesbibliographicalreferences.
ISBN978-1-107-61003-3(Paperback)
I. Hennerici,M.(Michael),editorofcompilation. II. Kern,Rolf,editorofcompilation. III. Caplan,
LouisR.,editorofcompilation. IV. Szabo,Kristina,editorofcompilation. V. Casestudiesinstroke.
Precededby(work):[DNLM:1. Stroke–diagnosis–CaseReports. 2. DiagnosticTechniques,Neurological–
CaseReports. 3. NeurologicManifestations–CaseReports. 4. Stroke–therapy–CaseReports.WL356]
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Everyefforthasbeenmadeinpreparingthisbooktoprovideaccurateandup-to-dateinformationwhich
isinaccordwithacceptedstandardsandpracticeatthetimeofpublication.Althoughcasehistoriesare
drawnfromactualcases,everyefforthasbeenmadetodisguisetheidentitiesoftheindividualsinvolved.
Nevertheless,theauthors,editorsandpublisherscanmakenowarrantiesthattheinformationcontained
hereinistotallyfreefromerror,notleastbecauseclinicalstandardsareconstantlychangingthroughresearch
andregulation.Theauthors,editorsandpublishersthereforedisclaimallliabilityfordirectorconsequential
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Contents
List of contributors page ix
Preface xiii
List of abbreviations xiv
Introduction 1
Section 1. Common cases of stroke 11
Case 1 Woman with aphasia and right-sided numbness 13
Kristina Szabo
Case 2 Dysarthria and hemiparesis 16
Martin Griebe
Case 3 From vertigo to coma 20
Angelika Alonso
Case 4 Laughing and crying without apparent reason 24
Angelika Alonso
Case 5 Severe stroke in a 66-year-old man 27
Angelika Alonso
Case 6 Right hemispheric stroke in a young man 31
Micha Kablau
Case 7 Dysarthria and severe hemiparesis 35
Valentin Held
Section 2. Uncommon cases of stroke 39
Case 8 Stroke in a 12-year-old girl 41
Manuel Bolognese
Case 9 Woman with headache, arthritis, and nausea 45
Johannes Binder and Kristina Szabo
Case 10 Woman with transient sensory disturbance 49
Kristina Szabo
vi Contents
Case 11 A severe attack of migraine 53
Marc Wolf
Case 12 An acute loss of vision 56
Tilman Menzel
Case 13 Angiography with complications 60
Alex Förster and Kristina Szabo
Case 14 “I can still write” 63
Caroline Ottomeyer and Kristina Szabo
Case 15 Old lady with sudden confusion 66
Kristina Szabo
Case 16 Neck pain and upper arm paresis 70
Ralph Werner, Miriam M. Pfeiffer, Johannes C. Wöhrle
Case 17 Aphasia during pregnancy 73
Ralph Werner and Johannes C. Wöhrle
Case 18 Hemiparesis in two men treated for prostate carcinoma 77
James A. Adams
Case 19 Horner syndrome and headache 83
Paolo Costa and Alessandro Pezzini
Case 20 Involuntary shaking of the arm and leg 87
Sefanja Achterberg, Suzanne Persoon, L. Jaap Kappelle
Case 21 A young woman with infertility 90
Patricia Martínez-Sánchez, Blanca Fuentes, Exuperio Díez-Tejedor
Case 22 Acute weakness of the right lower limb 95
Angelika Alonso
Case 23 Recurrent embolic stroke in a 61-year-old man 98
Christopher Schwarzbach
Case 24 Repeated episodes of weakness and visual loss 101
Eva Hornberger and Valentin Held
Case 25 A woman with transient double vision 104
Philipp Eisele
Case 26 Acute myocardial infarction during thrombolysis 108
Ana Patrícia Antunes, Ruth Geraldes, Tiago Teodoro
vii Contents
Case 27 A misleading ca(u)se of cerebral microbleeds 114
Sofie De Blauwe, Katlijn Schotsmans, and Gregory Helsen
Case 28 A psychiatrist battered by the sea 118
Louis R. Caplan
Case 29 Severe migraine with double vision 121
Louis R. Caplan
Case 30 Another young woman with infertility 124
Markus Stürmlinger
Case 31 Man with bilateral hypoglossal palsy 128
Bettina Anders
Case 32 Thoracic pain and right hemispheric syndrome 131
Nadja Meyer
Case 33 Severe gait disorder in a 38-year-old man 135
Tilman Menzel and Rolf Kern
Case 34 Visual field loss and memory disturbance 138
Marc Wolf and Rolf Kern
Section 3. Stroke mimics 141
Case 35 Right hemiparesis with behavioral changes 143
Kristina Szabo
Case 36 Acute stroke symptoms in a 23-year-old man 147
Björn Reuter and Marc Wolf
Case 37 Acute onset of expressive speech disturbance 150
Martin Griebe
Case 38 Complete loss of vision in a 44-year-old woman 154
Philipp Eisele
Case 39 Spells of numbness in a biochemical graduate 157
Louis R. Caplan
Case 40 Recurrent episodes of disturbed speech 160
Tilman Menzel and Rolf Kern
Case 41 Acute aphasia and hemiparesis 163
Marc Wolf and Rolf Kern
Case 42 Man with gait disturbance and urinary retention 166
Valentin Held
Index 169
viii Contents
Thefollowingcasesdescribedhereinhavebeenpublishedpreviously:
Case 8. Bolognese M, Griebe M, Foerster A, Hennerici MG, Fatar M. Throm-
bolytic stroke treatment of a 12-year-old girl with intracranial fibro-
muscular dysplasia. Case Rep Neurol 2011; 3(3): 210–13.
Case 12. Menzel T, Kern R, Griebe M, Hennerici M, Fatar M. Acute posterior
ischemic optic neuropathy mimicking posterior cerebral artery stroke
visualized by 3-tesla MRI. Case Rep Neurol 2012; 4(3): 173–6.
Case35. SzaboK,AchtnichtsL,GripsE,etal.Stroke-likepresentationinacase
of Creutzfeldt–Jakob disease. Cerebrovasc Dis 2004; 18: 251–3.
Case 36. Reuter B, Wolf ME, Förster A, et al. Stroke-like presentation of toxic
leukoencephalopathy as the initial manifestation of HIV infection.
Case Rep Neurol 2012; 4(3): 231–5.
List of contributors
Sefanja Achterberg Manuel Bolognese
Department of Neurology, Utrecht Department of Neurology,
StrokeCenter,RudolfMagnusInstitute UniversitätsMedizin Mannheim,
of Neuroscience University Medical University of Heidelberg, Mannheim,
Center Utrecht, Utrecht, the Germany
Netherlands
Louis R. Caplan
James A. Adams Beth Israel Deaconess Medical Center,
Division of Cerebrovascular Stroke,
Royal Surrey County Hospital NHS
Boston, MA, USA
Foundation Trust, Surrey, UK
Paolo Costa
Angelika Alonso
Department of Clinical Neurology,
Department of Neurology,
University of Brescia, Italy
UniversitätsMedizin Mannheim,
University of Heidelberg, Mannheim,
Sofie De Blauwe
Germany
Department of Neurology, Antwerp
University Hospital, Antwerp, the
Bettina Anders
Netherlands
Department of Neurology,
UniversitätsMedizin Mannheim, Exuperio Díez-Tejedor
University of Heidelberg, Mannheim,
Department of Neurology and Stroke
Germany
Centre, La Paz University Hospital,
Autónoma of Madrid University;
Ana Patrícia Antunes Neurosciences Area of IdiPAZ Health
Neurology Department, Hospital Santa Research Institute, Madrid, Spain
Maria, Lisbon, Portugal
Philipp Eisele
Johannes Binder Department of Neurology,
Zentrum für Nervenheilkunde UniversitätsMedizin Mannheim,
Herbolzheim, Herbolzheim, University of Heidelberg, Mannheim,
Germany Germany
