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Leptomeningeal Infiltration, the Hallmark of Neurosarcoidosis

A 22-year-old human immunodefiency virus–negative man was admitted to the intensive care unit for generalized seizures. The patient’s family reported a 1-month history of asthenia and intermittent confusion. Clinical examination revealed isolated inappropriateness of behavior related to a frontal lobe syndrome, without any neck stiffness or neurologic deficit. The patient’s temperature was 37°C. Results from […]

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Hemispheric Cerebral Edema

  A 67-year-old previously healthy man was admitted in November after a seizure. Examination showed normal vital signs, right hemiparesis and facial palsy, global aphasia, and right upper motor neuron signs but no meningeal irritation. Results from chest X-ray, electrocardiogram, and laboratory tests were normal. Neuromaging revealed left hemispheric cerebral edema without evidence of vascular […]

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An Unusual Presentation of Thrombotic Thrombocytopenic Purpura

  We describe a patient with sudden and severe postoperative thrombocytopenia whose diagnosis was delayed. The patient was a 58-year-old black man with diabetes mellitus type 2, hypertension, and chronic kidney disease, who presented to our institution with 4 days of abdominal pain. He had a history of remote exploratory laparotomy for an abdominal gunshot […]

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A Tale of Two Valves

To the Editor: Radiation heart disease is associated with a high level of morbidity and mortality. Its natural history is not well understood. Its management is difficult. We report a case of radiation heart disease with dramatic disease progression over 11 years, captured on echocardiography. Case Report A 66-year-old woman presented with increasing dyspnea on […]

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Necrotizing Sarcoid Granulomatosis: Clinico-Radio-Pathologic Diagnosis

A 30-year-old man was referred to the rheumatology outpatient department and seen urgently after developing diplopia over a 4- to 8-hour period and an isolated left fourth cranial nerve palsy associated with a bifrontal and left temporal headache and episodic vertigo. Magnetic resonance imaging of the brain at that time was unremarkable. The following week […]

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