Inimioara Mihaela Cojocaru

Latest posts by Inimioara Mihaela Cojocaru (see all)

MENINGIOMA – DIFFERENT LOCALIZATIONS AND PRESENTATIONS - 21/01/2016
WHERE IS THE BRAIN? - 15/09/2015
FROM HEADACHE TO BINSWANGER - 15/09/2015

Articles signed on Romanian Journal of NEUROLOGY:

MENINGIOMA – DIFFERENT LOCALIZATIONS AND PRESENTATIONS

Romanian Journal of Neurology, Volume XIV, No. 4, 2015

ISSN 1843-8148 | e-ISSN 2069-6094
ISSN-L 1843-8148
DOI: 10.37897/RJN

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

Daniela Stefanescu, Vlad Claudiu Stefanescu and Inimioara Mihaela Cojocaru

ABSTRACT

Meningioma is a benign tumor of the meninges, which occur at sites of dural folds, most commonly the fronto-parietal parasagittal convexities, but also at the cerebello-pontine angle and on the sphenoid wing and the tuberculum sellae. They are highly vascularized, and are hypo/iso-intense on MRI and show enhancement. Clinical expression varies from asymptomatic to seizures and focal neurologic deficits. Treatment is surgical.

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WHERE IS THE BRAIN?

Romanian Journal of Neurology, Volume XIII, No. 4, 2014

ISSN 1843-8148 | e-ISSN 2069-6094
ISSN-L 1843-8148
DOI: 10.37897/RJN

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Vlad Claudiu Stefanescu, Daniela Trasca, Adelina Simona Serban-Pereteanu and Inimioara Mihaela Cojocaru

We present the CT of a 26-year-old female patient with infant encephalopathy and hydrocephalus, referred to the Neurology emergency room from "Prof. Dr. Matei Bals" Institute of Infectious Diseases, where she was brought for high temperature and increased frequency of tonic-clonic seizures. Physical examination revealed neck stiffness, tetramelic hypotrophy and flexion of the upper limbs, extension, and internal rotation of the lower limbs, fever 38 degrees Celsius. Brain CT revealed massive hydrocephalus.

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FROM HEADACHE TO BINSWANGER

ISSN 1843-8148 | e-ISSN 2069-6094
ISSN-L 1843-8148
DOI: 10.37897/RJN

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Vlad Claudiu Stefanescu, Daniela Trasca, Adelina Simona Serban-Pereteanu and Inimioara Mihaela Cojocaru

We present the case of a 66-year old female, with hypertension, who presents headache for about 1 year, emotional unsteadiness, and anxious states. Clinical examination revealed nystagmus, upper limb dysmetry, and has a MMSE score of 26 points. Brain MRI emphasized multiple hyperintense lesions on T2 sequences distributed supratentorially, and affecting the cerebral white matter. The differential diagnosis was established between Binswanger disease (subcortical atherosclerotic encephalopathy) and CADASIL syndrome (cerebral autosomal dominant encephalopathy with subcortical infarcts and leucoencephalopathy. The last was ruled out because the patient had no family history of such syndrome.

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ANTI-NMDA-RECEPTOR ENCEPHALITIS IN A YOUNG WOMEN: A DIAGNOSTIC CHALLENGE

ISSN 1843-8148 | e-ISSN 2069-6094
ISSN-L 1843-8148
DOI: 10.37897/RJN

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Adelina Simona Serban-Pereteanu, Daniela Trasca, Vlad Claudiu Stefanescu, Mihaela Bustan, Sabina Zurac and Inimioara Mihaela Cojocaru

ABSTRACT

A 42-year-old women is admitted in the Psychiatric Department with signs of acute psychosis. She had orolinguofacial dyskinesias, episodes of bilateral rigidity, oculocephalogyric crisis and becomes stuporous. The cerebral MRI highlighted two supratentorial demielination lesions. The CSF examination shows clear CSF with moderate pleocitosis and the predominance lymphocyte. Viral and bacterial cultures were negative. The patient is transferred to our Department of Neurology after 5 days, and runs a fever. Also, orolinguofacial dyskinesias, hypersalivation, puppet’s eye syndrome, swallowing disorders, bilateral jerks osteotendinous reflexes, and coma state (GCS=5) are present. A second cerebral MRI was performed, which suggested two hypersignal lesions, T2, FLAIR and T1 hyposignal present, with no diffusion restriction, one being 0.9 cm, situated subcortically and to the right, the other of 0.5 cm being located on the left subcortical parietal, without gadolinium enhancement. The native pelvic CT scan marked out a 4.9 cm left annex cyst present. Anti-NMDAR antibodies were present in the CSF. As the patient was comatose, an interventional genital procedure is contraindicated. The patient was given iv Immunoglobulis, Methylprednisolone, Cyclophosphamide, anticonvulsives, and large spectrum antibiotics. She manifested multiple oculocephalogyric crisis, in both directions, bronchopneumonia, respiratory failure, requiring mechanical ventilatory support. The patient dies three weeks after the onset of the symptoms. The pathological examination revealed a left mature ovarian teratoma. The anti-NMDAR encephalitis is a life-threatening condition consisting of memory and psychiatric disorder, alteration of consciousness and hypoventilation, common associated with ovarian teratomas. The fast diagnosis and an early specific treatment can strongly influence the antiNMDAR encephalitis’s natural evolution.

Keywords: Anti-N-methyl-D-aspartate-receptor (NMDAR) encephalitis, autoimmune encephalitis, paraneoplastic syndrome, ovarian teratoma

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A STROKE OF NEGLIGENCE

Romanian Journal of Neurology, Volume XIV, No. 1, 2015

ISSN 1843-8148 | e-ISSN 2069-6094
ISSN-L 1843-8148
DOI: 10.37897/RJN

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Daniela Trasca, Vlad Claudiu Stefanescu and Inimioara Mihaela Cojocaru

A 81-year-old female patient suffering from type II diabetes mellitus, atrial fibrillation, hypertension and who neglected taking any medication at home, was referred to our clinic from the "St. Pantelimon" Hospital, where she had been brought by her family one day earlier, because of severely altered state of consciousness. Upon examination she was comatose – 3 pts. on the Glasgow Coma Scale (E1V1M1), had midriatic pupils, was tetraplegic and had abolished reflexes. Brain CT revealed bilateral massive stroke – right medial cerebral artery and the entire left hemisphere. Although rare, massive bilateral stroke may have developed in the context of the patient's untreated atrial fibrillation, and also hypertension, diabetes mellitus and old age. Other factors may include: stress, smoking, TIA, giant cell arteritis, sick sinus syndrome, infective endocarditis, left atrial myxoma

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A CASE OF STURGE-WEBER SYNDROME

ISSN 1843-8148 | e-ISSN 2069-6094
ISSN-L 1843-8148
DOI: 10.37897/RJN

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Daniela Trasca, Vlad Claudiu Stefanescu and Inimioara Mihaela Cojocaru

ABSTRACT

Encephalo-trigeminal angiomatosis of Sturge-Weber-Krabbe-Dimitri is a rare hereditary sporadic facomatosis, characterized by the presence of angiomatosis of brain lining vessels, face and eye capillaries. We present the case of a 25-year old girl with a birth mark, an facial angioma localized in the territory of the right ophthalmic nerve, also since she had 4 months, she presents generalized tonic-clonic seizures, for which she is currently under treatment with Levetiracetam 1000 mg/day, Lamotrigine 100 mg/day, Valproic Acid 1500 mg/day and Clonazepam 2 mg/day. She was hospitalized because of the higher incidence of the seizures, despite the treatment that she performs. Physical examination revealed her facial angioma, a facial dysmorphism, gingival hypertrophy with sharp teeth, and she has an upper limb asymmetrical development. The neurological exam reveals central facial paresis, a rough motor deficit on her left side, increased tendon reflexes on the left side, left limb ataxia, and a minor cognitive disorder. The cerebral CT identified cortical asymmetry with right frontal atrophy, gyriform calcifications and frontal hyperostosis. The brain MRI showed hemihypotrophia of the right cerebral hemisphere, especially regarding the frontal lobe, gyriform calcifications on the right side, hypertrophy of the right frontal sinus. We increased the dosage of antiepileptic drugs, to 1500 mg/day of Levetiracetam and 200 mg/day of Lamotrigine. The outcome was favorable, the patient was seizures-free. The particularity of the case is that being a rare disease, it is easily overlooked, although the patient had classic symptoms and imagistic findings for Sturge-Weber-Krabbe disease.

Keywords: Encephalo-trigeminal angiomatosis, Sturge-Weber syndrome, seizures

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Inimioara Mihaela Cojocaru

Latest posts by Inimioara Mihaela Cojocaru (see all)

Articles signed on Romanian Journal of NEUROLOGY:

MENINGIOMA – DIFFERENT LOCALIZATIONS AND PRESENTATIONS

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