Nervous System Diseases Commons^™

Cauda Equina Neuroendocrine Tumor (Paraganglioma), Cameron Summers-Powell, Tricia O'Brien, Susana Ferra

East Florida Division GME Research Day 2023

No abstract available.

Multiple Sclerosis In A 32-Year-Old Female With History Of Prolactinoma, Aleeza Ali, Jesse Simon, Adekunle Bamgboye

East Florida Division GME Research Day 2023

Among disorders affecting the central nervous system (CNS), excluding trauma, multiple sclerosis (MS) is the most common cause of permanent disability in young adults. This condition is characterized by IgG autoantibody-mediated destruction of oligodendrocytes in the brain and spinal cord. Although the origin of MS is not fully understood, some suggest that prolactin may be involved in the development of the disease process evidenced by the fact that it predominately affects women of childbearing age, and the diverse role of prolactin (PRL) as a peptide hormone, cytokine, and immune modulator. Here we review the case of a 32-year-old female with …

Extra-Axial Desmoplastic/Nodular Medulloblastoma, Shh-Activated In Adult: A Case Report, Gul Wymer, Fatemeh Mousavi, Jennifer Barker

East Florida Division GME Research Day 2023

Introduction: Medulloblastoma (MB) is an embryonal central nervous system (CNS) tumor located in the posterior cranial fossa. Medulloblastoma is one of the most common malignant pediatric brain tumors, accounts for 25% of all pediatric intracranial tumors, but rare in adults; and constitute 0.4%-1% of adult primary brain tumors. The incidence of medulloblastomas in adults is approximately 0.5 per million per year and decreases with age with male predominance. Medulloblastomas classically appear as well-defined masses in the cerebellum that enhance both computed tomography (CT) of the head and brain magnetic resonance imaging (MRI) with gadolinium contrast. The clinical symptoms and signs …

Challenges Of Cerebral Hyperperfusion Syndrome: A Clinical Case Report, Ruth Williams, Ranga Rathakrishnan

East Florida Division GME Research Day 2023

Introduction: Cerebral Hyperperfusion syndrome (CHS) is a clinical syndrome of hypertension, headache, neurological deficits, with or without seizures, following a revascularization procedure. It is characterized by an excessive and sudden increase in cerebral blood flow. The mechanism is largely not understood but theories involve impaired cerebrovascular autoregulation (thought to be mitigated by collateral circulation), free radical damage, and baroreceptor reflex damage, possible from the procedure itself1 . Common presentations include severe ipsilateral headache to the side of the lesion with typical onset within 12 hours to 6 days, but can occur up to one month, after carotid revascularization processes2 . …

The Treatment Of Rem Sleep Disorder Using Neuromodulation: A Literature Review, Aaron Marbin, Shane Ragland, Orestes Hadjistamoulou, Clara Alvarez Villalba, Samuel Neuhut

East Florida Division GME Research Day 2023

No abstract available.

The Treatment Of Depression In Alzheimer's Disease Using Neuromodulation: A Literature Review, Aaron Marbn, Shane Ragland, Thalia Adrian, Clara Alvarez Villalba, Samuel Neuhut

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with references.

INTRODUCTION: An estimated 44 million individuals live with Alzheimer's Dementia globally, a number expected to triple by 2050.1 Depression is a commonly observed comorbidity in individuals with Alzheimer's disease. Traditional antidepressant medications often pose challenges due to their side effects and limited efficacy in this population. As a result, alternative therapeutic approaches are being explored, with Transcranial Magnetic Stimulation (TMS) emerging as a promising intervention for treating depression in Alzheimer's patients. TMS is a non-invasive brain stimulation technique that utilizes magnetic fields to modulate neural activity in targeted brain regions …

Late Onset Sheehan Syndrome 23 Years After Post-Partum Hemorrhage, Igbayilola Dosunmu, Ali Tariq Alvi, Sarah Kaufman, Ayesha Malik

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with figures and references.

Sheehan syndrome is defined as ischemic necrosis of pituitary gland following massive postpartum hemorrhage leading to panhypopituitarism. It has an insidious course with multitude of presentations. The majority of cases remain undiagnosed for many years after the delivery with average time following postpartum hemorrhage to diagnosis of Sheehan syndrome is believed to be almost 13 years according to one study. Here, we present a unique case of late onset of Sheehan syndrome 23 years after the last childbirth which was complicated by hemorrhage. To our knowledge, this is the …

Risk Factors For Depression Progression In Parkinson's Disease: A Retrospective Cohort Study, David Kosoy, James Cassuto, Gregory Kurgansky

East Florida Division GME Research Day 2023

Introduction: Depression is a common non-motor symptom in Parkinson's disease (PD) with a significant impact on quality of life and overall prognosis. Despite the availability of effective treatments, many PD patients with depression do not receive timely diagnosis and appropriate intervention. This study aimed to identify risk factors for depression progression in PD to inform clinical practice and future research.

Methods: We conducted a retrospective cohort study of PD patients using registry data from the Parkinson's Progression Markers Initiative (PPMI) dataset. The primary outcome was depression progression, defined as a 2-point or greater increase in the MDS-UPRDS depression score within …

A Young Case Of Giant Cell Arteritis, Tricia O'Brien, Philip Mesquita, Zahid Chaudhry

East Florida Division GME Research Day 2023

Introduction: Giant Cell Arteritis is condition that commonly affects patients between the ages of 70 and 80 years old. It rarely affects those younger than 50 years of age.

Description: A 40-year-old African American woman, who had previously been diagnosed with Giant Cell Arthritis via temporal artery biopsy at age 33, presented to the emergency department due to facial and arm numbness and throbbing headache. Her ESR was markedly elevated and she was placed on prednisone.

Discussion: The incidence of Giant Cell Arthritis is between 5.8 to 31.3 per 100,000 in the population. This disease affects women 2-3 times more …

Diagnostic Considerations Of Giant Cell Arteritis In Veterans, Paul Kay, Molly Phan, Kimberly M. Winges

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with references.

Introduction: Giant cell arteritis (GCA) is the most common primary systemic vasculitis in adults, but studies to date have been limited in volume or subject to retrospective meta-analysis.1 The United States Veterans Health Administration (VHA) holds the nation’s largest electronic medical database. Veterans comprise 7% of the American population, including 24% of the population over 75 years old.2 Building upon a clinical study of one VHA site cohort,3 we used this database to identify differences in demographics, risk factors, associated systemic conditions, and biopsy yield within the entire veteran population using …

Subacute Stroke Like Presentation Likely Due To Disseminated Histoplasmosis In An Immunocompromised Patient, Ashley R. Diaz, Priya Mohan, Utmitha Konda, Alfonso Manotas, Issac Ichoa

East Florida Division GME Research Day 2023

Histoplasmosis capsulatum is an opportunistic fungal infection that is largely asymptomatic and found to have nonspecific signs and symptoms. It predominates in Central and North America, and is one of the leading causes of hospitalization among the fungal family. However, in the right host, such as in this case, a patient with significant immunosuppression can develop serious manifestations as it disseminates outside of the pulmonary system. The challenging element of disseminated histoplasmosis is that despite proper treatment immunocompromised patients will frequently relapse with worsening presentation. There is limited literature on subacute stroke-like presentation in a patient with chronic infection of …

Sudden Onset Ams, Focal Weakness, Fever And Aphasia Due To Intracranial Subdural Empyema In Left Temporo-Parietal Lobe, Lily Hyunjung Lim, Menachem M. Nagar, Pallavi Aneja

East Florida Division GME Research Day 2023

Intracranial subdural empyema (ISE) is a rare infection of brain, which occurs when pus is collectively located in the space between dura and arachnoid matter. In the past, its mortality was nearly 100%, if it was not treated appropriately within 24-48 hours. Thanks to improvement of diagnostic modalities and treatment, its mortality has dramatically decreased. Though, it can still cause a devastating consequence if it is not managed in a timely manner. The common etiology of ISE is different depending on the age group. In younger patients, it occurs frequently as a complication of infection in neighboring structures like sinusitis …

Fever Of Unknown Origin Secondary To Staphylococcus Epidermidis Infective Endocarditis In A Patient With Aicardi Syndrome, Kimberly Sanchez Lopez, Elvis Caraballo Antonio, Gabriel Barciela Perez, Melanio J. Rodriguez, Yeissen Godinez

East Florida Division GME Research Day 2023

INTRODUCTION Aicardi syndrome is a rare neurodevelopmental disorder predominantly affecting females and characterized by agenesis of the corpus callosum, infantile spasms, and distinctive chorioretinal lacunae. We present the case of a 24-year-old female with a known history of Aicardi syndrome who presented with fever of unknown origin, ultimately attributed to Staphylococcus Epidermidis infective endocarditis involving a native valve.

CASE DESCRIPTION A 24-year-old female with a history significant for Aicardi syndrome and epilepsy presented to the emergency department for fever during the past week; her primary care physician sent her for outpatient blood work a few days prior, including blood culture, …