Biomedical subjects

Frank A Rubino

Publications and source records attributed to Frank A Rubino.

5 recordsLinked to original sources

PubMed2005

Pure sensory stroke as an isolated manifestation of the lateral medullary infarction.

Pure sensory stroke is a common manifestation of a thalamic stroke and may occur less frequently in the infarction of the brainstem, internal capsule, and parietal cortex. The authors report a 47-year-old man who presented with loss of pain and temperature sensation in the left face, arm, trunk, and leg and was found to have a right lateral medullary infarction on diffusion-weighted magnetic resonance imaging. To the authors' knowledge, this is the first case describing pure sensory stroke as a single, isolated manifestation of the lateral medullary infarction that was detected by diffusion-weighted magnetic resonance imaging. This case suggests that with the availability of diffusion-weighted magnetic resonance imaging, pure sensory stroke may carry a broader spectrum of the anatomical localizations than previously determined and can localize to the lateral medulla. Therefore, a possibility of medullary infarction should be considered when a patient presents with pure sensory stroke, especially when diffusion-weighted magnetic resonance imaging is not immediately available to provide radiographic correlation.

Diffusion Magnetic Resonance Imaging↗

PubMed2004

Perioperative management of patients with neurologic disease.

Because many of the perioperative problems of the neurologic patient are predictable, they should be anticipated by the neurologist so that measures can be taken to prevent as many complications as possible and to recognize and manage those that cannot be prevented in a timely, efficient manner.

Carotid Artery Diseases↗

PubMed2004

Nonvasculitic autoimmune inflammatory meningoencephalitis.

Caselli and colleagues described five cases with encephalopathy, progressive cognitive decline, ataxia, abnormal CSF studies and steroid responsiveness, and proposed the term non-vasculitic autoimmune inflammatory meningoencephalitis (NAIM). Many of these cases had brain biopsy showing mild leptomeningeal perivascular lymphocytic inflammation, however, none of the cases had a post-mortem. Nonvasculitic autoimmune mediated meningoencephalitis has been described in patients with Sjogren's syndrome, systemic lupus erythematosus and, more recently, with Hashimoto's disease. The present study is the first post-mortem report of a case with a clinical diagnosis of NAIM. Neuropathological examination revealed a panencephalitis with intact vessel walls. T and B immunostaining showed a mixture of T and B cells. The findings were not consistent with other reported findings in collagen vascular diseases including Sjogren's syndrome, CNS vasculitis or Hashimoto's encephalopathy. There was no evidence of neoplasia, bacteria, acid-fast bacilli, fungi or atypical infectious agents. This is the first post-mortem report of a case with a clinical diagnosis of NAIM and demonstrates a panencephalitis without evidence of a vasculitis. The pathology seems unique, however, Sjogren and Hashimoto's encephalopathy might be variants of NAIM.

Aged↗

PubMed2002

Occipital condyle syndrome.

OBJECTIVE: Review the clinical features of occipital condyle syndrome. BACKGROUND: Occipital condyle syndrome consists of unilateral occipital region pain associated with ipsilateral 12th cranial nerve paresis. It is typically due to metastasis to the skull base and is underdiagnosed. DESIGN: We report a retrospective case series of 11 patients (8 men, 3 women), aged 32 to 72 years. RESULTS: Eleven cases of occipital condyle syndrome were identified. All patients complained of severe occipital region pain. In addition, 2 patients complained of ipsilateral ear or mastoid pain, 2 noted associated vertex pain, and 2 had frontal region pain. Six of the 11 cases involved the right side. In all patients, the occipital pain was ipsilateral to the 12th nerve paresis. All patients were mildly dysarthric, and 3 had dysphagia. In 7 of the 11 patients, occipital region pain preceded the hypoglossal paresis by several days to 10 weeks. On examination, tenderness to palpation of the occipital region was noted in all patients. All 11 patients had unilateral hypoglossal paresis. Skull films were abnormal in 2 of 5 patients for whom they were obtained, and tomograms were abnormal in 1 of 2 patients. High-quality computed tomography, bone scanning, and magnetic resonance imaging were abnormal in all cases in which they were performed. Nine patients had a known primary malignancy. The most common malignancies were breast cancer in women (2 of 3) and prostate cancer in men (4 of 8). In 2 patients, occipital condyle syndrome was the initial manifestation of a metastatic lesion. Radiation therapy was the treatment of choice for the occipital region pain. CONCLUSION: Occipital condyle syndrome is a rare, but stereotypic syndrome. Early detection has important therapeutic implications. Evaluation of the craniovertebral junction with special attention to the occipital condyles should be a routine part of all brain and cervical spine radiologic examinations, and the possibility of occipital condyle syndrome, particularly when patients have persistent occipital pain and a history of cancer, should be considered.

Adult↗

PubMed2002

Gait disorders.

BACKGROUND: Disorders of gait and mobility are common neurologic abnormalities of aging and can have disastrous consequences. Etiology is multifactorial, and normal age-related changes are difficult to distinguish from those resulting from the disease. REVIEW SUMMARY: Gait evaluation with special techniques provides scientific understanding of physiologic mechanisms, but experienced clinicians can make diagnoses based on general medical and neurologic history and physical examination. Details to observe include posture, length of stride, width of base, speed and fluidity of motion, arm swing, bilateral symmetry of motor activity, and neurologic signs. Gait disorders are classified into lowest-level, middle-level, and highest-level disorders. In lowest-level gait disorders, only one major afferent system (visual, proprioceptive, or vestibular) is affected and the disturbance is usually self-limited or compensated. Middle-level disorders include myelopathy from cervical spondylosis; spastic hemiparetic gait from unilateral impairment of the corticospinal tract; gaits associated with movement disorders; and dystonic, choreic, hemiballistic, and cerebellar ataxic gaits. Highest-level gait disorders include cautious gait, subcortical dysequilibrium, frontal dysequilibrium, isolated gait ignition failure, frontal gait, primary progressive freezing gait, and psychogenic gait disorders. CONCLUSIONS: A treatable cause can often be found. Physical therapy with gait evaluation and training is recommended. Medication must be kept to a minimum.

Journal Article↗