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Ioan-Cristian LUPESCU

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Articles signed on MÆDICA, JCM:

Subacute Subdural Hematoma Presenting as Non-Fluent Aphasia

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MÆDICA - a Journal of Clinical Medicine | Vol. 14, nr. 1, 2019
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Subacute Subdural Hematoma Presenting as Non-Fluent Aphasia

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ABSTRACT

We present the case of a 69-year-old male, alcohol consumer, who was brought in by the ambulance for language impairment with onset two days prior to presentation in our hospital. Medical history revealed therapeutically neglected gout and colchicine allergy. On neurological exam, the patient presented predominantly motor aphasia with poor verbal fluency and anomic elements, mild right-sided hemiparesis 4/5 MRC and right-sided Babinski sign. Still, he was conscious and cooperative, and denied any recent head trauma or headache. Based on clinical picture, an acute cerebrovascular event was suspected, and the patient was hospitalized. However, brain CT revealed a late subacute subdural hematoma in the left hemisphere, with maximum thickness of 20 mm and displacement of median structures by 12 mm to the right (subfalcine herniation). The patient was then rapidly transferred to a Neurosurgical department for appropriate treatment and care.
Keywords: aphasia, subacute subdural hematoma, alcohol consumption

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Predominant Upper Limb Chronic Demyelinating Polyneuropathy Associated with HBV Infection

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MÆDICA - a Journal of Clinical Medicine | Vol. 12, nr. 4, 2017
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Predominant Upper Limb Chronic Demyelinating Polyneuropathy Associated with HBV Infection

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ABSTRACT

Chronic inflammatory demyelinating polyneuropathy is an acquired, presumably immune-mediated peripheral neuropathy, characterized by symmetric sensory-motor involvement. Although most often idiopathic, it has been described in association with several disorders, sometimes improving under treatment. We present the case of a 57-year-old male who was admitted to hospital for paresthesias and muscle weakness affecting both upper limbs, initially only the hands, but with worsening and ascending progression during the last three years. The lower limbs were also involved but to a lesser extent. Electromyography indicated multifocal chronic demyelinating polyneuropathy with predominant upper limb involvement. Lumbar puncture showed a raised cerebrospinal fluid protein level. Laboratory samples revealed positive serology for HBV. Based on these, the diagnosis of chronic inflammatory demyelinating polyneuropathy with chronic hepatitis B was made. The patient received IVIG therapy and has since been coming periodically for IVIG sessions, with clinical and electromyographic improvement.
Keywords: chronic demyelinating polyneuropathy, hepatitis B.

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