Ali Özeren

Detection of aortic plaques by transesophageal echocardiography in patients with ischemic stroke

Twenty‐eight consecutive patients, aged 34–78 years with non‐cardiogenic ischemic stroke were evaluated by transesophageal echocardiography (TEE). All patients were in sinus rhythm. Six of 28 patients (21.4%) displayed protruding masses in the aortic lumen. Five of these masses were located in the ascending aorta and one in the thoracic aorta. Our study suggests that cerebral infarction may also be due to aortic atherosclerotic plaques. Although our findings do not necessarily provide a causative link between atherosclerotic lesions in the aortic lumen and cerebral infarction, they may be an alternative potential source of stroke. TEE is the method of choice in detecting such lesions at the present time.

Left atrial appendage aneurysm presenting with recurrent embolic strokes

A case of left atrial appendage aneurysm is described in a 40-year-old man, who presented with recurrent embolic strokes and was asymptomatic until the last 6 months. Chest X-ray revealed a slightly prominent upper left heart border. The diagnosis was made by transthoracic two-dimensional echocardiography and confirmed by transesophageal echocardiography, magnetic resonance imaging and also by surgery.

Transient parkinsonism: Induced by progesterone or pregnancy?

We report on the development of transient parkinsonism after progesterone injection in a pregnant patient with a risk of abortion. Etiological possibilities are discussed, including pregnancy itself, possible toxic effects of the dead fetus, and progesterone injection. Progesterone‐induced parkinsonism seems the most likely diagnosis in this case.

Global aphasia due to left thalamic hemorrhage

Global aphasia is an acquired language disorder characterized by severe impairments in all modalities of language. The specific sites of injury commonly include Wernikes and Brocas areas and result from large strokes--particularly those involving the internal carotid or middle cerebral arteries. Rarely, deep subcortical lesions may cause global aphasia. We present three cases with global aphasia due to a more rare cause: left thalamic hemorrhage. Their common feature was the large size of the hemorrhage and its extension to the third ventricule. HMPAO-SPECT in one of the cases revealed ipsilateral subcortical, frontotemporal cortical and right frontal cortical hypoperfusion. Left thalamic hemorrhage should be considered in the differential diagnosis of global aphasia.

Crossed aphasia in multiple sclerosis.

Aphasia is a rare sign of multiple sclerosis (MS). Several different forms of aphasia have been reported in MS. We report, to our knowledge, the first case of a MS patient with crossed aphasia during an attack.