Internal medicine
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Case Reports
Aphasia with No Apparent Paralysis in Progressive Stroke of the Anterior Choroidal Artery.
Some anterior choroidal artery (AChA) infarctions in the posterior limbs of the internal capsule (plIC) have been reported to cause aphasia, typically with apparent paralysis. We herein report an 84-year-old woman with AChA infarction. Although her dysarthria remained mild with no apparent paralysis, we overlooked progression to branch atheromatous disease-related infarct with exacerbation of her anomia, which delayed the initiation of more intense therapy. Even in AChA infarction, especially when the lesion is located mainly in the anterior part of the plIC, as in our case, it is possible to encounter progressive stroke predominantly with aphasia.
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Hepatocellular carcinoma (HCC) hemorrhaging/rupture is a rare adverse effect of lenvatinib, and only limited pathological examinations have been reported. This report presents the case of a 69-year-old man who suffered from cardiac arrest and died 7 days after starting lenvatinib treatment for HCC, with an autopsy subsequently performed. ⋯ This pathological feature is unusual in normal HCC. Thus, it is believed to have been the effect of lenvatinib.
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A 77-year-old man arrived at our hospital with bilateral shoulder pain persisting for several months and headache for 1 month. Giant cell arteritis with polymyalgia rheumatica was suspected. ⋯ He was successfully treated for two weeks with penicillin G infusions. Symptoms reminiscent of giant cell arteritis and polymyalgia rheumatica may reveal syphilis, which is called the "great imitator."