Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
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Immune checkpoint inhibitors, also known as immunotherapy, have revolutionised the treatment of metastatic melanoma, but are frequently associated with immune-related adverse events (irAEs) affecting a variety of organ systems. Here, we present a case of a patient with metastatic melanoma, being treated with combination ipilimumab-nivolumab, who developed a foot drop. ⋯ The patient had other irAEs, which warranted cessation of immunotherapy and the introduction of corticosteroids, and this also resulted in improvement in the patient's lower limb symptoms and MRI appearances. This confirmed an autoimmune polyradiculitis - a rare irAE.
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Transient neurological events (TNEs) are observed after direct bypass surgery in patients with moyamoya disease (MMD). Although a correlation between cortical hyperintensity belt signs (CHBs) and TNEs has been reported, the pathophysiology of CHBs is still unknown. The purpose of this study was to reveal the pathophysiology of CHBs by using dynamic susceptibility contrast-magnetic resonance imaging. ⋯ Patients with TNEs showed a significantly higher CBV IR than those without (p < 0.05). As for the cut-off level to predict an appearance of TNEs, the CBV IR was 1.36 by the Receiver Operating Characteristic analysis, and the sensitivity and specificity were 80% respectively. We hypothesize that the pathophysiology of the CHBs are vasogenic edemas because the postoperative CBV increase correlated with the CHBs.