Neuromyelitis optica is a demyelinating disease of the central nervous system with various patterns of brain lesions. Corpus callosum may be involved in both multiple sclerosis and neuromyelitis optica. Previous case reports have demonstrated that callosal lesions in neuromyelitis optica are usually large and edematous and have a heterogeneous intensity showing a “marbled pattern” in the acute phase. Their size and intensity may reduce with time or disappear in the chronic stages. In this report, we describe a case of a 25-year-old Caucasian man with neuromyelitis optica who presented clinically with optic neuritis and myelitis. His brain magnetic resonance imaging demonstrated linear enhancement of the corpus callosum. Brain images with contrast agent added also showed linear ependymal layer enhancement of the lateral ventricles, which has been reported in this disease previously. Linear enhancement of corpus callosum in magnetic resonance imaging with contrast agent could help in diagnosing neuromyelitis optica and differentiating it from other demyelinating disease, especially multiple sclerosis.

Sturge–Weber syndrome is an uncommon neurocutaneous disorder with characteristic vascular lesions, leptomeningeal angiomas, and facial nevi. Seizureis the most prevalent neurological sign of Sturge–Weber syndrome and complications related to seizure control, comorbidities, or outcome can make the way of medical care turbid. Accordingly, the co-occurrence of Sturge–Weber syndrome with mesial temporal lobe sclerosis/mesial temporal sclerosis and low-grade glioma has not been reported in literature. In this report, we present a 29-year-old Kurdish male with Sturge–Weber syndrome showing evidence of sclerotic changes in the medial part of the right temporal including the hippocampus in magnetic resonance imaging, in addition to a low-grade glioma. He used to have seizures, starting with left dominant somatosensory aura, before puberty. Interestingly, the semiology has changed to an epigastric aura afterward. Therefore, we assumed that there could be a new seizure onset zone. Seizures from the right mesial temporal region were recorded during long-term electroencephalogram monitoring admission. This finding was compatible with lesions found in the right temporal lobe. Debates arise whether the co-occurrence of mesial temporal sclerosis and low-grade glioma with Sturge–Weber syndrome lesions is incidental or secondary to Sturge–Weber syndrome pathogenesis. Furthermore, this association can be attributed to a common genetic underlying. While there is no compelling evidence in this case to address the exact pathogenicity, the impact of early diagnosis and intense control of primary seizures on preventing downstream effects, such as sclerosis and tumor formations, is considerable. We strongly believe further research is needed to address this concern.

Background: One of the most effective treatments for patients with acute ischemic stroke (AIS) is intravenous recombinant tissue plasminogen activator (rtPA) which can minimize mortality and morbidities. In this historical cohort study, we investigate the factors affecting clinical outcomes after IV thrombolysis for AIS. Methods: We included 87 patients with acute ischemic stroke who were treated with rtPA between 2015 and 2019. Demographic and clinical data were recorded. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the clinical outcomes. Results: 36 patients showed lack of improvement at discharge. In unadjusted model, hypercholesterolemia was the only predictor of lack of improvement (P= 0.043; OR=0.304; CI= 0.096-0.963). After adjusting, hypertension (P= 0.018; OR= 0.18; CI= 0.043-0.749) and hypercholesterolemia (P= 0.008; OR= 8.68; CI= 1.773-42.54) were independent determinants of lack of clinical response. To evaluate risk factors in association with the duration of hospitalization, we found variables which lengthened hospitalization span including; age over 60 years (HR= 0.42 P= 0.002), hypercholesterolemia (HR= 2.19 P= 0.031), Angiotensin-converting enzyme (ACE) Inhibitors consumption (HR= 1.87 P= 0.022), and type of infarction (non -lacunar) (HR= 0.51 P= 0.026). Results indicated no considerable relationship between dose of rtPA and the appropriate response to treatment (OR=8.686 P= 0.324). Conclusion: The closer dose of rtPA goes up to standard range, the more chance of improvement will gain without increasing the risk of symptomatic intra -cerebral hemorrhage (SICH). Determining factors involved in intravenous reperfusion outcomes help physicians to identify the patients who benefit the most from rtPA.