Background: Corynebacterium spp. is a rare culprit in periprosthetic joint infections (PJIs), with limited data available on outcomes and appropriate treatment course. The aim of this study was to evaluate the success rate of a clinical cohort of patients with PJI, where Corynebacterium spp. was the causative organism (CPJI), treated according to an institutional algorithm based upon European Bone and Joint Infection Society guidelines. Methods: From the institutional bone infection registry, 44 patients treated for CPJI between 2007 and 2023 were identified. CPJIs were divided into 2 groups according to the isolated microbes: monomicrobial (14 [32%]) and polymicrobial (30 [68%]). Patients were treated with debridement, antibiotics, and implant retention (DAIR; 14 [32%]) or with 1- or 2-stage implant exchange (reimplantation group; 30 [68%]). In 13 (30%) cases, antibiotic combination with rifampicin was used. Results: Out of 44 patients, 4 required further treatment. In monomicrobial CPJI, the treatment course was successful in all patients, whereas in polymicrobial CPJI it was successful in 87%. Antibiotic combination including rifampicin was used in 4 monomicrobial cases (29%) and 9 polymicrobial (30%) cases. In the polymicrobial group, DAIR was successful in 90% (9/10), while the reimplantation group had an 85% (17/20) success rate. Conclusions: In contrast with the previously published papers on CPJI, the results in our cohort were good, with the total cure rate being 91%. The cure rate was slightly lower in the polymicrobial group compared with the monomicrobial: 87% and 100%, respectively. Surgical therapy according to the established institutional algorithm resulted in a high success rate.

Background: Cerebral amyloid angiopathy (CAA) is a small- and medium-vessel cerebrovascular disease characterized by β-amyloid accumulation within cortical and leptomeningeal arterial walls. Although it most commonly manifests in older individuals as spontaneous lobar hemorrhage, uncommon cases have been reported in younger patients, especially those with risk factors such as previous head trauma, genetic predisposition, or prior exposure to cadaveric dura. Case Description: We describe a diagnostically challenging case of suspected CAA in a 42-year-old man with a history of multiple traumatic brain injuries, prior neurosurgical interventions, neuropsychiatric symptoms, and late-onset seizures. Importantly, during treatment for head trauma in early adulthood, he received a cadaveric dura transplant. Over subsequent years, he developed recurrent lobar hemorrhages and progressive cognitive and behavioral changes, raising concern for an atypical, possibly iatrogenic, form of CAA. Conclusion: This case highlights the need to consider CAA – even in younger patients – when recurrent lobar hemorrhages and neuropsychiatric symptoms occur in the context of relevant risk factors such as previous head trauma or cadaveric dura exposure. We believe that such exposure may underlie this patient’s gradual but persistent neurological and cognitive decline.

Background: Tenecteplase (TNK) is a novel thrombolytic agent with improved fibrin specificity and longer half-life than alteplase. It is increasingly being adopted worldwide for the treatment of acute ischemic stroke (AIS). Although well tolerated, rare adverse reactions can occur, such as angioedema, which can rapidly progress and potentially cause airway compromise. Case Description: We report a 60-year-old female presenting to the neurology emergency department with acute right-sided hemiplegia and motor aphasia who received intravenous TNK approximately 2 h after symptom onset. Shortly after admission, she developed progressive oropharyngeal angioedema accompanied by urticaria and inspiratory stridor. Given the risk of impending airway obstruction, she required urgent airway management with endotracheal intubation and initiation of mechanical ventilation. After stabilization, she underwent subsequent mechanical thrombectomy and carotid stenting, which were successful. Conclusion: Early recognition of thrombolytic-associated angioedema and immediate involvement of a multidisciplinary team are critical for airway protection and continuation of reperfusion therapies, helping to optimize clinical outcomes in AIS.

Prompt reversal of anticoagulation in the elderly population with subdural hematoma (SDH) is critical to reduce morbidity and facilitate timely surgical intervention. In patients receiving dabigatran, idarucizumab provides rapid anticoagulation reversal. We evaluated clinical and radiological outcomes of dabigatran-treated SDH patients receiving idarucizumab, including those undergoing surgical management. We conducted a single-center retrospective observational study of dabigatran-treated patients who received idarucizumab reversal for traumatic or spontaneous SDH between 2016 and 2024. Hematoma evolution was monitored using follow-up computed tomography. Clinical and neurological outcomes were recorded. Of eleven included patients (mean age 80.8 ± 6.7 years; 36% female), falls were the primary cause (64%). SDH was chronic in 64% and acute in 36%, with associated traumatic lesions in 33%. Surgical evacuation was performed in 82% of cases. Anticoagulation was resumed in 27% of patients within 3–4 weeks post-discharge. The median Glasgow Outcome Scale Extended (GOSE) score was 5, indicating moderate disability. In-hospital mortality was 9.1%. Idarucizumab enabled rapid and safe dabigatran reversal in this high-risk elderly cohort, supporting both surgical and conservative SDH management. Functional outcomes were moderate and mortality was low, underscoring its clinical utility. Targeted reversal strategies remain essential, and further research should refine long-term anticoagulation management.